The contents of the subject cover three main thematic blocks: promotion and prevention in sexual health, human reproduction / obstetrics and gynecological nursing.

The sexual and reproductive health of the woman includes from adolescence to the climacteric, passing through the fertile age stage of human reproduction. In all these stages of the life cycle, physiological changes occur within the normal range and there can also be pathology that we must know to apply the most appropriate nursing care to the situation that occupies us.

Sexual and reproductive rights have been recognized by the international community as human rights in declarations, conventions and covenants of the United Nations and other internationally approved documents. To ensure the development of healthy sexuality in human beings and societies, sexual rights must be recognized, promoted, respected and defended by all societies with all their means. In this way, sexual health will be the result of a context that recognizes, respects and exercises sexual rights.

Sexual health is a dynamic and continuous process whose needs vary throughout life and depend on a complex combination of individual characteristics, as well as the cultural, socioeconomic, geopolitical and legal environment. Combinations between these factors can create vulnerabilities, whether temporary or long-lasting, that affect health and access to health care.

Sexual and reproductive health has as a reference for the study of men and women, since reproduction is a shared function for both sexes. Preventive sexual health (contraceptive methods, early detection of cervical cancer, breast cancer, and sexually transmitted diseases) and health promotion (healthy lifestyles related to sexual and reproductive health (SRH)) will be addressed.

In terms of reproductive and obstetrical issues, we will work on nursing care topics in the care of normal and risky pregnancy, childbirth, puerperium, breastfeeding, newborn care until the 28th day of life, nurse functions in the techniques of assisted reproduction, gestational nurse advice, pharmacological and non-pharmacological methods of pain relief (nursing care in the administration of analgesia / anesthesia), menstrual cycle and more frequent pathology.

Another section of the subject will be gynecological nursing, nursing care during the most frequent gynecological processes: nursing care in gynecological pathology (gynecological cancer, breast cancer), adolescent pregnancy, emergency contraception, legal termination of pregnancy, nursing care in obstetric or gender violence.

Learning objectives

Referring to knowledge

- Describe and differentiate the functions of the nurse in attention to motherhood and sexual and reproductive health care.

 - Recognize the different biological processes of the reproductive cycle of women.

 - Identify the health needs of women with sexual and reproductive health problems.

 - Describe nursing care in the process of pregnancy, childbirth and the physiological and pathological puerperium 

 

Referring to skills and abilities

- Solve exercises and clinical cases related to nursing care in the field of sexual and reproductive health with the most appropriate nursing interventions and activities for each situation. 

 

Referring to attitudes and values

- Understand and discuss the different options of women and the family in aspects of procreation and upbringing, always with respect, with a holistic approach and adapted to the gender perspective. 

 - Argue, accept and support the decisions of the woman and the family in the different situations that can affect sexual and reproductive health. 

Competences

Basic skills:

CB1: Possessing and understanding knowledge in an area of study that starts from the base of general secondary education, and is usually found at a level which, although supported by advanced textbooks, also includes some aspects involving knowledge from the The vanguard of its field of study.

CB2: Apply their knowledge to their work in a professional way and possess the skills that are usually demonstrated through the elaboration and defense of arguments and problem solving within their area of study.

CB4: To transmit information, ideas, problems and solutions to a specialized and non-specialized public.

 

Specific Competences:

CE12. Establish an empathic and respectful relationship with the patient and family, according to the person's situation, health problem and stage of development.

CE13. Use strategies and skills that allow effective communication with patients, families and social groups, as well as the expression of their concerns and interests.

CE15. Know and identify the psychological and physical problems derived from gender violence to train the student in the prevention, early detection, assistance, and rehabilitation of the victims of this form of violence.

CE18: Apply the nursing process to provide and guarantee the welfare, quality and safety of the people served.

CE22. Understand the role and activities and cooperative attitude that the professional has to develop in a Primary Health Care team.

CE30: Identify the care needs derived from health problems.

CE31: Analyze the data collected in the assessment, prioritize the problems of the adult patient, establish and execute the care plan and carry out their evaluation.

CE33. Select the interventions aimed at treating or preventing the problems derived from health desviations.

CE34. Have a cooperative attitude with the different members of the team.

CE35: Identify the characteristics of the women in the different stages of the reproductive cycle and in the climacteric, as well as in the alterations that can be presented, providing the necessary care at each stage.

CE36: Apply general care during the maternity process to facilitate the adaptation of women and newborns to new demands and prevent complications.

CE37: To know the specific aspects of neonatal care.

CE43. Be able to provide health education to parents or primary caregivers.

CE52: Provide care guaranteeing the right to dignity, privacy, privacy, confidentiality and decision-making ability of the patient and family.

CE53: Individualize care considering age, gender, cultural differences, ethnic group, beliefs and values.

 

Transversal Competences (According to UdL)

CT3. Acquire training in the use of new technologies and information and communication technologies.

CT6. Apply the gender perspective to the tasks of the professional field.

 

Learning outcomes:

Referring to knowledge:

- Describe and differentiate the functions of the nurse in the attention to the motherhood and in the sexual and reproductive health care. That the student knows and knows to carry out the proper activities of nursing in the assistance of maternal and child health.

- Describe the different programs of care for sexual and reproductive health, nursing care and the preventive activities they comprise.

- Recognize the different biological processes of the reproductive cycle of women. That the student knows the determinants of health in relation to gender.

 - Identify the health needs of women with sexual and reproductive health problems.

 - Design a plan of care appropriate to the different gynecological pathologies, including health promotion and prevention of the disease.

- Ability to develop a professional contraceptive advice.

- Describe nursing care in the process of pregnancy, delivery and postpartum. That the student can describe the physiology of fertilization, pregnancy, childbirth and puerperium. Learn to recognize maternal and fetal risk factors and know how to prevent and act on them.

 

Referring to skills and abilities:

- Resolve exercises of clinical cases of sexual and reproductive health of women with the interventions and nursing activities more appropriate to each situation.

 

Referring to attitudes and values:

- Understand and discuss the different options of women and the family in family planning and aging.

- Argue and accept the decisions of women and the family in the different situations that can occur in sexual and reproductive health.

Description of contents:

The contents of the subject cover three major thematic blocks: promotion and prevention of sexual health, human reproduction / obstetrics and gynecological nursing.

 Unit 1. Introduction to sexual and reproductive health.

1.1. Introduction to the nursing of sexual and reproductive health. Importance of sexual and reproductive health care.

1.2. Sexual and reproductive health care program (ASSIR). The medical history.

1.3. Obstetric and gynecological terminology.

1.4. Clinical examinations in gynecology and obstetrics.

1.5. Anatomy of the female genital tract.

1.6. Physiology of the female genital tract. Menstrual cycle: ovarian and endometrial cycle. Neurohormonal regulation. More frequent alterations or dysfunctions.

 

Unit 2. Human reproduction.

Human.Sexuality. Biopsychosocial aspects of sexuality. Human sexual response.

2.2. Family planning. Family planning goals and recommendations of the World Health Organization. Contraceptive methods. Assisted reproduction. Professional nursing advice on fertility and infertility problems. Nursing care in assisted reproduction.

2.3. Adolescence, puberty, menarche. Physiological changes, health education and nursing care.

2.4. Climaterium, menopause. Health promotion, problem prevention and nursing care.

 

Unit 3. Reproductive health problems.

3.1. Infections of the female genital tract.

3.2. Population screening programs, early diagnosis, risk and protective factors and nursing care in gynecological and breast cancer. 

3.3. Benign pathology of the female reproductive system and nursing care. Uterine myoma. Uterine prolapse, types, diagnosis and treatment. Isthmic-cervical insufficiency. uterine malformations. Urinary incontinence, types, nursing performance, professional advice. Endometriosis. Polycystic ovary syndrome. Pelvic inflammatory disease. 

3.4 Malignant pathology of the female reproductive system and nursing care. 

3.5. Gynecological surgical interventions and nursing care.

3.6. Nursing care for the hospitalized gynecological patient.

3.7. Sexually transmitted diseases. bacterial vaginosis. Vaginal candidiasis. Prevention, treatment and professional advice. 

3.8. Gender violence, types, prevention, detection and nursing professional approach. 

3.9. Female genital mutilation, types, prevention, detection and professional nursing advice. 

3.10. Pregnancy in adolescence. Risk factors, professional approach. 

3.11. Gender and sexual health. Definitions and most important concepts. Professional approach in nursing consultation. 

 

Unit 4. Gestation.

4.1. Gametogenesis, fertilization and implantation. Fertilization process. Embryonic structures: morphological and functional characteristics of the placenta and the umbilical cord. Periods of intrauterine life.

4.2. Physiology of gestation. Modifications and clinical manifestations. Diagnosis of pregnancy.

4.3. Infectious diseases in pregnancy, teratogenesis.

4.4. Pregnancy control. Health education for motherhood. Low risk pregnancy.

4.5. Gestation of risk. Assessment of the risk of pregnancy.

4.6. Health problems during pregnancy, high-risk pregnancy: gestational diabetes, gestosis, first/third trimester bleeding, threatened miscarriage, miscarriage, ectopic pregnancy and hydatidiform mole. Voluntary Termination of Pregnancy Law 2023. Multiple gestation, hyperemesis gravidarum, threat of premature labor. Control and nursing care. 

4.7. Obstetric emergencies: placental abruption, cord prolapse, previous placenta, uterine rupture, eclampsia. Nursing performance.

4.8. Vaccinations and pregnancy.

 

 Unit 5. Childbirth.

5.1. Labor. Obstetric care and nursing care.

5.2. Nursing care for the newborn.

5.3. Health problems in childbirth. Control of intrapartum fetal well-being.

5.4. Eutocic delivery and dystocic delivery, obstetric interventions, nursing care.

5.5. Caesarean section. Surgical instruments.

5.6. Pharmacological and non-pharmacological techniques for pain relief.

5.7. Places of birth and attendance at childbirth. Hospital and out-of-hospital delivery.

 

 Unit 6. Postpartum and breastfeeding.

6.1. Physiology of the postpartum. Modifications and clinical manifestations.

6.2. Nursing care in the puerperium.

6.3. Physiology of milk secretion. Nursing care during lactation.

6.4. Health problems in the postpartum and lactation. Nursing care.

6.5. Psychological alterations in the postpartum: postpartum depression, puerperal psychosis. 

6.6. Perinatal mourning process, professional accompaniment.

The theoretical classes will be taught in the second grade nursing class room. They will consist of participatory master classes with audiovisual media support. A theoretical session will be held in collaboration with experts on specific topics. Attendance at theory classes are not compulsory, but they are recommended to integrate and assimilate theoretical knowledge more effectively. The theoretical content will be posted on subject resources weekly to facilitate the monitoring of classes.

The seminars will be carried out in small groups with the active participation of the student, including theoretical-practical sessions, in which theoretical contents will be worked on and transferred to clinical practice to work on the different nursing competences. The seminars will consist of the resolution of clinical cases individually and in groups, the carrying out of synthesis works with bibliographic review and oral presentation of the same with different formats (power point, triptych and poster) and innovation works on current nurse issues. 

The skills classroom will work on an expository part, a test of assimilation of theoretical knowledge and a practical part of acquisition of techniques / skills of nursing.

The simulation seminars will be carried out in pairs, in which the students will work theoretical-practical aspects, technical skills and specific nursing care.

At the beginning of the course, a schedule will be presented with the content to work, the modality and the evaluative activity of the different seminar sessions, skills classroom and simulations for each teaching week, as well as the delivery and evaluation dates of each of them.

The sessions can be recorded, for this reason the University of Lleida (UdL) informs that, for teaching purposes, will record images that identify students and other people who participate in academic activities. The responsible person for processing these images is the UdL (contact details of the representative: Secretaria General. Plaça de Víctor Siurana, 1, 25003 Lleida,sg@udl.cat; contact details of the data protection officer: dpd@udl.cat). These images are only used for teaching, assessing subject’s knowledge and for teaching improvement projects.

The use of the images responds to the legal obligation of the UdL to teach and improve university teaching, in accordance with Organic Law 6/2001, of 21 December, on universities. The images, once recorded, are kept at least as long as they do not prescribe the corresponding actions and claims against the evaluation approved by the teacher. They are destroyed in the terms and conditions provided for in the regulations on the conservation and disposal of the administrative documents of the UdL, and the document evaluation tables approved by the Generalitat de Catalunya (http://www.udl.cat/ca/serveis/arxiu/). The UdL will never communicate this data to third parties, except in the cases strictly provided for in the Law. Interested people can access to their images; request rectification, deletion or portability; oppose the treatment and request its limitation, by writing to the address dpd@udl.cat </src/compose.php?send_to=dpd@udl.cat>. They can also submit a complaint addressed to the Catalan Data Protection Authority, through the electronic headquarters of the Authority (https://seu.apd.cat) or by non-electronic media.

 

Teaching methodologies:

1. In person activities (40%):                                theoretical classes (50%, 30 hours) and seminars (50%, 30 hours), total 60 hours:

1.1. Theoretical classes: (30 hours)

- Participatory master classes.

- Conferences, classes of experts.

 

1.2. Tutored or directed activities: (30 hours)

- Seminars.

- Team work.

- Problem solving or clinical cases.

- Simulation of clinical cases.

- Skills classroom.

 

2. Non-asistance activities: 90 hours.

- Autonomous work.

- Assistance to external activities: interviews, practical observation.

- Reading of supplementary material.

- Preparation of evaluation activities.

- Preparation of seminars and resolution of clinical cases.

 

 

The theoretical content will be posted on subject resources weekly to facilitate the monitoring of classes.

At the beginning of the course, a schedule will be presented with the content to work, the modality and the evaluative activity of the different seminar sessions for each teaching week, as well as the delivery and evaluation dates of each of them.

 

Distribution of 6 ECTS credits:

- In-class activities (40%): Theoretical class (50% - 30h) and seminars, classroom skills and simulations (50% -30h) = 60 hours

- Non-attendance activities: student self-employment (60%) = 90 hours

Total student dedication: 150 hours.

Theory	Seminars	Autonomous work	Total
30 hours	30 hours	90 hours	150 hours

CONTINUOUS EVALUATION

To overcome the subject will be necessary overcome:

1. Theoretical part

All the theoretical content exposed in the lectures and seminars will be evaluated by means of a test type test of 80 questions (with four options, for every 3 incorrect answers the equivalent of 1 correct answer will be subtracted), in the official examination of the subject exam. To overcome it will be essential to have a grade equal to or higher than 5 of final grade. Partial exams are not contemplated.

Attention: the correction of exams is automated. Exams that do not have a name/surname/DNI or do not follow the guideline well indicated in the response template will not be evaluated.

2. Seminars: 

The seminars include different evaluation activities. The activities carried out by the student in the seminars will be evaluated individually (resolution of clinical cases, preparation of medical records, bibliographic review work, oral synthesis and exposition, skills classroom and simulation seminars) following a specific evaluation guideline where they will have Keep in mind: evidence of learning, skills and attitudes. The seminars are developed weekly associated with the theoretical content, promoting theoretical aspects and practical. For this reason, they are mandatory and are evaluated continuously, therefore, in In case of suspending the Seminar block, only the students who have attended 80% of the seminar sessions and the recovery will be based on activities of those specific seminar sessions suspended.

• Attendance at the seminars is obligatory, being attendance at least 80% of the seminars essential, only two absences for excused attendance will be allowed.
• Attendance at simulations is obligatory,with 100% attendance at simulation seminars * being essential.

 

ABSENCE JUSTIFICATION OF THEORETICAL-PRACTICAL SUBJECTS

In relation to absence justifications, the reasons for which the absence is considered to be justified, will be the same as those stated in the Regulations for Assessment and Qualification of Teaching in Degrees and Masters at the UdL for failure to attend the assessment tests scheduled in the teaching guide or on the degree website.

For the rest of situations derived from health, personal or family problems, the student will be allowed to change the day and recover the seminar during the week, if possible.

Justification or absence requests that entail failure to appear for an evaluation test must be submitted on the same absence day. The rest absence justifications must be submitted within the following 10 days.

In general, the student will only be excused the absence, but not the lack of compliance with their academic commitments.

 

ISSR 2023/24	CONTINUED ASSESSMENT
Evaluative activity		Assistance	Evaluation value
1. Theoric exam, multiple choice.			40%
2. Seminars Participation in seminars, resolution of clinical cases and problems. Specific evaluation of each seminar, according to rubric. Group and individual work and oral presentation. Cervical and breast cancer prevention skills classroom. test exam. Bibliographic review work and group synthesis and oral presentation. Specific evaluation according to rubric. Group work with oral defense. 3. Simulation seminars*. Resolution of clinical cases with simulated practice (competence assessment: observation rubric)		80%             100%	25%   10%   10%                                15%

 

IMPORTANT NOTE: To carry out the average of each of the parts (theoretical part, seminars and simulation) will be indispensable requirement to have each one of them approved with a minimum grade of 5. In the case of not exceeding one of The parts: the subject will be suspended.

 

SINGLE EVALUATION

Those students who cannot carry out continuous assessment and avail themselves of the single assessment system, must notify it at the beginning of the course.

To overcome the subject will be necessary:

Theoretical exam, multiple choice, which will include all the contents worked on in the theoretical classes and seminars: 80% of the final note.

Simulation seminars: 20% of the final note. It will be evaluated individually following an evaluation guideline adapted to the simulation seminar according to the competences to be assessed. Obligatory attendance.

To pass the subject, it will be necessary that the final grade of each of the parts (Theory and Simulation) corresponds to a minimum grade equal to or greater than 5 points (out of 10)

 

SINGLE EVALUATION
Evaluative activity	Assistance	Evaluation value
1.  Theoric exam		80%
2.  Simulation seminars *	100%	20%

 

 

 

 

 

 

 

 

 

Honors

Those students who obtain a final grade for the course equal to or greater than 9.0 points will be candidates to qualify for the Honors Degree. The number of Honor Registrations awarded will be in relation to the information detailed in the Regulations for Assessment and Qualification of Teaching in the Degrees and Masters of the UdL

.

Bibliography

 

1. Generalitat de Catalunya. Departament de Sanitat i Seguretat Social. SCatOG - Protocolo de asistencia al parto y al puerperio y de atención al recién nacido [Internet]. 2003. Available from: http://portal.guiasalud.es/GPC/GPC_472_Parto_Normal_Aquas_compl_cat.pdf
2. Federación de Asociaciones de Matronas de España (FAME). Definicion de parto normal FAME [Internet]. 2005 [cited 2020 Dec 12]. Available from: https://www.federacion-matronas.org/informacion-de-interes-para-profesionales/parto-normal-definicion-fame/
3. Generalitat de Catalunya. Departament de Salut. Protocolo para la asistencia natural al parto normal. Direcció General de Salut Pública: Barcelona; 2007.
4. Grupo de trabajo de la Guía de Práctica Clínica sobre atención al parto normal. Guía de Práctica Clínica sobre la atención al parto normal. Plan de Calidad para el Sistema Nacional de Salud del Ministerio de Sanidad y Política Social; 2010.
5. Grupo de trabajo de la Guía de práctica clínica de atención en el embarazo y puerperio. Guía de práctica clínica de atención en el embarazo y puerperio. Ministerio de Sanidad, Servicios Sociales e Igualdad. Agencia de Evaluación de Tecnologías Sanitarias de Andalucía; 2014.
6. Ministerio de Sanidad, Servicios Sociales, e Igualdad. Estrategia de atención al parto normal en el sistema nacional de salud [Internet]. Madrid: Ministerio de Sanidad Servicios Sociales e Igualdad; 2015. Available from: https://www.mscbs.gob.es/organizacion/sns/planCalidadSNS/pdf/InformeFinalEAPN_revision8marzo2015.pdf
7. FAME. Iniciativa Parto Normal. Guía para madres y padres. Pamplona: Federación de Asociaciones de Matronas de España; 2011.
8. Grup Elaborador de la Guia. Actualització i adaptació a Catalunya de la Guia de Pràctica Clínica del Sistema Nacional de Salut sobre l’Atenció al Part Normal. Barcelona: Agència de Qualitat i Avaluació Sanitàries de Catalunya. Departament de Salut. Generalitat de Catalunya; 2013.
9. Pla de salut de Catalunya 2016-2020. Barcelona: Direcció General de Planificació en Salut; 2016.
10. Recomendaciones de la OMS para la prevención y el tratamiento de las infecciones maternas en el periparto. http://apps.who.int/iris/bitstream/10665/205685/2/WHO_RHR_16.01_spa.pdf
11. Contracepció d’emergència. http://www.gencat.net/ics/usuaris/campanyes/contracepcio/index.html
12. Malalties de transmissió sexual. http://www.gencat.net/salut/depsan/units/sanitat/html/ca/dir479/index.html
13. Sexe joves. http://www.sexejoves.gencat.net/ics_webjove/AppPHP/index.php
14. Centre jove d’anticoncepció i sexualitat. http://www.centrejove.org/home.htm
15. Federación de Planificación Familiar Estatal (FPFE). El acceso de las mujeres a la anticoncepción en las comunidades autónomas. Madrid: Bayer; 2016. 60 p.
16. Grupo de trabajo de la Guía de Práctica Clínica de Anticoncepción Hormonal e Intrauterina. Guía de Práctica Clínica de Anticoncepción Hormonal e Intrauterina. Ministerio de Sanidad, Consumo y Bienestar Social. Instituto Aragonés de Ciencias de la Salud; 2019. Guías de Práctica Clínica en el SNS.
17.17. OMS. Criterios médicos de elegibilidad para el uso de anticonceptivos [internet]; 2016 [citado 07 de julio de 2022]. Disponible en: https://www.who.int/es/publications/i/item/9789241549257.
18. OMS. Recomendaciones sobre prácticas seleccionadas para el uso de anticonceptivos, tercera edición [Selected practice recommendations for contraceptive use, 3rd edition]. Ginebra: Organización Mundial de la Salud; 2017. 75 p.
19. OMS. Rueda con los criterios médicos de elegibilidad para el uso de anticonceptivos [internet]; 2016 [citado 07 de julio de 2022]. Disponible en: https://www.who.int/es/publications/i/item/9789241549257.
20. Generalitat de Catalunya. Departament de Salut. Cures pal.liatives perinatals. Barcelona: Direcció General de Planificació en Salut;2016. 25 p.
21. Generalitat de Catalunya. Departament de Salut. Guia d’acompanyament en el dol perinatal. Barcelona: Direcció General de Planificació en Salut;2016. 44p.
22. Instituto Aragonés de Servicios Sociales. Maternidad responsable. Opciones y recursos ante un embarazo no planificado. Zaragoza: Instituto Aragonés de Servicios Sociales; 2020. 55p.
23. Burrouhs A. Enfermería materno-infantil. 8ª ed. Madrid:MacGraw-Hill Interamenicana, 2002.
24. Didona NA, Marks MG, Kumm R. Enfermeria maternal. México: McGraw-Hill Interamerica; 2015.

The updates of the clinical practice guidelines, the updated protocols and published scientific articles that are published during the course, will be posted in bibliographic resources of the subject by thematic units to reinforce the contents and facilitate their consultation by the student. .