The role of perceived stress in the relationship between sexual communication, health literacy, and quality of life in women diagnosed with cervical cancer.

BackgroundSexual health literacy is essential for improving communication about sexual health, especially among married nursing students. Emotional intelligence may play a significant role in facilitating this communication by mediating the relationship between sexual health literacy and sexual communication self-efficacy.ObjectiveThis study aimed to examine the relationships between sexual health literacy, emotional intelligence, and sexual communication self-efficacy among married nursing students and assess the mediating role of emotional intelligence.MethodsA cross-sectional study was conducted with 340 married female nursing students at the Faculty of Nursing, Tanta University, Egypt. Data were collected using validated scales for sexual health literacy, emotional intelligence, and sexual communication self-efficacy. Statistical analyses were performed, including t-tests, ANOVA, Pearson correlation, and mediation analysis via the PROCESS macro (Model 4). Bias-corrected bootstrapping with 5,000 resamples was applied to test for the mediating effects of emotional intelligence.ResultsThe results revealed no significant differences in sexual health literacy, sexual communication self-efficacy, or emotional intelligence across demographics. Pearson correlations demonstrated that sexual health literacy was positively correlated with sexual communication self-efficacy (r = .388, p < .01) and emotional intelligence (r = .560, p < .01). Mediation analysis showed that emotional intelligence significantly mediated the relationship between sexual health literacy and sexual communication self-efficacy (B = 0.04,). The effect of sexual health literacy on sexual communication self-efficacy was significant (B = 0.19, p < .001), with emotional intelligence accounting for a portion of this relationship.ConclusionThis study highlights the importance of sexual health literacy in promoting effective communication about sexual health. Emotional intelligence plays a key mediating role, suggesting that enhancing both sexual health literacy and emotional intelligence could improve sexual communication self-efficacy among married nursing students. These findings suggest potential interventions to integrate emotional intelligence training into sexual health education programs to enhance communication outcomes.Clinical trial numberNot applicable.

Background Health literacy is a priority for health policy. However, there is limited research on how health literacy influences sexual health, particularly among men who have sex with men (MSM). Aim To review sexual health literacy research among MSM in high-resource countries (UK, Canada, USA, Australia). Methods We searched relevant databases (MEDLINE, Embase, Health and Psychosocial Instruments, Web of Science) to identify research which examined sexual health literacy and MSM explicitly and implicitly (using formal and informal articulations of health literacy) along with a set of sexual health and MSM terms. Relevant articles were identified, coded and assessed to illustrate the range of evidence available. Results We found no studies explicitly focusing on sexual health literacy, and three exploring health literacy. Findings highlight the need for tailored information, healthcare and promotion for different groups of MSM, variable health literacy levels, and the importance of social context. We found 611 articles that implicitly explored sexual health literacy. We analysed a sub-sample which focused on interactive health literacy (negotiating, applying knowledge and interaction). There was a strong focus on communication and negotiation (verbal, non-verbal and online) with sexual partners and health providers, and the varying contexts within which these interactions take place. Discussion We found no research on explicit sexual health literacy with MSM. Clinic-based interventions could use health literacy as a tool to improve sexual health. Findings suggest that tailored health information, communication skills, and the role of social context in shaping sexual health literacy skills could play a critical role.

Existing literature suggests that sexual health literacy may influence sexual function by enhancing sexual satisfaction and other dimensions of sexual health. This study aimed to investigate the effect of sexual health literacy on sexual function, mediated by sexual satisfaction and sexual self-efficacy, among Iranian women. A cross-sectional study was conducted using structural equation modeling (SEM) with 431 eligible women of childbearing age recruited from health centers in Asadabad city, Hamadan, Iran, from 2023 to 2024 through convenience sampling method. Data were collected using several tools: demographic and obstetric information form, sexual health literacy for adults (SHELA) questionnaire, female sexual function index (FSFI), sexual self-efficacy questionnaire (SSE), and the inventory of sexual satisfaction (ISS). Structural equation modeling was performed using IBM SPSS AMOS version 23. The mean ± SD age of the participants was 31.92 ± 7.24 years. The direct effects of sexual health literacy, sexual self-efficacy, and sexual satisfaction on sexual function were significant (P < 0.001). The indirect effect of sexual health literacy on sexual function, mediated by sexual satisfaction, was also significant (P < 0.001). Overall, the total effect (direct and indirect) of sexual health literacy on sexual function was deemed appropriate, and the proposed conceptual model demonstrated a good fit with the data (χ2/df = 3.35; CFI = 0.966; IFI = 0.967; GFI = 0.951; AGFI = 0.904; RMSEA = 0.070). Based on these findings, sexual health literacy has both direct and indirect effects (mediated by sexual satisfaction) on sexual function. These results may guide professionals in the field of marital relationships to recognize the importance of sexual health literacy and to develop educational or counseling interventions aimed at improving sexual health literacy, ultimately enhancing sexual function.

Adolescent pregnancy in Thailand and globally remains a major public health issue, often leading to significant health and social consequences. Among adolescents outside the formal education system, low levels of sexual and reproductive health literacy contribute to poor decision-making and increased risk of unintended pregnancy. Targeted, culturally sensitive interventions are essential to bridge these gaps and reduce associated hardships. This study aimed to evaluate the sexual health literacy of Thai female adolescents in non-formal education, focusing on their knowledge levels, decision-making processes, and barriers to accessing accurate sexual health information and services. A mixed-methods sequential explanatory design was used. Quantitative data were collected between November 2021 and September 2022, and qualitative data between December 2022 and August 2023. Multi-stage random sampling was used to select 270 participants aged 15-19 from non-formal education programs, yielding a final sample of 200 after excluding incomplete data (response rate = 74.07%). The qualitative phase involved semi-structured interviews with 30 participants who scored low on the sexual health literacy assessment. Information was gathered through semi-structured interviews to explore their knowledge and decision-making process. Descriptive statistics were used to analyze the quantitative data, and thematic analysis was used to analyze the qualitative responses. Participants demonstrated moderate overall sexual health literacy (M = 97.73, SD = 16.91). Decision-making regarding sexual practices scored the highest (88.79%), while access to health information and services scored the lowest (54.72%). Thematic analysis revealed four major themes: 1) The need for supplemental sexual education beyond formal classrooms, 2) Widespread misconceptions and reliance on unreliable contraceptive information sources, 3) Limited access to sexual health services for adolescents, and 4) The decision-making process prior to selecting a contraceptive method. There is a clear need for targeted, comprehensive sexual health literacy programs that improve adolescents' knowledge, communication skills, and understanding of contraception. Engaging mothers and other female relatives as key influencers, along with the involvement of nurses and youth-friendly service providers, is essential. These initiatives should focus on preventing high-risk behaviors, delaying sexual initiation, and reducing unplanned pregnancies, especially in underserved non-formal education contexts.

Young refugees often have limited access to sexual health information and resources in their places of resettlement. However, there is currently little research examining differences in sexual health literacy between young refugee men and women. Consequently, this study employed qualitative research methods to better understand sexual health literacy, sources of information and perceived barriers to access across groups of refugee men and women between the ages of 18 and 24 years old. Three focus groups and 12 interviews were conducted with 25 refugee men and women living in the metropolitan Atlanta area. Both men and women appeared to have limited knowledge about sexual health. School was their primary source of information; women also talked with their parents, whereas men preferred to reach out to teachers, peers and online sources. For both groups, barriers to access included language difficulties and lack of money, insurance and transport. Men also stressed concerns about confidentiality, whereas women focused on shame and embarrassment when discussing sexual health. Overall, study findings emphasise the need for sexual health education as part of resettlement services. Moreover, programmes need to be independently designed for men and women to address gender differences in sexual health literacy and concerns.

BackgroundDespite the importance of health literacy and the self-care skills in improving individual and social health and health costs reduction, scientific evidence indicates women’s poor awareness of self-care needs and low health literacy concerning reproductive and sexual health in most societies. The present study was conducted to specify the effect of health awareness promotion on self-care needs and reproductive and sexual health literacy of newly married women.MethodsThis randomized controlled clinical trial was conducted on 64 newly married women aged 15–45 in Tehran, Iran from August 2021 to the end of December 2021. The participants were randomly assigned into the intervention (n = 32) and control (n = 32) groups. The intervention group received four individual health awareness-promotion education sessions. The reproductive and sexual self-care needs, and sexual health literacy questionnaires, were completed before and 4-week after the intervention through interview. The data were analyzed using SPSS26 software. The independent t-tests and ANCOVA were used to comparison the mean scores and a significance level of P < 0.05 was considered.ResultsThe results of this study indicated that after counseling, the average overall score of perceived reproductive and sexual self-care needs significantly decreased in the intervention group [Mean (standard deviation(SD)): 125.70 (24.70)] compared to the control group [Mean (SD): 87.1 (23.42)][P = 0.001]. Also, the mean score of sexual and reproductive health literacy significantly increased in the intervention group [Mean (SD): 125.50 (14.09)] compared to the control group [Mean (SD): 97.15 (14.90)] after intervention [P = 0.01].ConclusionsThe results indicated the positive effect of health promotion awareness educations on reproductive and sexual self-care needs and health literacy among newly married women. Therefore, health promotion interventions should be incorporated in health services provision programs for newly married women in comprehensive health centers to improve the health of women and families.Trial registrationIranian Registry of Clinical Trials (IRCT): IRCT20171007036615N7 Date of registration: 2021-09-21. URL: https://fa.irct.ir/trial/58597.

Background: Adolescent pregnancy is one of the major public health issues globally, as well as in Thailand. Sexual health literacy (SHL) has been a proved effective intervention for preventing teenage pregnancy. The objective of this study was to evaluate the effects of mobile messages to improve sexual and reproductive health literacy among secondary school female students.Methods: A comparative cross-sectional study with pre–post design was conducted in two secondary schools of rural Thailand.128 respondents were selected through a simple random sampling method; equal number of female secondary school students were selected from each school. Health education through mobile messages on sexual and reproductive health literacy were delivered in one group while the other group was observed through routine care for 24 weeks. Baseline (pre) and endline (post) measurement was taken to compare the effects of mobile messages. Study was ethically approved by the institutional review board of Chulalongkorn University, Thailand.Results: Both groups were same at baseline and found statistically non-significant (p>0.05). After the 24-week health education program, the mean scores of health education groups was found statistically significant (p<0.05), while the mean score in observed group did not show any statistical change (p>0.05) . Level of sexual health literacy scores among female students in the health education group was found statistically significant (p<0.05) in all four domains. While, the observation group was remained same at both measurements pre and post (p=0.521).Conclusion:The study concluded that the mobile messages have proved an effective information method for sexual and reproductive health information among female secondary students of rural Thailand.

Background: Adolescent pregnancy is one of the major public health issues globally, as well as in Thailand. Sexual health literacy (SHL) has been a proved effective intervention for preventing teenage pregnancy. The objective of this study was to evaluate the effects of mobile messages to improve sexual and reproductive health literacy among secondary school female students. Methods: A comparative cross-sectional study with pre-post design was conducted in two secondary schools of rural Thailand. 128 respondents were selected through a simple random sampling method; equal number of female secondary school students were selected from each school. Health education through mobile messages on sexual and reproductive health literacy were delivered in one group while the other group was observed through routine care for 24 weeks. Baseline (pre) and endline (post) measurement was taken to compare the effects of mobile messages. Study was ethically approved by the institutional review board of Chulalongkorn University, Thailand. Results: Both groups were same at baseline and found statistically non-significant (p>0.05). After the 24-week health education program, the mean scores of health education groups was found statistically significant (p<0.05), while the mean score in observed group did not show any statistical change (p>0.05) . Level of sexual health literacy scores among female students in the health education group was found statistically significant (p<0.05) in all four domains. While, the observation group was remained same at both measurements pre and post (p=0.521). Conclusion: The study concluded that the mobile messages have proved an effective information method for sexual and reproductive health information among female secondary students of rural Thailand.

Young people from culturally and linguistically diverse backgrounds experience barriers accessing sexual and reproductive health (SRH) information and care. This systematic review, utilising a pre-determined protocol, performed according to PRISMA guidelines, explored SRH knowledge, attitudes and information sources for young (16–24 years) culturally and linguistically diverse background people living in Australia, to gain understanding of their sexual health literacy. CINAHL, Embase, MEDLINE, PubMed and Scopus were systematically searched with inclusion criteria applied to 216 articles. After title and abstract screening, backward/forward searching, and full-text review of 58 articles, 13 articles from eight studies were identified. Thematic analysis, guided by core constructs from cultural care theory, identified three themes: (1) SRH knowledge varied by topic but was generally low; (2) young people’s attitudes and beliefs were influenced by family and culture; however, ‘silence’ was the main barrier to sexual health literacy; and (3) Access to SRH information was limited. To attain sexual health literacy and equitable access to culturally-congruent and responsive SRH information and care, there is a need for theory-informed strategies and policies that address the diverse social, cultural and structural factors affecting young culturally and linguistically diverse background people, especially the ‘silence’ or lack of open SRH communication they experience.

Purpose Health literacy among patients is crucial for effective stroke management. The European Health Literacy Survey Questionnaire is a theory-based measure that comprehensively captures 12 domains of health literacy. We aimed to develop a computerized adaptive test of the European Health Literacy Survey Questionnaire to efficiently assess health literacy among patients with stroke. Materials and methods The European Health Literacy Survey Questionnaire data of 311 patients and item parameters were retrieved from a Rasch validation study. Real data simulations were performed to develop a computerized adaptive test of the European Health Literacy Survey Questionnaire and explore its efficiency and reliability. Results The computerized adaptive test of the European Health Literacy Survey Questionnaire displayed suitable reliability in all 12 domains (0.72–0.84) with a mean test length of 17 items (36.2% of the 47-item European Health Literacy Survey Questionnaire). Conclusions Our findings indicate that the computerized adaptive test of the European Health Literacy Survey Questionnaire, which assesses 12 domains of health literacy among patients with stroke in a timely and precise fashion, is efficient and reliable. Implications for rehabilitation The computerized adaptive test of the European Health Literacy Survey Questionnaire assesses the subjective fit of personal health literacy competencies to environmental demands, providing insight into patient strengths and weaknesses when dealing with health tasks and interacting with health systems. The computerized adaptive test of the European Health Literacy Survey Questionnaire assesses the 12 domains of health literacy among patients with stroke in a timely and precise manner. Our study has demonstrated the utility of the computerized adaptive test of the European Health Literacy Survey Questionnaire in reducing the assessment burden of patients in clinical practice. Developing of the computerized adaptive test of the European Health Literacy Survey Questionnaire provided findings that may benefit researchers and clinicians interested in developing efficient outcome measures.

Sexual health literacy is critical for young people to make informed decisions and access sexual and reproductive health services. In Türkiye, factors such as social stigma, lack of information, and cultural taboos and structural barriers may negatively affect young people's sexual and reproductive health service-seeking behaviors. The aim of this study is to determine the levels of sexual health literacy and sexual and reproductive health service seeking among Turkish youth, identify the factors affecting these levels, and to examine the relationship between sexual health literacy and service-seeking behavior. The cross-sectional descriptive study was completed with 512 young people aged 18-30 years in Türkiye using an online survey distributed via social media platforms. Data were collected using the Sexual Health Literacy Scale and the Sexual and Reproductive Health Service Seeking Scale. Descriptive statistics, t-test, one-way ANOVA, Pearson correlation, and linear regression analyses were used in the analysis of the data. Participants' sexual health literacy was found to be at a moderate level (50.09 ± 9.23), while service seeking was above moderate (37.62 ± 9.87). A positive relationship was found between sexual health literacy and service seeking (p < 0.05). According to regression analysis, sexual health literacy level and history of unwanted pregnancy were factors predicting service seeking (R²=0.125, F = 7.983, p < 0.001). The level of sexual health literacy was found to be associated with gender, income level, family type, parents' education level, receipt of sexual health education, active sexual life, contraceptive use, unwanted pregnancy, and sexually transmitted disease history. The level of service seeking was influenced by marital status, family type, parental education, sexual activity, sexually transmitted disease diagnosis, unwanted pregnancy, and the need for emergency contraception. Main barriers to service seeking were embarrassment (35%), not prioritizing sexual health (22.1%), minimizing the problem (21.5%), and lack of information (18%). This study shows that limited sexual health literacy may restrict Turkish youth's access to sexual and reproductive health services. Strengthening sexual health education, improving access to reliable online information, and fostering youth-friendly health services including guidance by nurses are essential. These measures can ensure equitable, inclusive, and effective sexual and reproductive health care.

Objective: To assess college students’ sexual and reproductive health (SRH) literacy experiences, specific to contraception use and STI prevention. Participants: In Spring 2015, participants (n = 43) from a large institution participated in six focus groups (two male and four females groups). Methods: Focus groups were guided by the health literacy domains (access; understand; appraise; apply); data were analyzed in MaxQDA using the constant comparative method. Results: The Internet was the most commonly accessed source for SRH information. Participants discussed facilitators (eg, use of visuals) and barriers (eg, medical jargon) to understanding information; and personal lifestyle, advice from family/friends, symptoms, and sexual partners as appraisal factors. Participants applied information by communicating with friends/providers and seeking healthcare. However, findings were not linear nor mutually exclusive, representing the interaction of health literacy skills. Conclusion: Findings suggest that a patient-centered intervention capitalizing on technology and trusted individuals (providers/peer educators) may facilitate college students’ SRH literacy.

Sexual health literacy is one of the factors that affect sexual health. Several factors can influence sexual health literacy. As a result, the current study was carried out to determine sexual health literacy and its associated factors among Iranian couples. In 2022, 410 couples of reproductive age were referred to comprehensive health service centers and private clinics in Kerman city for the descriptive-analytical study. The study questionnaires included sexual health literacy for adults, sexual knowledge and attitude scale, marital intimacy scale, sexual intimacy scale, depression anxiety stress scale, sexual self-efficacy, the multidimensional scale of perceived social support, and socioeconomic status. Finally, multiple linear stepwise regression models were used to determine the factors related to sexual health literacy using the SPSS software version 22. According to the findings of this study, the mean(SD) of sexual health literacy in couples was 68.76(12.96), which was a desirable level. Furthermore, the findings revealed that sexual self-efficacy (B = 0.649، P<0.001), sexual knowledge and attitude (B = 0.217، P<0.001), the ability to identify reliable and non-reliable sources (B = -3.116، P<0.001), feelings of shame and embarrassment for obtaining sexual information (B = 1.860، P = 0.011), social support (B = 0.127، P<0.001) and the obscenity of sexual issues in family (B = 1.764، P = 0.015) were the final predictors of sexual health literacy in couples. It is suggested that researchers and health managers consider these factors when designing interventions to promote sexual health literacy.

Objectives Sexual health is a key factor in the stability of marital life and is considered one of the most important determinants of couples’ well-being, contributing to a satisfactory quality of life. By enhancing sexual satisfaction, sexual health literacy plays a significant role in sexual functioning. Therefore, this study aimed to investigate the effect of a sexual health education program based on the Health Belief Model (HBM) on sexual health literacy and sexual function among Iranian women. Methods This experimental study involved 160 married women, with 80 participants in the intervention group and 80 in the control group, who attended urban comprehensive health service centers in Fasa city, Iran, during 2023–2024. The educational intervention was designed based on the constructs of the Health Belief Model (HBM) and was implemented over eight sessions, each lasting 50 minutes. Data were collected using a demographic questionnaire, a knowledge questionnaire, an HBM constructs questionnaire, the Female Sexual Function Index (FSFI), and the Iranian Adult Sexual Health Literacy Questionnaire. Both groups completed the questionnaires before the intervention and again three months after. Results Before the intervention, there was no statistically significant difference in the mean scores of knowledge and HBM constructs between the two groups. However, post-intervention, a significant increase was observed in knowledge and all HBM constructs except for perceived barriers. Moreover, sexual health literacy and sexual function scores significantly improved in the intervention group (p < 0.05). Conclusions The comprehensive sexual health education program based on the Health Belief Model (HBM) effectively improved women’s sexual function and enhanced their sexual health literacy in the short term. Therefore, it is recommended to integrate sexual counseling and education into the services offered by comprehensive health centers as part of women’s health care. Additionally, empowering women through counseling and training in relationship and life skills is essential for promoting their sexual health.

Background: Adolescent pregnancy is one of the major public health issues globally and in Thailand. Sexual health literacy (SHL) is an important factor to prevent teenage pregnancy. Objective: To assess the level of SHL and to explore factors associated with SHL among female secondary school students, in a southern province of Thailand. Materials and Methods: A cross-sectional study was conducted in a southern province of Thailand. One hundred twenty-eight female secondary school students were randomly selected to participate in the present study. The SHL questionnaire was used to access participants’ SHL and included four domains 1) accessing information, 2) understanding information, 3) appraising information, and 4) applying or practicing. The scores of SHL were calculated using the formula “Index – score, which is mean less the minimal value of mean times 50 divided by 3”. The results were divided into four levels as inadequate if less than 25, problematic from 26 to 33, sufficient from 34 to 42, and excellent if greater than 42. Both the formula and the levels were adopted from the European Health Literacy Survey (HLS-EU-Q47) method. Descriptive statistics were used to analyze general characteristic information. Chi-square was used to find factors associated with SHL. Results: The findings revealed that more than half of the participants had inadequate SHL scores regarding access to sexual health information, understanding and appraising SHL, and applying SHL in life. The results showed that the grade point average (GPA) was statistically significant associated with SHL (chi-square=6.24, p-value=0.04). Conclusion: Most adolescents in the present study had inadequate scores on SHL. Therefore, knowledge information and practice regarding accessing information, understanding of SHL, appraising of SHL, applying or practice and skill development, and decision making should be provided and encouraged among high school teenagers. Keywords: Sexual Health Literacy; Health Literacy