|
附錄
IV.
性衛生保健專業人員培訓課程
A.專門從事生殖保健專案的衛生保健專業人員性健康教育
B.
專門從事性傳播疾病與HIV/AIDS預防和控制專案的專業人員性健康教育
C.
專門從事性科學的專業人員性健康教育與培訓
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
中文翻譯：彭曉輝(中國
武漢
華中師範大學生命科學學院，430079)完成時間：2006年3月
Translator：Xiaohui
Peng
(Life Science College of CCNU, Wuhan, 430079, China)
校
對：吳敏倫(中國
香港
香港大學醫學院)完成時間：2006年8月
附錄
IV.
性衛生保健專業人員培訓課程
A.
專門從事生殖保健專案的衛生保健專業人員性健康教育
B.專門從事性傳播疾病與HIV/AIDS預防和控制專案的專業人員性健康教育
C.
專門從事性科學的專業人員性健康教育與培訓
基礎性健康教育(Basic
Sexual Health education)應該成為所有衛生保健專業人員培訓課程的組成部分。已經有了大量的為不同層次的衛生保健專業人員和技術人員開發的優質培訓課程。實施培訓課程時，尤其必須要兼顧所實施國家的特點和所在國家/地區的特殊需要。
我們建議應該為所涉及的每一個學科或每一類人員(醫學、護理學、衛生保健的促進者，等等)的健康保健專業人員制定性健康基礎培訓的最低限度大綱。
無論如何，這些最低限度的大綱應該包括：
人類性學的基本知識；
對自身和他人的性的個人態度意識：對不同性取向和性習慣的人應該抱有尊重的態度；
基本的識別技能；如果有必要，有配合適當的專業人員識別的技能，或通過查閱資料識別性健康問題的技能；
由於性知識不斷更新的特性和許多基礎培訓課程實際案例仍可能處於探索之中，所以，我們認為需要制定和支援對衛生保健人員的繼續教育策略；
A.專門從事生殖保健專案的衛生保健專業人員性健康教育
專門從事生殖保健專案的衛生保健人員應該得到充分的人類性學的培訓。由於生殖健康與人類性學之間顯而易見的關係，有人常常想當然地以為實施了生殖健康保健就足以滿足由性健康權利所派生出的需要了；可是，這種假設並不正確。“性健康”已經成為附加于生殖健康項目中一個指標。儘管生殖健康的定義涵蓋了人類性學的各個複雜方面，與其讓性健康隱含于生殖健康之中，倒不如旗幟鮮明地把它闡述得明明白白。
專門從事生殖保健專案的衛生保健人員應該得到比一般衛生保健從業人員更深入的人類性學方面的培訓。正如對一般衛生保健從業人員培訓所需要的情形一樣，所擬定的特殊培訓課程應該適應於所選定的國家/地區的特殊需要，而且值得讓被培訓的人員具備以下專業技能：
人類性學的基本知識
廣泛的人類生殖知識和重視性的廣泛權利的生殖調控方法。
對自身和他人的性的個人態度意識：對不同性取向和性習慣的人應該抱有尊重的態度。
基本的識別技能、諮詢服務技能；如果有必要，有配合適當的專業人員識別的技能，或通過查閱資料識別性健康問題的技能；
所以，我們建議應該在所涉及的每一個適當層面(專案規劃者、服務提供者、教育工作者、社會活動家，等等)為專門從事性傳播疾病和HIV/AIDS預防和控制專案的專業人員制定性健康基礎培訓的最低限度大綱。
B.
專門從事性傳播疾病與HIV/AIDS預防和控制專案的專業人員性健康教育
HIV/AIDS流行的巨大威脅已經促使許多國家政府制定了預防和控制這類流行性疾病的特殊規劃。最近以來，人們清醒地認識到，如果把減少和控制HIV/AIDS的舉措與控制和預防性傳播疾病這一更廣泛的途徑相結合，這可能會更加有效。因為，性傳播疾病除了自身對健康存在威脅以外，它還增大HIV/AIDS傳播的風險。這種威脅已經造就了一批新型的衛生保健專業人員，他們針對這個焦點制定防治規劃和在實施方面發揮著作用。
這些傳染病是通過性行為傳播的事實，使我們有絕對的必要讓工作在疾病預防和控制崗位的專業人員獲得足夠的性健康課程培訓，尤其象在本會議紀要所設想的一樣，人類性學的所有方面都要給予重視。
專門從事性傳播疾病和HIV/AIDS預防與控制專案的衛生保健專業人員應該得到性健康課程培訓，這種培訓將會讓他們對人類性行為的決定因素具有全景的視野。正如其他的例子所例舉的那樣，所擬定的特殊培訓課程應該適應於所選定的國家/地區的特殊需要，而且值得讓被培訓的人員具備以下專業技能：
人類性學的基本知識；
在負責任性行為的決定因素方面具有廣泛的知識；
在性傳播疾病方面具有廣泛知識；
在已被驗證的預防性傳播疾病傳播策略方面具有廣泛的知識。
基本的HIV/AIDS和性傳播疾病的流行病學和傳播範圍的知識，同時具有公共危險行為的流行病學知識。這樣的知識除了流行病學一般知識以外，還包括相應的目標人群的專門知識。
具備當地性教育項目知識和確定合適的性教育干預地點和選擇合適的物件進行性教育的能力。
對自身和他人的性的個人態度意識：對不同性取向和性習慣的人應該抱有尊重的態度。
基本的識別技能、諮詢服務技能；如果有必要，有配合適當的專業人員識別的技能，或通過查閱資料識別性健康憂慮和性健康問題的技能；
與目標人群工作的技能，包括對性習慣、性健康憂慮和高危人群的性行為做出反應並加以引導的能力。
我們也建議應該在所涉及的每一個適當層面(專案規劃者、服務提供者、教育工作者、社會活動家、性少數群體的提倡者，等等)為專門從事性傳播疾病和HIV/AIDS預防和控制專案的專業人員制定性健康培訓的最低限度大綱。
C. 專門從事性科學的專業人員性健康教育與培訓
一直以來就缺乏對衛生保健專業人員進行以人類性學為主題的培訓。有關學科(心理學、精神病學、婦科醫學和泌尿科學)的專員人員在涉及人類性學的具體問題方面已經開闢出專門的工作領域，但是，因為他們的視野常常局限於他們最初的專業領域，我們難以在他們的工作中發現對人類性學有綜合的研究方法。鑒於此，本專家工作小組建議應該要做出特別的努力，以促進性健康專業人員的培訓，除了他們原初的受訓領域知識和技能以外，讓他們有足夠的知識和技能能夠履行涉及他們附屬專業領域的任務。迄今為止，不同國家的經驗已經使得人們承認下述的專業範圍是性健康專業人員的附屬專業：
性教育學
臨床性科學(包括性醫學、性外科學、性諮詢和性心理療法)
理論性學
性教育學(Sexuality
education)是專門研究性教育的性科學分支學科。全面的性教育除了涉及到父母、教師、社會活動家、大眾傳媒專業人員和宗教領袖以外，它還關乎億萬普通大眾。然而，社會還需要擅長於性教育專案和特定性教育課程的設計、實施和評估的專業人員(為其他非專業教育工作者能夠依賴的專家)。全面的性教育含有性健康的教育內容，所以也稱為性健康教育(Sexual
Health education)。
性教育專業人員應該通過培訓具有下列範圍的最低限度的專業技能：
人類性學的知識
包括對人類性學的教育設計、實施和評估教育項目的技能在內的廣泛的知識，尤其具有予人分享的性教育學觀點。
對自身和他人的性的個人態度意識：應該包括對有不同性取向和性習慣的人的尊重態度。
基本的識別技能；如果有必要，有配合適當的專業人員識別的技能，或通過查閱資料識別性健康問題的技能；
臨床性科學(Clinical
sexology)是專門預防和護理性功能障礙綜合征(sexual
dysfunction syndromes)、性別認同綜合征(gender identity syndromes)、強迫性行為綜合征(compulsive
sexual behavior syndromes)以及性受害後綜合征(syndromes
following sexual victimization)等性健康問題的性科學分支學科。至於其他類型的性健康問題由於需要特殊的臨床技術，已經分別歸屬於其他學科所管轄，它們是：生殖綜合征病例（the
case of reproductive syndromes）——由婦產科學(gynecology)、男科學(andrology)和泌尿科學(urology)予以處理；性傳播疾病病例——由傳染病學(infectology)來處理。然而，正如在本紀要所提及的那樣，既然這些學科的專業人員原初的專業訓練缺乏人類性學的綜合知識，值得對他們進行性健康基本知識的培訓。臨床性科學的每一個分支學科利用不同的臨床治療方法，有特殊的專業訓練要求；但是，儘管性健康知識至今仍然未成系統，讓處理各自臨床病症的專業人員分享這些知識也是完全值得的。依據所運用的治療方法不同，臨床性科學專業人員可以按照各自的專業領域進行分類：性醫學醫師、性外科學醫師、性諮詢師和性心理治療師。
臨床性科學專業人員應該通過培訓具有下列領域的最低限度的專業技能：
人類性學的知識
具備廣泛的性健康憂慮和性健康問題知識
具備當地性教育項目知識和確定合適的性教育干預地點和選擇合適的病人進行性教育的能力。
對自身和他人的性的個人態度意識：對不同性取向和性習慣的人應該抱有尊重的態度。
臨床診斷技能，包括對臨床性科學領域[即性功能障礙、性別(性別認同綜合征)、強迫性行為綜合征以及性受害後綜合征]的性健康問題的病因學的診斷技能。
臨床診斷技能；如果有必要，對諸如生殖綜合征疾病和性傳播疾病等其他專業領域的性健康問題，有配合適當的專業人員會診的技能。
在他們的專業領域實施治療方略的技能，這些專業領域是：性醫學、性外科學、性諮詢和性心理療法，以及當病因學診斷顯示需要不同專業人員提供治療技能時，有舉薦合適的專科醫師的能力。
理論性學(Research
sexology)是在人類性學內專門整合資訊以建立新知識的性科學分支學科。它運用適合於該學科和研究領域的方法展開研究。理論性學專業人員應該在人類性學和性健康方面具有廣博的知識和受到嚴格的訓練，以很好地履行研究活動中的特殊任務。
理論性學專業人員應該通過培訓具有下列領域的最低限度的專業技能：
人類性學的基本知識
按照他們的專業領域在研究方法論方面具有廣泛的知識和技能。
對自身和他人的性的個人態度意識：對不同性取向和性習慣的人應該抱有尊重的態度。
對其他研究者的學科的態度意識：應該包括促進各學科研究的相互尊重的態度。
識別性健康問題的基本技能；如果有必要，有配合適當的專業人員的技能。
承諾只對最高道德準則承擔義務，諸如通過課程和引導來研究倫理規範，尤其在與性健康相關聯的研究中，更應該如此。
我們建議專門從事臨床性科學的專業人員的性健康培訓應該對下列諸項專業類型制定出最低限度的大綱：臨床性科學(包括性醫學、性外科學、性諮詢和性心理療法)和理論性學。
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.
中文翻譯：彭曉輝（中國
武漢 華中師範大學生命科學學院
430079）
Translator：Xiaohui
Peng
(Life
Science College of CCNU, Wuhan, 430079, China)
校
對：
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2005年8月18日
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