Developing and Testing a Small Private Online Course (SPOC) for Nurse-patient Communication About Sex.

Study Overview
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Brief Summary
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This is a three-year research project. The goal is to develop and test The SPOC-based blended teaching and learning platform (Nightingale in Gen-sEx) that integrates effective educational strategies and e-learning methods to meet the Taiwanese nurse's learning needs. This project is aimed at resolving sexual education learning problems in nursing continuing education due to the time constraints at clinical sites and the shortage of teaching staff. Nurse-patient communication attitudes and skills about sex will be enhanced.

Detailed Description
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The research team constructed a course for hospital nurses that followed the commonly used ADDIE (Analysis, Design, Development, Implementation, and Evaluation) model. The first year research purpose is to: (1) explore the characteristics of nursing-patient communication about sex and the core educational needs content for nurses using triangulation methods. (2) Construct gender-sensitivity structures characteristics of nursing-patient communication about sex and course framework according to the modified Delphi method results and course needs assessment. The second year develops the SPOC-based blended teaching and learning platform (E-generation Angel of Happiness) and conducts a pilot study to test and correct the course content and method. In the third year a pretest-posttest randomized control group design will be implemented to investigate the effectiveness of the course E-generation Angel of Happiness in improving competencies of nurse-patient communication about sex, including attitudes, and practices, among nurses.

Official Title
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Developing and Testing a Small Private Online Course (SPOC) for Nurse-patient Communication About Sex.

Conditions
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Nurse-Patient Relations

Intervention / Treatment
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* Behavioral: Received the Nightingale in Gen-sEx course


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 20 to 50 years old. Below N3 rank. Full-time nurse in clinical care. Have smartphones or computers, and be able to use and be online. Nurses who are willing to participate in this study and sign the consent form Exclusion Criteria: Will leave within 3 months. unable to learn online. The working units are surgery room, recovery room, hospice ward, supply center.

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 50 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: The course includes five online teaching and learning modules and two hours of offline teaching and learning, using MOOCs/SPOCs online teaching system and constructs on the Chinese Open Education platform. For this prospective, randomized controlled trial, 150 nurses working in a medical center in northern Taiwan were recruited and randomized into 2 groups. The experimental group (n=75) received the Nightingale in Gen-sEx course. The control group (n=75) received without course. Data were collected at baseline, 1month, and 3 months after the course.
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: The experimental group<br>The experimental group will participate in the SPOC- based education program, consisting of five online teaching and learning modules over the span of 3 months and two hours of offline classroom. | Behavioral: Received the Nightingale in Gen-sEx course<br>* The experimental group (n=75) will participate in the SPOC- based education program, consisting of five online teaching and learning modules over the span of 3 months and two hours of offline classroom.<br>|
| No Intervention: The control group<br>The control group will not receive any education. Data will be collected at baseline, 1 month and 3 months after intervention. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Sexual Communication between Nurses and Patients | The research project assessed changes in sexual communication between Nurses and Patients by Sexual Communication Scale between Nurses and Patients(SCS-NS) from baseline to 3 months after the course. Sexual Communication Scale between Nurses and Patients (SCS-NS) is developed with reference to Questionnaires of barriers to discussing sexuality with patients by Hordern et al. (2009). It has 14 items and consists of two parts: 1. Frequency of sexual communication with patients (4 items ) and 2. Sexual Communication Barrier Scale (10 questions). The Sexual Communication Obstacle Scale adopts a Likert 5-point scale for scoring, and the higher the score, the higher the sexual barrier to talking with the patient and the lower the level of nurse-patient communication. The questionnaire will undergo expert validity testing again, and the internal consistency of the scale reliability will be evaluated by the Cronbach Alpha coefficient. | Data were collected at baseline. | 
| Sexual Communication between Nurses and Patients | The research project assessed changes in sexual communication between Nurses and Patients by Sexual Communication Scale between Nurses and Patients(SCS-NS) from baseline to 3 months after the course. Sexual Communication Scale between Nurses and Patients (SCS-NS) is developed with reference to Questionnaires of barriers to discussing sexuality with patients by Hordern et al. (2009). It has 14 items and consists of two parts: 1. Frequency of sexual communication with patients (4 items ) and 2. Sexual Communication Barrier Scale (10 questions). The Sexual Communication Obstacle Scale adopts a Likert 5-point scale for scoring, and the higher the score, the higher the sexual barrier to talking with the patient and the lower the level of nurse-patient communication. The questionnaire will undergo expert validity testing again, and the internal consistency of the scale reliability will be evaluated by the Cronbach Alpha coefficient. | Data were collected at 1 month after the course. | 
| Sexual Communication between Nurses and Patients | The research project assessed changes in sexual communication between Nurses and Patients by Sexual Communication Scale between Nurses and Patients(SCS-NS) from baseline to 3 months after the course. Sexual Communication Scale between Nurses and Patients (SCS-NS) is developed with reference to Questionnaires of barriers to discussing sexuality with patients by Hordern et al. (2009). It has 14 items and consists of two parts: 1. Frequency of sexual communication with patients (4 items ) and 2. Sexual Communication Barrier Scale (10 questions). The Sexual Communication Obstacle Scale adopts a Likert 5-point scale for scoring, and the higher the score, the higher the sexual barrier to talking with the patient and the lower the level of nurse-patient communication. The questionnaire will undergo expert validity testing again, and the internal consistency of the scale reliability will be evaluated by the Cronbach Alpha coefficient. | Data were collected at 3 month after the course. | 
| Gender sensitivity | The research project assessed changes in gender sensitivity by Gender-Sensitivity Scale for Nurses from baseline to 3 months after the course. The scale Gender-Sensitivity Scale for Nurses is a self-development scale, referring to the gender-blind connotation of sexual health guidance for medical staff proposed by Lee et al. (2017) and the Gender Awareness Scale developed by Verdonk et al. (Njmegen Medical Gender Awareness Scale). (2007), to be developed. The scale consists of 14 items, with a five-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). Questions 10, 12, 13, and 14 are reverse-scoring, and the scoring range is 10-50 points. The higher the score, the lower the gender sensitivity and gender blindness. The questionnaire will undergo the expert validity test, and Cronbach's α coefficient will evaluate the internal consistency of the scale reliability. In this study, Cronbach's alpha for the quantitative learning needs assessment was 0.79. | Data were collected at baseline. | 
| Gender sensitivity | The research project assessed changes in gender sensitivity by Gender-Sensitivity Scale for Nurses from baseline to 3 months after the course. The scale Gender-Sensitivity Scale for Nurses is a self-development scale, referring to the gender-blind connotation of sexual health guidance for medical staff proposed by Lee et al. (2017) and the Gender Awareness Scale developed by Verdonk et al. (Njmegen Medical Gender Awareness Scale). (2007), to be developed. The scale consists of 14 items, with a five-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). Questions 10, 12, 13, and 14 are reverse-scoring, and the scoring range is 10-50 points. The higher the score, the lower the gender sensitivity and gender blindness. The questionnaire will undergo the expert validity test, and Cronbach's α coefficient will evaluate the internal consistency of the scale reliability. In this study, Cronbach's alpha for the quantitative learning needs assessment was 0.79. | Data were collected at 1 month after the course. | 
| Gender sensitivity | The research project assessed changes in gender sensitivity by Gender-Sensitivity Scale for Nurses from baseline to 3 months after the course. The scale Gender-Sensitivity Scale for Nurses is a self-development scale, referring to the gender-blind connotation of sexual health guidance for medical staff proposed by Lee et al. (2017) and the Gender Awareness Scale developed by Verdonk et al. (Njmegen Medical Gender Awareness Scale). (2007), to be developed. The scale consists of 14 items, with a five-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). Questions 10, 12, 13, and 14 are reverse-scoring, and the scoring range is 10-50 points. The higher the score, the lower the gender sensitivity and gender blindness. The questionnaire will undergo the expert validity test, and Cronbach's α coefficient will evaluate the internal consistency of the scale reliability. In this study, Cronbach's alpha for the quantitative learning needs assessment was 0.79. | Data were collected at 3 month after the course. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Sexual health care attitudes | The research project assessed changes in sexual health care attitude by the Sexual Health Care Scale-Attitude (SHCS-A) from baseline to 3 months after the course. The Sexual Health Care Scale-Attitude (SHCS-A) was used to measure attitudes toward Sexual Health Care for oncology patients. This scale was developed for oncology nurses, and has been proven valid and reliable (Kim & Kim, 2011). The scale consists of 17 items, with each item rated on a three-point scale ranging from 1 (agree) to 3 (disagree). The total scores range from 17 to 51. The SHCS-A consists of four factors: discomfort in providing SHC, feeling uncertain about patient's acceptance, fear of colleagues' negative response, and lack of environmental support. Higher scores indicate a more positive attitude toward SHC for oncology patients. Cronbach's α for this scale was .93 (Kim & Kim, 2011). | Data were collected at baseline, 1 month, and 3 months after the course. | 
| Readiness of talking about sex | The research project assessed changes in readiness of talking about sex by Lee's (2019) Readiness to Talk About Sex Stage Scale from baseline to 3 months after the course. Lee's (2019) Readiness to Talk About Sex Stage Scale assesses nurses' readiness to talk about sex with patients: I do not think it is necessary to talk to patients about sex or provide sexual health information; I do not want to talk about sex with patients, nor have I talking to patients about sex; I think I should give sexual health advice to patients or talk to patients about sex, but I do not want to do so yet; I want to talk to patients about sex or provide sexual health counseling, however, I still not started; I have started talking to patients about sex or giving sexual health counseling; I have started talking to patients' about sex or giving sexual health counseling and have done so routinely for more than three months'; and according to These five options are scored on a scale of 1 to 5. | Data were collected at baseline, 1 month, and 3 months after the course. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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sex education, gender-sensitivity, nurse-patient communication, continuing education, SPOC