Sexual health matters! learning for life: mapping client need and professional sexual health education for nurses in England

Sexual health matters! This motif underpins the entire thesis. With survey responses from university educators and focus group encounters with clinical professionals undertaking the UK-wide Sexual Health Skills course, the study explores ways in which specific discourses pertaining to sexual health and illness inform the need for, and provision of, professional education for nurses in England. Through using a Foucauldian ‘lens’ and a novel process called crystallisation in sexualities and gender epistemologies (S&GE), it was possible to shed new light on some old problems hindering nurse education. The methodologies facilitated a discursive engagement between the power / knowledge of sexual health sciences (scientia sexualis), the orthodox ‘regimes of truth’, and various silenced voices. The silenced voices pertain to wider, socially and clinically ‘invisibilised’, needs of clients or patients in relation to the provision of nurse education. Set against the backdrop of England's first ever Government strategies on teenage pregnancy, sexual health and HIV, statistics on narrow definitions of sexual ill-health are still considered the worst in western Europe. Nurses acknowledge these poor facts, and witness to additional neglect related to sexual well-being in the wider, holistic, domains of a person's life, health and relationships. Respondents recount a lack of formal sexual health education in pre- and post qualifying curricula, including incidents of critical, experiential, ‘on the job’, learning which are capped and thwarted by clinical and educational staff who are unable and / or unwilling to explore the full learning potential through reflection and analysis of practice. Respondents acknowledge how their professional education frequently ill-equips them to deal with requirements in practice as well as newer, public health, demands on their roles to increase preventative education and effective health promotion. This thesis gives them a voice in expressing such concerns. The outcome of this work has led to the conceptualisation of a model of ‘learning for life’ across a curricular triptych for professional education which supports client care. Panels of this triptych relate to the foundational or holistic dimensions of sexual health matters; ancillary aspects secondary to other health conditions, and finally, the specifics, those formally defined in epidemiology and strategies of sexual ill-health and associated stigmas. Whether someone qualified twenty-five years ago or within the last three months, the quality and quantity of formal sexual health learning across the curricular triptych model remains negligible and incommensurate with clinical demands on professional nursing care