|
附录
IV.
性卫生保健专业人员培训课程
A.专门从事生殖保健项目的卫生保健专业人员性健康教育
B.
专门从事性传播疾病与HIV/AIDS预防和控制项目的专业人员性健康教育
C.
专门从事性科学的专业人员性健康教育与培训
Appendix
IV. Curriculum for the Training of Health
Professionals
in Sexual Health
A.
Sexual Health education for health
professionals specializing in reproductive
health programs
B.
Sexual Health education for professionals
specializing in STI’s and HIV/AIDS
prevention and control programs
C.
Sexual Health education and training for
professionals specializing in sexology
中文翻译：彭晓辉(中国
武汉
华中师范大学生命科学学院，430079)完成时间：2006年3月
Translator：Xiaohui
Peng
(Life Science College of CCNU, Wuhan, 430079, China)
校
对：吴敏伦(中国
香港
香港大学医学院)完成时间：2006年8月
附录
IV.
性卫生保健专业人员培训课程
A.
专门从事生殖保健项目的卫生保健专业人员性健康教育
B.专门从事性传播疾病与HIV/AIDS预防和控制项目的专业人员性健康教育
C.
专门从事性科学的专业人员性健康教育与培训
基础性健康教育(Basic
Sexual Health education)应该成为所有卫生保健专业人员培训课程的组成部分。已经有了大量的为不同层次的卫生保健专业人员和技术人员开发的优质培训课程。实施培训课程时，尤其必须要兼顾所实施国家的特点和所在国家/地区的特殊需要。
我们建议应该为所涉及的每一个学科或每一类人员(医学、护理学、卫生保健的促进者，等等)的健康保健专业人员制定性健康基础培训的最低限度大纲。
无论如何，这些最低限度的大纲应该包括：
人类性学的基本知识；
对自身和他人的性的个人态度意识：对不同性取向和性习惯的人应该抱有尊重的态度；
基本的识别技能；如果有必要，有配合适当的专业人员识别的技能，或通过查阅资料识别性健康问题的技能；
由于性知识不断更新的特性和许多基础培训课程实际案例仍可能处于探索之中，所以，我们认为需要制定和支持对卫生保健人员的继续教育策略；
A.专门从事生殖保健项目的卫生保健专业人员性健康教育
专门从事生殖保健项目的卫生保健人员应该得到充分的人类性学的培训。由于生殖健康与人类性学之间显而易见的关系，有人常常想当然地以为实施了生殖健康保健就足以满足由性健康权利所派生出的需要了；可是，这种假设并不正确。“性健康”已经成为附加于生殖健康项目中一个指标。尽管生殖健康的定义涵盖了人类性学的各个复杂方面，与其让性健康隐含于生殖健康之中，倒不如旗帜鲜明地把它阐述得明明白白。
专门从事生殖保健项目的卫生保健人员应该得到比一般卫生保健从业人员更深入的人类性学方面的培训。正如对一般卫生保健从业人员培训所需要的情形一样，所拟定的特殊培训课程应该适应于所选定的国家/地区的特殊需要，而且值得让被培训的人员具备以下专业技能：
人类性学的基本知识
广泛的人类生殖知识和重视性的广泛权利的生殖调控方法。
对自身和他人的性的个人态度意识：对不同性取向和性习惯的人应该抱有尊重的态度。
基本的识别技能、咨询服务技能；如果有必要，有配合适当的专业人员识别的技能，或通过查阅资料识别性健康问题的技能；
所以，我们建议应该在所涉及的每一个适当层面(项目规划者、服务提供者、教育工作者、社会活动家，等等)为专门从事性传播疾病和HIV/AIDS预防和控制项目的专业人员制定性健康基础培训的最低限度大纲。
B.
专门从事性传播疾病与HIV/AIDS预防和控制项目的专业人员性健康教育
HIV/AIDS流行的巨大威胁已经促使许多国家政府制定了预防和控制这类流行性疾病的特殊规划。最近以来，人们清醒地认识到，如果把减少和控制HIV/AIDS的举措与控制和预防性传播疾病这一更广泛的途径相结合，这可能会更加有效。因为，性传播疾病除了自身对健康存在威胁以外，它还增大HIV/AIDS传播的风险。这种威胁已经造就了一批新型的卫生保健专业人员，他们针对这个焦点制定防治规划和在实施方面发挥着作用。
这些传染病是通过性行为传播的事实，使我们有绝对的必要让工作在疾病预防和控制岗位的专业人员获得足够的性健康课程培训，尤其象在本会议纪要所设想的一样，人类性学的所有方面都要给予重视。
专门从事性传播疾病和HIV/AIDS预防与控制项目的卫生保健专业人员应该得到性健康课程培训，这种培训将会让他们对人类性行为的决定因素具有全景的视野。正如其他的例子所例举的那样，所拟定的特殊培训课程应该适应于所选定的国家/地区的特殊需要，而且值得让被培训的人员具备以下专业技能：
人类性学的基本知识；
在负责任性行为的决定因素方面具有广泛的知识；
在性传播疾病方面具有广泛知识；
在已被验证的预防性传播疾病传播策略方面具有广泛的知识。
基本的HIV/AIDS和性传播疾病的流行病学和传播范围的知识，同时具有公共危险行为的流行病学知识。这样的知识除了流行病学一般知识以外，还包括相应的目标人群的专门知识。
具备当地性教育项目知识和确定合适的性教育干预地点和选择合适的对象进行性教育的能力。
对自身和他人的性的个人态度意识：对不同性取向和性习惯的人应该抱有尊重的态度。
基本的识别技能、咨询服务技能；如果有必要，有配合适当的专业人员识别的技能，或通过查阅资料识别性健康忧虑和性健康问题的技能；
与目标人群工作的技能，包括对性习惯、性健康忧虑和高危人群的性行为做出反应并加以引导的能力。
我们也建议应该在所涉及的每一个适当层面(项目规划者、服务提供者、教育工作者、社会活动家、性少数群体的提倡者，等等)为专门从事性传播疾病和HIV/AIDS预防和控制项目的专业人员制定性健康培训的最低限度大纲。
C. 专门从事性科学的专业人员性健康教育与培训
一直以来就缺乏对卫生保健专业人员进行以人类性学为主题的培训。有关学科(心理学、精神病学、妇科医学和泌尿科学)的专员人员在涉及人类性学的具体问题方面已经开辟出专门的工作领域，但是，因为他们的视野常常局限于他们最初的专业领域，我们难以在他们的工作中发现对人类性学有综合的研究方法。鉴于此，本专家工作小组建议应该要做出特别的努力，以促进性健康专业人员的培训，除了他们原初的受训领域知识和技能以外，让他们有足够的知识和技能能够履行涉及他们附属专业领域的任务。迄今为止，不同国家的经验已经使得人们承认下述的专业范围是性健康专业人员的附属专业：
性教育学
临床性科学(包括性医学、性外科学、性咨询和性心理疗法)
理论性学
性教育学(Sexuality
education)是专门研究性教育的性科学分支学科。全面的性教育除了涉及到父母、教师、社会活动家、大众传媒专业人员和宗教领袖以外，它还关乎亿万普通大众。然而，社会还需要擅长于性教育项目和特定性教育课程的设计、实施和评估的专业人员(为其他非专业教育工作者能够依赖的专家)。全面的性教育含有性健康的教育内容，所以也称为性健康教育(Sexual
Health education)。
性教育专业人员应该通过培训具有下列范围的最低限度的专业技能：
人类性学的知识
包括对人类性学的教育设计、实施和评估教育项目的技能在内的广泛的知识，尤其具有予人分享的性教育学观点。
对自身和他人的性的个人态度意识：应该包括对有不同性取向和性习惯的人的尊重态度。
基本的识别技能；如果有必要，有配合适当的专业人员识别的技能，或通过查阅资料识别性健康问题的技能；
临床性科学(Clinical
sexology)是专门预防和护理性功能障碍综合征(sexual
dysfunction syndromes)、性别认同综合征(gender identity syndromes)、强迫性行为综合征(compulsive
sexual behavior syndromes)以及性受害后综合征(syndromes
following sexual victimization)等性健康问题的性科学分支学科。至于其他类型的性健康问题由于需要特殊的临床技术，已经分别归属于其他学科所管辖，它们是：生殖综合征病例（the
case of reproductive syndromes）——由妇产科学(gynecology)、男科学(andrology)和泌尿科学(urology)予以处理；性传播疾病病例——由传染病学(infectology)来处理。然而，正如在本纪要所提及的那样，既然这些学科的专业人员原初的专业训练缺乏人类性学的综合知识，值得对他们进行性健康基本知识的培训。临床性科学的每一个分支学科利用不同的临床治疗方法，有特殊的专业训练要求；但是，尽管性健康知识至今仍然未成系统，让处理各自临床病症的专业人员分享这些知识也是完全值得的。依据所运用的治疗方法不同，临床性科学专业人员可以按照各自的专业领域进行分类：性医学医师、性外科学医师、性咨询师和性心理治疗师。
临床性科学专业人员应该通过培训具有下列领域的最低限度的专业技能：
人类性学的知识
具备广泛的性健康忧虑和性健康问题知识
具备当地性教育项目知识和确定合适的性教育干预地点和选择合适的病人进行性教育的能力。
对自身和他人的性的个人态度意识：对不同性取向和性习惯的人应该抱有尊重的态度。
临床诊断技能，包括对临床性科学领域[即性功能障碍、性别(性别认同综合征)、强迫性行为综合征以及性受害后综合征]的性健康问题的病因学的诊断技能。
临床诊断技能；如果有必要，对诸如生殖综合征疾病和性传播疾病等其他专业领域的性健康问题，有配合适当的专业人员会诊的技能。
在他们的专业领域实施治疗方略的技能，这些专业领域是：性医学、性外科学、性咨询和性心理疗法，以及当病因学诊断显示需要不同专业人员提供治疗技能时，有举荐合适的专科医师的能力。
理论性学(Research
sexology)是在人类性学内专门整合信息以建立新知识的性科学分支学科。它运用适合于该学科和研究领域的方法展开研究。理论性学专业人员应该在人类性学和性健康方面具有广博的知识和受到严格的训练，以很好地履行研究活动中的特殊任务。
理论性学专业人员应该通过培训具有下列领域的最低限度的专业技能：
人类性学的基本知识
按照他们的专业领域在研究方法论方面具有广泛的知识和技能。
对自身和他人的性的个人态度意识：对不同性取向和性习惯的人应该抱有尊重的态度。
对其他研究者的学科的态度意识：应该包括促进各学科研究的相互尊重的态度。
识别性健康问题的基本技能；如果有必要，有配合适当的专业人员的技能。
承诺只对最高道德准则承担义务，诸如通过课程和引导来研究伦理规范，尤其在与性健康相关联的研究中，更应该如此。
我们建议专门从事临床性科学的专业人员的性健康培训应该对下列诸项专业类型制定出最低限度的大纲：临床性科学(包括性医学、性外科学、性咨询和性心理疗法)和理论性学。
A.
Sexual Health education for health
professionals specializing in reproductive
health programs
B.
Sexual Health education for professionals
specializing in STI’s and HIV/AIDS
prevention and control programs
C.
Sexual Health education and training for
professionals specializing in sexology
Basic
Sexual Health education should be part of
the curricula of all health professionals.
There have been a number of good curricula
developed for different levels of health
professionals and technicians. The
implementation of a particular curriculum
must take into account the particularities
of the country and specific needs of a
country/region.
It
was suggested that a minimal profile of
basic training in Sexual Health for health
professionals should be developed for each
of the disciplines (medical, nursing, health
promoters, etc.) involved.
In
any case these minimum profiles should
include:
Basic
knowledge of human sexuality.
Awareness
of personal attitudes towards one's own and
other people's sexuality which should
include a respectful attitude towards
persons with different sexual orientations
and sexual practices.
Basic
skills in identifying and, if necessary,
referring to the appropriate professional,
problems of Sexual Health.
It
was also agreed that there is need for
establishment and support of continued
education for health professionals, due to
the changing nature of sexual knowledge and
the deficiencies that in many instances
still can be observed in the basic training
curricula.
Health
professionals specializing in reproductive
health programs should have adequate
training in human sexuality. Due to the
obvious connection between reproductive
health and human sexuality, it is often
assumed that taking care of the reproductive
aspects of health will be enough to satisfy
the needs posed by the right to Sexual
Health, but this assumption is incorrect.
“Sexual health” has been a common
addition to reproductive health programs.
Although the definitions of reproductive
health include aspects of the complexity of
human sexuality, Sexual Health is implied,
rather than explicitly stated.
Health
professionals specializing in reproductive
health should have a more in-depth training
in human sexuality issues than the general
health practitioner. As in the case of
training needs for the general health
practitioner, specific curricula should be
designed adapted to the specific needs of
the country / region, but it is desirable
that the abilities include:
Basic
knowledge of human sexuality
Extensive
knowledge in human reproduction and the
means for its regulation that takes into
account broader sexual rights concerns.
Awareness
of personal attitudes towards one's own and
other people's sexuality which should
include a respectful attitude towards
persons with different sexual orientations
and sexual practices.
Basic
skills in identifying, counseling and, if
necessary, referring to the appropriate
professional, problems of Sexual Health.
It
is therefore suggested that a minimal
profile of training in Sexual Health for
professionals specializing in reproductive
health programs should be developed for each
of the appropriate levels (program planners,
service providers, educators, community
leaders, etc.) involved.
The
magnitude of the threat of the HIV/AIDS
epidemic has prompted many governments to
set up special programs to prevent and
control the epidemic. More recently, it has
become clear that the efforts to reduce and
control HIV/AIDS could be more effective if
actions are linked to a broader approach of
controlling and preventing sexually
transmitted infections, which, in
themselves, besides being a significant
threat to health, increase the risk of
HIV/AIDS transmission. This threat has
created a new type of health professional
who works in the planning and implementing
of programs with this focus.
The
fact that these infections are transmitted
through sexual activity makes it
indispensable that professionals working in
its prevention and control have sufficient
training in Sexual Health, especially as it
is conceived in this document, where all
aspects of human sexuality are taken into
account.
Health
professionals specializing in STIs and
HIV/AIDS prevention and control programs
should have training in Sexual Health that
gives them an integrated vision of the
determinants of human sexual behavior. As in
the other cases, specific curricula should
be designed to adapt to the specific needs
of the country / region, but it is desirable
that the abilities include:
Basic
knowledge of human sexuality.
Extensive
knowledge in the determinants of responsible
sexual behavior.
Extensive
knowledge in sexually transmitted
infections.
Extensive
knowledge in the proven strategies in
prevention of STI's transmission.
Basic
HIV/AIDS and STIs epidemiological prevalence
and incidence knowledge, together with
knowledge of epidemiology of common risk
behaviors. Such knowledge should include a
general knowledge of the epidemic plus
specific knowledge relevant to any target
populations.
Knowledge
of local sexual education programs and
ability to refer, where appropriate, clients
for educational intervention.
Awareness
of personal attitudes towards one's own and
other people's sexuality which should
include a respectful attitude towards
persons with different sexual orientations
and sexual practices
Basic
skills in identifying, counseling and, if
necessary, referring to the appropriate
professional, Sexual Health concerns and
problems.
Skills
to work with target populations, including
sensitivity towards and comfort with the
sexual practices, concerns, and sexualities
of populations at risk.
It
is also suggested that a minimal profile of
training in Sexual Health for professionals
specializing in STI's and HIV/AIDS
prevention and controls programs should be
developed for each of the appropriate levels
(program planners, service providers,
educators, community leaders, and advocates
of minority groups, etc.) involved。
There
continues to be a shortage of health
professionals who have human sexuality as
their focus of training. Professionals of
related disciplines (psychology, psychiatry,
gynecology, urology) have developed a
specialized field of work in problems
related to human sexuality, but an
integrated approach in their work is
difficult to find because their point of
views are usually biased by their original
training. For these reasons, the expert
working group recommends that a special
effort should be made in promoting the
training of specialists in Sexual Health
that, in addition to their original field of
training, have sufficient knowledge and
skills as to be able to perform the tasks
related to their subspecialty field. So far,
the experience in different countries has
led to the recognition of the following
areas of sub specialization of the
professionals of Sexual Health:
Sexuality
education)
Clinical
sexology (including sexual medicine, sexual
surgery, sexual counseling and sexual
psychotherapy)
Research
sexology)
Sexuality
education is the area of sexology that
specializes in sexuality education.
Comprehensive sexuality education concerns
many individuals, including parents,
teachers, community leaders, mass media
professionals, and religious leaders, among
others. However, there is a need for
professionals specializing in the design,
implementation and evaluation of programs
and specific curricula (on which the rest of
the non-specialized educators can rely).
Comprehensive sexuality education implies a
sexuality education for Sexual Health, also
named Sexual Health education.
Professionals
in sexuality education should have as a
minimum the following areas of expertise
covered by their training:
Knowledge
of human sexuality
Extensive
knowledge of education including educational
skills to design, implement and evaluate
educational programs in human sexuality,
particularly from a participatory
perspective.
Awareness
of personal attitudes towards one's own and
other people's sexuality which should
include a respectful attitude towards
persons with different sexual orientations
and sexual practices.
Basic
skills in identifying, and if necessary,
referring to the appropriate professional,
problems of Sexual Health.
Clinical
sexology is the area of sexology that
specializes in the prevention and care of
sexual problems that pertain to sexual
dysfunction syndromes, gender identity
syndromes, compulsive sexual behavior
syndromes and, syndromes following sexual
victimization. Other kinds of sexual
problems have been covered by other
disciplines due to the specific skills
required for their solution: gynecology,
andrology and urology in the case of
reproductive syndromes and infectology in
the case of sexually transmitted infections.
However, training in the basic issues of
Sexual Health is still desirable for
professionals of these disciplines since
their original training often lacked an
integral approach to human sexuality and
Sexual Health as proposed in this document.
Each of the areas of clinical sexology
utilizes different therapeutic modalities
that require specialized training for its
utilization, but it is desirable that
professionals dealing with these problems
share a basic knowledge in Sexual Health
that is still unfortunately fragmentary.
Depending on the therapeutic approach
utilized, a clinical sexologist can be
classified in the following areas: sexual
medicine, sexual surgery, sexual counseling
and sexual psychotherapy.
Professionals
in clinical sexology should have as a
minimum the following areas of expertise
covered by their training:
Knowledge
of human sexuality
Extensive
knowledge of Sexual Health concerns and
problems
Knowledge
of local sexual education programs and
ability to refer, where appropriate,
patients for educational intervention
Awareness
of personal attitudes towards one's own and
other people's sexuality which should
include a respectful attitude towards
persons with different sexual orientations
and sexual practices
Skills
in identifying, and etiologically diagnosing
problems of sexual problems included in the
area of clinical sexology: (i.e.:sexual
dysfunctions, gender (gender identity
syndromes), compulsive sexual behavior
syndromes and, syndromes following sexual
victimization
Skills
in identifying, and if necessary, referring
to the appropriate professional, problems of
Sexual Health in the other areas such as
reproductive syndromes and sexually
transmitted infections
Skills
for implementing treatment strategies in
their areas of specialization: sexual
medicine, sexual surgery, sexual counseling
and sexual psychotherapy, as well as skills
in referral to the appropriate treatment
specialist when the etiologic diagnosis
indicates the need for a treatment different
from that which the professional is able to
provide.
Research
sexology is the area of sexology, which
specializes in the gathering of information
to build new knowledge in human sexuality.
It utilizes methodologies appropriate to the
discipline and area of study. Professionals
in research sexology should have a broad
based knowledge and training in human
sexuality and Sexual Health in order for
them to better perform their specific tasks
in research activity.
Professionals
in research sexology should have as a
minimum the following areas of expertise
covered by their training:
Basic
knowledge of human sexuality
Extensive
knowledge and skills in research
methodologies according to their field of
specialization
Awareness
of personal attitudes towards one's own and
other people's sexuality which should
include a respectful attitude towards
persons with different sexual orientations
and sexual practices.
Awareness
of personal attitudes towards other
researchers' disciplines, which should
include a respectful attitude that
facilitates interdisciplinary investigation
Basic
skills in identifying problems of Sexual
Health and if necessary, referring to the
appropriate professional
A
commitment to undertaking research only of
the highest ethical standards, as promoted
through courses and mentoring on research
ethics, particularly as they pertain to
Sexual Health research.
It
is suggested that a minimal profile of
training in Sexual Health for professionals
specializing in clinical sexology should be
developed for each of these professional
categories: education for sexuality,
clinical sexology (including sexual
medicine, sexual surgery, sexual counseling
and sexual psychotherapy) and research
sexology.
中文翻译：彭晓辉（中国
武汉 华中师范大学生命科学学院
430079）
Translator：Xiaohui
Peng
(Life
Science College of CCNU, Wuhan, 430079, China)
校
对：
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2005年8月18日
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