The adoption of my professional practice to further develop my role as a sexual health adviser
In accordance with WHO (World Health Organisation), sexual health is considered to be a complete emotional, mental, physical and social being. These all variables relate to sexuality. This issue of paramount importance is never to be simply considered as the infirm, dysfunction or disease. The requirement of the sexual health approach is not only to be positive, but also to be respectful towards sexuality as well as sexual relationships. It also manifests the requirement of possible, safe and pleasurable sexual experiences, free from violence, discrimination and coercion.
Purpose of the assignment
Over more than two and half decades sexual health, across the world, has been considered as one of the crucial areas of health care as a global epidemic, subjecting rapid spread of sexually transmitted diseases like HIV. This pandemic phenomenon has caused all the health practitioners, think tanks and governments to create awareness, surrounding issues of sexual health, Miller and Green (2002). All the stakeholders of this area of public health management have taken the matter in a very serious way. As I am also one of the stakeholders of this serious issue, I need to also contribute to the public awareness program through this research paper.
For properly addressing to the need of the hour, I am not only discussing the theories by eminent scholars on this subject, I am also incorporating my practical experiences in this field through my delivery care responsibilities attached in this arena.
If I want to express my intention, by correlating with my competence in this important area of discussion, I need to first emphasise that for attaining and maintaining sexual health, the sexual rights of all individuals need to be fully respected, fulfilled and protected, which are in line with the vision of WHO (2002). In this reflective essay, I am discussing about focusing on sexual health, the importance of promotion of sexual health among teenagers. I must also highlight about the need of different intervention levels, policies on sexual health, strategies and related theories of sexual health.
Aim of this essay
As a nursing practitioner and an aspiring student, I want to highlight the formal views of family planning association, in the context of sexual health. The association defines sexual health not only as the capacity, but also as the freedom of enjoying and expressing sexuality without repression, fear of exploitation and emotional and physical harm (FPA, 2007). According to Department of Health, since the rates of STI are rising, the rates of terminations are also following suit (DH, 2008). This is the indication about addressing to both of these dangerous issues, which need immediate attention. The highlights of HPA (2008) emphasises on the people’s self-protection in regards to the unplanned pregnancy and also about STIs, while envisaging importance to the promotion of sexual health.
Justification of the relevance of my practice development and my service delivery—the “so what factor”
Who am I? My practice area
What I am going to write about?
A brief overview in regards to the promotion of sexual health among the young women and men in the UK is my prime focus area. The justification of my focus area is supported by the valid documents and facts. According to the health records, released by the DH (2010), UK records worst public health conditions. The records reveal that STIs that include HIV are increasing very rapidly, mainly from teenage pregnancies, supplemented by the increase of different types of sexual violence. Due to this hard fact, there is the need for emphasizing on the promotion of sexual health among the younger group.
Clarifications of my terms of concepts
What I exclusively want to highlight is reducing the STIs among the teenaged girls and boys, which has been the discussion points of DH (2010). The Department of Health has the serious concerns for the unwanted pregnancies among the teenage girls in the UK, which even lead to STIs. Different researches have also penned down their concerns about influencing the attitudes of the young boys’ and girls’ exploration of sexual behaviours. This vulnerable group has also resorted to negotiating about contraception and their influences on the peer groups, spread across the world, beyond their homeland in the United Kingdom (Widdice et al. 2006). As per my in-depth study of the subject as a professional nursing practitioner, many reports say about the high rate of sexually transmitted diseases are continuously increasing in the country, especially among the young population. The alarming situation is men are indulging in sex with men. The population of some the ethnic minority is found to have transmitted the disease like STIs, as has been studied by Miles (2006). My area of study focuses on the young men and women between 14 and 24 years of their ages. Due to the fact that these teenagers are very much accounted for their STIs, unwanted pregnancies and in the background the sexual violence is growing on in alarming rates.
Evidence of critical appraisal, Evaluation and synthesis of useful literature
The urgent need for focusing on the sexual health promotion’s significance has prompted me to take up this research study. By this research, I want to educate the society, especially the teenagers and reduce the menace of STIs and unwanted pregnancies. As a health care provider, I want to educate the young population across the world, with special emphasis on the UK teenagers. I completely base on the accurate and complete information, which are in fact supported by the medical fraternity’s accepted standards. By going on with the views of Santelli (2008), all medical fraternity must stick to the professional standards, subjecting to the public health and medical ethics, as are guided by the professional health bodies. As per the available preventive medicines’ guidelines for the STIs, HIV and undesired pregnancies, the delivery of the support system must consider the inclusion of the counseling on the uses of contraceptives and condoms. It must not be doubted that recognizing the evidence based medicines are on the rise. Medical practices are also experiencing a wide range of variations, which lead to the proper judgment in determining the patient care. The information from the AMA (2009) suggests that the proper awareness program should be in place which can support the clinics, in addition to the extension of the counseling to the parents of the teenagers.
Justification of concepts & parameters
Sexuality undoubtedly plays a vital role in any one’s quality of life, health and also in the general well being. As said, it is an inseparable factor of any total person, which can invariably affect the personality and quality of life to every single person. The realization of the sense of healthy sexuality of sex can lead to countless benefits. The benefits may include the linkage between the present and the future by means of procreations, which is, according to Norbun and Rosenfeld (2004), related to physical release, physical pleasure and feelings of connections with others, leading to a contributory factor of self-identity.
Identification of the main issues affecting my decision focus
As per the sincere studies on the subject, teenagers pass through different emotional, mental, physical and social changes. Among all these change factors, the most important one is their onset of puberty or onset of sexual maturity. For the girls, this period of life starts with attaining the age 10-14 and for the boys it is 12-16. During this period of life, the body of the either sex passes through constant changes, triggering their inquisitiveness about the sex and the related physical anxieties. At this stage of their life, they are prone to developing their own unique opinions and personality. The significant changes they usually experience include additional concerns about their self-image, independence from the family circle, their concerns about their clothes. The peer influences cast a dominant psychological impact on their choice of right and wrong with greater thrust. To accord with Medline plus (2011), all of these vital issues may sometimes be found to overwhelm them.
Legal aspects, connected with the sexual health promotion’s delivery systems
As per the historical evidences, there were confusions about the legal responses which could create the balancing act between providing the people the right to avail the support systems of sexual health problems. The UK’s legal structure is divided between criminal and civil laws. Enough teeth in the legislation became the stumbling block by placing the boundaries, as workers engaged in health care had to face the legalities, in regards to promoting sexual health to the public. The Human Rights Act was introduced in 2000 for providing health care and impacting on the individual’s rights, Human Rights Act (2000).
People’s sexual behavior was governed by the criminal law of the country, as the law barred some of the activities as unlawful. The legislation’s purpose was to put some breaks on some types of sexual activities, while preventing some types of exploitations. The legislation was aimed at providing the young as well the teenagers with the skills, knowledge and also the confidence for resisting any pressure, which could have caused unwanted or early sexual relationships, resistance to encounter any inappropriate sexual advance or so on. Instead, the legislation helped this vulnerable group to manage themselves, in regards to their sexual health.
The legislation was also helpful for the young people in the UK, as they could use it for discussing about the sexual relationships and over and above sex, which could practically develop their self-awareness and self-esteem. The other aim of this legislation was allowing young minds to reconnoiter their attitudes and values.
What changes I want to make in my practice and/or service delivery as a result of my investigation from this module
I want to encourage young people in the UK to practice on the informed decisions, in regards to their personal relationship, behavior and sexual health. They are also expected to get indulged in the healthy discussions on sex and relationship, as suggested by Mellor and Williams (2005), so that they can develop their own self-awareness and self-esteem.
Theoretical perspectives of Sexual health promotions
According to different theories, any individual’s protections like the use of condoms and other means of contraception depends on the individual’s predisposition towards STI infections or pregnancy, followed by the severity of the occurrence of the disease like HIV or STI. This can also be the result of the self-protection related implementation, as opined by (Abraham and Sheeran 2005). To accord with the views of Norman et al. (2005), the model of motivational theory is a rather complex one. The model has many components like response costs, perceptions of severity, social approval and pleasure. The model also fathoms the belief that the behavior is aimed at reducing the self-efficacy and threat, (Norman et al. 2005). A person’s belief is denoted by self-efficacy, as it can be successful to perform the suggested behavior.
On the other hand, planned behavior theory is a complex one. Conner and Norman (2005) suggest that the control of the perceived behaviour of an individual indicates that the person thinks that his/her behaviour is within the control, and hence, connected to his/her autonomy or efficacy. Conner and Norman (2005) further inform that there are several factors, such as skill and information, within perceived behaviour.
The theory of social cognition is individual’s motivation focused and also action based, in which three variants of expectancy rule the roost. The variants are perceived self-efficacy, action outcome and situation outcome. Since the theories are deemed as complex, they require in-depth study, before their practical use. As per the recommendations of NICE (2007), the trained health care professionals should make use of the theories in such a structured discussion that the client and the practitioners are engaged in one-to-one situation.
How will it improve the client/patient/ user’s experience?
Fool-proof strategical approach needs to be mooted by imparting guidance and education to the youth mothers and by reminding them about the danger of life-time social elimination. The HIV and sexual health related national strategy have agreed to the fact that the consequential effects of humble sexual health can result to the severity of terminations of unwanted pregnancies. A number of key indicators, attached with the strategy, must include the increased number of accesses to sex related health services, exclusively targeting the young people. Screening for Chlamydia must be increased and so accepted by the young people. As per the suggestions of DH (2001), provision of accessing to the clinics, providing Genito-Urinary Medicines should be within 48 hours. The legal age, as on date, of the young people consenting to sex is as low as 16. The person may be bisexual, gay or even straight. This needs to be addressed to by the legal luminaries and legal authorities. If we can amend the sexual offence act, came into being in the year 2003, which is already 15 years old, so seem to be in need of realigning with the need of the day. The interests and the rights of the young people, although protected by this law, it is not for those people who force or pressurise others to get indulged in sex without their own consent. Since the law (2003) permits the consenting age of a young must be as low as 16, the law does not allow the prosecution of sexual activities by the same age young or teenagers, if not it becomes a case of exploitation or abuse. According to Mellor and Williams (2005), there must be a system of advising those teenagers who are just 13 and in serious need of the ill effects of sex, abortion, pregnancy, condoms and over all contraception.
Although, sex education is imparted in the school education systems, it must not be confined within the classroom instructions. As a health practitioner, my thrust area is, the health education must be practiced in homes also. The main reason is, in the classrooms neither the tutor can express 100% nor the student comprehend it fully about the Ps and Qs of sex education. So this gap needs to be plugged in by imparting the same lessons at home. It may look awkward, but the parents have the equal responsibilities in regards to sex education to their wards.
I also envision that, by the reinforcement and supplementation of the lessons being imparted in the classrooms, the teachers do set the healthy sex educational stage for the students and that too for their life time. Different factors like loneliness and curiosity, peer pressure and many such other psychological and emotional factors drive the teenagers to the menace of sexual activity.
The teenagers need to be taught that many ways are there to initiate intimate or affectionate talks, such as holding hands, long walks, dancing, listening to music, hugging, touching or even kissing.
For the parents
In case the ward is sexually active, whether the ward likes or not, the conversation about the sex education must go on. A parent must not hesitate to express the feelings with openness and honesty. The parents are supposed to convey the message that the ward (he/she) must understand the consequences of sex with responsibilities and seriousness. The parents must also stress about the safe sex, while making sure the teen(s) can understand the meaning and use of contraception. The issue is tricky, but result oriented, if conveyed with tricks and tact. By rightly conveying about safer sex, contraception or abortions, a parent can save a child from STIs or pregnancy. It is also necessary that the parents must set the reasonable and logical boundaries
Parents can advise the teen (either he or she) to undergo routine check-up. By doing so, the teenager can open up about the sexual behavior or sexual activity, provided the atmosphere is confidential, supportive. The practice can also help the ward in learning about safe sex and contraception. A gynecologist can also stress on the vaccination of HPV (human papilloma virus), which is useful for knowing about the prevention of cervical cancer and genital warts (MFMER, 2009).
A critical awareness and evaluation in the sexual health advice within the public health agenda
Since it is the truth that we have failed to fully inculcate the knowledge of safe sex among the teenagers, we have no excuse to accept the fact that we are some way or other are responsible for unplanned teenage pregnancies STIs and other related issues. As a practitioner, I must assert that there are the needs of significant changes, which is achievable by well thought of endeavours, reaching the young generation to their aspects of own-ness, providing young generation with the right knowledge, which can have the useful values, so that they can get focused and duly attended. They should be also provided with a strong platform of self-preservation and self-esteem, as a priority. This is only possible, as suggested by HPA (2008), if the professional’s mind is unbiased, open and non-judgmental and can deliver in a friendly and relaxed atmosphere.
Over a decade, the UK government has initiated a number of educational programs, in which young people are supported as the individuals, while it is also seen that they can improve their idea and/or position about sexual health. But unfortunately, some trained staffs in some schools do not agree to the implementation of the strategies, which becomes the stumbling block, DH (2005), at the time of communicating with the teenagers or with the young people. The education, regarding sexual relationships, should be imparted by the confident as well as up-to-date professionals. They must use straight forward language, which can result to an indication of awareness among the pupils. In the views of Ingham et al (2009), there must be sufficient availability of sexual health clinics for these young people, in addition to the confidentiality factors, binding the relation between the service giver and the service recipient.
For the teenagers, the sexual health campaigns have been changed from the condom’s uses or condom related educative campaigns to a new dimension. The new campaign is targeted to improving both the knowledge base and open communication based encouragement, which is connected with the sexual relationships and the targeted audience are professionals, parents and the young people DH and DCSF (2009).
With a view to removing the shackles of caring for the sexual health, health education which can fully address to the needs of care giving clinics and sexual health related discourses. As discussed above, many studies have proved that human sexual related training along with the case studies of sexual abuses or cases of STIs can bring down the number of unwanted pregnancies among the teenagers. On the other hand the education and awareness programs can reduce the incidences of the menace of teenage pregnancies, Nussbaum and Rosenfeld (2004), in addition to improving the overall sexual health.
We must not ignore one important issue that teenagers’ sexual health promotion is very crucial issues for all. Political, cultural and social factors can jeopardise the effective communications among the young people and health professionals. The proper interventions from all walks of the society, including parents, educators, professionals, media, government and the internet can do the most needed services for saving this vulnerable group of our society.
Recommendations for future work
Having discussed all the above points at length, it is prerogative to recommend some important points for the future research works. The future researches not only should look into the prevailing gaps in the overall systems in the UK, they must also research on the other important issues, which can help the academicians, practitioners and the society as a whole.
The issues for further researchers are to look for practical concerns. UK is principally a patriarchal society. The country has the vulnerability of gender imbalance, which is susceptible to societal negative imbalance. The paradoxical role can be observed in the UK when it matters about the sexual health provision. The contraceptive clinics largely target young females. The reason behind this is ascribed to the country’s political system, which is prone to protecting any negative outcomes of the unplanned pregnancies, as viewed by Evans (2008). As on records, teenage pregnancies are on the rise in the UK. This is not all, in every passing year, the rate of increase of these menace is highest among all the European countries. With these true facts, the future researches must concentrate on the two issues, the first one is bringing down the teenage conceptions, especially among the age group of 18 and the other one is parents education must be the important point to get rid of these crying needs of the society. Although, DCSF (2010) claims that their goals were somehow achieved by the combined efforts of the private sector, media and government.
One more important issue can be researched upon in the future. The adaptability of health promotion program should be researched in an innovative way. The innovative ways must include different methods, which should include expressions, feelings, opportunities for the young peoples’ embodiments of self-esteems.