4. DISCUSSIE
4.6 MAATSCHAPPELIJK BELANG VAN DE STUDIE
Conceptualizering van seksueel welzijn is belangrijk daar het aandeel van seksueel welzijn en welzijn in het algemeen in de toekomst waarschijnlijk nog groter zal worden.
De huidige maatschappij wordt gekenmerkt door vergrijzing. De bevolking wordt steeds ouder, de levensverwachting neemt toe maar door de hoge prevalentie van chronische ziekten neemt de levenskwaliteit af (63). Ook bij mensen van oudere leeftijd is seksuele gezondheid van belang. Over de definitie van seksuele gezondheid kan de opmerking gemaakt worden dat hij te idealistisch is. Er zijn zodanig veel criteria waaraan voldaan moet worden, dat er zelden nog iemand als gezond kan beschouwd worden. De huidige definitie is eerder een doel waaraan voldaan moet worden dan een omschrijving van de staat waarin een gemiddeld persoon zich bevindt (64). Voor een gemiddeld persoon in een vergrijzende samenleving, is het niet mogelijk om te voldoen aan alle criteria van seksuele gezondheid. Het begrip seksueel welzijn biedt hier echter een tegenwicht door te vragen naar de subjectieve evaluatie van seksuele gezondheid.
45 Ook in de andere populaties mag het belang van welzijn niet ontkend worden. In de tienerpopulatie wordt onderzoek naar seksuele gezondheid vaak gedomineerd door een negatieve benadering van de seksualiteit. Dit wordt aangekaart in de publicatie van Harden K (65). Veel gebruikte indicatoren zijn onthouding van seksueel gedrag, gebruik van anticonceptie en het vermijden van risicogedrag. Er wordt hier de opmerking gemaakt dat deze indicatoren niet noodzakelijk positief zijn voor de seksuele gezondheid van tieners. Onthouding van seksuele activiteit kan bijvoorbeeld een teken zijn van angst, gevoelens van onaantrekkelijkheid. Er moeten inzichten verworven worden over de seksuele verwachtingen, de angsten en de assertiviteit van een adolescent (65). Seksuele gezondheid moet ook bij adolescenten ruimer gezien worden dan enkel het vermijden van risicogedrag. Het is duidelijk dat in de literatuur de adolescentenpopulaties heel weinig worden betrokken bij het onderzoek naar seksueel welzijn. Naarmate het belang van een positieve benadering van seksualiteit bij adolescenten erkend zal worden, kan ook hier seksueel welzijn een belangrijke meerwaarde bieden ten opzichte van de huidige uitkomstmaten.
4.7 Besluit
In deze literatuurstudie werd bevestigd dat er nog geen goede definitie of schaal bestaat om seksueel welzijn te meten. Binnen de wetenschappelijke literatuur wordt seksueel welzijn in verschillende onderzoeksdomeinen gebruikt als uitkomstmaat. Ondanks een aantal overeenkomsten, wordt seksueel welzijn niet consequent gemeten en gedefinieerd. Het belang van seksueel welzijn wordt wel erkend. Men lijkt de verschillende domeinen van seksuele gezondheid, namelijk de fysieke, mentale, emotionele en sociale aspecten, te willen meten en te verruimen door een aspect met betrekking tot de individuele perceptie of evaluatie toe te voegen. Zodoende is er nood aan een vastgelegde definitie met een duidelijke omschrijving van de verschillende sub- constructen van seksueel welzijn. Op basis van de meest gebruikte definities en sub-constructen werd een voorstel gedaan voor een definitie om seksueel welzijn in toekomstig onderzoek te kunnen gebruiken. Meer onderzoek is noodzakelijk om deze bevindingen te valideren.
46
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