High student ignorance about sexual health issues increases multiple risks
University students lack education in sexual and reproductive health by the time they start university. This is one of the results of doctoral thesis "Teaching strategies in Nursing for addressing sexuality, sexual health and reproductive health in adolescents and teenagers" performed by Dr. Manuel Antonio Velandia Mora. Maria Mercedes Rizo Baeza, one of the two directors of the thesis, said that students come to university with little knowledge on sexual and reproductive health and cases of sexually transmitted diseases among young people are increasing. More education in this field with an emphasis on prevention of STDs with barrier contraceptives (condoms) would be a solution.
The researcher worked with students in the second year of Nursing degree at the University of Alicante (UA). Talks on this topic in high schools have been in many cases insufficient or non-existent. Only talks on purely biological aspects related to reproductive organs have been given to them. Of these, those students who attended the talks - which were only given in Alicante city- value them very badly. As stated by the researcher, sexual education is not part of the education programme in this region. As Rizo confirmed, they also did research with the University students in Social Work and Education degrees and the result was similar.
This study focuses on the training given at Nursing degree in adolescent sexuality, sexual health and reproductive health, and makes a diagnosis on the academic training needs of nursing students from the UA in those fields as a strategy to guide their own self-determination, empowerment and responsible sexuality and that of adolescents they treat. To do this, Velandia, who has been improving quantitative and qualitative methodologies during the three-year thesis, conducted surveys and group interviews to a sample of 1st-year students of Nursing at the University of Alicante in the academic years 2008/2009 and 2009/2010, as well as to students of Educational Science, undergraduates in Teacher's Training, specialising in primary education in 2009/2010.
According to the doctor, sexuality, sexual health and reproductive health were referred to as not being part of the academic training programme in Nursing at the UA. He added that noteworthy is the fact that students assumed that the curriculum of nursing studies included these kind of subjects. The same findings were discovered in the Teacher's Training undergraduate programme, whose students experienced the same lack of information. The risk is there, because of the lack of knowledge, said the researcher. Velandia posed the question of if they would consult this to nursing professionals and they responded that they usually would not do that; nor would they consult with their teachers. Their lack of trust is very serious, he added.
The author considers as crucial the role of health professionals in the prevention of sexually transmitted diseases, teen pregnancy and the promotion of safe sexual behaviour. Therefore, they should be involved in the affective-sexual education of adolescents, being necessary to include such kind of interventions within the model of nursing services from health centres.
The most effective method
The richness of the study resides in the different methodologies that have been designed for the acquisition of knowledge in psycho-emotional skills. Initially, students filled in an anonymous questionnaire, which indicated their knowledge and their needs on sexual and reproductive health; followed by a theoretical lecture and finally a practical class. During the workshop, students in groups of five people reproduced a case study through role playing, raising the issues on which they had most queries. Five different cases were assessed. For this purpose, they managed the material and prepared a query. As a result, they realised that theory and practice are far apart and that in these complex situations some previous and simulated experience is required. After this seminar, they found that students did go to talk with the teacher and ask them about these issues, Velandia stated. Afterwards, a fully anonymous evaluation form was handed out.
Rizo and Velandia have contributed in their study with suitable methodology through role playing designed and drafted by the actors themselves, who are students in this case. Students have recognised that this practical part is where they have most learned and was absent in the maternal-child nursing course, Maria Mercedes Rizo said. The methodology is thus the key, as recognised by the thesis supervisor.
The second strategy undertaken was to offer an external, free and voluntary seminar, without credits, with more advanced information about sexual and reproductive health, in which 23 students enrolled during the May 2014 examinations period.
The study verifies the need of training alternatives. The result of this study shows that 18-year students enter university with very low knowledge in these areas, with a very important gap in key aspects that will contribute to a sexual dysfunction, regardless of pregnancies and STDs. This is why researchers created an advanced seminar on sexual and reproductive health. The seminar was taught in the nursing undergraduate degree, lasting five hours and within the subject on maternal and child health. In the new curriculum, it is a two-hour course included in "Nursing Care in the life cycle" and "mother and the child care" subjects. In countries like Colombia, this training course is included in the degree.
Rizo Baeza claims the duty of the regional ministry to introduce the knowledge of all basic needs in education, as is it envisaged since 1991 with the Cross-curricular Basic Education Act, something that has not happened. In the 21st century, adolescents are less prepared than before, says Baeza.
Nearly a thousand students have already attended the seminars since they started in 2012. One proposal is to create a special unit for children and adolescents in health centres. Spain is the only country in Europe that has not introduced nursing in schools.
The scientific study was conducted within the doctoral programme in Nursing and Culture of caring, Department of Nursing, and was supervised by María Mercedes Rizo Baeza and Ana Luisa Velandia Mora. Funded by the Research & Funding Programme 2008/2009, by the Women's Studies Centre at the University of Alicante, it was granted the Doctoral Special Award and can consulted online, having reached until now over 17,000 visits, the number of visits from Spain exceeding those from Latin America, which is very significant according to the researcher.
The thesis project has led to the creation of an interdisciplinary and inter-institutional research group which continues to refine the methodologies and expanding their field of study to the role played by emotions and language in the construction of knowledge.
Queries
Some of the results extracted from the questions arising from women and men and their comparative resulted in assertions such as women believe that men know more than them, which is not true according to the doctor; and the imaginary that women have over men are not such. Surprisingly, they do not ask for gender issues such as transsexuality, but instead about homosexuality, although not so much about lesbianism, of which they believe there are the same needs as in homosexuality. As for contraception, they used from an early age hormonal contraceptives, when condoms are the best option as they should not be exposed to high hormonal load. Female students' belief is that condoms are not that secure, he said. Women assume that the morning-after pill can be used several times a year, mixing up contraception with an abortion method, the expert stated. Nor do women relate genital intercourses with the possibility of pregnancy or sexually transmitted disease, about which they are only concerned afterwards. They raise illogical questions with many myths spread by grandmothers.
