A Qualitative Study of Egyptian School Nurses’ Attitudes and Experiences Toward Sex and Relationship Education

Abstract

School nurses play a vital role in the promotion of sexual health. However, there is very limited evidence of how school nurses experience this topic in an Islamic cultural setting. Using an exploratory qualitative design, 13 in-depth interviews were conducted with Egyptian school nurses. Data were subject to thematic analysis. Four themes emerged from this analysis, "personal issues," "cultural and political dimensions," "parental issues," and "skills and confidence." These themes represented how nurses' views on sex education were tempered by personal and social forces--affecting their practice. Fear of being blamed for creating a permissive culture was a feature of nurses' concerns in this culture. The belief that sex education is morally challenging affected nurses and must be addressed to enable effective sex education to take place. School nurses must contribute actively to this debate and receive governmental support.

The emancipatory potential of nursing practice in relation to sexuality: a systematic literature review of nursing research 2009–2014

“…Farrag and Hayter () point to the gendered, moral, cultural and political location of school nurses in Egypt, where some expressed the view that it is difficult for them to interact with boys, that sex education is morally challenging and that sex education is a western import. Nash () investigated the influence that a nurse's power in her own primary sexual relationship has in her sense of self‐efficacy in promoting condom use.…”

“…Researchers point to nurses fearing being blamed for creating a permissive culture, particularly in relation to services in schools (Brewin et al. ; Farrag and Hayter ). In addition, nurses may see sexuality as too private an issue to discuss with patients, particularly outside of sexual and reproductive health settings (Zeng et al.…”

A Scoping Review to Identify Barriers and Enabling Factors for Nurse–Patient Discussions on Sexuality and Sexual Health

“…Contextual differences such as upbringing, social learning [ 11 ], media exposure, and the environment [ 12 ] also seem to foster age and gender-related differences regarding attitudes to sexual relationships. The influence of religion and culture on prevailing norms and attitudes regarding sexuality is well documented [ 13 ] and indicates that heteronormativity is common. Even in countries that rank high in terms of human rights and gender equality, the Lesbians, Gay, Bi-sexual, Trans-sexual, or Queer (LGBTQ) community report being more exposed to violence, discrimination, and lack of acceptance in specific social contexts than the rest of the population [ 14 , 15 ].…”

Abstinence versus harm reduction approaches to sexual health education: views of key stakeholders in Saudi Arabia

“…In construing harm needing to be limited, stakeholders mentioned harms to health but placed equal if not greater emphasis on detrimental effects on the reputation and social standing of individuals engaging in specific sexual practices and partnerships, and the damage to societal ties, structure and the Muslim identity. (Zaabi et al 2018;Farrag and Hayter 2014;Hasnain 2005;Mohanna et al 2017;Tabatabaie 2015) Both international guidelines and local studies rarely focus on damage to social standing and reputation, aspects which it would be essential to address in the Saudi context. These data suggest that sex education programmes which appear to accept practices which in Islamic settings are likely to bring opprobrium on the actor will face obstacles to delivery in Saudi Arabia.…”

“…Religious scholars can be difficult to recruit and may withhold disclosing personal views on sex education for fear of public reaction. The majority of research within MENA region that explores the need for sex education usually focuses on presenting the opinions of adolescents' and parents' views, while shying away from capturing the voices of government personnel in relation to sexual health matters who may have a direct impact on formulating and implementing any possible sex education programme (Zaabi et al 2018;Alquaiz et al 2012;Mohanna et al 2017;Farrag and Hayter 2014). Success in recruiting and engaging these participants may have been partly attributable to the background of the interviewer, a clinically trained Saudi national.…”