Examining Nurses’ Willingness to Facilitate Sexual Experiences in Dementia Nursing Care Using the Theory of Planned Behavior

Abstract

Person-centered care emphasizes recognizing and affirming the whole person with dementia, including their need for sexual experiences. For nursing home residents, this often requires facilitation by nurses. Yet, it is unknown which factors contribute to or diminish nurses’ willingness to facilitate such experiences. A survey was completed by 253 (vocational) nurses from 25 Dutch nursing homes. The survey included a newly developed sexual facilitation questionnaire based on the theory of planned behavior. Only one-third of the nurses were motivated to pre- and post-facilitate sexual experiences. Key predictors of the intention to facilitate were their attitude, social norms, and perceived controllability. Nurses’ confidence to include personal boundaries during care bolstered their attitude and perceived controllability. Additionally, nurses expressed interest in training and support options. The hesitancy among nurses to facilitate residents’ sexual expression was substantial. Supportive interventions that enhance nurses’ attitudes and capabilities seem essential for achieving a culture shift towards sexually inclusive person-centered care that also feels comfortable for the nurses themselves.