Ethics of justice and ethics of care. Values and attitudes among midwifery students on adolescent sexuality and abortion in Vietnam and their implications for midwifery education: a survey by questionnaire and interview.
Adolescent's sexuality and related reproductive health and rights problems are sensitive issues in Vietnam. Globalisation has had an impact on the lifestyles of young people, and rising numbers of abortion and STI/HIV risks among youth are posing major health concerns in the country. These problems need to be addressed. Midwives belong to a key category of health personnel in Vietnam, whose task it is to promote adolescents' sexual and reproductive health and prevent reproductive ill health. It is important to understand future midwives' perceptions and attitudes in order to improve their education and training programmes.


OBJECTIVE
The aim of this study was to investigate Vietnamese midwifery students' values and attitudes towards adolescent sexuality, abortion and contraception and their views on professional preparation.


METHODS
A quantitative survey including 235 midwifery students from four different secondary medical colleges in northern Vietnam was carried out in 2003. A qualitative study addressing similar questions was performed and 18 midwifery students were individually interviewed.


RESULTS
Findings revealed a general disapproval of adolescent pre-marital sexual relations and abortion-'an ethics of justice'-but also an empathic attitude and willingness to support young women, who bear the consequences of unwanted pregnancies and social condemnation-'an ethics of care'. Gender-based imbalance in sexual relationships, limited knowledge about reproductive health issues among youth, and negative societal attitudes were concerns expressed by the students. The students saw their future tasks mainly related to childbearing and less to other reproductive health issues, such as abortion and prevention of STI/HIV.


CONCLUSIONS
Midwifery education in Vietnam should encourage value-reflective thinking around gender inequality and ethical dilemmas, in order to prepare midwives to address adolescents' reproductive health needs.
Klingberg-Allvin
Marie
M
Department of Public Health Sciences, Division of International Health (IHCAR), Karolinska Institutet, Stockholm, Sweden. marie.klingberg@phs.ki.se
Van Tam
Vu
V
Nga
Nguyen Thu
NT
Ransjo-Arvidson
Anna-Berit
AB
Johansson
Annika
A
D000029:Abortion, Legal / Q000941:ethics / Q000451:nursing; D000293:Adolescent; D000294:Adolescent Behavior / Q000941:ethics / Q000208:ethnology; D000328:Adult; D001291:Attitude of Health Personnel / Q000208:ethnology; D002983:Clinical Competence / Q000592:standards; D004645:Empathy; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D009721:Nurse Midwives / Q000193:education* / Q000941:ethics / Q000458:organization & administration; D024802:Nurse's Role / Q000523:psychology; D015404:Nursing Methodology Research; D036301:Qualitative Research; D020377:Self Efficacy; D019529:Sexuality / Q000941:ethics / Q000208:ethnology; D012935:Social Justice; D012944:Social Support; D012945:Social Values; D013338:Students, Nursing / Q000523:psychology*; D011795:Surveys and Questionnaires; D014744:Vietnam