title: Sexual knowledge, attitudes and activity of older people in Taipei, Taiwan.
abstract: OBJECTIVE
  We examined sexual activity and predictive factors among older people in Taipei, Taiwan. We aimed to characterize the older population engaged in sexual activity and determine influencing factors, exploring aspects of sexuality that may influence elders' health and quality of life (QOL).
  
  
  BACKGROUND
  Studies of sexual attitudes and behaviour have found that sexual difficulties are common among mature adults worldwide, influenced in men and women by physical health, ageing, psychosocial and cultural factors.
  
  
  METHODS
  We conducted a community-based retrospective study involving a random sample of 412 men and 204 women over age 65. A questionnaire on demographics and social situations was administered, along with a Sexuality Knowledge and Attitudes Scale; 34 questions evaluated sexual knowledge and 18 evaluated sexual attitudes.
  
  
  RESULTS
  Two-hundred and twenty participants were sexually active (35.7%), 185 mainly with spouses (84.1%); frequency was 21.4 (SD 16.9) times per year (range: 1-120). Multiple logistic regressions identified five significant predictors of sexual activity: gender, age, being with spouse, sexual knowledge and sexual attitudes. Sexual activity was significantly associated with higher education levels, lower stress and more self-reported daily activities.
  
  
  CONCLUSIONS
  Our results agreed with Western studies linking sexual activity with better health and higher QOL in older adults. Older peoples' stress and daily activity levels are recognized quality-of-life measures; lower stress and more daily activities among sexually active older people suggests a connection between sexual activity and higher QOL. Increasing knowledge and improving attitudes about sexuality may help older people build healthier relationships and enhance health and QOL. Relevance to clinical practice. If healthcare professionals possess greater understanding of older peoples' sexuality, healthcare systems may find ways to increase sexual knowledge and foster healthier attitudes and relationships to improve older peoples' overall health and QOL.
authors.affiliation: School of Nursing, National Yang Ming University, Taipei, Taiwan. fang@ym.edu.tw
authors.forename: Tze-Fang
authors.initials: TF
authors.lastname: Wang
authors.forename: Chwen-Hwa
authors.initials: CH
authors.lastname: Lu
authors.forename: I-Ju
authors.initials: IJ
authors.lastname: Chen
authors.forename: Shu
authors.initials: S
authors.lastname: Yu
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000368:Aged / Q000523:psychology* / Q000706:statistics & numerical data; D000704:Analysis of Variance; D001294:Attitude to Health / Q000208:ethnology*; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D015577:Geriatric Assessment; D007722:Health Knowledge, Attitudes, Practice; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008297:Male; D015404:Nursing Methodology Research; D010549:Personal Satisfaction; D010865:Pilot Projects; D011788:Quality of Life / Q000523:psychology; D012189:Retrospective Studies; D012736:Sex Education; D012725:Sexual Behavior / Q000208:ethnology* / Q000706:statistics & numerical data; D013315:Stress, Psychological / Q000208:ethnology; D011795:Surveys and Questionnaires; D013624:Taiwan / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data