SEXUALITY CONCEPT

IN
NURSING

By
Purwaningsih

Organs have dual functions:

Produce reproductive cells
Produce hormones
responsible for sex
characteristics
Females - estrogen and
progesterone
Males - testosterone

REPRODUCTIVE
SYSTEM

SE
XU
A

LI
T

Y
Expressed by individuals of all ages
A way to show feminine or masculine
qualities:
Clothing styles and colors
Hairstyles
Hobbies and interests
Sexual habits (continue into
old age)
Gestures

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SE
XU
A

LI
T

May be expressed
by:
Sexual intercourse
Caressing, touching,
holding hands
Masturbation
Is a right of all
residents to
experience

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Factors affecting
sexuality

Culture

Religion

Ethics

Lifestyle
Health state

Age

Stereotypes
Fathers more than mothers
5

External genitals of the

female

Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Female Reproductive System

oviduct
oviduct
ovary
uterus
urinary bladder
pubic symphysis

fimbriaeovary
cervix
rectum

urethra
vagina

anus

uterus
vagina

Function of Female Reproductive

System
Ovulation ova begins to mature &
enlarge until discharged
Migrates toward & enters oviduct where
possible fertilization may take place
Mentrual Cycle involves production of
estrogen & progesterone
Menopausal period end of womans
reproductive capacity.
Early menopause surgical removal of
ovaries, chemotherapy, radiations,
unknown etiology

Sexual Health
Negative definitions
Avoidance of unintended pregnancy
Avoidance of sexually transmitted infections
Absence of sexual dysfunctions

Positive definitions (the above plus)

Equitable relationships
Sexual fulfilment
Sexual rights (and responsibilities)

Sexual Rights

WHO, 2002

Sexual rights include the right of all persons, free of

coercion, discrimination and violence, to
the highest attainable standard of sexual health,
including access to sexual and reproductive health care
services
seek, receive and impart information related to sexuality
sexuality education
respect for bodily integrity
choose their partner
decide to be sexually active or not
consensual sexual relations
consensual marriage
decide whether or not, and when, to have children
pursue a satisfying, safe and pleasurable sexual life

Infantile sexuality
Freud
orality

Montague
Touch

Parental reinforcement
Trust

Toddlers
Body image
Self concept
Autonomy vs. shame and doubt

Primary identification
Traditionally imitation from observation of
same sex parent

Exploration of body
Masturbation
anality

Preschoolers
Initiative vs. guilt
Conscience, superego

Self concept ~ emerging overt

sexuality
Parental and peer (re)enforcements

Masturbatory substitutes
Rocking, riding

Schoolagers
Sexuality sublimated into industry
Doesnt mean asexual
Cognition
Social interaction skills

More self concept and body image

Inter-relationship depends on environment
Chum-ship

Some mid- and late schoolagers are sexually

active
Development of secondary sexual maturation

Answering questions about

sex
Open acceptance
Answer what is asked
Know the facts!
Be honest

Dont skip information because initial

response is Oh, I know that
Also, dont include too much information
in one sitting

Adolescence
Establishing sexual identity or self concept
Involves understanding roles, values, duties
and responsibilities as well as physical
responses
Sexual orientation is a continuum

A personal evaluation of ones sexual feelings

and actions
Accommodating adult erotic feelings
Experimental sexual behaviors
Dealing with behavior choices

Biology vs. Psychology

Physical sexual response cycles in men and
women only understood since the 1970s
Masters and Johnson
excitement, plateau, orgasm, resolution

Most people closely tie physiology with

emotions
Sex for sexs sake vs. sex for loves sake
Sex for procreation vs. recreation
Abstinence is not a dirty word

Young adults
Developmental level and chronology often not
synchronous
Making love and having sex arent the same
There arent any abnormals in sexual
relationships if the behavior is acceptable to
both parties
Overtly or covertly, everybody cares about
and is interested in sex, whether or not they
act on it

Adulthood
Developmental stages of partners impacts
quality of relationship
Stresses of everyday life can negatively
impact sexual expression
Being all things to all people
What to do with the kids

Fatigue and poor communication greatest

impediments to positive sexual behavior
Creativity and time management

Loss of partner from divorce or death

Aging and sexuality

Age should not be a barrier to sexual
expression
Social circumstances might be but
can be changed
Attitudes and expectations may be
problematic
Those who are aging
Relatives and friends

Sexuality and Aging

Human drive
Diminishes with aging

Other bodily changes

Mechanically less responsive

Opportunity
Partner passes away or is ill

Cultural bias
Images of beauty, sexuality

Sexuality and Dementia

Partners must adapt to change
Degree of intimacy
May be less interested

Patience
May be clumsy, poorly coordinated

See as appropriate
Be supportive of their desire for intimacy

May alter what regarded as intimacy

Normal sexual activity may be unrealistic

May be uncomfortable, frustrating

Persons views, attitudes on sexuality may change

Sexuality in the Nursing

Home
Most still want to be sexually active
Over 60% of elderly residents endorsed a
desire for intimacy
52% of men 60-69 report intercourse in the
previous 4 weeks

Barriers to intimacy exist

Lack of privacy
Staff, family attitudes
Informed consent issues
Lack of a partner

Hypersexuality
Definition
Exposure
Obscene sexual language
Inappropriate masturbation
Propositioning of others
Touching breasts and genitalia

Infections can be transferred through

the exchange of bodily fluids like:
Blood
Semen
Vaginal secretions
Saliva
Breast milk

Nursing Role in Womens

Health

Health promotion
Illness prevention
Provide support & counseling
Encourage women in their health goals
and behaviors
personal hygiene, detecting & preventing
diseases (STDs), diet & exercises, sexuality
issues- menopause, contraception,
preconception, pre-/postnatal care, stress
management & well-being, healthy lifestyles,
& avoiding risky behaviors

Nursing Role in Womens

Health

Nurses need to model that lifestyle for

patients
Recommend & promote regular
examinations
Non-judgmental, understanding &
sensitive
Screen for/and recognize s/sx. abuse
Recognize cultural differences &
beliefs
Respect sexual orientation

Nursing Dx r/t sexuality

Sexual dysfunction
Sexuality patterns,
ineffective
Body image, disturbed

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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
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Guidelines For The Nurse Aide In

Dealing With Resident Sexuality
(continued)

Assist to prepare for special

activities by dressing up
selecting attractive clothing
fixing hair in a special way
applying cosmetics
wearing a special perfume
or aftershave
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Guidelines For The Nurse Aide In

Dealing With Resident Sexuality
(continued)

Help to develop a positive self-image

Show acceptance and understanding
for residents 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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Guidelines For The Nurse Aide In

Dealing With Resident Sexuality
(continued)

Never expose the resident

Accept the residents sexual
relationships

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Guidelines For The Nurse Aide In

Dealing With Resident Sexuality
(continued)

Provide protection for the nonconsenting resident

Be firm but gentle in your
rejection of a residents sexual
advances

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Possible Effects Of Injury Or

Illness On Sexuality
Disfiguring surgery may
cause a person to feel:
unattractive and ugly to
others
mutilated and
deformed
unworthy of love or
affection
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Possible Effects Of Injury Or

Illness On Sexuality
(continued)

Chronic illness and

certain medications
can affect sexual
functioning

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Possible Effects Of Injury Or

Illness On Sexuality
(continued)

Disorders that cause

impotence
diabetes mellitus
spinal cord injuries
multiple sclerosis
alcoholism
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Possible Effects Of Injury Or

Illness On Sexuality
(continued)

Surgery can have both physical

and/or psychological effects
removal of prostate or testes
amputation of a limb
removal of uterus
removal of ovaries
removal of a breast
colostomy
ileostomy
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Possible Effects Of Injury Or

Illness On Sexuality
(continued)

Disorders affecting the ability

to have sex:
stroke
nervous system disorders
heart disease

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Possible Effects Of Injury Or

Illness On Sexuality
(continued)
Disorders affecting the ability to have sex:

chronic obstructive
pulmonary disease
circulatory disorders
arthritis or
conditions affecting
mobility/ flexibility
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Sexuality and the Nursing Home, Thomas Magnuson, M.D.

Assistant Professor
Division of Geriatric Psychiatry
UNMC
Peter Aggleton
University of Sussex