Knowledge of School Nurses in the U.K. Regarding Sexual Health Education

Effectiveness of the Dual Approach Program to promote sexual abstinence in Thai early female adolescents and improve parent-daughter sexual communication

Purpose

The purpose of this paper is to examine the effectiveness of abstinence-based sexual education programs delivered in parallel to Thai parents and their early adolescent daughters to promote sexual abstinence and improve communication regarding sexual topics between them and their parents.

Design/methodology/approach

A quasi-experimental design included groups of parent/daughter dyads; Group 1 (controls) (n=40), Group 2 Adolescent Program (n=40) and Group 3 Adolescent Parent Program (APP) (n=42). Outcome measures included parent–adolescent communications and adolescents’ sexual abstinence cognitions and intent to abstain from sexual behaviors, measured at five and nine weeks post-programs.

Findings

Generalized estimating equation analyses indicated that the dual program (APP) was more effective in increasing parental communication with their daughters compared with Group 1 (p-value<0.05) and only the daughters in the APP program reported more positive subjective norms, sense of perceived behavioral control and intent to abstain than did Group 1 (p-value<0.05).

Originality/value

The overarching goal of supporting the development of family environments where female adolescents are able to talk about sexuality is essential for adolescent sexual health promotion. The data provide further evidence that a dual program with simultaneous parent and female adolescent interactive activities over three sessions is superior compared with programs that target either the parents or the adolescents only. Hence, further replication with more parent–daughter dyads and then within more diverse cultures and populations is warranted. Developing and testing a similarly structured program for parents and sons is also required.

'Let's talk about sex' - A Knowledge, Attitudes and Practice study among Paediatric Nurses about Teen Sexual Health in Hong Kong

AIMS AND OBJECTIVES

To explore the knowledge, attitudes and practices of paediatric nurses in Hong Kong towards adolescent sexual health issues.

BACKGROUND

In Hong Kong, teens are becoming more sexually permissive. As a result, early sexual activity, Sexually transmitted diseases (STD) and unplanned pregnancies among adolescents are increasing. Paediatric nurses are potentially excellent sexual health educators; however, studies in other countries have reported that nurses have inadequate knowledge and skills about sexual health. Little is known about the knowledge, attitudes and practices of nurses in Hong Kong related to teen sexual health.

DESIGN

This is a cross-sectional survey study. The survey was developed after an extensive literature review and partially adapted from previously validated questionnaires on nursing needs, knowledge, attitude and practice.

METHODS

An anonymous self-administered questionnaire in Chinese was distributed to 500 nurses in Hong Kong attending a local paediatric conference. Participants (n = 394) were recruited using convenience sampling methods. Survey data were analysed using descriptive statistics, correlation tests and logistic regression analyses.

RESULTS

The majority of nurses had a high awareness of the importance of sexual healthcare, but rarely felt knowledgeable or comfortable discussing sexual health issues with adolescents. Higher comfort level was associated with higher frequency of practice with an average adjusted odds ratios of 2·64. Inadequate or lack of training (39·4%) was the most significant barrier in providing adolescent sexual health screening and counselling.

CONCLUSION

Nurses' clinical practices towards adolescent's sexual health issues were influenced by their perceived comfort level followed by their self-ranked knowledge and training experience. Further specific training on communication, counselling and general sexual health should be provided to nurses in Hong Kong.

RELEVANCE TO CLINICAL PRACTICE

Nurses' comfort level was the most important factor influencing their clinical practice with teens. Further specific training should be provided to nurses in Hong Kong to improve adolescent sexual health.

Behind Closed Doors

School nurses can play a key role in providing sexual education in schools. However, they often face barriers from the school administration and concerned parents. Additionally, school nurses may have limited formal preparation in managing sexual health issues. This study used a descriptive qualitative method to explore the school nurses’ experiences with facilitators and barriers to providing sexual education. Eighteen nurses from 12 Massachusetts high schools were interviewed. Results showed that the school nurses do not provide formal sexual education at their schools but frequently conduct informal sessions. School nurses reported that students needed more sexual health information, yet there was no collaboration with the school health teachers. Common barriers included lack of privacy and time, confidentiality issues, and fear of conflict. Nurses working in communities with high teen pregnancy rates reported more barriers. The findings can inform the development of policies and practices for sexual education by school nurses.

The school nurse, the school and HPV vaccination: a qualitative study of factors affecting HPV vaccine uptake

School nurses in the United Kingdom are largely responsible for delivering the human papillomavirus (HPV) vaccine to 12-13 year old girls. In order to assess the impact of HPV vaccination on school nurses' roles, we gave a questionnaire to all 33 school nurses who offered Cervarix ™ in two Primary Care Trusts one year ahead of the national vaccine programme. Key organisational issues raised by the school nurses were the size of the team and its skill mix. A few found their schools uncooperative and were dissatisfied with mechanisms for problem resolution. On average, nurses spent an additional 69 h (0.80 h per child) on vaccine-related activities. In semi-qualitative interviews (n=17), school nurses complained of work overload and described the difficulties of establishing good relationships with some of their schools. Nurses expected schools to take some responsibility for ensuring good uptake and were frustrated when help was not forthcoming. We conclude that variation in uptake between schools in part reflects a difficult relationship with the school nurse which may be attributed to characteristics of the school, schools' attitudes towards health interventions, organisational problems, multiple school nurse roles and/or personal ability. Some of these issues will need to be addressed to ensure continued high vaccine coverage as HPV vaccination becomes a less prioritised, routine activity.

Young people and sexual risk-taking behaviour in Central England

BACKGROUND

Sexually transmissible infections and the rate of teenage pregnancy in the UK are among the highest in the industrialised world. Research has suggested that high rates of risk-taking behaviours may account for the concerning increase in the rates of sexually transmissible infections and higher rates of teenage pregnancy in the UK.

METHODS

This cross-sectional analysis investigated the sexual risk-taking behaviours of a group of sexually active 12-15-year-old school pupils from a single county in Central England (n = 493). Data were analysed to investigate the sexual risk activity of adolescents, urban/rural location, and gender.

RESULTS

In this sample, rural students were more likely than their urban counterparts to have used drugs or alcohol the first time they had sex. Female students were more likely than male students to report ever having had sex without contraception. Male students were more likely than female students to have ever had a one night stand.

CONCLUSIONS

As expected there were differences in sexual risk-taking behaviour between pupils in urban and rural locations, and males and females. In most cases these differences were consistent with previous research on general trends, with a few exceptions that can be meaningfully interpreted using previous research in this area. In future, researchers may wish to investigate the underlying factors that determine these differences in risk-taking behaviour.

The application of the theory of reasoned action to school nurses’ behaviour

The aim of this paper was to ascertain how valuable the Theory of Reasoned Action (TRA) would be in the prediction of the sexual health education behaviour of school nurses. The current government in the United Kingdom has made a commitment to reducing the high rates of teenage conceptions and sexually transmitted infections and emphasise an increased public health role for school nurses. However, there appears to be no research to suggest that school nurses are the most appropriate healthcare professionals to competently assist with sexual health education in schools. In accordance with the TRA, a questionnaire was designed to measure the intention, attitude, subjective norm and behaviour of the group being surveyed. The purpose-designed questionnaire was distributed to all school nurses in a large geographical area in the United Kingdom. All 46 participants who responded were female (as there are currently no male school nurses in the United Kingdom). No demographic data were obtained as it is believed that the components of the model incorporate all information needed. The major components of the model accounted for 43% of the variance in intention and 46% of the variance in behaviour. Results suggest that the model has good predictive utility in this area and could usefully be employed in interventions with school nurses with the aim of modifying their behaviour. This is the first time the TRA has been used in this context, and it has provided some important information regarding school nurse’s intentions to practise in sexual health.