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Sexual health and sexual health promotion in the transition from adolesence to emerging adulthood
Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).ORCID iD: 0000-0002-2102-324X
2020 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim: This thesis aims to explore the transition from adolescence to emerging adulthood, related to adolescents’ sexual behavior, conceptions concerning sex, sexual relationships and sex education, their need for knowledge and support related to sexuality. A further aim was to explore professionals’ views on promotion of sexual health, and interprofessional collaboration in relation to adolescents’ sexual health. Methods: Both quantitative methods (I) and qualitative methods (II, III, IV) were used. In study I, 139 adolescents responded to a cross-sectional survey. The qualitative data was obtained through focus group interviews with 32 adolescents (II) and individual, pair and group interviews (III) with 26 adolescents. Further, 24 professionals participated in focus group interviews (IV). Findings: Adolescents’ reported a low level of sexual risk behavior and high self-esteem, yet put themselves at risk by inconsistent condom use (I). Learning about sex and relationships included values, knowledge and practical skills in relation to maturity, enabling internalization of different aspects of sexuality, creating meaning and fostering autonomy and identity (II). Developing sexuality involved changing needs for knowledge, discussing, interacting with others, and gaining experience (III). Professionals reached out to adolescents through competence and trusting relationships. It was important to keep up to date with changes regarding sexuality, to reach vulnerable groups, and include questions about sexuality in all health care contexts involving adolescents (IV). Conclusions: Adolescents’ needs for knowledge and support were constantly changing with development through learning, experience and interaction with peers, parents, and health professionals. Different efforts are necessary in sexual health promotion depending on age, maturity or gender in order to provide high quality nursing interventions in relation to adolescents’ sexual health.

Abstract [sv]

Syfte: Avhandlingen syftade till att undersöka övergången från adolescens till ung vuxenhet relaterad till tonåringar sexuella beteenden, uppfattningar om sex, sexuella relationer och sex- och samlevnadsundervisning, samt deras behov av kunskap och stöd relaterad till sexualitet. Ytterligare ett syfte var att undersöka hälsopersonals syn på sexuell hälsopromotion och interprofessionell samverkan i relation till tonåringars sexuella hälsa. Metoder: Kvantitativa (I) och kvalitativa (II, III, IV) metoder användes. I studie I svarade 139 tonåringar på en enkät. De kvalitativa data inhämtades genom fokusgruppintervjuer med 32 tonåringar (II), och individuella-, par- och gruppintervjuer (III) med 26 tonåringar. Vidare deltog 24 hälsopersonal i fokusgruppintervjuer (IV). Resultat: Tonåringar rapporterade låga nivåer av sexuella riskbeteenden och hög självkänsla, men utsätter sig för risker på grund av inkonsekvent kondomanvändning. Lärande om sexualitet och relationer inkluderade värderingar, kunskap och praktiska färdigheter i relation till mognad, vilket möjliggjorde för internalisering av olika aspekter av sexualitet, skapade mening och främjade autonomi och identitet (II). Sexuell utveckling innebar ändrande behov av kunskap, diskussion, interaktion med andra samt att få erfarenheter (III). Personal nådde ut till tonåringar genom kompetens och tillförlitliga relationer. Det var viktigt att hålla sig uppdaterad med förändringar beträffande sexualitet, att nå sårbara grupper och att inkludera frågor om sexualitet i alla delar av hälso- och sjukvården som inkluderar tonåringar (IV). Konklusion: Tonåringars behov av kunskap och stöd är dynamiskt och förändrades genom lärande, erfarenhet, och interagerande med andra.  För att främja sexuell hälsa är olika insatser nödvändiga vilket måste anpassas till tonåringars ålder och mognad för att därmed leda till omvårdnadsinterventioner av hög kvalitet.

Abstract [en]

Adolescents today are living in an increasingly complex world and are actively involved in developing their sexuality and personal identity. Sexuality is something which is positive for adolescents and subsequently their experience of health. This thesis aims to explore the transition from adolescence to emerging adulthood, related to adolescents’ sexual behavior, conceptions concerning sex, sexual relationships and sex education, their need for knowledge and support related to sexuality.

Adolescents’ reported low sexual risk behavior, high self-esteem, yet inconsistent condom use. Adolescents’ needs for knowledge and support related to sexuality and relationships were constantly changing with increasing development which came through learning, experience and interaction with peers, parents, health professionals.  Different efforts are needed in sexual health promotion depending on age, maturity or gender. Nurses need to be aware of individuals’ changing needs for support along with the importance of timing interventions. This thesis shows important factors which should be used to assess adolescents’ needs, contributing to high quality nursing interventions in relation to adolescents’ sexual health.

Place, publisher, year, edition, pages
Karlstad: Karlstads universitet, 2020. , p. 96
Series
Karlstad University Studies, ISSN 1403-8099 ; 2020:27
Keywords [en]
adolescents, sexuality, sexual health, sexual health promotion, transition
National Category
Nursing
Research subject
Nursing Science
Identifiers
URN: urn:nbn:se:kau:diva-80057ISBN: 978-91-7867-142-7 (print)ISBN: 978-91-7867-147-2 (electronic)OAI: oai:DiVA.org:kau-80057DiVA, id: diva2:1463834
Public defence
2020-10-23, Frödingsalen, 1B 364, Karlstads Universitet, Karlstad, 10:00 (Swedish)
Opponent
Supervisors
Funder
Region VärmlandAvailable from: 2020-10-02 Created: 2020-09-03 Last updated: 2022-04-29Bibliographically approved
List of papers
1. Rural High School Students' Sexual Behavior and Self-esteem
Open this publication in new window or tab >>Rural High School Students' Sexual Behavior and Self-esteem
2015 (English)In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 5, no 1, p. 24-31Article in journal (Refereed) Published
Abstract [en]

Background: Negative consequences for sexual health may be caused by risky sexual behavior related to attitudes, norms and self-efficacy regarding sexuality. Research has not resulted in a consensus on the associations between self-esteem and adolescents’ sexual behavior.

Aims and objectives: The aim of the study was to describe high school students’ sexual behavior and self-esteem, along with investigating the relationship of attitudes, norms, self-efficacy, and self-esteem to sexual risk behavior. Another aim was to describe and compare gender differences in self-esteem and sexual risk behavior in high school students in a rural context.

Methodological design: A cross-sectional design was used. The participants were 139 high school students, 16 to 18 years of age, sample size was decided by power calculation, and systematic randomized sampling was used. The students replied to a questionnaire about self-esteem, factors affecting sexual risk behavior, and sexual behavior.

Results: Swedish high school students reported having few sexual partners, a low use of alcohol along with sex, yet a low consistency in condom use. The students reported both high basic self-esteem as well as earned self-esteem. Basic self-esteem was higher for male students while earned self-esteem was higher for female students. Significant correlations were found between self-esteem and some factors affecting sexual risk behavior related to condom use.

Conclusion: High school students exhibited positive sexual behaviors and high levels of self-esteem, yet they put themselves at risk by inconsistent use of condoms Our findings can contribute  the need of  to an awareness of  the role self-esteem, attitudes, norms and self-efficacy plays in adolescents’ sexual behavior. Nurses working at the youth clinics are in a key position to discuss sexual health issues with adolescents to promote healthy outcomes in sexual health.

Place, publisher, year, edition, pages
Scientific Research Publishing, 2015
Keywords
Reproductive health, Sexual behavior, Self-esteem, Adolescent health
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-35023 (URN)10.4236/ojn.2015.51004 (DOI)
Available from: 2015-01-27 Created: 2015-01-27 Last updated: 2020-09-03Bibliographically approved
2. Adolescents’ conceptions of learning and education about sex and relationships
Open this publication in new window or tab >>Adolescents’ conceptions of learning and education about sex and relationships
2020 (English)In: American Journal of Sexuality Education, ISSN 1554-6128, Vol. 15, no 1, p. 25-52Article in journal (Refereed) Published
Abstract [en]

In order for adolescents to learn about sex and relationships, the education must be of significance and meet their needs and interests. The study investigated adolescents’ conceptions of learning and education about sex and relationships. A phenomenographic approach was used. Six focus group interviews were conducted with adolescents ages 18–19 in Sweden. The results showed that stable ground for learning implies select issues of importance, that is, values and prejudices, up-to-date knowledge, and practical skills. These issues should be dispersed throughout the school years in relation to the students’ own maturity. This seemed to enable internalization of different aspects of sex and relationships. Learning about sex and relationships can create meaning for youth and generate progress by fostering autonomy and identity, correcting misconceptions, counteract prejudices, not in isolation rather in society in a defined culture.

Place, publisher, year, edition, pages
Taylor & Francis, 2020
Keywords
Adolescents, education, phenomenography, sexual health, sexuality
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-73353 (URN)10.1080/15546128.2019.1617816 (DOI)000511330000002 ()2-s2.0-85066989907 (Scopus ID)
Available from: 2019-07-02 Created: 2019-07-02 Last updated: 2023-06-21Bibliographically approved
3. Adolescents' changing needs for knowledge and support related to sexuality and sexual relationships - a grounded theory study on the transition from adolescence to emerging adulthood
Open this publication in new window or tab >>Adolescents' changing needs for knowledge and support related to sexuality and sexual relationships - a grounded theory study on the transition from adolescence to emerging adulthood
(English)Manuscript (preprint) (Other academic)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:kau:diva-80055 (URN)
Available from: 2020-09-03 Created: 2020-09-03 Last updated: 2020-10-08Bibliographically approved
4. Professionals' experience of sexual health promotion and interprofessional collaboration
Open this publication in new window or tab >>Professionals' experience of sexual health promotion and interprofessional collaboration
(English)Manuscript (preprint) (Other academic)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:kau:diva-80056 (URN)
Available from: 2020-09-03 Created: 2020-09-03 Last updated: 2020-10-08Bibliographically approved

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