Exploring the knowledge, explicit and implicit attitudes of health care professionals on sexuality amongst older persons

Abstract

Sexuality is an integral aspect of every human being and has significance throughout the lifespan. Interest in sexuality and intimacy do not cease with age; however, sexual expression and intimacy may be overlooked or discouraged by healthcare professionals (HCPs). The primary aim of this study was to explore the knowledge, and explicit and implicit attitudes of HCPs on sexuality in later life. A further aim was to examine the relationship between explicit ratings of attitudes obtained by the Ageing Sexual Knowledge and Attitude Scale (ASKAS) and implicit ratings obtained by the Implicit Relational Assessment Procedure (IRAP). The ASKAS is a questionnaire consisting of two subscales that address knowledge and attitudes related to sexuality in later life. The IRAP, is a computer-based task that requires the participant to directly deny or confirm a specific attitude or belief, by responding rapidly and accurately to different stimuli. The participants recruited in the current study were all HCPs from different disciplines and working with older adults. The findings indicated that knowledge among HCPs regarding sexuality in later life was average; however, findings indicated that males had more knowledge about sexuality in later life than females. Moreover, the higher the level of education, the greater the knowledge HCPs possessed. HCPs with longer years of service showed higher knowledge than those with less years of service. Explicit attitudes measured by the ASKAS were permissive; the higher the level of education, the more permissive the attitude. Furthermore, people working in the private sector held more permissive attitudes than those who worked in the public service. The study identified a strong negative implicit bias measured by the IRAP. There was no association between explicit attitudes measured by the ASKAS and implicit attitudes measured by the IRAP. Hence, HCPs implicit beliefs did not correspond to their explicit ones. A negative implicit bias held by HCPs towards sexuality in later life was identified in the study. Further research, knowledge and continuous education programmes are recommended to provide care that transcends stereotypes and negative attitudes of sexuality in later life. The need for the implementation of institutional policies were highlighted in order to assist older adults in maintaining their sense of identity, wellbeing, quality of life and autonomy, irrelevant of their living arrangements.