Chapter 45 - Sexuality Flashcards
Components of Sexuality
Biologic sex Anatomic determination Gender Identity Psychological identification Inner sense of being Gender Role Behavior Behavior related to “maleness/femaleness”
WHO definition:
“the integration of the somatic, emotional, intellectual and social aspects of sexual beings, in ways that are positively enriching and that enhance personality, communication, and love” Sexual Preferences Heterosexual Homosexual Bisexual Transsexual Transvestite
Factors affecting sexuality
Developmental Considerations Relationships, lifestyle Cognition and perception Culture, values, beliefs, religion, ethics Previous experience Self-concept Childbearing Considerations Sexually Transmitted Infections Sexual Dysfunction Other Health Conditions
Other Health Conditions Affecting Sexuality
Diabetes Erectile dysfunction (Rx meds/implants) Orgasmic dysfunction (female) Cardiovascular disease HTN (modify/change meds) MI (gradually increase sexual activity) Joint and mobility Pain, fatigue, stiffness (discomfort, anxiety) Chronic pain (need warmth, contact) Body Image (anxiety) Mental Illness (side effects of meds) Spinal Cord Injuries Medications
Nursing Assessment
Not included in every exam Sexual history Assess when appropriate (diseases affecting sexuality) Should be aware of any clues Asks vague questions Asks specific questions
Principles for Talking about Sex
Desensitize
Use matter-of-fact manner
Use “allowing” statements and open-ended questions
Introduce topics with statement of acceptability
Discuss facts and attitudes before experiences
Principles for Talking about Sex
Assume full range of sexual experience Use gender-neutral terms Keep a sense of humor about terms Explain your terms or employ terms used by patient Be attentive to cues
Barriers
Elderly may have difficulty asking about sexual topics with nurses/MD’s who are significantly younger than them
Males may be uncomfortable discussing sexual issues with female nurses/MD’s
Adolescents may have difficulty discussing sexual concerns with adults
Other barriers
Physiological changes Lack of privacy Illness & erectile dysfunction Lack of a partner Negative attitudes from staff & physicians Feeling of unattractiveness Guilt & “widow’s syndrome”
Sample Questions
“Are you currently sexually active?”
“Because STDs, including AIDS are becoming more prevalent, it’s important for you to know whether you are at risk for these diseases. Do you currently have more than 1 sexual partner?”
“In what way has your present illness affected your sexual relationships?”
“Many pts worry about having to change their sexual activity when they go home. Do you have any concerns?”
Nursing Diagnosis
Ineffective Sexuality Patterns as the problem, related to
Medications
Disease process
History of abuse
Fear of rejection
Fear of pain
Ineffective Sexuality Patterns as the Etiology
Impaired adjustment R/T loss of sexual partner
Anxiety R/T loss of sexual desire
Ineffective coping R/T effects of body image
Beliefs about sex & aging
Sexual desire goes with age
Older women who enjoy sex were ‘nymphomaniacs’ when younger
The ‘dirty old man’
Elderly are not “desirable, desirous, capable”
Physiological changes = sexual dysfunction
“cute”, “disgusting”, “troublesome”
Physical illness obviates sex & sexuality
Viagra leads to divorces!
Hearing from the AARP’s
Health-providers should:
Help us feel comfortable talking about sex
Not be afraid or embarrassed
Help us “break the ice”
Offer permission to express feelings & needs
Treat us with respect & non-judgmental attitude
See us as individuals with sexual needs
Accept us ( gay, straight, bisexual)
Provide advice & suggestions
Nursing Implementation
Establish a trusting nurse-patient relationship
Promoting Sexual Health
Self-awareness
Self-examination
Sex education
Responsible sex / STIs
Contraceptive use / Unwanted Pregnancy
Facilitate Coping with Special Sexual Needs
Healthcare Needs of People with different Sexual Orientations
Advocate Sexuality Needs of Patients
Counseling (concerns, abortion, abuse)
Nursing Evaluation
Evaluate patient:
Appearance
Self-confident
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