title: Nurses' perceptions of sexuality in institutionalized elderly: a literature review.
abstract: BACKGROUND
  Institutionalized elderly continue to have the need for sexual expression and intimacy. Nurses often display negative responses when they are confronted with the sexual behavior of residents. They feel ashamed and do not know how to react. This generates feelings of discomfort, resulting in the denial of resident's needs and desires for sexual fulfillment.
  
  
  OBJECTIVE
  The objective of this review is to thoroughly analyze the literature about the knowledge, attitudes, and experiences of nursing staff toward sexuality in institutionalized elderly. We shed light onto the relationship between knowledge and attitudes, and determined whether certain demographic factors relate to the knowledge and attitudes of nursing home caregivers.
  
  
  METHODS
  We conducted an extensive search of the electronic databases Medline, Cinahl, Psychinfo, Web of Science, Philosophers Index, Google Scholar, and Invert for papers published between January 1980 and September 2010. A broad range of search keywords was used.
  
  
  RESULTS
  The quantitative studies revealed nursing staff to show rather positive attitudes toward later-life sexuality. However, the extent of the staff's knowledge regarding sexuality in the aged seemed to be very limited. There was no consensus found about the relationship between knowledge and attitudes. As regards the influence of demographic variables, the results were very ambiguous. The qualitative studies showed that caregivers hold rather conservative attitudes toward sexuality in institutionalized elderly. Feelings of discomfort prevailed. The responses to residents' sexual behavior were influenced by the staff's own level of comfort related to sexuality issues and the ethos within the institution where they work.
  
  
  CONCLUSIONS
  This review gives us a broad outline of the knowledge, attitudes, and experiences of geriatric nurses toward sexuality in institutionalized elderly. If we want the sexual needs of residents to be recognized, more research is needed. Especially needed are more in-depth qualitative studies that explore the experiences of nurses and managers. The development of a more accurate educational program could increase the knowledge of later-life sexuality and cultivate positive and permissive attitudes toward sexuality in the aged.
authors.affiliation: Centre for Biomedical Ethics and Law, Catholic University of Leuven, Belgium. lieslot.mahieu@med.kuleuven.be
authors.forename: Lieslot
authors.initials: L
authors.lastname: Mahieu
authors.forename: Kim
authors.initials: K
authors.lastname: Van Elssen
authors.forename: Chris
authors.initials: C
authors.lastname: Gastmans
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D009740:Nursing Staff / Q000523:psychology*; D019529:Sexuality