La plupart des informations est acquise par l'audition et entrer dans le processus de la connaissance des individus; cela explique pourquoi les adolescents sourds sont privés. De plus, une telle déficience peut entraîner des problèmes personnels tels que des rapports sexuels dangereux, des grossesses non désirées, des maladies sexuellement transmissibles, le sida. L'étude de la différence entre adolescents sourds et entendants dans leur vie sexuelle va nous amener à mieux comprendre les problèmes et besoins liés à la sexualité chez les jeunes sourds (Anat, Yehudit, 2011), en se limitant aux filles. Nous avons utilisé les méthodes d'étude qualitative et quantitative. Les données proviennent d’entretiens semi-directifs et de questionnaires menés avec les adolescentes sourdes et entendantes âgées de 16 à 20 ans, dans une population de France et d'Iran. Les résultats ont montré qu’il y a une différence significative entre les jeunes filles sourdes et entendantes Dans" l'information sexuelle (p = 0,01), « processus cognitifs " (p = 0,01); et «comportement préventif» (p = 0,05). Parmi les jeunes sourdes, nous notons une différence significative entre les Iraniennes et les Françaises quant aux « besoins d'éducation sexuelle » (p = 0,01), aux « processus cognitifs » (p = 0,05), au « bien-être » (p = 0,05) et au « comportement préventif » (p = 0,05). En revanche, il n’a y aucune différence significative entre les sourdes iraniennes et françaises pour ce qui est de « l'information sexuelle » et des « comportements à risque ». Nous constatons également Il n’a y aucune différence significative entre les jeunes filles sourdes SCES et NSCES mais seulement pour "l'information sexuelle» (p = 0,05).Bien que les filles entendantes ont des informations sexuelles plus riches que les jeunes filles sourdes; elles montrent une incapacité à les utiliser dans leur vie sexuelle. Les sourdes ont en fait besoin d’une éducation sexuelle spécifique, alors que l'éducation sexuelle actuelle n’est pas efficace pour les sourds. Malgré l'existence de l'éducation sexuelle officielle en France et son absence en Iran, nous voyons que les deux groupes sourds ont la même connaissance sexuelle et ont le même comportement sexuel à risque. / Most of information is acquired by hearing and enter the process of knowledge of individuals; this explains why deaf adolescent are deprived. Moreover, this hearing defect can add other problems for them such as having dangerous sex, unwanted pregnancy, sexual diseases or AIDS. Studying the difference between deaf and hearing teenagers in their sexual lives help us to understand their sexuality related problems and needs (Anat, Yehudit, 2011).We used methods of qualitative and quantitative study. The data were obtained from semi-structured interviews as well as questionnaires undertaken with the deaf and hearing adolescents aged 16 and 20 years who were selected in France and Iran.The results showed that 'there is a significant difference between young deaf and hearing girls in "sexual information" (p = 0.01), "cognitive processes" (p = 0.01); and "safe behavior" (p = 0.05). We note that there is a significant difference between the deaf young Iranian girls and young French deaf girls on "Sex education needs" (p = 0.01), "cognitive processes" (p = 0.05), "well-being" (p = 0.05) and "safe behavior" (p = 0.05). However, no significant difference is found between the Iranian and French deaf in "sexual information" and "risky behavior". We also find that there is a significant difference between young girls deaf FSE and DFSE only in "sexual information" (p =0.05).Although the hearing girls have richer sexual information than young deaf girls; they are unable to use their sexual information in their sexual lives. The result shows that the deaf need specific sex educations and the existing sex education it is not effective for the Deaf. Despite the existence of formal sex education in France and its lack in Iran, we see that both deaf groups have the same sexual knowledge and have the same risk sexual behavior.

Among girls in foster care, 48% become pregnant at least once by age 19 (Dworkey & Courtney, 2010). Teen moms are less likely to graduate from high school and their children also are more likely to be placed in foster care due to abuse or neglect (Hoffman, 2006). Furthermore, 50% of 21-year-old men aging out of foster care report they have gotten someone pregnant, compared to 19% of their peers not involved in foster care (Courtney et al., 2007). Youth in or at-risk for foster care (YFC) report limited knowledge about, access to, and use of condoms; ambivalent attitudes toward teen parenting; and participation in other risky behaviors. For the current study, we adapted and supplemented an evidence-based sexual health program called SiHLE, using a systematic adaptation framework (ADAPT-ITT, Wingood & DiClemete, 2008), to address these unique and targeted needs of YFC. Thirty-six youth participated in four sessions of SiHLE-YFC during their stay at a temporary shelter. Four 90-minute sessions focused on increasing sexual health knowledge, improving attitudes toward and self-efficacy of condom use, and developing core skills such as problem-solving and communication. As hypothesized, youth showed high satisfaction with the intervention and significant improvement in sexual health knowledge from pre to post. At one month follow-up, youth continued to show significant improvement in sexual health knowledge, along with a significant reduction in risky sexual behaviors. Though not significant, there were moderate effect sizes for changes in attitudes toward teen pregnancy and condoms. There were no changes in attitudes towards teen parenting. Taken together, findings suggest that sexual health education directly targeting the unique needs of YFC may improve sexual health knowledge and behavior, and are discussed in the context of challenges associated with intervention and research with this population.

Since 1999, youth have experienced an increase in HIV incidence. Gay male youth, in particular, are a priority sub-population because they accounted for the highest exposure category in 2008 among youth. Due to the lack of studies on gay male youth who are susceptible to HIV, and the reality that most previous research on stigma may no longer reflect the contemporary context, nursing based research was undertaken. Utilizing critical theory, stigma within the therapeutic relationship was investigated through eight semi-structured interviews with gay male youth who were recruited through a gay men’s sexual health clinic in Ottawa, Canada. The results of this research showed that while stigma, whether perceived stigma or the fear of stigmatization, was still felt by these participants in some interactions, overall, these youth had positive experiences with the health care system, particularly within the context of the gay men’s sexual health clinic.

Understanding the history of the Israeli-Palestinian conflict is important for a greater understanding of the current state of sexual and reproductive rights of Palestinian women. Constant military occupation has been a determining factor hindering the development of comprehensive and coherent health policies and programmes. As a result of the Oslo Accords and the Israeli-Palestinian Interim Agreement in 1994, the Palestinian National Authority was granted limited authority over portions of the West Bank and Gaza. In 2007-2008 a multi-national, multi-disciplinary study team undertook a national study to assess the reproductive health content of nursing education and identify gaps in curricular coverage and implementation. One component of this project included exploring final year nursing and midwifery students’ attitudes toward a range of sexual and reproductive health issues. This thesis analyzes these data and explores the demographic factors, including gender, region, and residence, associated with nursing and midwifery students’ attitudes toward abortion and contraception-related laws and policies. Our findings suggest that there is a considerable need to incorporate values clarification exercises as well as structured sessions dedicated to laws and policies governing sexual and reproductive health into the formal curricula of programs in both the West Bank and the Gaza Strip. Our results also shed further light on the dynamics shaping abortion and contraception attitudes among health professions students in the Occupied Palestinian Territories.

Perhaps one of the most embodied of human experiences, sexuality can be greatly affected by the way in which women perceive their body. Historically, scholars have dedicated their attention to negative facets of body image and how it is associated with poorer female sexual health, while mostly overlooking the positive aspects of this relationship. Similarly, although ageing is a key factor to consider when examining body image and sexual health, only a dearth of studies has attempted to describe the experiences of non-university aged women. To fill these gaps, this research program was designed to investigate the associations between positive and negative aspects of body image and explore how each contributes to sexual health in age-varied samples of adult women. Two survey studies were carried out. A total of 215 heterosexual women, aged 18 to 88, participated in the first study. Despite a high statistical overlap between body appreciation (i.e., positive body image) and body dissatisfaction (i.e., negative body image), the former was found to be a greater contributing factor to indicators of sexual health. Specifically, body appreciation was related to improved sexual function, lower sexuality-related distress, and higher sexual satisfaction, even when controlling for body mass index. Although many changes occur to the body as women get older, body appreciation was unrelated to age in this sample. Nevertheless, it was shown to moderate the negative association between age and sexual satisfaction, such that older women with high appreciation for their body reported being significantly more sexually satisfied than those with low body appreciation. While the first study explored the body image and sexual health experiences of adult women in general, the second article focused on the mechanisms through which one is related to the other in midlife and older women specifically. A total of 193 heterosexual women, aged 50 to 83, completed an online survey. Support was provided for the use of objectification theory (Frederickson & Roberts, 1997), a well-established theoretical framework in body image research, in explaining sexual health in midlife and older women. Body self-consciousness during sex partially explained the relationship between body shame, appearance anxiety, and sexual function, distress, and satisfaction. High body appreciation mitigated the detrimental effect of self-objectification constructs (i.e., body surveillance, appearance anxiety) and body self-consciousness during sex on midlife and older women's sexual health. Overall, based on the results of this dissertation, body appreciation appears to serve as a protective factor for improved sexual health. Similar to sexual satisfaction and sexual distress, positive and negative aspects of body image are related, but nonetheless distinct, concepts that should not be used interchangeably. Furthermore, midlife and older women's body image and sexual experiences differ from that of their younger counterparts; systematic generalisation of findings from one group to the other is thus unwarranted. Consideration for these various distinctions is not only required for increased understanding of the complex links between body image and sexuality across adulthood, but also relevant to guide prevention efforts at a sociocultural level and clinical interventions at the individual level.

A growing number of studies suggest that the reasons for which people engage in sexual activities matter for their sexual well-being. Grounded in self-determination theory (SDT), this thesis research investigated the contributions of autonomous and controlled sexual motivation to sexual well-being. These objectives were achieved through a series of five studies presented in four manuscripts. In Manuscript 1, we validated the Sexual Motivation Scale (SexMS), a measure of self-regulation for sexual activities grounded in SDT (Study 1: N = 1,070, Study 2: N = 575). Collectively, the findings provided strong support for the factorial validity of the SexMS. Additionally, the SexMS captured important individual differences in sexual well-being, specifically with respect to sexual satisfaction, sexual distress, and sexual function. Manuscript 2 explored how autonomous and controlled sexual motivation are integrated with broader psychological functioning by examining their motivational antecedents and well-being consequences (N = 828). The results showed that global and relational motivation explained individual differences in autonomous and controlled sexual motivation. Additionally, autonomous and controlled sexual motivation explained individual differences in sexual, relational, and global well-being. Finally, the results suggested that, for the most part, the associations between the motivational antecedents and the well-being consequences of autonomous and controlled sexual motivation followed a heterarchical structure. Next, in Manuscript 3, the motivational sequence proposed by SDT – in which basic psychological needs satisfaction predicts quality of motivation, and in turn quality of psychological functioning – was validated in the context of within-person variations in sexual well-being (N = 113). The results indicated that on days when people experience more basic psychological needs satisfaction during interactions with their partner, their sexual motivation was more autonomous and this was associated with higher sexual well-being. However, basic needs satisfaction did not significantly predict controlled sexual motivation. Additionally, on days when people reported higher controlled sexual motivation, they experienced lower sexual well-being. Finally, in Manuscript 4, we examined the motivational sequence proposed by SDT from a dyadic perspective to better understand the contribution of sexual motivation to sexual well-being in couples (N = 225 couples). Specifically, we examined whether basic needs satisfaction during sexual activities and autonomous and controlled sexual motivation in one partner influenced the sexual well-being of the other partner. The unique contribution of each basic psychological need (i.e., autonomy, competence, and relatedness) to sexual well-being was also investigated. Taken together, the results supported SDT’s predictions regarding the relevance of the motivational sequence and the unique contribution of each basic psychological need in explaining between-couple differences in sexual well-being. However, different patterns of association emerged for women and men, suggesting that in the context of sexual activities within heterosexual relationships, the motivational processes proposed by SDT may be moderated by gender. In sum, the findings from this thesis extend SDT and sexual motivation research. Overall, SDT may provide novel insights on human sexual behaviour, notably by improving our understanding of the factors that can enhance or impede sexual well-being in committed relationships.

Aim of this thesis was to determine by using a questionnaire what information sources young people use to find information on sexual and reproductive health. Than, based on these findings, to find recommendations for non-profit organization that operates in this field. The Theoretical Part of the thesis is focused on theory of marketing research and sex education. The practical part is focused on the evaluation questionnaires, hypotheses and then to the recommendations for non-profit organization.

Bakgrund: The World Health Organization betraktar sexuell hälsa som en betydande del för god hälsa, välbefinnande och livskvalitet. Sexuell hälsa kan på olika vis påverkas av sjukdom men är ändå en viktig aspekt för hälsan. Sjuksköterskan har ett ansvar att vårda patienten med ett holistiskt perspektiv där alla hälsoaspekter beaktas. Trots detta är sexuell hälsa ofta ett åsidosatt ämne i vården och i samtal med patienter. Syfte: Syftet var att undersöka vilka faktorer som hindrar respektive främjar sjuksköterskans samtal om sexuell hälsa med patienten. Metod: En strukturerad litteraturöversikt. Resultatet baseras på totalt 12 artiklar, med både kvalitativ och kvantitativ metod. Resultat: Totalt framkom 53 faktorer, 35 hindrande samt 18 främjande faktorer. Alla faktorer formade följande åtta kategorier; ett tabubelagt ämne, otillräckliga resurser och förutsättningar, brist på utbildning, träning och kunskap, sjuksköterskans inställning och patientens karaktärsdrag, tillräckliga resurser och förutsättningar, adekvat utbildning, träning och kunskap, yrkeserfarenhet och självförtroende samt vårdrelationen mellan sjuksköterska och patient. Slutsats: Sexuell hälsa upplevdes vara ett känsligt ämne att samtala om med patienten. Det är viktigt att identifiera barriärer och att adekvata metoder tillämpas för att överkomma dem. Utbildning kan bidra till ökad kunskap och medvetenhet om sexuell hälsa och vidare främja samtal. Styrdokument och riktlinjer bör utvecklas för att ge sjuksköterskan redskap att tillämpa i samtalet med patienten. Dessa verktyg kan eventuellt bidra till goda samtal mellan patient och sjuksköterska. Sjuksköterskan bör se sexuell hälsa som en naturlig del av den holistiska vården. / Background: The World Health Organization regards sexual health as a significant part of good health, well-being and quality of life. Sexual health can in different ways be affected by illness, but is nevertheless an important aspect of health. The nurse has a responsibility to care for the patient from a holistic perspective where all aspects of health are taken into account. Despite this, sexual health is often a neglected subject in health care and in dicussions with patients. Aim: The aim of this study was to examine what factors acts as barriers and facilitators for the nurse to discuss sexual health with the patient. Method: A structured literature review. The result is based on a total of 12 articles, with both qualitative and quantitative methods. Results: A total of 53 factors were identified, 35 inhibited factors and 18 promoting factors. The factors resulted in following eight categories; a taboo subject, insufficient resources and conditions, lack of education, training and knowledge, the nurse's attitude and the patient's characteristics, sufficient resources and conditions, adequate education, training and knowledge, experience and confidence and the nurse-patient relationship. Conclusion: Sexual health is perceived to be a sensitive topic to talk about with patients. It is important to identify barriers and to apply appropriate methods to overcome them. Education can contribute to greater knowledge and awareness of sexual health and further promote the conversations. Regulatory documents and guidelines should be developed to provide nurses adequate tools to use in the conversation with the patient. These tools may contribute to good conversations between the patient and the nurse. The nurse should regard sexual health as an integral part of the holistic care.

Bakgrund: Av alla barn i världen har cirka 5-20% någon gång blivit utsatt för ett sexuellt övergrepp. Flickor utsätts för sexuella övergrepp i tre gånger högre utsträckning än pojkar enligt tidigare studier. Ett sexuellt övergrepp innebär alla former av sexuella handlingar som ett barn utsätts för av en annan person. Dessa sexuella handlingar kan leda till traumatisk sexualisering vilket innefattar en process där barnets sexualitet inte utvecklas på ett lämpligt sätt. Sexuell hälsa är ett begrepp som innebär ett tillstånd av fysiskt, emotionellt, mentalt och socialt välbefinnande i förhållande till sin sexualitet och är inte enbart avsaknad av sjukdom, dysfunktion eller svaghet. Syfte: Syftet med denna studie är att undersöka hur kvinnors sexuella hälsa påverkas av sexuella övergrepp i barndomen. Metod: Litteraturöversikt med en kvantitativ ansats. Innehållande 11 artiklar som analyserats och bearbetats enligt Forsberg och Wengströms analysmetod. Databaserna PubMed och PsycInfo användes vid datainsamlingen. Roys adaptionsteori utgjorde litteraturöversiktens teoretiska referensram. Resultat: Studien baseras på elva originalartiklar med kvantitativa studier genomförda i Australien, Kanada, Kina och USA. Kvinnornas sexuella hälsa påverkades i flera avseenden och bildade tre olika kategorier: Kvinnans sexuella beteenden, Psykologisk påverkan; sexuell självkänsla, kroppsuppfattning och anknytning och Kvinnans fysiologiska påverkan, tillfredsställelse och funktionalitet. Slutsats: Kvinnors sexuella hälsa blir negativt påverkat av sexuella övergrepp i barndomen i flera aspekter så som det sexuella beteendet, självkänslan och kroppsuppfattningen. Även en negativ påverkan uppstår i anknytningen till partnern och den sexuella fysiologin, tillfredsställelsen och funktionaliteten. / Background: About 5-20% of all children in the world have been sexually abused. Girls are sexually abused up to three times more than boys according to previous studies. Sexual assault combines all forms of sexual abuse that a child is subjected to by another person. Traumatic sexualisation in children refers to a process in which the child's sexuality does not develop in an appropriate way. Sexual health is a concept that implies a state of physical, emotional, mental and social well-being in relation to one's sexuality and is not merely the absence of illness, dysfunction or weakness. Aim: The purpose of this study is to investigate how women's sexual health is affected by childhood sexual abuse. Method: Literature study with quantitative approach. Including 11 articles that have been analyzed and processed according to Forsberg and Wengström's analysis methodology. The databases PubMed and PsycInfo were used for data collection. Roy's adaptation theory constituted the theoretical reference framework of the literature review. Results: The study is based on eleven original articles with quantitative studies conducted in Australia, Canada, China and the United States. Women's sexual health was impacted in several respects and formed three different categories: Women's sexual behaviors, Psychological impact; sexual self-esteem, body perception and attachment and the Woman's physiological affect, satisfaction and functionality. Conclusion: Women's sexual health is negatively affected by childhood sexual abuse in several aspects such as sexual behavior, self-esteem and body image. A negative affect can also be seen in the connection with the romantic partner and the sexual physiology, satisfaction and functionality.

Bakgrund: Begreppet hälsa är komplext och innefattar flera olika delar, bland annat sexuell hälsa. Människans sexuella hälsa riskerar att påverkas vid exempelvis åldrande, läkemedelsbehandling eller sjukdom. Patienter upplever att de själva får ta initiativ till att inleda en kommunikation kring sin sexuella hälsa. De önskar att sjuksköterskor istället initierar samtalsämnet, då det underlättar för patienterna att våga lyfta frågor. Sjuksköterskan kan ta hänsyn till patienters önskan samt sitt professionella ansvar genom att ha kunskap inom området och öppna upp för samtal. Syfte: Att beskriva sjuksköterskors erfarenheter av kommunikation kring sexuell hälsa i patientmötet. Metod: Den kvalitativa litteraturöversikten baserades på 13 vetenskapliga artiklar. Analysen genomfördes utifrån en femstegsanalys beskriven av Friberg. Resultat: Sjuksköterskor uttryckte att ämnet var känsligt att diskutera. Egna värderingar och kunskaper inom området visade sig påverka huruvida samtalsämnet togs upp av sjuksköterskan eller inte. Dessutom visade sig strukturella faktorer vara betydelsefulla. Det förekom delade meningar gällande vem som bar ansvaret för att lyfta frågor kring sexuell hälsa. Slutsatser: För att främja kommunikation kring sexuell hälsa behöver sjuksköterskor erbjudas mer utbildning inom ämnet. Verksamheterna behöver utveckla rutiner, riktlinjer samt ge tillgång till en avgränsad samtalsmiljö. / Background: The concept of health is complex and includes sexual health as well. Sexual health may be affected by aging, medication or illness. Patients experience that they need to take the initiative to initiate a communication about their sexual health. Instead they want nurses to bring up the subject, as it facilitates for patients to ask questions. Nurses can meet patient's wishes and take their professional responsibility by having knowledge in the area and raise the topic. Aim: To describe nurses experiences of communication about sexual health in the meeting with patients. Method: The qualitative literature review was based on 13 scientific articles. The analysis was followed out by a five-step analysis described by Friberg. Result: Nurses expressed that the topic was sensitive to discuss. Their own values ​​and knowledge in the area were found to influence whether the subject was raised or not. Furthermore, structural factors were proved to be important. Various opinions prevailed regarding the responsibility for raising issues related to sexual health. Conclusions: To promote communication about sexual health, nurses need to be offered more education on the subject. The healthcare needs to develop routines, guidelines and provide access to a private environment.