Development of Islamic-Based Nursing Model for Intention of Sexual Abstinence Behavior among Muslim Female Adolescents Participatory Action Research

Abstract

This participatory action research (PAR) aimed to develop an Islamic- based nursing model for the intention of sexual abstinence behavior for Muslim female adolescents. The two-phase PAR design was implemented in a private religious Muslim school in southern Thailand after exploring the perspectives of adolescents, family members, teachers, and nurses on sexual abstinence. Twelve Muslim female adolescents in grade 8 at secondary school, three teachers and five mothers/female guardians, and two nurses were assessed using observation, focus group discussions and in-depth interviews. Data were also obtained via self- administered questionnaires on the intention of sexual abstinence. Qualitative data were assessed via content analysis, while for descriptive statistics, the t-test was used to compare pre and post intention score. Results showed that the main component for all participant groups was positive communication to overcome the difficulty in sharing sexual content within the Islamic way of thinking. The uniqueness of this model was rooted at integrating Islamic teaching in sexual health education via experiential learning in which this study was conducted. The Islamic-based nursing model for improving the intention of sexual abstinence behavior among Muslim female adolescents included two stages. In the first stage, the Muslim female students' self-awareness was raised through critical thinking. The three strategies were carried out encompassing: 1) enhancing support to communicate in positive ways for creating a comfortable environment for Muslim female adolescents; 2) creating Islamic based content in performing interactive education through experiential teaching; 3) facilitating the learning process on Islamic sexual morality to raise female adolescents' awareness through self-reflective practice. The implementation for this stage was focused on encouraging positive communication within Muslim perspectives. There were three components to fulfill consisting of: 1) positive behavioral beliefs related to sexual abstinence; 2) school and guardian support; and 3) constantly participating in experiential learning activities by integrating Islamic sexual morality. In the second stage, the overall goal was to gain important skills to maintain intention of sexual abstinence based on Islamic concepts. The three strategies used were: 1) facilitating mutual goal-setting and decision making to remain abstinent with Muslim female adolescents; 2) encouraging important skills by using experiential learning within Islamic concepts and sharing lessons learned; and 3) emphasizing positive messages in convincing female adolescents to remain abstinent within Islamic concepts. The four activities with the active participation of parents were carried out encompassing: 1) empowering girls for sexual abstinence; 2) facilitating mutual goal-setting and decision making for Muslim female adolescents; 3) constantly conducting activities using participatory learning, integrated with Islamic sexual morality; and 4) emphasizing positive messages to convince Muslim female adolescents to remain abstinent. The major influencing factors for the intention of sexual abstinence behavior among Muslim female adolescents within Islamic-based cultural care were: 1) mutual goals of parent-teacher and Muslim female adolescents; 2) school and guardian support; 3) information related to the power of positive communication; 4) appropriate use of experiential learning integrated with Islamic sexual morality; and 5) belief of self-efficacy in Muslim female adolescents. The key success of the model was derived from the active participation of parents, teachers, and female adolescents in applying an Islamic-based nursing model in the school programs that address the intention of sexual abstinence behavior. In addition, eleven of the twelve female adolescents were able to maintain or increase their intention of sexual abstinence. The t-test showed no significant differences in the intention of sexual abstinence behavior (t = 0.861, p = 0.408), partly due to the short period of evaluation. However, the participants were satisfied with the process of the sexual abstinence intention program. This study showed that parents and teachers play an important role in their adolescents' sexual abstinence. It is suggested that nurses incorporate religious knowledge in the sexual health school program to enhance the sustainability of the model.