The teaching of sexuality in Undergraduate Nursing courses: a systematic literature review

Beraldi, Mariana Lectícia; Paranhos, Will; Garcia, Olga Regina Zigelli; Horta, Ana Lucia de Moraes

doi:10.1590/interface.230310

Mariana Lectícia Beraldi mlberaldi@hotmail.com

Pós-graduanda do Programa de Enfermagem (Doutorado), Escola Paulista de Enfermagem, Universidade Federal de São Paulo (Unifesp). Rua Botucatu, 740, Vila Clementino. São Paulo, SP, Brasil. 04023-062.

https://orcid.org/0000-0002-2730-7331

Will Paranhos williamroslindoparanhos@gmail.com

Pós-graduande do Programa de Pós-Graduação em Educação (Doutorado), Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.

https://orcid.org/0000-0003-4454-4272

Olga Regina Zigelli Garcia olga.regina@ufsc.br

Departamento de Enfermagem, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina. Florianópolis, SC, Brasil.

https://orcid.org/0000-0002-3636-8822

Ana Lucia de Moraes Horta ana.horta@unifesp.br

Departamento de Saúde Coletiva, Escola Paulista de Enfermagem, Unifesp. São Paulo, SP, Brasil.

https://orcid.org/0000-0001-5643-3321

mlberaldi@hotmail.com

williamroslindoparanhos@gmail.com

olga.regina@ufsc.br

ana.horta@unifesp.br

Authors’ contribution

All authors actively participated in all stages of preparing the manuscript.

Conflict of interest

The authors have no conflict of interest to declare.

Editor

Roseli Esquerdo Lopes

Associated editor

Josefina Leonor Brown

Translator

Félix Héctor Rigoli Caceres

Protocol	Description
Conceptual framework	Sexuality refers to the interaction of aspects such as sex, sexual identities and gender roles, sexual orientations, eroticism, pleasure, intimacy and reproduction, inherent to psychological, social, economic, political, cultural, legal, historical, religious and spiritual issues1.
Context	Human sexuality featuring in undergraduate nursing curricula.
Languages	English, Portuguese and Spanish.
Inclusion criteria	Studies carried out between January 2013 and September 30, 2022 (date of search). Studies within the scope of the research. Type of document: article of any kind. Studies that refer to undergraduate generalist nursing.
Exclusion criteria	Duplicate studies. Studies that do not cover the scope of the research. Studies which, in the end, only indicate the need to include human sexuality in curricula. Articles in repositories. Studies in other languages. Other types of documents.
Databases searched	Scopus, Web of Science, LILACS and PubMed.

Databases	Keywords	Results
Scopus	(nurse OR nursing) AND (“pre licensure” OR student* OR bachelor OR baccalaureate OR pupil) AND (curricula OR curriculum OR curricular) AND (“sex education” OR sexuality OR sexual OR sex OR “sexual health” OR “reproductive health”)	181
Web of Science	(nurse OR nursing) AND (“pre licensure” OR student* OR bachelor OR baccalaureate OR pupil) AND (curricula OR curriculum OR curricular) AND (“sex education” OR sexuality OR sexual OR sex OR “sexual health” OR “reproductive health”)	166
LILACS	(estudante OR universit) AND (graduaç) AND curricul* AND (enferm* OR nursing OR nurses) AND (ti:sex* OR sexualidade OR “educação sexual”)*	10
PubMed	(“nursing”[MeSH Terms] OR “nursing”[All Fields] OR “nursings”[All Fields] OR “nursing”[MeSH Subheading] OR “nursings”[All Fields] OR “nurse”[All Fields]) AND (“pre licensure”[Text Word] OR “student”[All Fields] OR “graduat”[All Fields] OR “undergraduat”[All Fields] OR (“bachelor”[All Fields] OR “bachelor s”[All Fields] OR “bachelors”[All Fields]) OR (“pupil”[MeSH Terms] OR “pupil”[All Fields] OR “pupils”[All Fields] OR “pupil s”[All Fields]) OR (“baccalaureate”[All Fields] OR “baccalaureates”[All Fields])) AND (“reproductive health”[Text Word] OR “sex education”[MeSH Terms] OR “sex”[Title] OR “sexual*”[Title] OR (“sexuality”[MeSH Terms] OR “sexual behavior”[MeSH Terms]) OR “sexuality”[Title] OR “sexual health”[MeSH Terms] OR “sexual and gender minorities”[MeSH Terms]) AND (“curriculum”[MeSH Terms] OR ““curriculum”[”[Title] OR ““curricula”[”[Title] OR ““program education”[Title] OR “program educational”[Title] OR ““degree education”[Title])	78
Total	435

Authors	Títle	Year	Journal
Aaberg V²	The state of sexuality education in baccalaureate nursing programs	2016	Nurse Education Today
Agramonte del Sol A¹⁴	Enfoque interdisciplinario de la salud reproductiva y sexual en la formación de enfermeros universitarios en Cuba	2013	Revista Cubana de Enfermería
Aguiar FAR et al.¹⁵	Vocational training and sexual assault against women: challenges for graduation in nursing	2020	Escola Anna Nery
Aslan F et al.¹⁶	Turkish nurse educators knowledge regarding LGBT health and their level of homophobia: a descriptive–cross sectional study	2019	Nurse Education Today
Bell LM et al.¹⁷	Learning about culturally humble care of sexual and gender minority patients	2019	Teaching and Learning in Nursing
Bosse JD et al.⁴	Integrating sexual minority health issues into a health assessment class	2015	Journal of Professional Nursing
Braun HM et al.¹⁸	The LGBTQI health forum: an innovative interprofessional initiative to support curriculum reform	2017	Medical Education Online
Burkey DF et al.¹⁹	Infusing LGBTQ cultural competency into nursing curriculum	2021	Nurse Education Today
Burton CW et al.⁵	Queering nursing curricula: understanding and increasing attention to LGBTQIA+ health needs	2021	Journal of Professional Nursing
Cappiello J et al.⁸	Systematic review of sexual and reproductive health care content in nursing curricula	2017	Journal of Obstetric, Gynecologic, and Neonatal Nursing
Clever K et al.²⁰	Current approaches to the integration of sex- and gender-specific medicine in teaching: a qualitative expert survey	2020	Journal of Medical Education
Cornelius JB et al.²¹	Examination of lesbian, gay, bisexual, and transgender health care content in North Carolina schools of nursing	2017	Journal of Nursing Education
Hickerson K et al.³	Sexual orientation/gender identity cultural competence: a simulation pilot study	2018	Clinical Simulation in Nursing
Souza FTP et al.²²	Interface between women’s health and violence in the training of nurses in Brazil	2021	Investigación y Educación en Enfermería
Kim M et al.²³	Development and evaluation of simulation-problem-based learning for sex education	2016	Computers, Informatics, Nursing
Lim FA et al.²⁴	Lesbian, gay, bisexual, and transgender health: fundamentals for nursing education	2013	Journal of Nursing Education
Lima ACS et al.²⁵	Gênero e sexualidade na formação de enfermeiros no ensino superior público brasileiro: estudo documental	2021	Revista de Enfermagem do Centro-Oeste Mineiro
Magalhães BC et al.²⁶	How is violence themed in nursing education? Curricular components in Northeastern Brazil	2022	Journal of Interpersonal Violence
Maley B et al.²⁷	A writing assignment to address gaps in the nursing curriculum regarding health issues of LGBT+ populations	2019	Nursing Forum
Maruca AT et al.²⁸	Using simulation with nursing students to promote affirmative practice toward the lesbian, gay, bisexual, and transgender population: a multisite study	2018	Nursing Education Perspectives
McCann E, Brown M²⁹	The needs of LGBTI+ people within student nurse education programmes: a new conceptualisation	2020	Nurse Education in Practice
McDowell A, Bower KM³⁰	Transgender health care for nurses: an innovative approach to diversifying nursing curricula to address health inequities	2016	Journal of Nursing Education
McEwing E³¹	Delivering culturally competent care to the lesbian, gay, bisexual, and transgender (LGBT) population: education for nursing students	2020	Nurse Education Today
McNiel PL et al.³²	Advocacy and awareness: integrating LGBTQ health education into the prelicensure curriculum	2018	Journal of Nursing Education
Morris M et al.³³	Training to reduce LGBTQ-related bias among medical, nursing, and dental students and providers: a systematic review	2019	BMC Medical Education
Nietsche EA et al.³⁴	Nursing training for care to the homosexual and bisexual population: students’ perception	2018	Revista Baiana de Enfermagem
Paiva EM et al.³⁵	Sexualidade e infecções sexualmente transmissíveis: análise da formação de alunos da área da saúde	2021	Revista de Pesquisa Cuidado é Fundamental Online
Petry S et al.³⁶	The said and the unsaid in the teaching of sexually transmitted infections	2021	Acta Paulista de Enfermagem
Petry S et al.³⁷	Approaching sexually transmitted infections in a nursing undergraduate curriculum	2021	Revista da Escola de Enfermagem da USP
Pratt-Chapman ML³⁸	Implementation of sexual and gender minority health curricula in health care professional schools: a qualitative study	2020	BMC Medical Education
Rosser BRS et al.³⁹	Tailoring a sexual health curriculum to the sexual health challenges seen by midwifery, nursing and medical providers and students in Tanzania	2022	African Journal of Primary Health Care & Family Medicine
Saus-Ortega C et al.⁴⁰	Contents of the sexual and reproductive health subject in the undergraduate nursing curricula of Spanish universities: a cross-sectional study	2021	International Journal of Environmental Research and Public Health
Sheinfeld L et al.⁴¹	Assessing abortion coverage in nurse practitioner programs in Canada: a national survey of program directors	2016	Contraception
Sherman ADF et al.⁴²	Transgender and gender diverse health education for future nurses: students’ knowledge and atitudes	2020	Nurse Education Today
Tsai LY et al.⁴³	Assessing student nurses’ learning needs for addressing patients’ sexual health concerns in Taiwan	2013	Nurse Education Today
Tsai LY et al.⁴⁴	Undergraduate nursing education to address patients’ concerns about sexual health: the perceived learning needs of senior traditional four-year and two-year recurrent education (RN-BSN) undergraduate nursing students in Taiwan	2014	Nagoya Journal of Medical Science
Yang H-C⁴⁵	What should be taught and what is taught: integrating gender into medical and health professions education for medical and nursing students	2020	Research and Public Health

Contents
Anatomy, physiology and biological aspects²^,⁸^,²⁰	Chronic diseases and sexuality²^,³^,⁸^,¹⁷^,¹⁹^,²⁰^,²⁸^,⁴⁴
Sexual and reproductive health²^,⁸^,¹⁴^,²²^,²⁵^,⁴⁰^,⁴⁴	Drugs and sexual behavior⁴⁰
Sexual violence against women¹⁵^,²²^,²⁶	Heteronormativity⁵^,³⁴^,⁴⁵
Sexuality at different stages of life⁴⁰^,⁴⁴	Basic concepts about genders⁵^,¹⁸^,²⁰^,⁴⁵
Components of sexuality⁴⁰	Advanced concepts about genders⁵^,²⁹^,⁴⁵
Human sexual response and sexual function²^,⁸^,⁴⁴	Concepts about affective-sexual diversities/orientations⁵^,⁴⁴
Mental health and sexual health³⁸^,⁴⁴	LGBTIAP+ and queer health care²^-⁵^,¹⁶^-¹⁹^,²¹^,²⁴^,²⁶^,²⁸^-³⁰^,³²^,³⁸^,⁴⁴^,⁴⁵
Sexual disorders and dysfunctions²^,⁴⁰^,⁴⁴	Cultural competence and humility in LGBTIAP+ and queer healthcare³^-⁵^,¹⁷^-¹⁹^,²⁷^-²⁹^,³¹
Expression of love and attraction⁴⁴	Gender equality⁴⁵
Body image related to intimacy⁴⁴

[1] Source: Adapted from Paranhos, Willerding e Lapolli¹¹.