Although experiences are mixed, there is evidence of widespread dissatisfaction with both the quality and amount of sex education that young people receive at school (Jewell, 2000; YWCA, 2001). Almost 400 young women under 18 who completed questionnaires in one study wanted sex education to provide more detail about contraception and STIs, and to place more emphasis on feelings and relationships (YWCA, 2001). They thought sex education should start at an earlier age and be given more priority (more lessons) in the school curriculum.
Young women also argued for boys and girls to receive sex education separately, and for time to be made available for one-to-one confidential question and answer sessions While young people express concern about their sexual health, this does not always influence their behaviour. A study involving 1,500 young people found that they were concerned about STIs in general but did not necessarily consider themselves to be at risk. They were concerned about pregnancy and STIs, but it was generally the concern to avoid pregnancy that appeared to drive condom use (and the quality of condom use) (Centre for Sexual Health and Brook, 2005).
Participants who knew someone who had been diagnosed with an STI often got tested themselves but were not necessarily motivated to use condoms to protect themselves in the future. An ongoing study by NAZ Project London and the Trust for the Study of Adolescence is investigating the sexual health service and support needs of young people aged 15 to 18 years, from black and minority ethnic backgrounds, and living in Greater London. So far, 3,007 have completed questionnaires and 50 have undertaken in-depth interviews.
Findings are not yet available, but the aims of the study are to identify and explore sexual beliefs, attitudes, lifestyles and behaviours among BME youth and develop a sexual health educational resource for practitioners. Young people have been asked about the topics they would like to discuss in school and from whom they feel it would be appropriate to get information from within that setting The Youth as Partners in Health Care Sutcliffe et al (2004) set out to establish whether young children can take an active part in managing their own diabetes care, and work as partners with health practitioners.
They interviewed 24 children (aged 3 to 12) with type 1 diabetes, and 29 parents. Children and parents reported high levels of knowledge and skill and high levels of satisfaction with the care they received from specialist diabetes staff. However, interviewees were critical of the ‘severe’ lack of knowledge of non-specialist health practitioners, who were said to be unable to provide adequate and safe care. The authors conclude that practitioners need to be able to recognise and learn from the knowledge of children and their parents, and work with them as partners to provide effective care and support.
There is also evidence that children can identify their own information needs before admission for elective surgery (Smith & Callery, 2005). Nine children aged 7 to 11 years were interviewed using the ‘write and draw’ technique. Between them, the children identified 61 questions about their forthcoming admissions. These included questions about procedures, anaesthesia, timing, hospital environment, pain and feelings, family support, as well as about their own condition. The researchers concluded that children can identify their own information needs and so contribute to the development of pre-admission education.
Young People as Individuals Young people frequently stress that they want to be treated as individuals. This means not only that they want to be listened to and to be treated with respect, but that they want it to be recognised that there will be children and young people who sometimes dissent from a majority view. So while a consistent theme across the literature exist young people want to be given more information and be involved in decisions about their care, one study identified by the Children’s Voices Project found that a small number of children mentioned that they ‘preferred not to know everything’ (Boylan, 2004).
Also, although children and young people usually want to be treated alongside their peers, some children who are very ill may prefer to be separated from those who are less ill (McArthur, 2004). Not surprisingly, the evidence suggests that younger children and their older counterparts can have rather different priorities (McArthur, 2004). Effective management of pain relief is important to all children and young people, and both younger children and teenagers want to be given more and better information (McArthur, 2004; Boylan, 2004).
However, when children aged 7 to 11 years were compared with those aged 12 or over within a consultation study of more than 350 young people, somewhat different concerns arose. For those aged 7 to 11, the priorities were: help me when I’m hurting; explain treatment so I understand; make sure people looking after me agree what they should tell me; use magic cream before injections; provide a place off the ward to see family and friends; and let me see outside and get fresh air.
In comparison, the priorities for those aged 12 or over were: dedicated adolescent wards; less time waiting at clinics; more fully qualified doctors and nurses (rather than junior doctors); more activities on the ward; pain relief when I need it; and let me know what you are saying or writing about me. Boylan (2004) has further indicated that older young people are more likely to emphasise the need for privacy.
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