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Aim: This paper is a report of a study to explore how school nurses perceive the influence of schools on their role in delivering sex and relationship education in primary schools., Background: School nurses play a key role in sex education in English schools. However, sex education is a contentious issue meaning the sex education of children is often an area of tension within the curriculum. However, the impact of these tensions upon school nursing practice is poorly described., Method: Three focus groups with a convenience sample of 16 nurses experienced in conducting sex and relationship education were conducted during 2006. Focus groups were audio-taped, transcribed verbatim and subjected to a thematic analysis., Findings: Four themes were identified in the data: 'covert surveillance' refers to school staff conducting clandestine surveillance of the classroom actions of the nurse; 'overt surveillance' reflects how nurses felt they were being openly monitored by teachers in the classroom; 'Teacher attitude' refers to the interventions of the supervising teacher in the classroom during the sex education session and 'resistance practices' detailed how nurses attempted to manage the disciplinary practices of the school., Conclusion: School nurses need to be pragmatic about the fact that there will be some attempts by the school to regulate sex education. Developing an early dialogue with the school can mediate this. Closer working practices and the involvement of school nurses in the development of sex education policy and practice is vital to ensure that they continue to make a valuable contribution to sex education in schools.

Aim: This paper is a report of an analysis of the discourse about contraceptive efficacy and side effects used by nurses when prescribing contraception., Background: All women seeking contraception should be informed of the efficacy and potential adverse effects of the particular method they are considering. This information facilitates an informed choice. Women also require this information in order to monitor for any side effects. Paradoxically, side effects are also a key factor in reducing adherence with contraceptive regimens. However, there is no literature that explores specifically how this issue is addressed in clinical consultations, or places these practices in a theoretical context., Method: Forty-nine consultations between nurses and women in sexual health clinics were audio-recorded during 2002. Data were subject to a discourse analysis using Foucault's 'procedures of exclusion' to explore the discursive construction of contraceptive efficacy and side effects, Findings: The nurses employed specific discursive strategies when discussing contraception. When addressing efficacy, discourse centred on medico-statistical facts, but side effects were described in lay terms that minimized their severity. Nurses contextualized contraceptive side effects within potential problems that women might experience in pregnancy, and also attempted to 'normalize' contraceptive-related problems., Conclusion: Discourse and its deployment play a key role in practitioner-client relationships that sexual health nurses need to become more aware of how they discuss clinical issues about contraception with women. Clinical data on contraceptive side-effects are present in the literature, and it is important that sexual health nurses use this to help women make truly informed decisions.

This paper explores an under-researched issue within the reproductive health of women - the discursive construction of self-examination instruction in sexual health clinics. The study utilises Foucault's work on 'productive power', the 'practices of the self' and discourse to map out how nurses instruct contraceptive-using women in self-care practices. Forty-nine consultations in sexual health clinics were tape recorded and analysed. The data reveal how nurses utilise the discourse of risk as a technique to reinforce and develop self-care practices - a concept congruent with the Greco-Roman concept of the cura sui, the philosophical notion that one must make oneself into the object of care. Nurses build upon the notion of risk by educating women about their reproductive anatomy and physiology utilising medical texts as tools. This provides a contemporary example of the mia chora: identified by Foucault as the incitement for the individual to develop a usable knowledge of the body. Lastly, nurses instruct women in the development of a self-care regimen - the epimeleia, the development of habitual body techniques. It is proposed that this process is congruent with the Aristotelian notion of habitus, the development of body knowledge, body techniques and self-care practices necessary to pursue health.

Aim: The aim of this paper is to report a study exploring the discursive construction of contraceptive use within nurse consultations with women in family planning clinics., Background: This paper takes as its starting point the lack of a contraceptive 'strand' to the literature on the discursive construction of the female body generally, and the female reproductive system specifically, within health care practice. The literature in this field concentrates on pregnancy, menstruation and menopause, and the manner in which contraceptive use is discursively constructed is under-explored. Furthermore, the literature on nurse-women consultations in family planning clinics is also limited, with the current literature concentrating on assessing clinical skills rather than discourse., Methods: Using a grounded theory methodology to explore how nurses educate women about contraception in family planning clinic, 49 consultations were audio-taped in two large family planning clinics in the United Kingdom (UK)., Findings: Open coding and subsequent axial coding resulted in the emergence of three elements of contraceptive education. One concerned reproductive anatomy, another reproductive physiology and a third education about contraceptive functioning. These three axial codes were formed into a core category: 'body education/reproductive vulnerability'. Within the consultation, nurses linked the 'vulnerable' reproductive system with the requirement for contraceptive 'protection'. This approach seems linked to ensuring women's future contraceptive use., Conclusion: The discourse employed by nurses differs from the body discourse aimed at menopause and menstruation. These areas of women's health were constructed as disintegrating, malfunctioning and failing, whereas reproductive vulnerability suggests a fully functioning, active system, in need of restraint. However, this discourse still constructs the female body as fundamentally weak and unstable, requiring contraception to protect it and prevent transgression.

Objective: To assess the views of service users towards sexual health nursing outreach clinics situated in youth clubs. The clinics were established in economically deprived areas to meet the needs of young people aged 13-18 yrs who are reluctant to attend mainstream services., Design: Descriptive cross-sectional study. SAMPLE AND MEASUREMENTS: 250 questionnaires collecting data on service use and service users' views of the clinics were distributed to a 25% sample of clinic users. In addition, 20 semi-structured interviews were conducted with service users., Results: 166 questionnaires were returned (66% response rate). The service was equally popular with males and females who often attended to meet friends but subsequently sought sexual health advice. Interviews found that young people appreciated the non-judgmental aspect of the clinics, although some reported concerns about confidentiality when the clinics were busy. Some respondents indicated that the clinics gave them confidence to discuss sexual health matters with others, but often the clinics provided advice for young people who had no one else to talk to., Conclusions: The clinics seem popular with young people, and situating services within an area young people access to socialize appears to be an effective way to target them with sexual health advice.

The use of anti-human immunodeficiency virus (HIV) drugs after occupational exposure to HIV is a proven method of preventing some HIV infections. There is anecdotal evidence that this treatment is being used to treat recently exposed sexual contacts of HIV infection, known as non-occupational post-exposure prophylaxis (NONOPEP). This raises the issues of the impact of such treatment on sexual behavior and public health. Six hundred questionnaires were distributed to nurses working in sexual health clinics. Four hundred and six (67%) were returned. Questionnaires contained items related to awareness of HIV NONOPEP and items included attitudes related to its use. Seventy two percent of respondents were aware of HIV NONOPEP, and 17% had experience of its use in their clinic. Twenty one percent of respondents indicated that their clinic had a specific HIV NONOPEP policy. In relation to attitudes, practitioners were more positive of NONOPEP in relation to an HIV exposure within a long-term relationship than exposure within a casual relationship, indicating that the mode of HIV exposure was a factor in the justification of NONOPEP. Practitioners seemed to support the notion that HIV NONOPEP use in a casual exposure may increase the likelihood of unsafe sexual practice; however, practitioners with experience were less likely to express this view. It is suggested that an informed debate and NONOPEP policy development within all sexual health clinics will militate against judgmental views affecting access and care.