Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / A dissertação visa compreender os sentidos atribuídos à sexualidade e ao gênero no cotidiano de uma unidade de saúde da família do município do Rio de Janeiro. Por meio do método etnográfico foram observadas as interações dos diferentes sujeitos no contexto do serviço e, especificamente, as situações relativas a planejamento familiar, assistência à gestação, saúde da mulher e do adolescente. Também foram registrados os modos como se processam as conversas e transmissões de conhecimento concernentes a identidade de gênero, relações sexuais e temas relativos. O estudo evidenciou que a atuação dos profissionais de saúde não se apoia apenas em seu saber, em sua subjetividade e nas relações estabelecidas com seus pares e com os usuários, está também implicada com os valores em jogo no território. A análise aponta que uma concepção hegemônica de gênero informa os limites discursivos do campo e delineia a produção do cuidado, orientando o acolhimento de demandas e a programação de ações no campo da saúde reprodutiva e sexual.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The object of this study consists of repercussion of the intestinal stoma by cancer in promoting women's sexual health. The investigation about promoting sexual health of women with stoma becomes challenging due to the condition imposed by surgery, in interface with the social, historical and cultural constructs related to the social roles that may influence the way women promote their sexual health. This research had the following objectives: to know the biological, psychological and sociocultural aspects before and after performing the definitive intestinal stoma in women; to analyze the repercussions of the stoma in promoting women's sexual health, and to propose nursing care strategies to women with stoma to self-promote sexual health, considering the Nola Penders Health Promotion Theory. It is a qualitative approach research, whose subjects are fourteen women with definitive intestinal stoma, after they were affected by cancer. The theoretical-methodological reference used was Nola Penders Health Promotion which, from the identification of the biopsychosocial and behavioral factors, seeks to stimulate healthy attitudes, with a view to well-being as proposal for health promotion. The setting was the Municipal Rehabilitation Center Oscar Clark, located in the municipality of Rio de Janeiro. For data production, the semi-structured interview technique was carried out using a pre-established script, based on Nola Pender diagram. The content analysis of the accounts obtained allowed the classification in three categories: a) sociocultural, psychobiological and behavioral profile of women with stoma: a pre- and post-surgery characterization; b) knowledge, influences and feelings of the woman with stoma on promoting sexual health after the surgery; c) result of behavior for the promotion of sexual health after the stoma: a process in progress. The factors to determine the behavior to promote sexual health involved the biological conditions, especially as a consequence of the side effects of the radiation therapy, in addition to a complex process surrounded by social factors, including the stigma, the gender inequalities, and the power relationships, among other values to guide the human behavior. The changes experienced required women to develop strategies to face the new situation with the need for behavioral adaptations to life and promotion of sexual health. Such adaptations reflected an occasional learning, at experienced persons level, which went through lack of guidance on health issues and sociocultural issues. Therefore, the experience of sexuality was considered the main obstacle for the promotion of sexual health. In turn, the behaviors towards the prevention of chronic conditions to sexual health were noticed as actions that offer most benefits. In this scenario, the nursing appointment becomes a relevant instrument in clinical and educational assistance. This study contributes for a deeper knowledge on the sexual health promotion for women with stoma and indicates proposals for the participation of the nurse in the assistance to these persons. / O objeto deste estudo são as repercussões do estoma intestinal por Câncer na promoção da saúde sexual de mulheres. A investigação sobre a promoção da saúde sexual da mulher com estoma torna-se instigante frente à condição imposta pela cirurgia, em interface com os constructos sócio-histórico-culturais relacionados aos papéis sociais, os quais podem influenciar na forma como as mulheres promovem sua saúde sexual. Esta pesquisa teve por objetivos: conhecer os aspectos biológicos, psicológicos e socioculturais anteriores e posteriores à confecção do estoma intestinal definitivo em mulheres; analisar as repercussões do estoma na promoção da saúde sexual de mulheres; e propor estratégias de cuidar de enfermagem às mulheres com estoma para autopromoção da saúde sexual, considerando a Teoria de Promoção da Saúde de Nola Pender. Trata-se de uma pesquisa com abordagem qualitativa, tendo como sujeitos 14 mulheres com estomia intestinal definitiva, após terem sido acometidas por Câncer. O referencial teórico-metodológico utilizado foi a Promoção da Saúde de Nola Pender, o qual, a partir da identificação dos fatores biopsicossociais e comportamentais, busca incentivar atitudes saudáveis, visando ao bem-estar como proposta de promoção da saúde. O cenário foi o Centro Municipal de Reabilitação Oscar Clark, localizado no município do Rio de Janeiro. Para a produção dos dados foi realizada a técnica de entrevista semiestruturada, utilizando um roteiro pré-elaborado, com base no diagrama de Nola Pender. A análise de conteúdo dos discursos obtidos permitiu criar três categorias: a) perfil sociocultural, psicobiológico e comportamental de mulheres com estoma: uma caracterização antes e após a cirurgia; b) conhecimentos, influências e sentimentos da mulher com estoma sobre a promoção da saúde sexual após a cirurgia; c) resultado do comportamento para promoção da saúde sexual após o estoma: um processo em construção. Os fatores determinantes do comportamento para a promoção da saúde sexual envolveram as condições biológicas, especialmente em decorrência dos efeitos colaterais da radioterapia, além de um processo complexo permeado por fatores sociais, incluindo o estigma, as desigualdades de gênero, as relações de poder, dentre outros valores que norteiam o comportamento humano. As mudanças experienciadas requereram das mulheres o desenvolvimento de estratégias de enfrentamento à nova situação, com a necessidade de adaptações comportamentais para a vivência e promoção da saúde sexual. Tais adaptações refletiram em um aprendizado pontual, da ordem do vivido, o qual perpassou pela falta de orientação em saúde e pelas questões socioculturais. Com isso, a vivência da sexualidade foi considerada a principal barreira para a promoção da saúde sexual. Já os comportamentos direcionados à prevenção de agravos à saúde sexual foram percebidos como as ações que mais proporcionam benefícios. Neste cenário, a consulta de enfermagem apresenta-se como um instrumento relevante na assistência clínica-educativa. Este estudo contribui para um aprofundamento do conhecimento acerca da promoção da saúde sexual de mulheres com estoma e sinaliza propostas para a atuação do enfermeiro na assistência a essas pessoas.

Estudos sobre a relação masculinidades-saúde tem apontando para a permanência de visões essencialistas sobre o sexo e desafios no que diz respeito aos direitos sexuais e reprodutivos, assim como para a dificuldade de se incluir homens nas práticas de cuidado em saúde devido às representações sociais do masculino e ao direcionamento dos serviços para mulheres e crianças. A implantação e implementação da \"Política Nacional de Atenção Integral à Saúde do Homem\" (PNAISH) no Brasil trouxe como desafio o reconhecimento das desigualdades de gênero vivenciadas pelos homens e de suas necessidades de saúde. Nesse sentido, compõe-se como justificativa para este trabalho a necessidade de se investigar como o homem tem sido contemplado institucionalmente em relação à sexualidade e reprodução. Assim, constitui-se como corpus da pesquisa o documento-base da política, documentos vinculados à construção da PNAISH e materiais desenvolvidos a partir desta, bem como publicações relacionadas à sexualidade e reprodução de homens nas páginas \"Saúde do Homem - Ministério da Saúde\" e \"Secretaria Municipal da Saúde de São Paulo\" em rede social. Por meio da análise de conteúdo, a discussão esteve amparada pelos pressupostos dos Estudos de Gênero e pelo pensamento foucaultiano. Buscou-se a compreensão de discursos que orientam a PNAISH: à que homens esta se dirige e como a política busca direcionar ações em saúde ao tratar da sexualidade e reprodução. Observou-se que a política reflete representações sociais, apresentando muitas das diferenças e desigualdades de gênero existentes. A sexualidade em seu sentido mais amplo é pouco abordada, observando-se ênfase dada à prática e potência sexual. Ainda, apesar de esforços, não houve plena incorporação de discursos de responsabilização igualitária nas questões reprodutivas e de parentalidade, estando ainda presentes visões sobre os homens como figuras de apoio. São necessárias ações que trabalhem as resistências a maiores liberdades e igualdades sexuais e reprodutivas? A PNAISH ainda precisa de maior aproximação das necessidades, diversidade de relações e desigualdades existentes / Studies about the masculinity-health relationship have pointed to the persistence of essentialist visions about sex and challenges regarding sexual and reproductive rights, as well as the difficulty of including men in health care practices due to the social representations of the masculinity and the direction of the services for women and children. The implantation and implementation of the \"Brazilian Comprehensive Healthcare Policy for Men\" (PNAISH) in Brazil has brought as a challenge the recognition of the gender inequalities experienced by men and their health needs. In this sense, the justification for this study is the need to investigate how man has been contemplated in sexuality and reproduction institutionally. Thus, is constituted as corpus of the research, the official text of the policy, documents related to the construction of the PNAISH and materials developed from it, as well as publications related to sexuality and reproduction of men in the Facebook pages \"Health of Man - Ministry of Health\" and \"Municipal Health Department of São Paulo \". Through content analysis, the discussion was supported by the theories of Gender Studies and Foucaultian thinking. We sought the understanding of discourses that guide the PNAISH: to which men this is directed and how politics seeks to direct actions in health when dealing with sexuality and reproduction. It was observed that the policy reflects social representations, presenting many of the existing gender differences and inequalities. Sexuality in its broadest sense is not too much discussed in the documents, with an emphasis on sexual act and potency. Yet, despite efforts, there was no full incorporation of egalitarian accountability discourses on reproductive and parenting issues, and visions about men as support figures are still present. Still are needed actions that work the resistance for greater sexual and reproductive freedoms and for equality. The PNAISH still needs to approximate more to the needs, to the diversity of existing relationships and to the inequalities

Bakgrund: Forskning visar att homo- bi- och/eller transsexuella ungdomar inte alltid får relevant sexualundervisning som är kopplad till deras sexuella läggning. Studier visar även på att homo- bi- och/eller transsexuella ungdomar har ett riskbeteende när det kommer till sex, att dessa ungdomar hämtar information från pornografin. Homo- bi- och/eller transsexuella ungdomar är i större utsträckning påverkade av alkohol eller droger när de har sexuellt umgänge. Dessa ungdomar upplever även utanförskap och vågar inte tala om sin sexualitet, vilket kan resultera i att de utsätter sig för risk att skada sig själva. Syfte: Att undersöka det stöd som homo- bi- och/eller transsexuella ungdomar får gällande sexuell hälsa från skola och skolsköterskor. Metod: Studien hade en kvantitativ ansats, den genomfördes som en enkätstudie som skapades via Google Form och kunde nås via en länk. Enkäten hade totalt 17 stycken frågor, 15 stycken med fasta svarsalternativ och 2 stycken öppna. Resultat: Ungdomar var mest negativt inställda till skolsköterskans bemötande kring sexuell hälsa och sexuella frågor vilket berodde på skolsköterskans heteronormativa synsätt. Många av homo- och bisexuella ungdomar ansåg att skolan var en viktig del i att kunna erbjuda rätt information om sexuell hälsa. Vissa ungdomar sökte information på egen hand och visste inte ens att de kunde samtala med skolsköterskan om sexuella hälsa. Slutsats: Skolsköterskan behöver ha mer kunskap för att kunna bemöta ungdomar som identifierar sig som homo- bi- och/eller transsexuella och inte ha ett heteronormativ inställning samt anpassa miljön inne på mottagning som bidrar till öppen klimat för homo- bi- och/eller transsexuella ungdomar. / Background: Research shows that LGBT youth do not always receive relevant sexual education linked to their sexual orientation. Studies also show that LGBT youth have a risk behavior when it comes to sex, that they get their information from alternative sites that also includes pornography. LGBT youth are more likely to be influenced by alcohol or drugs when they have sexual intercourse. LGBT youth experience exclusion and dare not to talk about their sexuality, which may result in the risk of harming themselves. Aim: The purpose is to investigate the support that gay and transgender youth receive regarding sexual health from school and school nurses. Method: The study had a quantitative approach, it was conducted by a survey that was created through Google Forms and could be accessed through a link. The survey had a total of 17 questions, 15 questions with fixed options and 2 were open.   Results: Young people were most disadvantaged to the school nurse's concerns about sexual health and sexual issues, which was due to the heteronormative approach by the school nurse. Many of the LGBT youths considered that school was an important part of being able to offer proper information on sexual health. Some young people searched for information on their own and did not even know that they could talk to the school nurse about sexual health.   Conclusion: The nurse needs more knowledge to be able to approach adolescence who identify as LGBT and not have a heteronormative attitude as well as adapt the environment at the reception that promotes open climate for LGBT youths.

This research addresses how transnational Filipino youth living in southwestern British Columbia negotiate their sexual lives and sexual health decisions, and how they do so within the context of individual, familial, and community dynamics. The research explores how youth contest and negotiate notions of sexuality that are discursively constructed and constituted through familial expectations, religious ideals, peer expectations and pressure, societal expectations, and sexual education curricula. Sexual subjectivities are shaped by the social and geographic locations individuals inhabit. My interviews with youth explored dynamic ways in which these youth enacted their sexual lives in the context of their position as transnational Filipino youth, and in turn how their positions as transnational Filipino youth interacted with and impacted their sexual subjectivities. I argue that while opinions and expectations of friends and family, as well as cultural norms and religious expectations impact youth's sexual subjectivities, youth nonetheless perceive themselves as the primary decision-makers in their sexual lives. This research shows dynamic ways in which youth enact their agency and control their sexual decisions and sexual lives. This research was conducted between August 2016 and March 2017 in southwest British Columbia (BC) in two main locations, the Southern Vancouver Island (SVI) region and the Vancouver/Greater Vancouver Area (GVA). I conducted a series of in-depth, semi-structured interviews and engaged in informal personal engagement activities (i.e. "deep hanging out") with ten transnational Filipino youth between the ages of 19 and 25 who live and study at the post-secondary level in SVI. I also conducted interviews with adult community members, experts in the sexual health field, scholars working with Filipino youth, and staff from migrant youth organizations in SVI and the GVA. / Graduate

Syftet med denna studie är att belysa hur äldres sexuella hälsa beaktas på äldreboenden. Samt att titta närmare på omsorspesonalens attityder kring sex och hur de påverkar den äldre brukarens välmående. Det är framför allt viktigt för de äldre men även för personalens framtida arbetssätt. Som enhetschef är det viktigt att känna till hur personalens värderingar påverkar arbetet med den äldre. Genom att använda teorierna ålderism och skam så är syftet att se om åldersdiskriminering förekommer kring frågor om sex inom äldreomsorgen. Teorier om skam används som teoretiska glasögon för att förstå de inre processer som frågor om sex kan väcka hos den äldre och personalen. Studien är en litteraturstudie och ett försök att göra en kunskapsöversikt över frågor kring den äldres sexulaitet på äldreboenden kopplat till personalen och samhällets attityder. Den huvudsakliga litteratur som ligger till grund för arbetet är vetenskapliga artiklar innehållande kvalitativ- och kvantitativ forskning. Artiklarna har gallrats enligt en systematisk litteraturstudie modell (Friberg 2017).Resultatet visar att forskning visar på att sexualitet kan spela en viktig roll för att äldre ska uppnå en god hälsa. Äldres sexualitet är ett tabubelagt ämne och äldre tenderas att diskrimineras pga. sin ålder. Mer kunskap behövs inom ämnet för att bidra till mer positiva attityder gentemot äldres sexuella hälsa och för att de äldre ska våga uttrycka sin sexualitet utan skam och obehag. Resultatet har delats upp i olika teman som framkommit ur de tio artiklar vi har läst. De teman som vi kommer att belysa i den här uppsatsen är äldres inställning till sex, attityder hos personal, attityder hos anhöriga samt samhällets attityder till äldres sexualitet. / The purpose of this study is to shed light on how the sexual health of the elderly is taken into account in nursing homes. And to take a closer look at the care staff's attitudes towards sex and how they affect the elderly user's well-being. It is above all important for the older and also for the staff's future working methods. As a unit manager for a nursing home, is it important to know how the care staff's values colours the work with the eldery person. By using the theories of Ageism and Shame, can we have a closer look and see if age discrimination occurs around issues of of the elderis sexual health in the nursung homes,.. Shame Theories as theoretical glasses can help us understand the internal process and feelings of the eldery. The study is a literature study and an attempt to make a knowledge overview of questions about the elderly's sexuality in nursing homes linked to the staff and society's attitudes. The main literature on which the work is based is scientific articles containing qualitative and quantitative research. The articles have been chosen according to a systematic literature study model (Friberg 2017). The results show that research shows that sexuality can play an important role for the elderly to achieve good health. Elderly sexuality is a taboo subject in both elderly care and in society. More knowledge is needed in the subject to help more positive attitudes towards the sexual health of the elderly and for the elderly to dare to express their sexuality without shame and discomfort. The results have been divided into four different themes: attitudes of staff, attitudes of relatives and society's attitudes to the sexuality of the elderly.

Bakgrund: Många barn kommer i kontakt med pornografiskt material under sin uppväxt. Pornografi är lättillgängligt och kan påverka beteenden, kroppsideal och föreställningar av sexualitet. Det kan problematiseras utifrån hälsa, jämställdhetssynpunkt och Sexuell och Reproduktiv Hälsa och Rättigheter (SRHR). Arbetet med SRHR sker både inom skolan och hälso- och sjukvård. Det finns behov av att prata om pornografi inom det hälsofrämjande arbetet med barn, där skolsköterskan har en viktig roll. Motiv: Tydliga riktlinjer kring hur skolsköterskor bör adressera ämnet saknas. Genom att beskriva skolsköterskors uppfattning kring att prata om pornografi kan en djupare förståelse fås för de behov, utmaningar och möjligheter som finns och därmed kan en förståelse erhållas för hur arbetet kan utvecklas. Syfte: Beskriva skolsköterskors uppfattning av att prata om ämnet pornografi i sitt hälsofrämjande arbete. Metod: Semistrukturerade intervjuer genomfördes med nio skolsköterskor inom grundskolan. Kvalitativ innehållsanalys användes för att analysera den insamlade datan. Resultat: Skolsköterskorna upplevde det viktigt att prata om pornografi med barn. Att våga prata, vara lyhörd, respektfull och inge förtroende lyftes som viktiga egenskaper för att få barnen att känna sig bekväma i samtalen. Skolsköterskorna ville förmedla en medvetenhet kring ämnet, såsom kritiskt förhållningssätt samt förmedla en annan bild av sexualitet. Det fanns svårigheter i när och hur ämnet skulle börja pratas om. Ett behov av ökad kunskap i ämnet och förståelse för vad barnen möter lyftes. Det upplevdes finnas behov att prata om ämnet kontinuerligt, och samverkan med andra kunde utgöra antingen ett hinder eller en tillgång. Konklusion: Att prata om ämnet pornografi med barn är känsligt och komplext men sågs som viktigt utifrån professionen. Ämnet kan bemötas på olika sätt men det behövs mer kunskap, kontinuitet och god samverkan. Utformning av evidensbaserade arbetsmodeller för samtal om pornografi skulle kunna minska osäkerheten bland skolsköterskorna. / Background: Many children encounter pornography during their childhood. Pornography is easily accessible and may affect behaviours, body ideals and ideas in relation to sexuality. This can be problematised from a health, gender equality and SRHR (sexual and reproductive health and rights) perspective. The work with SRHR is carried out within schools and healthcare, where the school nurse plays an important role. Motive: There is an absence of guidelines on how school nurses should address pornography. By describing school nurses’ perceptions about talking about pornography, a deeper understanding about the existent needs, challenges and opportunities can emerge and enable an appreciation on how to improve the work. Aim: To describe school nurses’ perceptions regarding talking about pornography within their health promoting work. Methods: Semi-structured interviews with nine school nurses were conducted. The data was analysed using qualitative content analysis. Result: The school nurses expressed that it was important to talk about pornography with the children. Courage, confidence, being careful and respectful, was described as valuable qualities in making the children feel more comfortable when discussing pornography. The school nurses wanted to convey a critical approach to pornography, and reveal a different view of sexuality. However, determining when and how the subject should be brought up proved difficult. The school nurses expressed a need for increased knowledge and understanding regarding children's experiences online, as well as a need to address the subject regularly. Cooperation with other professionals in the school could either be an obstacle or an asset. Conclusion: Talking about pornography is complex and sensitive, but it was thought of as important within the profession. The subject can be addressed in different ways but an increased knowledge, continuity and cooperation is required. A formation of evidence based working models for talking about pornography could decrease insecurity among school nurses.

Le cancer est désormais considéré comme une maladie chronique touchant une population toujours croissante. Une prise en charge et un suivi à long terme, à l’origine d’un bouleversement de la vie des patients et de leur entourage, semblent nécessaires et sont susceptibles d’initier une réorganisation du système de santé. Dans ce travail de thèse interdisciplinaire, nous nous sommes intéressés à l’impact du cancer sur le vécu psychologique et psychosocial des patients en France, en choisissant le modèle du cancer de la prostate. Pour cela, nous avons souhaité combiner deux études. L’une portait sur l’état de santé sexuelle des patients atteints d’un cancer de la prostate via une approche quantitative descriptive basée sur les données représentatives des enquêtes nationales VICAN. L’autre visait à déterminer l’impact du cancer de la prostate sur le couple et sa qualité de vie via une approche compréhensive qualitative complémentaire, focalisée sur une prise en charge en Surveillance Active et basée sur des entretiens semi-directifs de patients et de leurs conjointes. L’analyse des données a permis de montrer une détérioration de la santé sexuelle des patients, selon différents déterminants non nécessairement médicaux, et un endommagement du couple et des relations affectives perçues, avec des stratégies d’ajustements divergentes pour chacun des membres du couple, malgré une prise en charge initialement considérée comme optimale et indemne de conséquences. Une approche pluridisciplinaire pourrait permettre un accompagnement complet des couples pour une amélioration de leurs vécus, de leur bien-être et de leur qualité de vie / Cancer is now considered as a chronic disease affecting an ever-increasing population. Long-term care and follow-up, which are responsible of lives disruptions on patients and their relatives, seem necessary and likely to initiate health system reorganization. In this interdisciplinary thesis work, we focused on the impact of cancer on the psychological and psychosocial experiences of patients in France, by choosing the prostate cancer model. To do this, we decided to combine two studies. One aimed on the sexual health status of prostate cancer patients through a descriptive quantitative approach based on data representative of VICAN national surveys. The other one concentrated on the impact of prostate cancer on the couple and its quality of life through a complementary comprehensive qualitative approach, focused on Active Surveillance management and based on semi-directive interviews of patients and their spouses. The data analysis showed deterioration in patients' sexual health associated to several factors, which are not necessarily medical ones, and damages in the couple and perceived affective relationships, with divergent coping strategies for each member of the couple, despite a care management initially considered as optimal and free of consequences. A multidisciplinary approach could help couples to improve their experiences, well-being and quality of life

Bakgrund: Flera faktorer påverkar sexuell hälsa bl a biologiska och fysiologiska faktorer samt genus. Genus i sin tur påverkas av samhällets värderingar som i sin tur styrs av dess historia, politik, kulturella värderingar, ekonomiska förutsättningar mm. Tidigare studier har visat att det finns en brist i kunskapsbildning och uppföljning av kvinnors sexuella hälsa åren efter förlossning. Avsikten med denna studien är att få ökad insikt i kvinnornas upplevelse av sin sexuella hälsa åren efter förlossning. Syfte: Att sammanställa tidigare forskning kring kvinnors upplevda sexuella hälsa åren efter förlossning, genom forskningsfrågan: “Hur upplever kvinnor sin sexuella hälsa upp till sju år efter förlossning?” Metod: Detta är en kvalitativ litteraturstudie och inklusionskriterierna var tidigare friska kvinnor utan patologiska graviditeter, samt kvinnor som fött barn med episiotomi och kejsarsnitt. Däremot exkluderades tvillingfödslar och spontana sfinkterrupturer av grad 3-4. Studien avser åren efter förlossning, max sju år. Sexuell hälsa åren efter förlossning ur kvinnans perspektiv skall vara huvudfokus. Artiklarna ska vara på engelska eller svenska och de ska vara publicerade från 1960 till 2020. Tolv artiklar valdes ut och dessa granskades via latent kvalitativ innehållsanalys. Resultat: Visar att många kvinnor lider av en försämrad sexuell hälsa åren efter förlossning. Detta beror på flera faktorer, de som påverkar mest är: fysiska förändringar, amning, barnets påverkan, relationernas förändring och kvinnornas upplevelse av sjukvårdens bemötande. Dessa presenteras i studiens fyra teman. Konklusion: Kvinnorna upplever en försämring av sin sexuella hälsa och önskar ökat stöd från vården. Det krävs en bredare kunskap hos vårdpersonalen för att kunna bemöta kvinnornas önskemål och en fördjupad förståelse kring hur genus påverkar kvinnors sexuella hälsa. / Background: There are several factors that affect women's sexual health, among those are biological and physiological wellbeing and gender. Furthermore gender is derived from society’s values that comes from history, politics, socio-economic prerequisites among other things. Previous studies have shown a lack of knowledge and a lack of follow-up of women’s sexual health the years after childbirth. The purpose of this study is to get a deeper understanding of women’s experiences of their sexual health the years after childbirth. Aim: The aim of this study is to compile previous studies about women's experienced sexual health up til seven years after childbirth. This is done through the question “How do women experience their sexual health the years after childbirth?” Method: This is a qualitative literature review that contains twelve articles. The inclusion criteria is previous healthy women with no pathological pregnancies, women who experienced episiotomy or cesarean section during childbirth. However, twins and spontaneous sphincter tears of the 3de or 4th degree have been excluded. This studies scope is limited to the first seven years after childbirth. The articles are written in swedish or english and published between 1960- 2020. Latent content analysis is used to analyse the material. Result: Many women experience a loss in sexual health the years after childbirth. It depends on several different things such as physical changes, breast feeding, the impact of having a child, changes in relationships and how women experience the meeting with health care. All of this is presented through the four themes of our study. Conclusion: There is a general loss in sexual health among women after childbirth and they wish for better support from health care professionals. To meet this demand healthcare professionals need more knowledge and to actually apply it. Furthermore, a deeper understanding how gender affects women’s sexual health is needed.

Bakgrund: Sexuell hälsa utgörs av fysiskt, känslomässigt, psykiskt och socialt välbefinnande. Sjuksköterskan har som uppdrag att främja sexuell hälsa. Depression och ångest är faktorer som kan påverka kvinnors sexuella hälsa. Syftet: Syftet var att beskriva hur sexuell hälsa påverkas hos kvinnor med depression och ångestsyndrom. Metod: Litteraturöversikt med mixad metod användes. Eftersom syftet var förutsättningslöst utfördes studien med induktiv ansats. Till resultatet användes 14 artiklar som granskades, analyserades och presenterades med huvudkategorier och underkategorier. Artiklarna hämtades från tre databaser; Pubmed, Cinahl och psycINFO och genom manuell sökning. Resultat: Huvudfynd i litteraturöversikten utgjordes av fysiska förändringar i form av lägre sexuell tillfredställelse, lust, orgasm och upphetsning. Huvudfynd bestod även av ett påverkat känsloliv och påverkad relationen med partnern. Slutsats: Resultatet visar att kvinnor kan ha lägre sexuell funktion vid depression och ångest. Både fysiska och psykosociala faktorer påverkas hos kvinnorna där några av faktorerna är tillfredsställelse och lust. En viktig del i personcentrerad omvårdnad är ömsesidig respekt för varandras kunskap. / Background: Sexual health consists of physical, emotional, mental and social well-being. The nurse has the task of promoting sexual health. Depression and anxiety are factors that can affect women’s sexual health. Aim: The aim was to describe how sexual health affects in women with depression and anxiety syndrome. Method: Mixed literature review was used. Since the purpose was unconditional, the study was performed with an inductive approach. Where 14 articles were used that have been reviewed, analyzed and presented with main categories and subcategories. The articles were retrieved from three databases: Pubmed, Cinahl and psycINFO and by manual search. Results: The main findings in the literature review consisted of physical changes in form of lower sexual satisfaction, desire, orgasm and arousal. The main findings also consisted of an affected emotional life and an affected relationship with the partner. Conclusion: The results show that woman have lower sexual function in depression and anxiety. Both physical and psychosocial factors are affected in women, where some of the factors are satisfaction and desire. An important part in person-centered care is mutual respect for each other´s knowledge.