SEXUALITY – HUMAN NEED
Ns. HAFNA ILMY MUHALLA, S. Kep., M. Kep., Sp. Kep. M.B.
PRODI D-III KEPERAWATAN FAKULTAS VOKASI UNIVERSITAS AIRLANGGA
2nd semester, 2018
SEXUALITY
BASIC CONCEPT AND
NURSING CARE
HAFNA ILMY MUHALLA
PRODI D-III KEPERAWATAN
FAKULTAS VOKASI
UNIVERSITAS AIRLANGGA
2018
SEXUALITY, SEX AND
SEX ROLE
SEXUALITY
sexuality includes a person’s attitudes
toward relationships with people of the
same sex, relationships with those of the
opposite sex, and about touching and
being touched. The way people dress,
talk, and relate to others.
DIMENSI SEKSUAL
• Sexuality
• Human sexual response
• Sex roles
• Sexuality and health
• Development of sexuality
• Sexual dysfunction
• Gender identity
• Nursing process
• Needs
SEXUALITY
• All aspects of being male or female: Genital
sex, feeling, attitudes, beliefs, behavior
• An essential part of one’s personality.
SEXUALITY
How to feel about him self
How to communicate his feeling
Includes touching, hugging, soft attitude:
signs, dressing, word, think, experiences,
value, fantasy and emotion
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SEXUALITY – HUMAN NEED
Ns. HAFNA ILMY MUHALLA, S. Kep., M. Kep., Sp. Kep. M.B.
PRODI D-III KEPERAWATAN FAKULTAS VOKASI UNIVERSITAS AIRLANGGA
2nd semester, 2018

SEXUALITY SEXUALITY (WHO, 2006a)

• “…a central aspect of being human throughout life encompasses
Biological aspect sex, gender identities and roles, sexual orientation, eroticism,
Cultural aspect pleasure, intimacy and reproduction. Sexuality is experienced
and expressed in thoughts, fantasies, desires, beliefs, attitudes,
Psychological aspect values, behaviors, practices, roles and relationships. While
sexuality can include all of these dimensions, not all of them are
Spiritual aspect always experienced or expressed. Sexuality is influenced by the
Sociological aspect interaction of biological, psychological, social, economic,
political, cultural, legal, historical, religious and spiritual factors.”

SEX
SEX IS
Biological characteristics, male and female

Anatomical and physiological

Physical sexual activity

WHO, 2018

SEX ROLES
Are culturally determined patterns
associated with being male and female.
DEVELOPMENT OF
These patterns are developed as a result of
cultural expectations, customs, norms,
SEXUALITY
habits, and traditions.

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SEXUALITY – HUMAN NEED
Ns. HAFNA ILMY MUHALLA, S. Kep., M. Kep., Sp. Kep. M.B.
PRODI D-III KEPERAWATAN FAKULTAS VOKASI UNIVERSITAS AIRLANGGA
2nd semester, 2018

DEVELOPMENT OF SEXUALITY DEVELOPMENT OF SEXUALITY

• Begin with conception Baby (0-12 month) Toddler (1-3 yo)
• First 6 weeks of fetal development (no autonomic • Gender determination • A continuing of
difference) • Self diversification with other gradually developing gender
• Sensitive to touch on external genital identity
• At 7 to 8 weeks, testes develop (high level of • An erection on baby boy’s genitals • Able to identify his
gender
testosterone) • A vaginal lubrication on baby girl
• Began to imitate the
• Feeling pleasure and comfortable
• Feelings, attitudes, behavior related to sexuality toward interaction with others by
tactile stimulation
parent action of the
same sex
are learned in the family
Rozali, www.esaunggul.ac.id

DEVELOPMENT OF SEXUALITY DEVELOPMENT OF SEXUALITY

Pre-school (4-5 yo)
• An increasing awareness of
himself
• Explore the limbs (self and
playmates)
• Learn the name of the limbs
correctly
• Learn to control of feelings and
behavior
• Likes to a different sex of parent
• Asking how the baby was created
School (6-12 yo)
• They have a strong identification to his
parent of the same sex
• They take a fancy to be friends with the
same sex
• An increasing self awareness
• Learn the gender concept and role
• Begin to appreciate the personal things, ex
mode
• Begin to thing of sexual behavior,
reproduction and sexual matter at 8-9 yo
Teenager (12-18 yo)
• The characteristics of sex begin to
develop
• Begin to menarche
• Developing a pleasure relationship
• Begin to take a sexual activity, ex
masturbation
• Identifying the sexual orientation
• Seeking health care without his
parent
Early Adulthood (18-40 yo)
• Sexual activity is occurs
• the adopted lifestyles and
values have been strong
• Pair share task of finance and
house chores
• Experiencing threats to body
image due to aging

Rozali, www.esaunggul.ac.id Rozali, www.esaunggul.ac.id

DEVELOPMENT OF SEXUALITY
Middle adult (40-65 yo) Late Adult (>65 yo)

• Decreasing hormone production • Decreasing sexual activity

• Woman: Having menopause (40- • Decreasing vaginal
55 yo) secretion
• Man: Having a gradual
climacterically
• The breast has atrophy
• Sperm was decrease
GENDER IDENTITY
• Begin to strengthen a moral and
ethical standards • The man take a longer
time to erect and ejaculate

Rozali, www.esaunggul.ac.id

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SEXUALITY – HUMAN NEED
Ns. HAFNA ILMY MUHALLA, S. Kep., M. Kep., Sp. Kep. M.B.
PRODI D-III KEPERAWATAN FAKULTAS VOKASI UNIVERSITAS AIRLANGGA
2nd semester, 2018

GENDER IDENTITY GENDER IDENTITY

•Gender Identity
Is how one views ones’ self as male or female
in relationship to others
How the person decides to express sexuality
in behaviors with others
Nurse must assess on gender identity and
gender role
• Sexual Orientation
• An individual’s preference for ways of expressing
sexual feelings
• A dynamic lifelong process of growth
• Heterosexuality, homosexuality, bisexuality, trans-
sexuality
• Nurse must respect all individuals, regardless of sexual
orientation

SEXUAL HEALTH
• “…a state of physical, emotional, mental and social well-
being in relation to sexuality; it is not merely the absence of
disease, dysfunction or infirmity. Sexual health requires a
SEXUAL HEALTH and positive and respectful approach to sexuality and sexual
relationships, as well as the possibility of having pleasurable
SEXUAL RIGHT and safe sexual experiences, free of coercion, discrimination
and violence. For sexual health to be attained and
maintained, the sexual rights of all persons must be
respected, protected and fulfilled.” (WHO, 2006a)

THE CHARACTERISTICS OF SEXUAL HEALTH THE CHARACTERISTICS OF SEXUAL HEALTH

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SEXUALITY – HUMAN NEED
Ns. HAFNA ILMY MUHALLA, S. Kep., M. Kep., Sp. Kep. M.B.
PRODI D-III KEPERAWATAN FAKULTAS VOKASI UNIVERSITAS AIRLANGGA
2nd semester, 2018

KEY CONCEPTUAL ELEMENTS OF

THE CHARACTERISTICS OF SEXUAL HEALTH
SEXUAL HEALTH

• Sexual health is about well-being, not merely the

absence of disease.
• Sexual health involves respect, safety and freedom
from discrimination and violence.
• Sexual health depends on the fulfilment of certain
human rights.

KEY CONCEPTUAL ELEMENTS OF

SEXUAL HEALTH
• Sexual health is relevant throughout the individual’s
lifespan, not only to those in the reproductive years, but
also to both the young and the elderly.
• Sexual health is expressed through diverse sexualities
and forms of sexual expression.
• Sexual health is critically influenced by gender norms,
roles, expectations and power dynamics.
SEXUAL RIGHTS
Rights critical to the realization of sexual health
include:
• the rights to equality and non-discrimination
• the right to be free from torture or to cruel,
inhumane or degrading treatment or punishment
• the right to privacy

SEXUAL RIGHTS SEXUAL RIGHTS

• the rights to the highest attainable standard of
health (including sexual health) and social security
• the right to marry and to found a family and enter
into marriage with the free and full consent of the
intending spouses, and to equality in and at the
dissolution of marriage
• the right to decide the number and spacing of
one's children
• the rights to information, as well as education
• the rights to freedom of opinion and expression,
and
• the right to an effective remedy for violations of
fundamental rights.

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SEXUALITY – HUMAN NEED
Ns. HAFNA ILMY MUHALLA, S. Kep., M. Kep., Sp. Kep. M.B.
PRODI D-III KEPERAWATAN FAKULTAS VOKASI UNIVERSITAS AIRLANGGA
2nd semester, 2018

SEXUALITY
Expressed by individuals of all ages

A way to show feminine or masculine qualities (clothing

SEXUAL NEED AND styles, hairstyles, hobbies and interests, sexual habit,
gestures)

RESPONSES May be expressed by: sexual intercourse, caressing, touching,

holding hands, masturbation

Is a right of all residents to experience

HUMAN NEEDS THE AFFECTING FACTORS OF

RELATED TO SEXUALITY SEXUALITY

TENDER SENSUA
INTIMACY
NESS LITY
ATTACH PROCRE
CARING
MENT ATION

PHASES OF HUMAN SEXUAL

HUMAN SEXUAL RESPONSE
RESPONSE

Is combination of physiological responses

AROUSAL/
and emotional responses (thoughts and EXCITEMENT
PLATEAU ORGASM RESOLUTION

feelings)
DUNNING, 2003

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SEXUALITY – HUMAN NEED
Ns. HAFNA ILMY MUHALLA, S. Kep., M. Kep., Sp. Kep. M.B.
PRODI D-III KEPERAWATAN FAKULTAS VOKASI UNIVERSITAS AIRLANGGA
2nd semester, 2018

SEXUAL PROBLEMS

DYSFUN DISCRIMI
VIOLENCE
CTION NATION

SEXUAL PROBLEMS ABUSE

COERCI
ON

SEXUAL DYSFUNCTION
SEXUAL DYSFUNCTION IN MAN

PRIMER SECONDARY
UN-ORGASM HABITUAL

ABNORMALITY OF SEXUAL
SITUATIONAL
FUNCTION

SEXUAL DYSFUNCTION IN MAN

SEXUAL DYSFUNCTION IN WOMAN

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SEXUALITY – HUMAN NEED
Ns. HAFNA ILMY MUHALLA, S. Kep., M. Kep., Sp. Kep. M.B.
PRODI D-III KEPERAWATAN FAKULTAS VOKASI UNIVERSITAS AIRLANGGA
2nd semester, 2018

FACTORS OF SEXUAL PROBLEMS

BIOLOGICAL
(Physical health, neurobiology, endocrine function)

PSYCHOLOGICAL (anxiety, depression)

NURSING PROCESS
RELATIONAL (current and past) and SEXUALITY
CONTEXTUAL (life stressors)

SAMJ, June 2014, Vol. 104. No. 6

NURSING CONSIDERATION NURSING CONSIDERATION

• Nurse must not express shock or disapproval
regarding a client’s sexual practices
• Do not change beliefs and attitudes
• It is necessary to suspend in order to spare
the client any judgment
• Talking and listening to clients is important to
promotes intimacy
• Do not embarrassed to talk about sexuality
• It is imperative to deal
• with one’s own feelings in order to decrease the
client’s discomfort

ASSESSMENT
• Sexuality is a sensitive matter
• Nurse must sensitive to cultural and religious
differences
• While do assessment, establish an atmosphere
that encourages the client to freely discuss his or
her concerns
ASSESSMENT
• The conducive discussion will be achieve:
• Assure privacy and maintain confidentiality
• Use simple, direct language
• Provide explanations in terns understood by the client
• Allow time for the clients’ questions
• Demonstrate respect by adopting a nonjudgmental
attitude
• Use open-ended questions to elicit more information

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SEXUALITY – HUMAN NEED
Ns. HAFNA ILMY MUHALLA, S. Kep., M. Kep., Sp. Kep. M.B.
PRODI D-III KEPERAWATAN FAKULTAS VOKASI UNIVERSITAS AIRLANGGA
2nd semester, 2018

ASSESSMENT ASSESSMENT
• Preparing for the sexual assessment:
• Review the clients’ medical history Physical
• Greet the client and explain the assessment techniques that you Interview
will be using examination
• Assess the client’s anxiety level, and provide reassurance that
this is normal
• Ensure that the room temperature is warm and comfortable Supporting
• Use a quiet room that will be free from interruptions examination
• Have the client void prior to the examination

Possible Effects of Injury or Illness on Possible Effects of Injury or Illness on

Sexuality Sexuality

Disfiguring surgery may cause a person to feel: Surgery can have both physical and/or psychological
effects: removal of prostate or testes, amputation of a
unattractive and ugly to others, mutilated and limb, removal of uterus; ovaries; breast, colostomy,
deformed, unworthy of love or affection ileostomy

Disorders that cause Disorders affecting the ability

Chronic illness and certain Disorders affecting the ability
impotence: diabetes mellitus, to have sex: stroke, nervous
medications can affect sexual to have sex: COPD,
spinal cord injuries, multiple system disorders, heart
functioning circulatory disease, arthritis
sclerosis, alcoholism disease

DIAGNOSIS DIAGNOSIS

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SEXUALITY – HUMAN NEED
Ns. HAFNA ILMY MUHALLA, S. Kep., M. Kep., Sp. Kep. M.B.
PRODI D-III KEPERAWATAN FAKULTAS VOKASI UNIVERSITAS AIRLANGGA
2nd semester, 2018
INTERVENTIONS
IMPLEMENTATION
Important things:
• Communication and education
• Self-awareness
Guidelines for The Nurse Aide in
Dealing with Resident Sexuality
Assist to prepare for special activities by “dressing
up”: selecting attractive clothing, fixing hair,
applying cosmetics, wearing a special perfume or
aftershave
Help to develop a positive self-image
INTERVENTIONS
Guidelines for The Nurse Aide in
Dealing with Resident Sexuality
Assist to maintain sexual identity by dressing
residents in clothing appropriate for men or women
Assist with personal hygiene
Guidelines for The Nurse Aide in
Dealing with Resident Sexuality
Help to develop a positive self-image
Show acceptance and understanding for resident’s
expression of love or sexuality: provide privacy,
always knock prior to entering a room at any time,
assure privacy when requested
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SEXUALITY – HUMAN NEED
Ns. HAFNA ILMY MUHALLA, S. Kep., M. Kep., Sp. Kep. M.B.
PRODI D-III KEPERAWATAN FAKULTAS VOKASI UNIVERSITAS AIRLANGGA
2nd semester, 2018

Guidelines for The Nurse Aide in Dealing

with Resident Sexuality
EVALUATION
Use:
Never expose the resident
• Observation
Accept the resident’s sexual relationship • Expressions of intimacy
• Communication
Provide protection for the non-consenting resident
• Open-minded
Be firm but gentle in your rejection of a resident’s sexual advances • Nonjudgmental

DAFTAR PUSTAKA DAFTAR PUSTAKA

• Rozali, Yuli Asmi. 2018. Seksualitas Sebagai kebutuhan Dasar Manusia. www.esaunggul.ac.id
• Rowland, David. L and Incrocci, Luca. 2008. Handbook of Sexual and Gender Identity
Disorders. Wiley. John Wiley & Sons, Inc.
• Hatzimouratidis, K., Eardley, I., Giuliano, F., Moncada, I., Salonia, A. 2015. Guidelines on
Male Sexual Dysfunction: Erectile Dysfunction and Premature Ejaculation. European
Association of Urology.
• Boa, R. 2014. Female Sexual Dysfunction. S Afr Med Journal. 2014:104 (6):446. South Africa.
• DeLaune Sue C, Ladner Patricia K. 2002. fundamental of Nursing: Standards and Practice.
2nd Edition. Delmar, Thomson Learning, Inc. NY.
• Meston C, Bradford A. 2007. Sexual Dysfunctions in Women. ResearchGare. Annual Review
of Clinical Psychology. PubMed.
• Rozali, Yuli Asmi. 2018. Seksualitas Sebagai kebutuhan Dasar Manusia.
www.esaunggul.ac.id
• Rowland, David. L and Incrocci, Luca. 2008. Handbook of Sexual and Gender Identity
Disorders. Wiley. John Wiley & Sons, Inc.
• Hatzimouratidis, K., Eardley, I., Giuliano, F., Moncada, I., Salonia, A. 2015.
Guidelines on Male Sexual Dysfunction: Erectile Dysfunction and Premature
Ejaculation. European Association of Urology.
• Boa, R. 2014. Female Sexual Dysfunction. S Afr Med Journal. 2014:104 (6):446.
South Africa.
• DeLaune Sue C, Ladner Patricia K. 2002. fundamental of Nursing: Standards and
Practice. 2nd Edition. Delmar, Thomson Learning, Inc. NY.

SELESAI

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