Human Sexuality and Alterations sexuality

human sexuality

1. Sexuality

2. Learning Outcomes Define the term ‘sexuality’ Identify the importance of maintaining sexuality Describe the factors affecting sexuality including changes in the body Explain the disorders in sexuality Describe strategies to overcome above disorders Appraise nurses responsibility in caring patient with sexual disorders

3. Introduction Human sexuality is difficult to define. Sexuality is an individually expressed and highly personal phenomenon that evolves from life experiences. Physiologic, psychosocial, and cultural factors influence an individual’s sexuality and lead to the wide range of attitudes and behaviors seen in humans. Satisfying or “normal” sexual expression can be described as whatever behaviors give pleasure and satisfaction to those adults involved, without threat of coercion or injury to self or others

4. Factors Influencing Sexuality Many factors influence an individual’s sexuality. family culture religion personal expectations and ethics

5. Factors Influencing Sexuality Family Within our families we develop our gender identity, body image, sexual self-concept, and capacity for intimacy. Through family interactions we learn about relationships and gender roles and our expectations of others and ourselves. Family messages about sex range from “sex is so shameful it shouldn’t be talked about” to “sex is a joyful part of adult relationships.

6. Factors Influencing Sexuality Culture Culture influences the sexual nature of dress, rules about marriage, expectations of role behavior and social responsibilities, and sex practices. Societal attitudes vary widely. Attitudes about childhood sexual play with self or children of the same gender or other gender may be restrictive or permissive. Premarital and extramarital sex and homosexuality may be culturally unacceptable or tolerated. Polygamy (several mates or marriage partners) or monogamy (one mate or marriage partner) may be the norm. Gender expression also varies from culture to culture.

7. Factors Influencing Sexuality Religion Religion influences sexual expression. It provides guidelines for sexual behavior and acceptable circumstances for the behavior, as well as prohibited sexual behavior and the consequences of breaking the sexual rules. The guidelines or rules may be detailed and rigid or broad and flexible. Personal Expectations and Ethics ethical thought and ethical approaches to sexuality can be viewed separately from religion. Cultures have developed written or unwritten codes of conduct based on ethical principles. Personal expectations concerning sexual behavior come from these cultural norms.

8. Altered Sexual Function The ability to engage in sexual activity is of importance to most individuals. Many individuals experience transient problems with their ability to respond to sexual stimulation or to maintain the response. Fewer individuals experience problems lifelong. The problems may be generalized to all sexual interactions and settings, or they may be situational, occurring in specific circumstances or with specific types of sexual activity.

9. Altered Sexual Function Factors influencing altered sexual function Sociocultural factors – a very strict upbringing accompanied by inadequate sex education. parental punishment for normally exploring one’s genitals or for typical childhood sex play. Psychologic factors – negative feelings such as guilt, anxiety, or fear that interfere with the ability to experience pleasure and joy. Depressed individuals lose interest in sexual activity and often experience a loss of sexual desire and fulfillment.

10. Altered Sexual Function Cognitive factors – the internalization of negative expectations and beliefs. Those with low self-esteem may not understand how another individual could value and love them and also find them sexually attractive. Health factors – Physical changes brought on by illness, injury, or surgery may inhibit full sexual expression. There may be sexual side effects from several conditions such as heart disease, diabetes mellitus, joint disease, cancer, and mental disorders. Surgeries such as hysterectomy, prostate surgery, and radical surgeries alter an individual’s body image. Spinal cord injuries, traumatic amputations, or disfiguring accidents negatively affect sexual functioning.

11. Sexual Desire Disorders For most individuals, sexual desire varies from day to day and over the years. Some individuals, however, report a deficiency in or absence of sexual fantasies and persistently low interest or a total lack of interest in sexual activity these clients may have hypoactive sexual desire disorder .

12. Sexual Arousal Disorders Sexual arousal refers to the physiologic responses and subjective sense of excitement experienced during sexual activity. Lack of lubrication and failure to attain or maintain an erection are the major disorders of the arousal phase. In female sexual arousal disorder , the lack of vaginal lubrication causes discomfort or pain during sexual intercourse. The diagnosis of male erectile disorder is usually made when the male has erection problems during his sexual interactions. Some males cannot attain a full erection, and others lose their erection prior to orgasm. The term commonly applied to this condition, impotency , implies that the male is feeble, inadequate, and incompetent.

13. Orgasmic Disorders The more accurate and objective term is female orgasmic disorder , which simply means that the sexual response stops before orgasm occurs. In male orgasmic disorder , the male can maintain an erection for long periods (an hour or more) but has extreme difficulty ejaculating, referred to as delayed ejaculation . Premature ejaculation is one of the most common sexual dysfunctions among males.

14. Sexual Pain Disorders Both women and men can experience dyspareunia , pain during or immediately after intercourse. It is associated with many physiologic causes, especially those that inhibit lubrication. Skin irritations, vaginal infections, estrogen deficiencies, and use of medications that dry vaginal secretions can cause women to experience discomfort with intercourse.

15. Student Activity Nursing Management – Applying the Nursing Process

16. Assessment It is critical that nurses not make assumptions about clients because assumptions interfere with accurate history taking. Interviewing a client regarding sexual health may be uncomfortable for some nurses (and for the client). Nurses must be aware of their own feelings and beliefs so that they can prepare approaches for gathering data and creating the nursing care plan. The nurse sets aside personal values about sexual practices and uses a culturally sensitive, nonjudgmental, nonthreatening, and reassuring approach. It is extremely important to create an atmosphere that facilitates open communication and comfort for the client. Remind the client that all personal health information is handled in a confidential manner.

17. Nursing Diagnosis Sexual dysfunction, insufficient knowledge (e.g., about conception, STIs, contraception, or normal sexual changes over the lifespan) related to misinformation and sexual myths. Unsatisfying personal relationship related to unrealistic expectations. Fear related to history of sexual abuse or dyspareunia. Altered body image (e.g., from a mastectomy) related to perceived sexual rejection by partner.

18. Planning Overall goals to meet clients’ sexual needs include the following • Maintain, restore, or improve sexual health. • Increase knowledge of sexuality and sexual health. • Prevent the occurrence or spread of STIs. • Prevent unwanted pregnancy. • Increase satisfaction with the level of sexual functioning. • Improve sexual self-concept.

19. Interventions The interventions the nurse selects are based on the data obtained from the client and the identified nursing diagnoses. Many interventions are directed at providing information about sexual health and counseling for altered sexual function. Clients need to be taught about sexual function, the effects of medications on sexual function, preventing STIs, and performing breast and testicular self-examinations