Older people who have high sexual self-consciousness have better cognitive performance. A factor positively influencing the cognitive performance of older people is not only the continuation of sexual relations but also some features which can be described by the notion of elevated libido. There is a question whether medical staff, especially nurses is competent to inform older patients about the beneficial effects of sexual activity and high sexual self-consciousness. Counseling in this area would probably be easier and more effective if the nurses themselves have high sexual self-consciousness.

The question arises: what is the average sexual self-consciousness of contemporary nurses in a particular region and how different is it in comparison to older people? We decided to investigate it using our own questionnaire and we present here the preliminary results of such a survey. The obtained results lead to the conclusion that only some nurses, no more than half of the examined group, are predisposed to carry out the discussed kind of counseling.

Recent findings indicate that high sexual self-consciousness, interest in the sphere of sexuality and maintaining sexual activity by older people improve their cognitive efficiency.^1–5 It seems that the beneficial influence also depends on high sexual self-consciousness, and not necessarily on sexual activity itself.^1,3–5 The findings related to such a dependence make one consider whether it is justified to implement appropriate educational programs to explain these conditions to the elderly. Since nurses are often engaged in the care of the elderly, the question arises whether they could implement such educational programs.

The possibility of implementing such educational programs by nurses depends, in part, on the level of understanding the essence of high sexual self-consciousness, which can be worded otherwise in terms of high libido. It seems that the possible ability to provide advice in this area also depends on one's own predispositions in this regard, i.e. on the personal sexual self-consciousness of a person who would like to give such advice.

The contemporary available publications do not explain whether the majority of nurses are aware of the essence of high sexual self-consciousness and whether they exhibit the determined features or whether their level of libido is significantly higher than older people. There is also the question whether there are adequate tools to estimate the level of sexual self-consciousness. Therefore, we decided to plan and conduct our own survey which would allow us to consider these issues.

We formulated for the purpose of the study the questionnaire which is presented in Table 1. It contains 20 statements that should be answered with the terms: “yes”, “in the middle” or “no”. It is structured so, that a person with a high libido can obtain a maximum of 20 points. For questions No. 17 and 18, a positive value is assigned, when the respondent answered "no". The answer to question 20 regarding real sexual activity can be: a, b or c. The value for answer "a" is 1 point, for answer "b" the value is 0.5, for answer "c" it is 0.

With the help of this questionnaire, we collected data from 41 older women and 69 students of nursing. The older women were participants of the so-called University of the Third Age, in the age range <55-85> (mean 70.5). The surveyed members of the University of the Third Age are residents of the city of Nysa and the surrounding area in Poland. The average age of the students of nursing was 21.5years. They are in their third year of nursing studies, realized in the Institute of Medical Sciences, University of Applied Sciences in Nysa. We calculated, for every surveyed individual, the number of gathered points, which forms the value of a simple index, called here Index S. It represents a general evaluation of the discussed sexual self-consciousness of a person.

The statistical significance of the differences in the proportion of responses to individual questions was verified by the chi-square test, using the program.

The proportions of answers to particular questions of the questionnaire obtained from the above two groups of women are presented in Table 2. The differences among the proportions of answers to ten questions (No. 1,2,6,8,10, 11,12,14,15,20) were statistically significant.

The obtained data related to the so-called Index S are presented in Table 3. The mean values of Index S for these groups were respectively 12.45 and 9.50. This difference, verified by Student's t-test, was statistically significant (p<0.0002)

The students of nursing quite often responded positively to some questions/statements aimed at detecting the features of a high libido or, in other words, high awareness of one's sexuality. They are questions No. 3, 4, 15. However, there are many questions to which a positive answer was given relatively rarely. They are questions No. 1,2,9. An interesting finding is that only a small number of students of nursing responded positively to question No. 10, related to using erotic imagery. Also noteworthy is the finding that a significant proportion of students of nursing responded negatively to question No. 9.

The literature review shows that methods of assessing high libido have not been proposed so far. Most authors dealing with this issue formulate proposals for methods to evaluate real sexual activity in clinical situations when this activity is diminished.^6–10 There are authors who consider the concepts of sexual interest, desire and trait sexual motivation.^11–17 Discussions of these concepts clarify the problem of describing and assessing sexual self-consciousness. Publications on the states of reduced interest in sex in women are also helpful for these considerations.^18–22  Iveniuk et al.,¹¹ write that greater interest in sex reveal people "with a highly perceived positive marital quality, a positive and open personality, and better physical health".¹⁴

Stark et al.,¹² emphasize the importance of "trait sexual motivation".¹⁵ It is "a psychological construct that reflects the long-lasting degree of motivation for sexual activities, which is assumed to be the result of biological and sociocultural influences".¹⁵ This personality trait is related to "other similar constructs like sexual desire, sexual drive, sexual needs, and sexual compulsivity".¹⁵

Goldey et al.,¹³ initially assumed that sexual desire occurs spontaneously, but their investigation leads to the conclusion that desire responds rather to specific sexual stimuli.¹⁶ They examined the level of sexual desire in response to: erotic stories, unstructured fantasy, and so called Imagined Social Situation Exercise, which consists in writing about imagined, sexual encounters with a chosen attractive person. All three kinds of sexual stimuli significantly increased sexual arousal compared with the neutral condition. Goldey et al. found however that higher arousal was observed after unstructured fantasy.¹⁶ Meana draw similar conclusions from her investigations.¹⁷

Several authors published data on measuring tools for assessment of the intensity of sexual interest of women.^18–20 DeRogatis et al. describe the proposed method of the "Validation of a Women's Sexual Interest Diagnostic Interview".¹⁸ These researchers propose the scale modeled on The Female Sexual Function Index.¹¹ The DeRogatis' et al. scale is based on the estimations of sexual activity.

Comparing these scales with our original tool proposed in this paper, it should be noted that instead of assessing sexual activity (to which only question No. 20 refers)–we try to assess the overall attitude and valuation of behaviors in favor of interest in eroticism and sensuality. The obtained results allow us to express an opinion about the average predisposition or competency of nurses to offer advice to older people, regarding the pattern of behavior in the domain of erotic activity.

In the examined group of students of nursing there are women with significant values ​​of the proposed Index S. It can be said, that the nurses who obtained high Index S values are more predisposed to implement the counseling specified here.

It seems that the suggestion that all nurses could carry out the mentioned type of counseling may be unreasonable. Some of them can encounter difficulties in realizing such a task as we discovered that a significant proportion of them do not use erotic imaginary (question No. 10) and do not confirm that they "like to read sex articles and watch erotic movies" (question No. 5).

Our study provides only preliminary data. Next, one should check whether there is a relationship between the results obtained using the proposed method of assessing the sexual self -consciousness and the measurements of the cognitive efficiency. It would be necessary to check later whether the persons (nurses, members of the medical team) exhibiting higher values of Index S are willing to undertake a specialized educational program regarding the benefits of high sexual consciousness. It would then be necessary to specify the rules and content presented in such an educational program. It seems, that the contents of such an educational program could utilize the findings of the above cited Goldey et al.¹⁶ As we mentioned, these authors showed that sexual desire is augmented by erotic stories, unstructured fantasy, and so called Imagined Social Situation Exercises.¹⁶

1. The proposed questionnaire extends the possibilities of evaluating sexual self-consciousness.
2. The obtained results lead to the conclusion that only some nurses, no more than half of the examined group, are predisposed to carry out counseling related to promoting knowledge about the beneficial influence of sexual activity on cognitive performance.
3. There is a dilemma whether some medical institutions dealing with older patients should promote the raising the competences of nurses interested in implementing an educational program or counseling related to sexual activity.

None.

The author declares no conflict of interest.

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