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Looking for a lab report on Sexuality among elderly women. Will provide the 5 sources that must be used. Report is due May 13th. APA format. The sources:
Sex and the Elderly
Author(s): Winona Griggs
Source: The American Journal of Nursing, Vol. 78, No. 8 (Aug., 1978), pp. 1352-1354
Published by: Lippincott Williams & Wilkins
Stable URL: https://www.jstor.org/stable/3462191
Accessed: 19-04-2020 20:38 UTC
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Your use of the JSTOR archive indicates your acceptance of the Terms & Conditions of Use, available at
Lippincott Williams & Wilkins is collaborating with JSTOR to digitize, preserve and extend
access to The American Journal of Nursing
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Staying Well While Growing Old
Sex and the Elderly
her own feelings, attitudes, and comes shorter and narrower with
By Winona Griggs
comfort level about sexual matters.
Sexual needs and interests continue
Most older persons are willing to
into the later years of an individu-discuss their sexual activity and
al’s life and deserve respect andconcerns if the interviewer is frank,
accommodation if one is to provideopen, and comfortable with the
“total care” for the older person. subject.
The personal and emotional
needs of the older adults are similar
The nurse also needs to exam-
less expansive ability and elasticity.
These changes may result in pain
during the penetration phase. Uterine contractions occurring with or-
gasm frequently become painful
and reach a level of distress in the
aged woman, so great in some
ine her feelings and attitudes about women that they avoid orgasmic
to those of young adults and in- the sexual needs in the older adult,experience and even intercourse if
possible. Most symptoms can be
clude needs of intimacy and sexual alternative methods to sexual interexpression(1). Studies investigating course, and sexual activity for rec- alleviated with adequate amounts
sexual behavior in the aged indicate reation rather than for procreation. of topical or systemic estrogen rethat there is no strict correlation
Such sexual options as mastur- placement. A far better treatment
bation, fantasy, homosexual or les- for some women is continued frebetween age and sexual activity(24). Individuals maintain a life con-bian relationships, nonmarital co- quent and regular sexual activity,
habitation, and extramarital experistancy in their sexual drive and
either with suitable partners or
tance of sexual activity to the older
er male (particularly after age 60) is
ences should not be overlooked or
through masturbation(7). Intensity
patterns of sexual expression.
The most important step indisapproved of because of the and duration of response may denurse’s feelings or sexual biases. In crease in some women, but this is
helping the older person with sexual problems or with instruction onfact, if the nurse is open to these as not a hinderance to enjoyment and
choices and not as aberrations, she sexual fulfillment.
how to maintain his sexuality is to
obtain a data base on who the
Masters and Johnson’s studies
may help alleviate the guilt and
moral apprehensions felt by the in aged males (subjects were beperson is; his educational, cultural
and economic background; his older
pre- person who chooses to prac- tween ages 51 and 89) showed that
changes are quantitative rather
vious level of sexual activity; tice
and such options.
than qualitative when compared
his previous methods of sexual exwith the younger male(8). The oldpression. Information on the imporEffects of Aging
The Masters and Johnson’s slower to attain an erection, to penperson should be obtained in the
studies of the physical and physio- etrate his partner, and to ejaculate.
If sexual activity was not or islogical changes in the aging female The penile erection is also softer,
not a concern of the older person in are the major source for our ad- not attaining full erection until just
his earlier or present life, then thevancement of knowledge about the before ejaculation. The intensity of
nurse should not impose such prob-female sexual response cycle in this sexual tension may decrease(9).
lems or needs on the individual.
Ejaculation (the male orgasm)
age group (subjects were between
Some alternatives to sexual interthe ages of 51 and 78)(5). The major is diminished in intensity and duracourse may seem reasonable to the physical changes are due to the tion in the older male. The decrease
nurse, but the older person may not postmenopausal state of sex-steroid in volume of seminal fluid coupled
be able to accept or incorporatestarvation: the vaginal lining be- with the lower ejaculatory pressure
such activity into his own life-style. comes thin and atrophic, and vagi- frequently seen may reduce the sensual experience. Orgasm may still
Knowledge of the individual’s life-nal lubrication is diminished and
be pleasurable; however, after ejacstyle, obtained in the interview,delayed. Both changes can cause
ulation, the penis will become flacwould give some indication of this. irritation and pain to the woman
To obtain such a data base, the who engages only occasionally incid more rapidly. The time during
coitus. Mechanical irritation to the
nurse needs to be in contact with
which the male is unresponsive to
sexual stimuli is extended up to 12
adjacent bladder and the urethra
to 24 hours or longer. The demand
can result in a sense of urgency and
to ejaculate may lessen, and older
frequency of urination after interWinona Griggs, R.N., M.S.N., is director of
course(6).
males
may be satisfied with one or
nursing education, Rehabilitation Institute
at the most two ejaculations a week
of Chicago, Ill.
With aging, the vagina be-
interview.
1352 American Journal of Nursing/August 1978
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regardless of the number of oppor-
tunities or sexual demands of their
the actual physical act is not as
Social Effects on Sex
important as the feeling that a per-
Not all older persons, howev- son can be close to someone, can
partners(10).
er, will continue to be sexually hold the other person, and feel a
active. One reason may be that the body close to them in bed(12).
Teaching About Sex
As important and beneficial as
older person’s self-esteem is affectIntercourse, however, is only a ed by the many losses he is experi- remarriage is to some older per-
part of sexuality. Sexuality encom-encing: a loss of a job and possibly sons, some will encounter negative
passes many things-it is being aincome, physical strength, youthful reactions from friends and actual
man; it is being a woman; it is being attractiveness, or loss of a spouse or resistance from family members.
sensual; it is the total characteris- long-time friends. The feeling that One reaction is that the older pertics of a personality. As nurses, weone is lovable, that one is capable son is being taken advantage of.
should be aware that for the older
of being sexual, is an important Another centers around the issue of
aspect of an adequate self-concept. inheritance. This can be resolved,
adult there still is a language of love
The older adult is often robbed of
to some degree, by premarital
and pleasure in relationships bethis feeling. Our society, and older agreements and contracts about
sides the lunge for the peak of
orgasm. For those aged males whopersons themselves, see the old per-property and money already accrued and an agreement of sharing
experience the fear of impotenceson as being asexual.
For older women, loss of a
income, money, and property acdue to failure to perform, or for
spouse or lack of a suitable partner crued after the marriage.
those female partners who demand
Many children, however, are
performance, sex education is im-is the major difficulty in continuing
portant. Both partners should un-to be sexually active. The older relieved and welcome the new
woman lives longer than the older spouse as someone who will proderstand the normal changes with
age so that neither the man nor theman, and a small number of women vide care and relieve loneliness for
woman mistake such changes fornever marry. If the older woman their parent. The children’s attitude
does marry, she either becomes is one factor related to successful
loss of sexuality(11).
Partners should be encouragedwidowed or marries an older man, remarriage in the later years.
to explore the pleasures of touch-who may be ill or have a chronic
disease. In addition, most elderly
ing, holding, and caressing.
Specific techniques may havemen are married, leaving few men
to be incorporated into the olderavailable for the remaining unmarperson’s sexual activity. Hand ma-ried women.
When children become highly
obstructive to the remarriage, the
older person may need to be supported in his decision to marry. The
older person may need support in
the decision to exercise his individThe older woman is further
nipulation or oral stimulation of the
ual rights to a satisfying life even
older male’s penis may be necessary handicapped by old social mores.
She is less able to take the initiative
to obtain a firm erection. If the
past the age of 65.
woman includes these techniques in
indating or sexual matters, to mar-
ry a younger man, or, perhaps, to Illness and Sex
the foreplay, intercourse may be
accept extramarital sex as an opmore pleasurable for both. The oldtion.
er woman may find gentle, sensitive
stroking of the clitoris by a well- Lack of privacy is another malubricated finger pleasurable, and jor
it difficulty in maintaining sexual
activity, particularly for those older
may bring her to orgasm. A basic
Health is a deciding factor that
does affect sexuality. Some chronic
diseases, even though stabilized,
may interfere directly or indirectly
with sexual activity. Arthritis is an
persons living with family or in
rule should be: Don’t hurry. Sex
institutions for the aged. Many fam- example. The problems of immomay be better in the morning for
ily members find it difficult to bile and painful hip joints may
those older persons who tire easily.
that their mothers or fathers
Avoiding sexual activity afteraccept
a
heavy meal or overindulgence are
in still sexually active “at their
age.” In many nursing homes, not
alcohol is advisable, as potency is
only is there a lack of privacy but
affected by both. Above all, it is
interfere with or complicate sextual
intercourse; generalized pain and
fatigue from coping with stiff and
painful joints may decrease the per-
any sexual expression on the part of son’s desire for sex; steroid treatimportant for couples to communicate to each other about what
the resident is met with great disap- ment may have its side effects of
proval by the staff. This attitude, decreased sexual drive; the assault
pleases them and what is satison the body image by the progressive disfiguring elements of the dis-
however, is changing. Some nursing
fying.
Sex without orgasm is still en-
joyable and pleasurable, but the
nurse should not jump to the conclusion that this is always acceptable to the patient. Nor should she
conclude that the elderly have to
settle for intercourse without or-
homes now have social activities
ease may lead to feelings of unatthat encourage coupling, such as
tractiveness and being less than an
dinner-date night and dancing. Marideal sex partner(13).
ried couples may now be assigned
to the same room.
Nurses can suggest position
Older adults are taking the ini- changes to alleviate some of these
tiative in fulfilling their sexual problems. Often couples have
needs through marriage. Remargasm. Both partners should be inriage, or marriage at an advanced
structed that a consistent pattern of
sexual expression helps the olderage, is occurring more frequently
now than 10 years ago. For many,
couple maintain their sexuality.
worked this out themselves, howev-
er. Hip surgery to relieve joint
immobility may be an answer for
some; the surgeon should be made
American Journal of Nursing/August 1978 1353
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aware that a sexual problem has
existed. Other alternatives for sex-
may use chronic disease or the
chest. Again, other sexual activity
process as an excuse to give
besides sexual intercourse may beaging
a
up an activity that for years they
ual expression are possible for those means of fulfilling sexual needs.
or disliked and only indulged in
who wish to remain sexually active, The person may need instruction had
in of duty. These persons should
for example, masturbation or oral- permission or both to engageout
not be embarrassed or forced into
such activities.
genital techniques.
Generally, persons who have sexual activity by the questions or
Open communication between
partners should be encouraged, as had a stroke are not sexually im- suggestions of a highly zealous
feelings of unattactiveness may not paired. If they have a cardiac prob- nurse.
be shared by both partners or can lem as well, much of the instrucbe resolved by frank communica- tions for persons with coronary Sexuality and the Nurse
tion. For those who are bothered by heart disease will be necessary and
Human sexuality courses need
pain or fatigue, taking pain medica- helpful. The partner’s fear of caustion before the anticipated sexual ing another stroke or feeling insen- to and are being included in bas
interaction may help, as may a sitive for desiring sex of someone nursing curriculums. Courses in ag
warm bath or shower. For problems who has a physical disability may ing are also being designed to cove
of fatigue, sex in the morning or be a reason for the partner’s reluc- the total person and include con
after a rest period may be helpful. tance to engage in sexual activity. tent in sexuality of the older perso
Diminished sex drive should be reFears of causing another stroke are For the nurse out of school, con
ported to the physician, especiallyusually unwarranted, and simple in- tinuing education courses and
S.A.R. (sexual attitudes readjus
if the individual is taking steroidstruction on how to decrease anxi-
drugs, as this may be a side effect ofety and strain during sexual activity ment) programs are offered in man
may help to alleviate these fears. educational facilities throughou
the drug.
Any problems with potency should the country.
Many persons who have arthriSexual revolution or not, it is
be reported to the physician so that
tis and its associated problems have
related on interview that sexual
medications (if the cause) may bebeing realized or more openly ad-
changed. Antihypertensive drugsmitted that sex is as much of a need
intercourse has improved their dis-
prescribed after the stroke may as food. The need does not necesease state. They have experienced
contribute to impotency. If the old- sarily change with age nor does the
less pain, discomfort, and depression(14).
er person’s strength or mobility is desire or habits of satisfying the
Cardiovascular diseases are ancompromised, changes in position need. Sex, however, is not a new
may
be necessary. Changes in posi- idea, nor is it a major concern for
other group of major chronic diseases that can interfere with sexual
tion, however, may not always be many. Nurses should not go overboard in trying to incorporate sexexpression. How soon after a myo- accepted.
ual needs into a nursing care plan
A patient who had recovered
cardial infarction the patient can
when no need exists for the pabegin having sexual activity is usu- from a stroke was advised that he
ally discussed by his physician. would be able to engage in sexualtient.
Generally, sexual activity is re- intercourse again if he changed his
sumed slowly. As strength and position from a top to bottom posi-
health return, the same level of
sexual activity before the coronary
tion. This change was necessary be- References
cause he had severe residual paraly-
is possible. The oxygen cost during sis and problems with his balance.
sexual intercourse is equal to that of The patient found the new position
walking briskly around the block or too uncomfortable for him and a
1. Cavan, R. S. Speculations on innovations to
conventional marriage in old age. Gerontologist 13:409, Winter 1973.
2. Newman, Gustave, and Nichols, C. R. Sexual
climbing one or two flights of serious threat to his feelings of
stairs. The stress from abstaining being a man. He chose to give
from sexual intercourse may be
greater than that. Sudden death
sex.
Most older men who have had
activities and attitudes in older persons. JAMA
173:33-35, May 7, 1960.
up 3. Verwoerdt, A., and others. Sexual behvior in
senescence. II. Patterns of sexual activity and
interest. Geriatrics 24:137-154, Feb. 1969.
4. Masters, W. H., and Johnson, V. E. Human
Sexual Response. Boston, Little, Brown and
Co., 1966, pp. 223-270.
functioning
abilities.
Some
men
quently than feared(15).
5. Ibid, pp. 223-247.
Instruction about position may experience a change in sensa- 6. Ibid, p. 228.
7. Ibid, pp. 240-241.
changes may be necessary, but tion of ejaculation or even an ab- 8. Ibid, p. 248.
again the position used should be sence of ejaculation. A total prosta- 9. Ibid, p. 262.
what is comfortable for the couple. tectomy, which involves cutting 10. Ibid, p. 249.
11. Butler, R. N., and Lewis, M. I. Aging and
What should be avoided is the
the nerves controlling penile erecMental Health. 2d ed. St. Louis, C. V. Mosby
tion,
pushup activity that may be
re-will produce impotency. Old- Co., 1977, p. 117.
er men should be encouraged to 12. Sherbin, Janet. Why older marriages work.
during intercourse occurs less fre- a prostatectomy retain their sexual
quired of the man when he is in the
Mod. Maturity p. 53, Feb.-Mar. 1977.
discuss with the surgeon the opera- 13. Ehrlich, G. E. Total Management of the
superior or upper position.
Arthritic Patient. Philadelphia, J. B. Lippincott
tion proposed and its consequences
The person with coronary dis1973, p. 194.
ease should be instructed on the
for sexual performance before giv- 14. Co.,
Ibid, p. 203.
ing
consent(16).
The
nurse
may
15.
Hellerstein,
H. K., and Friedman, Ernest. Sexdanger signs that indicate too much
ual activity and the postcoronary patient.
stress-angina, unusual shortnesshave
of to suggest this as a topic for
Scand.J.Rehabil.Med. 2:109, 1970.
discussion.
breath, tiredness, irregular heart16. Comfort, Alex. A Good Age. New York, Crown
Publishers, 1976, pp. 160-161.
beat, and a tight feeling in the Some older persons, however,
1354 American Journal of Nursing/August 1978
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Sexuality and Older People
Author(s): Peggy J. Kleinplatz
Source: BMJ: British Medical Journal, Vol. 337, No. 7662 (Jul. 19, 2008), pp. 121-122
Published by: BMJ
Stable URL: https://www.jstor.org/stable/20510309
Accessed: 19-04-2020 20:37 UTC
REFERENCES
Linked references are available on JSTOR for this article:
https://www.jstor.org/stable/20510309?seq=1&cid=pdf-reference#references_tab_contents
You may need to log in to JSTOR to access the linked references.
JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide
range of content in a trusted digital archive. We use information technology and tools to increase productivity and
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Your use of the JSTOR archive indicates your acceptance of the Terms & Conditions of Use, available at
BMJ is collaborating with JSTOR to digitize, preserve and extend access to BMJ: British
Medical Journal
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Editorials represent the opinions ofthe authors and not C ^\ I T^^ D I A I C
necessarilythoseofthe?M/orBMA t l_f I I VlMMLJ
For the full versions of these articles see bmj.com
Sexuality and older people
Doctors should ask patients, regardless of age, about sex
Much of the literature on sexuality in elderly people
focuses on sexual problems, leaving clinicians with
the impression that older adults have either dismal
or non-existent sex lives. Few data are available on
30 years with increasingly positive attitudes to sexuality
over time. The implication is that a generation’s sexual
“normal” sexuality in elderly people, let alone the
2001. Yet, interestingly, both men and women continue
to blame men when sexual intercourse ceases between
sexuality.1 Beckman and colleagues’ linked study makes
a welcome contribution to the limited literature on sexu
them. This finding has been consistent for 40 years.”7
ality in older people.2
are so deeply ingrained that they are more resistant to
change. Even if women seem to be coming into their
A major contribution of Beckman and colleagues’
study is that it focuses on sexual attitudes and behav
iour in a sample of people?not patients?who are not
RESEARCH, p 151
general medical clinic. The methodology is strong, using
consistent interviewing techniques over a 30 year period
seeking treatment for sexual dysfunction or attending a
Peggy J Kleinplatz associate
to produce four comparable sets of cross sectional data
from 1971 to 2001.
professor and clinical professor,
Department of Family Medicine,
Faculty of Medicine and SchoolCurrent
of
knowledge suggests that sexual functioning
and
frequency
decline with age and that sex decreases
K1N6N5
Psychology, University of Ottawa,
in importance over time.3 The existing literature empha
kleinpla@uottawa.ca
Competing interests: None
declared.
Provenance and peer review:
Commissioned; not externally peer
reviewed.
Cite this as: BMJ 2008;337:a239
doi:10.1136/bmj.a239
1965-75?is evident in this latest cohort of 70 year olds in
entire spectrum of sexual expression including optimal
^^^^^^^^^^ *
Ottawa. ON, Canada
change?perhaps linked to the sexual revolution of
sises the widespread prevalence of sexual difficulties in
men and women.4 5 In contrast, Beckman and colleagues
provide good news?sex is an important and positive part
ofthe lives of their 70 year old participants, and more so
for the current cohort of men and women than for their
predecessors in 1971. Although these data are invalu
able, the study does have limitations. Sexual activity
was defined as sexual intercourse, and the researchers’
questions about same sex activities and self stimula
Perhaps some aspects of heterosexual relationships
own sexually?and more satisfied than ever in the latest
cohort?years of men being in charge of “making the
first move” in adolescent sexual encounters in the 1940s
and during marriage in early adulthood in the 1950s
and 1960s has led to the expectation that men remain
responsible for making sex happen. Thus, attributing
the responsibility for the frequency or lack of sex to
men continues. Perhaps the findings are a manifes
tation of the time lag between a change in attitude
and the ultimate shift in sexual behaviour patterns in
heterosexual couples. Clinicians should be sensitive
to this mindset when probing into patients’ concerns
over sexual frequency, desire, initiation, satisfaction,
and their meanings to all parties.
What are the implications of these findings for
clinical practice? Doctors in general are known to
be uncomfortable about asking patients questions
about their sex lives. This is particularly so when
tion were discontinued after 1971 for fear of offending
the patients’ personal characteristics differ from their
own (for example, their sex, age, sexual orientation).8 9
participants.
The study reports that subjective sexual satisfaction
is increasing, especially in women, even if sexual dys
This may be especially disadvantageous when dealing
with elderly patients who are already assumed to be
invisible and post-sexual by society. Such people may
functions are present. Some dysfunctions such as female
be even less likely than most to approach their doctors
with sexual problems and concerns, although research
shows that most people hope that their doctors will
approach them.10 Given that sex plays an increasingly
valuable role in the lives of older men and women,
anorgasmia and erectile dysfunction are decreasing,
whereas others such as ejaculatory dysfunction in men
have increased over the past 30 years. The authors
speculate that the decrease in erectile dysfunction
in 70 year old men may result from the availability
of phosphodiesterase type 5 inhibitors. Male sexual
dissatisfaction and ejaculatory dysfunction increased in
the latest cohort. One interpretation is that older men
are “performing” better sexually thanks to erectogenic
drugs, but enjoying themselves less, thus the difficulty in
male orgasm. The meaning of these findings is worthy
of further investigation.
Attitudes to sexuality seem to be converging in men
and women even though some behaviours remain strik
ingly constant. Beckman and colleagues seemingly link
the increasingly early sexual debut seen over the past
Beckman and colleagues’ study reinforces the dictum
that doctors should ask?and be trained to ask?every
patient, regardless of age, “Any sexual concerns?”9
Doctors are well placed to normalise and affirm the
value of fulfilling sexual relations for the wellbeing of
older patients.
1 Kleinplatz, PJ, M?nard, AD. Building blocks towards optimal sexuality:
constructing a conceptual model. FamJ Couns Ther Couples Fam
2007;15:72-8.
2 Beckman N, Waern M, Gustafson D, Skoog I. Seculartrends in self
reported sexual activity and satisfaction in Swedish 70 year olds:
cross sectional survey of four populations, 1971-2001. BMJ 2008; doi:
10.1136/bmj.a279.
3 Lindau ST, Schumm LP, Laumann EO, Levinson W, O’Muircheartaigh
BMJ 119 JULY 20081 VOLUME 337 121
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__| EDITORIALS ___|
CA, Waite LJ. A study of sexuality and health among older adults in the
United States. N EnglJ Med 2007-,357:762-74.
4 Laumann EO, Nicolosi A, Glasser DB, Paik A, Gingell C, Moreira E, et al.
Sexual problems among women and men aged 40-80 y: prevalence
and correlates identified in the global study of sexual attitudes and
behaviors. IntJ Imp?t Res 2005;17:39-57.
5 Nicolosi A, Buvat J, Glasser DB, Hartmann U, Laumann EO, Gingell
C. Sexual behaviour, sexual dysfunctions and related help seeking
patterns in middle-aged and elderly Europeans: the global study of
sexual attitudes and behaviors. WorldJUrol 2006;24:423-8.
6 Pfeiffer E, Verwoerdt A, Wang HS. Sexual behavior in aged men and
women. Arch Gen Psychiatry 1968;19:753-58.
7 Verwoerdt A, Pfeiffer E, Wang HS. Sexual behavior in senescence.
Changes in sexual activity and interest of aging men and women./
Geriatr Psychiatry 1969;2:163-80.
8 Maurice WL. Sexual medicine in primary care. St Louis: Mosby, 1999.
9 Moser C. How to ask sex questions during a medical interview. San
Francisco Med 2005;78:22-4.
10 Metz M, Seifert MH. Differences in men’s and women’s sexual health
needs and expectations of physicians. Can J Hum Sex 1993;2:53-9.
Improving the safety of peripheral intravenous catheters
Specialised teams could bring greater benefit than routine replacement
Current guidelines from the United Kingdom1 and
Australia2 recommend routine replacement of periph
eral intravenous catheters every 48-72 hours to prevent
highly experienced nurses insert the catheters and pro
vide follow-up monitoring and care,7which may explain
why the incidence of phlebitis in the trial was low.
painful infusion phlebitis and rare but life threatening
peripheral catheter related bacteraemia. In the United
can be generalised to the majority of hospitals, which
States, Centers for Disease Control and Prevention
guidelines recommend replacement every 72.-96
hours.3 However, numerous large prospective cohort
studies4″8 provide convincing evidence that the risk of
bacteraemia associated with the small Teflon or poly
etherurethane catheters now widely used in hospitals is
RESEARCH, p 157
Dennis G Maki professor
of medicine and hospital
epidemiologist, Section of
Infectious Diseases, Department
of Medicine, University of
Wisconsin School of Medicine and
Public Health, Madison,
Wl 53792, USA
dgmaki@medicine.wisc.edu
Competing interests: None
declared.
Provenance and peer review:
Commissioned; not externally
peer reviewed.
Cite this as: BMJ 2008;337:a630
doi:10.1136/bmj.a630
only about 0.1-0.3 per 100 catheters.910 Because many
hospitals do not have a team of nurses responsible for
the insertion and care of peripheral intravenous cath
eters, and the average duration of catheterisation rarely
exceeds three to four days, many hospitals ?o longer
routinely replace catheters at defined intervals.
In the linked study, Webster and colleagues report
a large randomised controlled trial of different meth
ods of managing peripheral intravenous catheters,11
following an earlier pilot study,12 seeking scientific
validation that peripheral venous catheters no longer
need to be replaced at least every 72 hours..In total,
755 medical and surgical patients were randomised to
have their peripheral intravenous catheter routinely
replaced every three days (control group) or only
when clinically indicated, for phlebitis, infiltration, or
unexplained fever (clinically indicated group). The
study found no significant difference between the
groups in premature removal of catheters for phlebitis
or infiltration (relative risk 1.15, 95% confidence inter
val 0.95 to 1.40). The authors estimate that peripheral
infusion related costs could be reduced by about 25%
if hospitals replaced catheters only when clinically
indicated, rather than at 48-72 hour intervals. How
ever, they conclude that larger trials are needed to
support this policy if phlebitis is used as the primary
As a consequence, it is unclear how well the results
do not have intravenous teams. The study is also
underpowered to reliably conclude that abandon
ing periodic replacement of peripheral intravenous
catheters is unlikely to increase the incidence of infiltra
tion or phlebitis. In addition, the cost analyses did not
include the estimated costs of treating severe phlebitis
and infiltration or the rare cases of peripheral intra
venous catheter related bacteraemia (about 1-3/1000
catheters7 910) that will certainly occur, mostly after
48 hours of catheterisation.4 710 Finally, large cohort
studies show that the risk of intravenous phlebitis
rises significantlyafter 48 hours not 72 hours,4 6 7 and
a large randomised trial comparing routine peripheral
intravenous catheter replacements at 48 hours with
replacing catheters only when clinically indicated might
well show a significant reduction in phlebitis and costs
with routine replacement.
Large randomised controlled trials have shown
that using specialised teams to insert and care for all
peripheral intravenous catheters,7 or adopting simple
and relatively inexpensive technological advances?such
as using in-line filters to remove microparticulates within
the inf?sate,13 using catheters made of polyetherurethane
rather than Teflon,5 6 and securing catheters with a
new tapeless device14?each substantially reduced the
incidence of infusion phlebitis and was cost effective.
Specialised teams also prevented peripheral intrave
nous catheter related bacteraemia.7 Such approaches
could potentially obviate the need to replace peripheral
intravenous catheters at periodic intervals.
In summary, Webster and colleagues’ trial did not
satisfactorily prove that not replacing peripheral intra
endpoint.
venous catheters at 72 hour intervals is safe and cost
Considering that nearly 200 million peripheral intrave
nous catheters are used each year in US hospitals alone,9
effective, especially in hospitals that do not have spe
cialised intravenous teams to insert and care for cath
Webster and colleagues’ trial is important. A limitation
of the trial, however, was that the nurses who provided
clinical care assessed the insertion sites when the cath
the study was done in a hospital with a dedicated nurse
intravenous therapy team. The incidence of all compli
eters, and the value of periodic catheter replacement
remains unresolved. Although abandoning scheduled
replacements may not greatly increase the incidence
of infusion phlebitis and infiltration in the average
hospital that currently replaces peripheral catheters
at 72 hour intervals, it would probably increase the
cations, especially phlebitis, is greatly reduced when
risk of catheter related bacteraemia with Staphylococcus
eters were removed, rather than researchers. Moreover,
122 BMJ 119 JULY 20081 VOLUME 337
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NSG230 2013/14
Grading Rubric for Scientific Research Paper
Component
Topic Outline and
Reference List
(Due Week 3)
______/ 5pts
Introduction and
conclusion
_____ / 10pts
Overview of the
Topic/Background
(Reason this topic
is worthy of
investigation)
_____ / 15pts
Literature Review:
Research Journals
_____ / 20pts
Literature Review:
Research Analysis
_____ / 20pts
Exceeds expectations
Topic is clearly and logically
presented in a detailed outline
format. Minimum of 5 primary
articles from peer-reviewed
scientific journals are listed in
APA format.
Meets expectations
Topic is presented but details are
not fully given. Only 4 primary
articles from peer-reviewed
scientific journals are listed. APA
format used with errors.
Does Not Meet Expectations
Point Range 5-4
Introduction clearly defines the
area of interest in women’s
health and gives rationale for
ALL of the following areas:
scientific/medical, political,
economical, social/cultural, and
international (if applicable).
Engages reader with a wellarticulated and concise
presentation of the topic.
Point Range 3.5-2
Introduction defines the topic in
but does not address or provide
rationale for ALL of the following
areas: scientific/medical, political,
economical, social/cultural, and
international (if applicable).
Point range 1.5-0
Does not clearly define the
topic, lacks direction, and
does not engage the
reader.
Point Range: 10 – 9
Presents all below components
in a way that builds a
compelling case for why this is
an important issue.
1. Population most affected
2. Incidence/prevalence of topic
3. Significance of the problem
(WHY do we care?)
4. History of the issue
(if applicable)
Point Range: 8.5 -7
Presents some of the below
components but does not
complete the scope of the topic:
1. Population most affected
2. Incidence/prevalence of topic
3. Significance of the problem
(WHY do we care?)
4. History of the issue
(if applicable)
Point Range: 6.5 – 0
Most or all components are
missing and/or are
unclearly presented and
the scope of the topic is
not defined.
Point Range: 15 – 13
Reviews and thoughtfully
evaluated more that 5
CURRENT (less than 6 years
old) scientific research articles.
ALL articles chosen came from
primary “peer reviewed” journal
sources and are cited WITHIN
THE BODY OF THE PAPER.
NOTE: the textbook DOES NOT
count as a reference and is not
to be used for the purposes of
this assignment.
Point Range: 12.5- 9.5
Reviews, evaluates, and cites 5
research articles but they do not
come from primary “peer
reviewed” journal sources OR the
content of the paper relies too
heavily on other relevant
references like books, newspaper
articles, magazines, etc.
Point Range: 9 – 0
Less than 5 scientific
research articles are
evaluated and cited within
the body of the paper.
Point Range: 20 – 17.5
Thoroughly and concisely
identifies, investigates, and
discusses the chosen topic
through ALL of the below listed
lenses:
1. Feminist
2. Cultural
3. Political
4. Social
5. Economic
6. International
Point Range: 17 – 12.5
Identifies and discusses the
chosen topic through most or all of
the below listed lenses but lacks a
thorough or concise investigation:
1. Feminist
2. Cultural
3. Political
4. Social
5. Economic
6. International
Point Range: 12 – 0
No evidence that the
author identified the
chosen topic through any
lens and is difficult for the
reader to follow.
Topic given but little to no
details outlined. Less than
4 articles from peer
reviewd scientific journals
are listed. APA format not
used.
Component
Suggestions for
Future Research
_____ / 10pts
APA
_____ / 10pts
Style/Organization
and Mechanics
_____ / 10pts
Writing Center
___ /Extra 5 points*
Semi-Final Draft
___ /Extra 5 points*
Exceeds expectations
Point Range: 20 – 17.5
Summarizes and concludes the
topic and available research
giving very specific
suggestions for future research.
The reader clearly understands
the direction this topic has the
potential to go and the path to
get there based on these
suggestions.
Meets expectations
Point Range: 17 – 12.5
Summarizes and concludes the
topic and available research but
does not bridge the current
evidence with future possibilities.
Stating that ‘future research on
this topic needs to be done’ but
minimal elaboration is evident.
Does Not Meet Expectations
Point Range: 10 – 9
No APA errors noted by the
‘gold standards’ of HACKER &
HARRIS. See APA link on
Blackboard.
Point Range: 9.5- 7
Few errors in title page, in-text
citations, and/or reference page
evident.
Point Range: 6.5 – 0
Major format errors
throughout noted: in title
page, in-text citations,
and/or reference list.
REMINDER: Complete
lack of using APA format
will result in ‘zero’ points
for this assignment.
Point Range: 10 – 9
Sentences are consistently
clear and well-structured.
Transitional sentences are
appropriate and organized to
guide the reader easily through
the paper.
Paper is free of typo/spelling
errors.
Point Range: 8.5 -7
Sentences clear and wellstructured for most of the paper.
Transitional sentences used are
appropriate for most of the paper.
Few typo/spelling errors noted but
not detrimental to the
understanding of the paper.
Point Range: 6.5 – 0
Paper lacks organization
and long, poorly
constructed sentences
noted. Inaccurate use of
vocabulary make the paper
difficult for the reader to
follow and understand.
Major typo/spelling errors.
Point Range: 12 – 0
No evidence that the
author identified any future
research suggestions for
the chosen topic.
Point Range: 10 – 9
Point Range: 8.5 -7
Point Range: 6.5 – 0
Attached to the completed 6-8 page final draft in APA format is a signed document from a Writing
Center Staff member recognizing that a minimum of 60 minutes were spend collaborating a review
of the paper.
Turns in a printed hard copy of a DETAILED and complete 6-8 page draft in APA format with an
evaluation of minimum 5 current, primary research articles cited within the body of the paper as
well as a reference page TO YOU LAB INSTRUCTOR IN LAB OF WEEK 6 OF THE QUARTER.
* A MAXIMIMUM of 5 Extra Points will be rewarded for EITHER completion of a semi-final draft OR a Writing Center visit, NOT BOTH
**Some of these components will be difficult to assess depending on the topic – instructors will use judgment where applicable
Note: Length of paper should be 6-8 pages of text. This does not include title page and references.
ADDITIONALLY: ANY PAPER WITH MORE THAN TEN TOTAL TYPOS, SPELLING, APA FORMAT,
STRUCTURAL, MECHANICAL, VOCABULARY or GRAMMAR ERRORS WILL AUTOMATICALLY LOSE
20 POINTS!! (WE ARE NOT KIDDING!) LATE PAPERS, FAXES, OR ELECTRONIC COPIES ARE
UNACCEPTABLE AND WILL ALSO BE MARKED AS ZERO POINTS! This is a formal, SCIENTIFIC
RESEARCH-based paper and as such, any use of first person pronouns, slang, clichés, etc. is
unacceptable and will count towards the total of TEN errors.
Women’s Health: The Physical Self
RESEARCH PAPER EXPLANATION-COMMENTS:
1. Use the rubric for organizing your thoughts as well as writing the paper. If an
instructor cannot pick out the specific components of the paper as described in the
rubric, there is a chance that the student will not receive all of the points.
2. Do not write in the first person (i.e. I, me, mine, we) or the second person (i.e.
you, your). Research papers are written in the third person (i.e. This author felt,
etc).
3. Have a clearly articulated purpose statement that guides the reader (i.e. The
purpose of this paper is to further explore the benefits and detriments of making
the HPV vaccine mandatory as well to discuss the moral and ethical ramifications
surrounding mandatory vaccination).
4. Rubric Point 1: Discuss the issue of interest in WOMEN’S HEALTH. What are
the scientific, medical, political, economic or social rationale for selecting this
topic? Statistics regarding the incidence and prevalence of the topic of may prove
useful in this area. The economic or social burden relative to the topic is another
area to address why this topic is of interest to the reader. If one does not attract the
reader’s attention in the beginning, as well as guide them with a clear purpose
statement, the author runs the risk of not communicating their message clearly.
5. Rubric Point 2: In discussing the general overview, it often helps to discuss the
opposing view point briefly. If one is reading a paper on genital mutilation in
women, one might briefly address genital mutilation in men in a short paragraph.
Also, discussing a variety of aspects of the topic is important. However, it is
important to note that one cannot address everything that is desired in a 6-8 page
paper. Therefore, discussing the limits of the paper is crucial so that the reader
does not think that the author neglected pertinent information. This may be
located relative to the purpose statement (i.e. The purpose of this paper is to
discuss how stress impacts the immune system in women. Because the
phenomenon of stress can be conceptualized as a multidimensional phenomenon,
the focus of this paper will engender the impact that emotional stressors have on
the immune system in women.) All information that was unknown to the author
prior to writing this paper or is not common knowledge will need to be cited
appropriately.
6. Rubric Point 3: Research articles are articles which are published in a research
journal and discuss a study at hand. Editorials or letters to the editor are not
research articles. Below is an example of a research article abstract:
Gtcb 4/07
Soc Sci Med. 2007 Apr 11; [Epub ahead of print]
Links
Sociocultural barriers to cervical screening in South Auckland, New Zealand.
• Lovell S,
• Kearns RA,
• Friesen W.
Department of Geography, Queens University, Kingston, Ont., Canada.
Cervical screening has been subject to intense media scrutiny in New Zealand in recent years
prompted by a series of health system failings through which a number of women developed cervical
cancer despite undergoing regular smears. This paper considers why underscreening persists in a
country where cervical screening has a high profile. It explores how the promotion of cervical
screening has impacted on the decisions of women to undergo a smear test. Ideas of risk and the new
public health are deployed to develop a context for thinking about screening as a form of governing
the body. Qualitative interviews with 17 women who were overdue for a cervical smear were
undertaken in 2001-2002, yielding understandings of their knowledge of screening and their reasons
for postponement. Nine providers of screening services were also interviewed. Concurrent with
socioeconomic limitations, concerns over exposing one’s body loomed large in women’s reasons for
delaying being screened. In particular, feelings of shyness and embarrassment were encountered
among Maori and Pacific women for whom exposing bodies in the process of smear taking
compromises cultural beliefs about sacredness. We conclude that medicalization of the body has,
paradoxically, assisted many women in dealing with the intrusion of screening. For others,
compliance with the exhortations to be screened brings a high emotional and cultural cost which
should at least be considered in health policy debates.
PMID: 17433510 [PubMed – as supplied by publisher]
If one was writing a paper on cervical cancer screening, one would need to evaluate this study and to
discuss this within the body of the paper. Relevant questions to address in the paper may include the
following:
1.) What is the report about?
2.) How does the study fit into what is already known?
3.) How was the study done?
4.) What was found? and,
5.) What do the results mean?
http://www.vawnet.org/DomesticViolence/Research/VAWnetDocs/AR_evalresearch.php
Gtcb 4/07
.
7. Rubric Point 5: Any good research paper provides a “wrap-up” of what has
already been discussed. Therefore, it is advised that the writer briefly summarize
the main-points of the paper and also end with future recommendations for
change in practice, policy, or research.
8. Review APA format as discussed and review other instructions as stated on the
rubric.
Gtcb 4/07
Older people and sexuality: Double jeopardy of ageism and sexism in youth-dominated
societies
Author(s): Gloria Chepngeno-Langat and Victoria Hosegood
Source: Agenda: Empowering Women for Gender Equity, Vol. 26, No. 4 (94), Gender,
Ageing & Intergenerationality (2012), pp. 93-99
Published by: Taylor & Francis, Ltd. on behalf of Agenda Feminist Media
Stable URL: https://www.jstor.org/stable/43824918
Accessed: 19-04-2020 20:21 UTC
REFERENCES
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cr
Older people and sexuality: Double
T
jeopardy of ageism and sexism in
zìi
5′
5′
IQ
youth-dominated societies
Gloria Chepngeno-Langat and Victoria Hosegood
abstract
Sexualit
and
sex
sexualit
sexualit
the
pra
prejudic
ageism
they
no
more
t
sexualit
sexualit
healthy
keywords
Sexuality,
segment of the adult population with respect to sexuality and sexual health, in
Issues on sexuality and sexual health in
favour of the younger generation. Ageism
sub-Saharan Africa have largely excluded
was a term coined by Robert Butler to
older people, and only recently emerged as
describe the irrational prejudice based on
a result of HIV and AIDS. The lack of
which
attention on older people is mainly age
due
to includes the assumption that
older people are asexual or that their sexuthe emphasis on sexuality in relation to
fertility and reproduction that is aimed at ality does not matter (Butler, 2005). Older
safe motherhood, preventing unintended people not only face negative age stereotypes, but sexuality and ageing is also
pregnancies, avoiding coercive sex, and
preventing sexually transmitted infections. gendered with older women facing a greatAs a result the focus has almost exclusively er brunt than men (Avis, 2000; Calasanti,
been on young adults (Dixon-Mueller, 1993; 2005). Sexuality is an important determinant of health and wellbeing of all adults,
Miller, 2000; Higgins and Hirsch, 2007).
and it has multiple dimensions that include
Older people have thus been a neglected
Introduction
Agenda 94/26.4 2012
ISSN 1013-0950 print/I SSN 2158-978X online
© 2012 G. Chepngeno-Langat and V. Hosegood
1 I M 1 Ç A I 12 Routled9e
vJ IN I Ur’ löfÄfrica Taylors, Francis Croup
PRESS
http://dx.d0i.0rg/l 0. 1 080/1 0 1 30950.201 2.757864
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All use subject to https://about.jstor.org/terms
pp. 93 99
h
U)
c
* mam
W*.
o
• mmm
L.
J3
aspects of identity, behaviour, and social
and cultural beliefs, values, attitudes and
of HIV in older people, age differences in
survival post-infection, morbidity and treatnorms (Nagel, 2004; Gagnon and Simon,
ment efficacy and co-morbidities (Wallrauch
2005).
et al, 2010; Minichiello et al, 2011; Mutevedzi
Sexuality and sexual activity include and and Newell, 2011). A similar change in the
are not limited to, negotiating new relation- HIV programme and policy areas has
seen the discourse and activities shift from
ships, cohabitations, protected/unprotected
silence on the topic of older people and
sex, desires, sexual satisfaction, emotional
sexuality or perception that older people are
intimacy, relationship satisfaction, marriage, dissolution of marriage, and compa- largely asexual (Tamale, 2011) – to a new
presentation of sexuality in older people in
nionship (Foucault, 1978; Weeks, 1985).
Sexual identity, behaviours, arousal and
pleasure are not static and may change
with age (Gott, 2004). Changes that may
impact on older people’s sexuality include
loss of a partner (Clarke, 2006; McGrath
et al, 2009), physical health problems such
as chronic ailments, disability and medication which directly affect sexual functioning
(Clarke, 2006; de Vries, 2009).
sexual identity, behaviours, arousal and
pleasure are not static
which sexual behaviour is described in
terms of risk or danger.
Perceptions on ageing and
sexuality
Sexuality is more than a bodily function and
the perceptions, meanings and attitudes
attached to sexuality are not just shaped by
individual preferences but by prevailing social, cultural and legal norms within a society
(Hillman, 2012). Throughout human civilization, societies have constantly regulated
terrelationships between sexuality, health
sexuality and viewed it according to various
and ageing with respect to older people
dimensions with different meanings ascribed
has been much slower to develop in subto sexuality which are appraised and given
Saharan Africa. In developed countries,
value judgement (Foucault, 1984). The life
a considerable body of knowledge on
creating potential associated with sex means
sexuality in older ages now exists in part reproduction or procreation are accorded
because of the strength and breadth of work
relatively more significance compared with
within the discipline of gerontology and by
other benefits derived from sex. The reprothose seeking to understand health across duction aspect of sexuality is vested with
the life course. Sexuality is part of the lived
power, whereas non-reproductive sexuality
experience at all ages and is embedded in
is perceived differently (Makinwa-Adebusoye
the way in which people present themand Tiemoko, 2007; Nyanzi, 2011c).
Awareness and interest around the in-
selves and interact with others.
The tendency for research in subSaharan Africa to overlook the influence of
In marked contrast to the way that
knowledge about sexuality and ageing has sexuality in older life is mirrored in the social
developed in Europe and other developed norms and attitudes in many African comregions, the increasing spotlight on the topic munities where issues related to the sexual
of older people, sexuality and sexual beha- behaviour of older people is considered
viour in sub-Saharan Africa has been motieither a moot subject or in some cases
vated by a much less positive framing of the
viewed quite negatively (de Aguilar, 1998;
topic – that of public health concerns related
Bagnol and Mariano, 2011; Agunbiade and
to the risk of HIV infection and transmission
Ayotunde, 2012). Sex is associated with
by older people and the treatment of older strength and power and in some African
HIV-infected people. With very limited con-communities, for example in a Voruba
temporary knowledge about the meanings study, participants viewed sexual activity
or behaviours related to sexuality in older as potentially overpowering older people,
people in the diverse communities in sub- and that sex could impact negatively on their
Saharan Africa, recent public health com- wellbeing (Agunbiade and Ayotunde, 2012).
mentaries have been largely dominated by While older people have been accorded
medical and epidemiological scholars seek- respect, this is under strain in most African
ing to address questions related to the risk societies (Carton, 1998; Aguilar, 1998a;
94 AGENDA 94/26.4 2012
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Mākoni and Stroeken, 2002; Ogolą, 2006),
Aguilar (2007) has argued that the youthful
demographic profiles in these countries
tend to lead to an emphasis on positive
aspirations by youth and youth-oriented
images of future promise – overshadowing
older people as vigorous and valued sources
of community pride.
Religious practice and beliefs also play a
role in the construction of social norms
therefore, the end of the reproductive phase,
particularly for women, is understood to be
synonymous with the end of sexuality.
a
