title: Nursing, sexual health and youth with disabilities: a critical ethnography.
abstract: OBJECTIVE
  To explore the experiences of nurses providing sexual health care to adolescents with physical and/or developmental disabilities, with attention to the institutional and social discourses that shape these interactions.
  
  
  BACKGROUND
  Previous research has shown that nurses demonstrate a lack of attention to the impact of illness or disability on sexual health. However, in their therapeutic relationship with patients and families, nurses are in an ideal position to promote sexual health.
  
  
  METHODS
  A critical ethnography study was conducted in an urban paediatric rehabilitative facility.
  
  
  METHODS
  Field work occurred over 4 months (2008-2009) and data collection included interviews (n = 9), key informant discussions, collection of documentary evidence and observation of the institutional setting.
  
  
  RESULTS
  Four themes were identified (institutional space, professional interactions, engaging with sexuality, nursing experience), which revealed that nurse-patient interactions about sexual health were affected by a complex network of discourses. These encounters were shaped by practical discourses, such as time and space and by more complex discourses, such as professional relationships, normalization and asexuality.
  
  
  CONCLUSIONS
  Nurses occupy and strive to maintain, the role of a caring agent. However, aspects of the clinical, institutional and broader social environments may undermine their ability to promote sexual health. In nurses' efforts to maintain therapeutic relationships with clients, sexual health is often medicalised to legitimize it as an appropriate topic of discussion with patients and families. Facilities serving youth with disabilities should take steps to address barriers to the delivery of sexual health promotion and several solutions are proposed.
authors.affiliation: College of Nursing, University of Saskatchewan, Prince Albert, Saskatchewan, Canada.
authors.forename: Janet
authors.initials: J
authors.lastname: McCabe
authors.affiliation: School of Nursing, Univerity of Ottawa, Ontario, Canada.
authors.forename: Dave
authors.initials: D
authors.lastname: Holmes
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities; D000884:Anthropology, Cultural; D001291:Attitude of Health Personnel; D003695:Delivery of Health Care; D006233:Persons with Disabilities / Q000534:rehabilitation*; D006801:Humans; D007400:Interprofessional Relations; D008875:Middle Aged; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D009726:Nurses / Q000523:psychology; D009732:Nursing Care / Q000592:standards*; D060728:Reproductive Health; D019529:Sexuality; D055815:Young Adult
keywords: Foucault; critical ethnography; disabilities; nursing; qualitative research; sexual health; youth