Sexual health communication in adolescent nursing care: A concept analysis using Walker and Avant's method

Background & Aim: Sexual health communication is central to adolescent nursing care, but its meaning remains conceptually inconsistent across nursing settings and adjacent disciplines. This conceptual ambiguity limits assessment, education, measurement, and service design. This study aimed to clarify sexual health communication in adolescent nursing care and identify its defining attributes, antecedents, consequences, and empirical referents. Methods & Materials: Walker and Avant's eight-step method guided the analysis. CINAHL, PubMed/MEDLINE, Scopus, ERIC, and the Cochrane Library were searched for English-language literature published from January 2000 to December 2025. A focused update through June 2026 used PubMed and backward and forward citation tracking. Full texts were assessed against predefined conceptual and disciplinary eligibility criteria, and data were extracted into a structured matrix. Nursing-specific evidence was prioritized for defining the concept. Thirty substantive sources were included. Results: Six defining attributes were identified: purposeful initiation and reciprocal adolescent participation; confidentiality enactment and interactional safety; accurate, clear, and developmentally responsive information exchange; responsive relational engagement during the encounter; timely, continuous, and care-linked communication; and contextually responsive and power-aware communication. Antecedents occurred at adolescent, professional, organizational, and sociocultural levels. Potential consequences included enhanced understanding, comfort and disclosure, follow-up, help-seeking, continued communication, and informed decision-making. Broader outcomes, including service access and equitable care, were considered potential distal implications. Existing measures capture selected components but not the complete nurse-adolescent concept. Conclusion: Sexual health communication in adolescent nursing care is a purposeful, reciprocal, confidentiality-protective, developmentally responsive, and clinically integrated nurse-adolescent interaction. The clarified concept provides a nursing-specific basis for education, clinical assessment, intervention design, and measure development and future validation across diverse cultures and nursing settings.