“A Story I Want to Be Able to Tell”: Late Adolescent Narratives of Sexual Decision-Making

 

“A Story I Want to be able to Tell”: Late Adolescent Narratives of Sexual Decision-Making

Objective: Globally, the World Health Organization (WHO) has declared addressing the sexual and reproductive needs of adolescents as a crucial element in promoting the sexual health and safety of all adolescents. Therefore, the aim of this study was to explore adolescents’ stories about their decisions to initiate and continue sexual activity to facilitate enhanced understanding of this complex phenomenon. The research question was what are late adolescents’ perceptions of factors that influenced their sexual decision-making?

Design: Qualitative, narrative inquiry

Setting: Naturalistic setting for all interviews

Patients/Participants: The sample consisted of 10 sexually active late adolescent females between the ages of 18 and 22

Methods: Narrative inquiry was the qualitative research method used to answer the research question. Narrative inquiry rests on the epistemological assumption that individuals make sense of their experiences by organizing story structures. Using narrative inquiry encouraged individual participants to reflect on their decisions about sexual activity, tell their stories, and make meaning of their experiences. This perspective is not currently represented in the literature and is necessary prior to designing relevant interventions for the adolescent population. Single interviews were conducted with ten late adolescent females between the ages of 18 and 22. Both purposive and snowball sampling were used and recruitment ended when data saturation was achieved.

Results: Narrative analysis was used to arrange each story in chronological order to represent a beginning, middle, and end for each adolescent’s decision-making process. This process identified an introduction, plot, and conclusion. Content analysis was also used to identify significant themes that were derived from units of in vivo coding. The resulting story contained three distinct and influential components: the influence of social context provided the introduction to the story, perceptions of the expected social norm for sex and relationships formed the plot, and the narratives concluded with a discussion of how these adolescents’ decision-making processes evolved in the years since coital debut.

Conclusion/Implications for nursing practice: The results of this study provide evidence that adolescent sexual decision-making is a multifaceted process with many layers of influence. This reflects the complex world adolescents must navigate as they make decisions about their sexual behaviors. Detailed assessment of adolescent sexual activity and anticipatory guidance by health care providers will lay the foundation for risk reduction behavior and safer sexual encounters.

Keywords: Adolescents, decision-making, sexual activity