David Thomas Evans

The demand for high-quality end of life care services for lesbian, gay, bisexual, transgender or trans, queer and other sexual or gender minority (LGBTQ+) people will continue to increase alongside that of the wider population. However, there does not appear to be the expected, representative numbers of LGBTQ+ patients within such services. In this article, the author examines some of the challenges experienced by LGBTQ+ people in accessing long-term and end of life care services, and discusses issues related to the concealment and disclosure of sexual orientation and gender identity. The author also explores some of the ways in which nurses, educators and healthcare organisations might improve the representation and inclusion of LGBTQ+ people in end of life care services.

Objective: In the United Kingdom (UK) and most countries worldwide, midwives are professionally required to undertake an initial perinatal mental health (PMH) risk assessment at every maternity contact. However, studies have found that midwives feel that they are not well-equipped to provide effective care for women with PMH needs. This study explores how the newly qualified midwives (NQMs) are prepared through pre-registration midwifery education and placements to have sufficient confidence in their knowledge, attitude, skills, and habits (KASH) for their post-registration PMH role. Methods: This explanatory sequential mixed methods study collected survey data from two independent groups: NQMs (n = 50), who qualified from 10 UK universities, and senior specialist midwives (SSMs) (n = 32). Descriptive and inferential responses were analysed using SPSS. Statistical differences between the ranged Likert scale responses of the NQMs and SSMs were analysed using the Mann-Whitney U test. The p-value of n = 12) and SSMs (n = 8). The qualitative data were thematically analysed using NVivo. Results: The pre-registration midwifery programme significantly prepared the NQMs to have sufficient confidence in their knowledge of the related PMH role, multidisciplinary team (MDT) role, and available services (p < 0.05) and good attitude towards women with varying PMH conditions (p < 0.0005). The NQMs had sufficient confidence in their skills in using the validated tool for PMH assessment, to build rapport to facilitate disclosure, and recognise deteriorating PMH (p < 0.01). They had regular habits of discussing PMH well-being at booking and made prompt referrals (p < 0.05). The NQMs were not prepared to have sufficient knowledge of PMH medications, perinatal suicide prevention, and the impact of maternal mental health on partners (p < 0.01) including children (p < 0.05); skills in managing PMH emergencies (p < 0.05), and to regularly discuss suicidal thoughts (p < 0.01), issues of self-harm, and debrief women following pregnancy or neonatal losses and traumatic births (p < 0.05). Some aspects were either confirmed or contradicted at the interviews. Conclusions and recommendations: The pre-registration midwifery programme prepares the NQMs to some extent for their post-registration PMH role. Perceived areas for improvement suggest implications for the development of educational, practice, policy, and preceptorship to facilitate the NQMs’ sustainable confidence in their KASH.

Since 2000, English child sexual exploitation (CSE) policy has expanded, both in its understanding and response, to the increasing recognition and scale of the problem. Since 2011, with the move from statutory guidance to a government action plan, there was, for the first time, a substantial increase in CSE responses across English local authorities. Within English CSE policy, male victims are often referenced as a minority population in the ‘dance’ between gender-neutral and gender-specific guidance. For an observable eight-year period, specific CSE guidance was issued on ‘Boys and Young Men’ between 2009 and 2017. Using a qualitative case study methodology with 18 professionals in England, a critical discourse analysis, inspired by Foucauldian and liminality theories, was undertaken to understand the ‘ethics’ within professional perceptions of male victims in contemporary CSE policy. The key findings highlight an incongruity of existing CSE vocabulary with male victims due to overtly gynocentric connotations. This article identifies how male victims have been perceived in the ‘shadows’ of their female peers, perhaps, as a policy ‘afterthought’, with consequential professional practice. Essentially, male victims have been implicated through this gendered conceptualisation and are assembled awkwardly on the surface of mainstream CSE discourse in England.

Purpose: The study aim was to determine whether self-reported temperament traits differentiate adults who stutter (AWS) from adults who do not stutter (AWNS). Additionally, associations between temperament and stuttering frequency, and between temperament and quality of life impacts of stuttering, were investigated in AWS.Method: Self-reported temperament traits were documented for 33 AWS and 43 AWNS using the Adult Temperament Questionnaire (ATQ;Evans & Rothbart, 2007). Quality-of-life impacts of stuttering were assessed using the Overall Assessment of the Speaker's Experience with Stuttering (Yaruss & Quesal, 2010). Stuttering frequency was calculated from 100-word monologue and reading samples.Results: A between-groups difference in scores on the ATQ Positive Affect subscale was nominally significant (i.e., before correcting for multiple tests) and also approached statistical significance after Bonferroni correction. Positive Affect scores were lower for AWS, and the size of this trending effect was moderate. Within AWS, a statistically significant positive correlation was found between impact scores on the General Information section of the Overall Assessment of the Speaker's Experience with Stuttering and ATQ Frustration subscale scores after Bonferroni correction. No associations were detected between temperament traits and stuttering frequency.Conclusions: Results reveal a nontrivial tendency for AWS to experience decreased positive affect compared to AWNS. In addition, increased frustration was found to be associated with reduced general knowledge about stuttering in AWS. Neither effect has been previously reported for adults or children who stutter. Finally, self-reported temperament traits were not found to vary with stuttering frequency in adults, consistent with previous results for AWS.

Acquired immune deficiency syndrome (AIDS) was first labelled as a new illness in 1981; it took two more years to discover a causative virus, which was named human immunodeficiency virus (HIV) in 1985. Nurses who practised during those times may recall the fear, panic, stigma, ethical dilemmas and refusals to care that were associated with the pandemic. Four decades later, HIV can be considered a long-term condition rather than a life-limiting disease, as a result of developments in treatment. However, the UK has the highest number of people living with the virus since the pandemic was first identified, and there remains a need to challenge stigma and prejudice in relation to HIV and AIDS, to ensure that people receive timely access to HIV testing, treatment and preventive measures. This article explores the role of nurses in all areas of practice in preventing onward transmission of HIV, providing treatment and patient education, and promoting the well-being of people living with HIV.

Referring in a plural case to “sexualities” indicates significantly more than a contemporary strategy at being inclusive across a spectrum of sexual diversity. Given the less than optimum ways many people have been, and still are, treated, based on minority sexual identity, or their attractions, practices, or gender differences, then using the plural case is a poignant reminder of the full wealth of humanity and not simply majoritarian representations of it.

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The under-18 conception rate in England is at a 40-year low but a further reduction is needed to reach levels in comparable western European countries. Sexually transmitted infections are common among young people, with chlamydia the most prevalent STI in the UK. To challenge this, a multi-agency approach is needed, with high-quality sex and relationships education, easy access to contraception and sexual health services and an open culture around relationships and sexual health. Nurses play a crucial role in supporting young people within both contraception and sexual health services and as trusted practitioners in a range of settings.

Anecdotal evidence from clinical practice, classroom learning and research studies suggests most aspects of sexual health and wellbeing are addressed inadequately or not at all. Some nurses may feel ill-equipped or underprepared to explore private or intimate aspects of a patient's sexual health or relationships, or may be too embarrassed to talk to the individual about the personal side effects of medical conditions or treatment regimens. This article identifies strategies to assist healthcare professionals in addressing patients' sexual health needs as part of holistic care.