Bakgrund: Ungdomars tillgång till internet gör pornografin lättillgängligt och inflytelserik. I svenska skolor påvisas brister inom sex och samlevnadsundervisningen där elevhälsans personal oftast inte inkluderas. Utifrån skolsköterskans profession kring det hälsofrämjande och förebyggande arbetet, har skolsköterskan en unik roll att främja elevernas hälsa.Syfte: Syftet med studien var att undersöka hur ungdomars psykiska och sexuella hälsa påverkas vid konsumtion av internetpornografi.Metod: Systematisk litteraturöversikt med deskriptiv design. Åtta kvantitativa artiklar inkluderades i resultatet som analyserades enligt tematisk analys. Resultatet beskrivs narrativt.Resultat: I resultatet framkom teman; psykisk ohälsa och tvångsmässig användning av pornografi samt ökat sexuellt risktagande och sexuellt våld. Resultatet visar att symtom på ångest, depression samt psykosomatiska symtom sågs hos flickor vid högre pornografikonsumtion. Hos pojkar med låg självkänsla sågs en ökad risk att utveckla symtom på ökad och tvångsmässig konsumtion av pornografi. Vid högre grad av pornografikonsumtion sågs ett ökat sexuellt risktagande hos pojkar och en ökad riskfylld livsstil hos flickor. Resultatet visar att pojkar konsumerar mer pornografi med våldsinslag.Slutsats: Resultatet visar att ungdomars psykiska och sexuella hälsa påverkas vid pornografikonsumtion. Med stöd av resultatet kan skolsköterskeprofessionen bidra med kunskap kring pornografins påverkan hos ungdomar / Background: Young people´s access to the internet makes pornography easily accessible and influential. In Swedish schools there are shortcomings in sex and cohabitation education, where they often do not include student health staff. Based on the school nurse´s work with health promotion and prevention, the school nurse has a unique role in promoting students´ health.Aim: The aim of the study was to investigate how young people´s mental and sexual health is affected when consuming internet pornography.Method: Systematic literature review with descriptive design. Eight quantitative articles were included in the results, which were analyzed with thematic analysis and described narratively.Results: The results revealed two themes; mental illness and compulsive use of pornography and increased sexual risk-taking and sexual violence. The results show that symptoms of anxiety, depression and psychosomatic symptoms were seen in girls with higher pornography consumption. In boys low self-esteem there was an increased risk of compulsive consumption of pornography. With higher pornography consumption, there was an increased sexual risk-taking in boys and an increased risky lifestyle in girls. The results show that boys consume more pornography with elements of violence.Conclusion: The result shows that young people get affected in their mental and sexual health by pornography consumption. With the support of the results, the school nursingProfession can contribute with knowledge about the impact of pornography on young people.

Bakgrund: Sexuell hälsa är en viktig del av folkhälsan och ses som en mänsklig rättighet. Patienter uttrycker behov av att samtala om sexuell hälsa och förväntningar finns på att få information från vårdgivare om ämnet.Syfte: Syftet med denna litteraturstudie var att beskriva patienters och vårdgivares erfarenheter av samtal om sexuell hälsa, med fokus på att identifiera förutsättningar för framgångsrika samtal och hinder för att samtalen sker.Metod: Studiens design är litteraturöversikt. Databassökning utfördes i PubMed och CINAHL. Kvalitetsgranskning och resultatanalys gjordes på utvalda studier.  Resultat: Totalt 14 kvalitativa studier ingår i resultatet. Fyra studier med patientperspektiv, åtta med vårdgivarperspektiv och två studier med både patient- och vårdgivarperspektiv. Tre huvudteman och 10 subteman identifierades. Patienter upplevde att samtalet om sexuell hälsa inte togs upp med vårdgivarna. Både patienter och vårdgivare beskrev att ansvaret för att initiera diskussioner om sexuell hälsa var vårdgivarens. Olika faktorer kunde påverka samtalet samt verktyg och resurser nämns hjälpa både patienter och vårdgivare att förbättra samtalet om sexuella hälsa.Slutsats: Samtal om sexuell hälsa mellan patienter och vårdgivare sker sällan. Otillräcklig kunskap om ämnet och tidsbrist är en del av anledningen. För att förbättra patienters erfarenheter kring samtal om sexuell hälsa behöver vårdgivare ta ansvar för att initiera samtalen, öka sin kunskap samt prioritera ämnet högre. Fler verktyg och resurser behövs för att underlätta samtalen. / Background: Sexual health is an important part of public health that can be seen as a human right. Patients express a need for conversations about sexual health and expect the health care provider to give them information about the subject. Aim: The aim of this study was to describe patients’ and health care providers’ experiences of conversations about sexual health, with a focus on prerequisites for successful conversations and barriers to them taking place.  Method: The design used in this study was a literature review. Database searches were done in PubMed and CINAHL. Quality checks and analysis of the results were done on the chosen articles. Results: Fourteen articles were included in the results. Four articles had a patient perspective, eight had a health care provider perspective and two were a combination of both. Three main themes and 10 subthemes were identified. Patients rarely experienced that health care providers started conversations about sexual health. Some patients and health care providers said that health care providers were responsible for initiating the conversation. Different factors affected the conversations and different tools and resources were suggested to help patients and health care providers improve conversations about sexual health.Conclusion: Conversations between patients and health care providers about sexual health were rarely brought up for reasons including a lack of knowledge and time for the health care providers. Health care providers need to take responsibility for initiating conversations about sexual health with patients, prioritizing the subject and increasing their knowledge. Tools and resources are needed to improve the conversations.

Background: For human beings´ sexuality is a core characteristic and in the Occupational Therapy Practice Framework sexuality is listed as an activity of daily living (ADL). Still, sexuality related issues are rarely investigated in occupational therapy and nursing. Aim: The aim was to investigate the relevance of the Quality of Sexual Function Scale (QSFS) for occupational therapists and nurses in Sweden. Methodology: Two Qualitative Focus Group Discussions (FGDs) with occupational therapists and nurses with 8 participants was done online (March 2021), recorded, transcribed and analysed with a deductive content analysis.Results: The analyses revealed five main categories that described the relevance of the QSFS; outdated wordings, heteronormative per default and definition of sex, an educational tool, needed to refine laws and break taboos and a facilitator to work with sexual health. Overall, an instrument measuring sexual health was desired and well received by the participants, however the QSFS need to be revised to adapt to accurate vocabular and embrace diversity. A revised tool may facilitate to address questions about sexuality, intimacy and expressions that are fundamental aspects of a person’s wellbeing. However, questions about sexuality should be raised by staff as a natural part of their work, without a tool. Conclusion: The QSFS is not an optimized tool to assess the quality of sexual function and needs among patients. The tool requires further development. Greater emphasis needs to be placed on policies and praxis in work-places and health care educations to address patients’ sexual expressions and needs.

Syftet med denna studie är att undersöka professionellas erfarenheter av att arbeta med sexualitet och sexuell hälsa med personer med intellektuella funktionsnedsättningar. I studien har fem yrkesverksamma personer på olika LSS-verksamheter i Malmö stad med olika yrkestitlar och bakgrund inom socialt arbete intervjuats. Eftersom studien ämnade att undersöka professionellas erfarenheter antog vi en kvalitativ ansats där vår datainsamling utgick från semistrukturerade intervjuer. Resultatet analyserades utifrån ett abduktivt förhållningssätt och vi alternerade därför mellan teori, tidigare forskningsläge och empiri. De centrala teoretiska begrepp som togs fram i relation till empirin var normer, avvikelse och stigmatisering. Vi fann även att vissa fenomen i vår empiri beskrev mer praktiska skeenden på arbetsplatserna. Dessa fenomen relaterade vi till teorier kring försvarsstrategier mot förändring och begreppet sunt förnuft. Resultatet visade en motstridighet till att arbeta aktivt med frågor som rör sexualitet och sexuell hälsa vilket hade en koppling till stigmatiserande normer om personer med intellektuella funktionsnedsättningars sexualitet. Andra anledningar till motstridigheten hade att göra med de yrkesverksammas egna erfarenheter av sexualitet och sexuell hälsa, då många uppgav att det var ett mycket privat ämne att tala om. Resultatet visade även på att en tillåtande arbetsgrupp och chef som prioriterade kontinuerlig samtalsträning i ämnet sexualitet och sexuell hälsa var framgångsrikt. Till skillnad från tidigare forskning visade våra resultat att yrkesverksamma i Malmö stad både hade tydliga riktlinjer och kunskap kring ämnet. Resultaten indikerar ett behov av att utbilda professionella kring hur man hanterar personer med intellektuella funktionsnedsättningars sexualitet och sexuella hälsa, inte bara i teorin utan också i praktiken inom socialt arbete. / The purpose of this study was to analyze the professionals experience of working with sexuality and sexual health with people with intellectual disabilities. LSS stands for “The Swedish Act concerning Support for Persons with Certain Functional Impairments''. In the study we interviewed five professionals at various LSS -workplaces in Malmö municipality, with different professional titles and backgrounds in social work. Since the study aimed to examine professionals' experience, we adopted a qualitative approach where our data collection was based on semi-structured interviews. The results were analyzed on the basis of an abductive approach and we therefore alternated between theory, previous studies and empirical data. The central theoretical concepts that were developed in relation to the empirical data were norms, abnormality and stigmatization. We also found that certain phenomena in our empirical data described more practical events in the workplace. We related these phenomena to theories about strategies of change and the concept of common sense. The results showed a reluctance to activly work with issues related to sexuality and sexual health, which was linked to stigmatizing norms about the sexuality of people with intellectual disabilities. Other reasons for the reluctance had to do with the professionals' own experiences of sexuality and sexual health, as many stated that it was a very private topic to talk about. The results also showed an example of an encouraging work group and manager who prioritized continuous conversational training in the subject of sexuality and sexual health, that was successful. Unlike previous studies, our results showed that professionals in the Malmö municipality had both clear guidelines and knowledge about the subject. Results indicate the need to train and educate professionals about handling people with intellectual disabilites’ sexuality and sexual health not just in theory but also in the everyday practice of social work.

This thesis is based on the premise that reproductive rights and environmental sustainability have synergistic interests: human population growth increases environmental impact and access to family planning triggers reduced fertility levels. Despite increasing scientific evidence indicating that the size of the global population matters for environmental sustainability, and by extension, that fulfilling reproductive rights may be beneficial for the latter, the linkages between reproductive rights and environmental sustainability have been largely understudied, ignored, and left out of environmental policy and reproductive rights agendas. Because of the complexity of this interdisciplinary field and its associated ethical questions, many researchers and policy makers have chosen to avoid this sensitive and polarizing issue altogether. However, capitalizing on these linkages could represent significant opportunity to advance the reproductive rights and environmental movements, and increase the prominence, legitimacy, and funding of global family planning services, in particular. This thesis uses an action research approach to explore the current framing of the reproductive rights and environmental sustainability linkage, study the perceptions of stakeholders of both the reproductive health and rights and environmental sustainability movements on this issue, and elaborate a strategic communication roadmap to promote its operationalisation.

Bakgrund: Forskning visar att den sexuella hälsan hos kvinnor minskar under barnafödandet och kvinnans relation till partnern förändras. Kvinnan har behov av närhet och intimitet men mindre fokus på sexuell aktivitet. Kvinnor upplever att barnmorskor saknar tid och intresse att fokusera på deras sexuella hälsa vid besöken på kvinnohälsovården. Barnmorskor upplever att de har en kunskapsbrist och känner osäkerhet kring hur frågorna ska ställas i mötet med kvinnorna. Syfte: Att beskriva barnmorskors erfarenheter av att stödja kvinnors sexuella hälsa under barnafödande. Metod: Kvalitativ innehållsanalys användes för att analysera intervjuer med åtta barnmorskor från kvinnohälsovården. Resultat: Fyra kategorier framkom: Anpassa samtalet till situationen, Stödja den fysiska processen, Stärka parets relation och Hinder som försvårar. Barnmorskors erfarenhet är att deras professionella kunskap bidrar till öppna samtal och att de stödjer genom att informera om de psykiska och fysiska förändringar som sker hos kvinnan och genom att stärka parets relation. Hinder för stödjande kan vara tidsbrist, kunskapsbrist, kvinnans fokusering på förlossningen eller att kvinnor förväntas ta egenansvar att inhämta information. Konklusion: För att förbättra stödet av kvinnors sexuella hälsa behövs mer utbildning till barnmorskor och eventuellt omorganisering av besöken för att kunna fånga upp kvinnan en längre tid efter barnafödandet.

Sexual anxiety is a prevalent issue among men who have sex with men (MSM) that negatively affects sexual satisfaction and wellbeing. However, research investigating sexual anxiety among MSM has been scarce. This descriptive phenomenological study was conducted to address knowledge gaps and identify the predominant underlying causes of sexual anxiety among non-monogamous MSM. Using purposive sampling, eleven sexually active, non-monogamous MSM were recruited for this study (N=11). Data were collected using audio-recorded, semi-structured interviews, and analyzed using Moustakas’ (1994) structured approach to data analysis in phenomenological research. Participant descriptions of their lived experiences of sexual anxiety identified six prevalent causes among MSM individuals. These included performance anxiety, fear of HIV, fear of bacterial STIs, internalized homophobia, body image dissatisfaction, and history of sexual abuse. Not surprisingly, fear of HIV was the dominant cause of sexual anxiety among most participants. Recommendations to prevent and reduce sexual anxiety among MSM are provided.

Female genital mutilation (FGM) is practiced primarily in many African countries as well as some in Asia and the Arab Peninsula; however, it also takes place elsewhere around the globe among those who migrate from countries to which it is indigenous. This study was designed (a) to investigate the prevalence of FGM among the Igbo women in the Dallas-Fort Worth (DFW) area in Texas and (b) to understand the factors that support the continuation of the practice and the effects on women's sexual health. Using a quantitative approach to examine a variety of social variables aligning with the ecological framework, survey data obtained from a sample of 139 Igbo women living in the DFW area were analyzed using a multivariate analysis. Results of the study demonstrated a decreasing prevalence of FGM from maternal incidence (46%), to second generation incidence (31.3%), and future intention for FGM (25%). Nearly half of the responding participants felt the practice was required by their religion, but over 65% felt the practice should be discontinued. Results supported a high incidence of dangerous complications to women's sexual health with the continued practice of FGM. Significant social influences associated with future intention for FGM among the population were found at the micro- and exosystem ecological levels. The findings of this research provide important information on current prevalence and health effects of FGM in Igbo women living in the DFW area. Understanding the reasons behind the culture of FGM will assist public health professionals in designing appropriate culturally-specific intervention strategies that will help to eliminate inappropriate and unsafe practices associated with FGM.

Although Provoked Vestibulodynia has a great impact on women’s relationships, including their partners, research has predominantly focused on the women. This thesis aimed to expand the knowledge regarding psychosexual health of the partner. Depressive symptoms, anxiety, sexual distress, and domains of sexual function (erectile function, orgasmic function, sexual desire, intercourse satisfaction, overall sexual satisfaction) were investigated through descriptive comparisons, correlations, and regression analyses. The sample consisted of male partners (N=53) of women with PVD, aged 20-50 years. Baseline data from a larger RCT was compared with data from external studies. Results showed that PVD partners reported similar levels of depressive symptoms and anxiety as comparison groups. However, PVD partners expressed higher levels of sexual distress, and lower levels of sexual function than comparison groups. Several domains of sexual function predicted overall sexual satisfaction, whereas depressive symptoms did not explain levels of sexual distress. However, depressive symptoms co-occurring with poorer overall sexual satisfaction and orgasmic function, explained higher sexual distress. We conclude that partners have a perceived impaired sexual health. Their impairment is localised to sexuality and not generalised to the rest of their lives. Partner involvement is integral in the treatment of PVD and should be investigated in future research.

The average age of first-time mothers is increasing, along with the incidence of sexually transmitted diseases. This indicates a low level of knowledge about fertility and an increased sexual risk-taking among young people. The aim of this study was to explore knowledge, attitudes and values about reproductive and sexual health among adolescents and young adults. An overview of the current literature was made using an integrated analysis method, including sixteen studies. The result showed an extensive lack of knowledge among young people regarding fertility, reproductive and sexual health. Many youths lacked knowledge about contraception and sexually transmitted diseases. A majority of the young people were not aware of the significance of age or the impact that sexually transmitted diseases had on their fertility. Many of the young people did however have knowledge about lifestyle factors such as smoking and diet and their impact on health. There was a positive attitude towards fertility treatments along with an overestimation of the efficiency of such treatments. The main part of the young people felt that the sex education they received was inadequate and lacked depth. It was also normative and old-fashioned. With a lack of proper education in school young people used other sources of information such as parents, friends or pornography. Young people expressed a want for easily accessible sources of information and more discussion about relations, consent and sexual abuse. More practical information was requested also. Midwives and nurses were good sources of information, a good opportunity to discuss their reproductive and sexual health was in connection with testing against sexually transmitted diseases or contraceptive counselling. In conclusion, this study showed a need for more sources of correct information regarding reproductive and sexual health that young people can easily access. Sexual education today needs to be modernized to be more inclusive to meet the needs and expectations of young people. / Medelåldern för när kvinnor föder sitt första barn har stigit, det har också förekomsten av sexuellt överförbara infektioner. Dessa fakta kan tyda på en låg kunskap om fertilitet och ett sexuellt risktagande hos unga personer idag. Syftet med studien var att undersöka vad ungdomar och unga vuxna har för kunskaper, attityder och värderingar avseende reproduktiv och sexuell hälsa. En litteraturöversikt gjordes med en integrativ analysmetod. Litteraturöversikten inkluderade sexton studier. I analysen framkom en utbredd kunskapsbrist hos ungdomar gällande fertilitet, reproduktiv och sexuell hälsa. Många ungdomar saknade kunskap om preventivmedel och sexuellt överförbara infektioner. En majoritet var inte medvetna om ålderns betydelse för fertiliteten eller hur sexuellt överförbara infektioner kan påverka fertiliteten. Många hade dock kunskap om livsstilsfaktorer som till exempel rökning och kost och dess påverkan på hälsan. I analysen framkom också en positiv inställning och övertro till fertilitetsbehandlingar. Huvuddelen av ungdomarna ansåg att den sexualundervisning de fått i skolan var bristfällig och saknade djup. Den upplevdes också som normativ och gammeldags. I brist på undervisning från skolan användes alternativa källor till information såsom föräldrar, kamrater eller pornografi. Ungdomarna efterfrågade lättillgängliga källor för information och mer diskussion om relationer, samtycke och sexuella övergrepp. Även praktisk information efterfrågades. Barnmorskor och sjuksköterskor ansågs vara bra källor i undervisningen, ett bra tillfälle att diskutera sin reproduktiva och sexuella hälsa var i samband med provtagning av könssjukdomar och preventivmedelsrådgivning. Slutsatsen från denna studie var att ungdomar behöver flera källor för korrekt information om sin reproduktiva och sexuella hälsa. Skolans sexualundervisning behöver moderniseras för att bli mer inkluderande och för att möta de behov och önskemål som finns hos ungdomar.