CONCEPT OF SEXUALITY

CHAP 9

Introduction

• Sexuality has been a consistent focus of curiosity, interest, and analysis to humankind
• Sexuality encompasses all those thoughts, feelings, and behaviors connected with sexual gratification and reproduction, including the attraction of one person to another.
• It is a key factor in our principal relationships and the formation of our families.
• It is also a common source of problems.

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Objectives

At the end of this unit, learners will be able to:

• Review the Anatomy and physiology of the male and female reproductive system
• Describe normal sexual pattern
• Relate sexuality to all stages of life cycle
• Identify factors that effects sexual functioning
• Describe common risks and alteration in sexuality
• Understand the nursing process as it relate to sexual functioning

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Male Reproductive System

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Male reproductive system consist of:

• External organs & Internal organs
• An adult male manufactures over 100 million sperm cells each day.
• Testosterone, is a hormone that is responsible for the development of the secondary sex characteristics. of men such as the beard, deep voice, and masculine body shape.

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Female Reproductive System

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Female reproductive system consist of:

• External organs & Internal organs
• Estrogen is responsible for the development of the secondary sexual characteristics of a mature woman.
• Estrogen continues to be secreted throughout the reproductive age of the female, regulates menstrual period in female, eggs production occur prior to birth.

Why to Study

• Reason for studying human sexuality is that we may face various personal and social problems involving sexuality, such as, sexually transmitted diseases, unwanted pregnancies, and sexual harassment

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�Sexuality pattern�

• Sexuality is a state or quality of being sexual including the collective characteristics that distinguish male and female. It comprises of:
• Sexual identity
• Sex role
• Sexual performance and
• Social norms.

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Sexual or Gender identity

• Anatomical state of being male and female, results from genetic and hormonal influence

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• It is sense of one's self as male or female

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• Characteristic develop 8 month to 3 years of life

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Sex role:

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• This is expression of one's own gender through behavior, feeling, attitude.

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• Culturally defined as feminine and masculine role.

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Sexual orientation:

It is a feeling of sexual attraction towards sexual partner

• Heterosexual: "romantic or sexual attraction to persons of the opposite sex“
• Bisexual: is sexual orientation involving physical or romantic attraction to both males and females.
• Homosexual: an enduring pattern to experience sexual, or romantic attractions to people of the same sex

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Social Norms:

• Each society has their own and different norms regarding premarital sex, sexual consent and many other sexual behaviors
• Mostly influenced by Religion & Culture

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�Sexual Reproductive pattern�

• Sexual reproduction is a union that results in increasing genetic diversity of the offspring.

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• Reproduction is only one component of sexuality

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Normal Sexual pattern

Four stages of sexual responsiveness

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Normal Sexual pattern

• Excitement Phase: is the first stage of the human sexual response cycle. It occurs as the result of any physical or mental stimulation that leads to sexual arousal
• Platuae Phase: is the period of sexual excitement prior to orgasm.
• Orgasm Phase: is the conclusion of the plateau phase of the sexual response cycle. It is accompanied by quick cycles of muscle contraction in the lower pelvic muscles, which surround both the anus and the primary sexual organs.

Resolution Phase: occurs after orgasm and allows the muscles to relax, blood pressure to drop and the body to slow down from its excited state.

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Abnormal Sexuality

• Sexual behavior that is destructive to oneself or others, that is markedly constricted, that cannot be directed toward a partner, that excludes stimulation of the primary sex organs, and that is inappropriately associated with guilt or anxiety.

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Stages of Sexuality

• Growth and development are continuous processes, which bring a change in an individual, every moment.
• Development of sexuality starts as early as in intrauterine life following conception and continues through infancy, childhood, adolescence, adulthood till death
• During infancy, there is no awareness of gender. The child acknowledges its gender in early childhood as early as by 3 years.
• Self-awareness about sexuality (gender role, gender identity) evolves during the childhood.

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Sexuality to all stages of life cycle

• Adolescence is a phase of transition during which major developments of sexuality takes place. Puberty is reached during adolescence, which is a major landmark in the development of sexuality.
• Adolescent sexuality development can be better explained with the bio-psycho-social model.
• Biological factors, psychological factors, as well as social factors have equal importance in determining, the development of sexuality in adolescents
• Other than the biological, psychological, and social factors, many more factors such as political, legal, philosophical, spiritual, ethical, and moral values significantly influence the sexuality development

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Sexuality to all stages of life cycle

• Sigmund Freud had proposed his theory of psychosexual development, where he described about – oral phase, anal phase, phallic phase, latency phase, and genital phase as the landmark steps of psycho-sexual development.
• During these phases, different body parts behave as most erotogenic and the individual attempts to explore or stimulate these erotogenic zones in order to get gratification
• He emphasized that a child's personality is formed by the ways which his parents managed his sexual and aggressive drives.

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Freud’s Psychosexual Stages

Stage:

Oral (0-18 months)

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Anal (18-36 months)

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Phallic (3-6 years)

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Latency (6 to puberty)

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Genital (puberty on)

Focus:

Pleasure centers on the mouth-sucking, chewing, biting

Pleasure focuses on bowel and bladder elimination; coping with demands for control

Pleasure zone is the genitals; coping with incestuous sexual feelings

Dormant sexual feeling

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Maturation of sexual interest.

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Sexuality to all stages of life cycle

• Sexuality is a normative and physiological component of adolescent development and usually this group engage in risky sexual practices such as early sexual intercourse, multiple sexual partners, unprotected sexual intercourse, and casual sex
• Adulthood, is a time of exploration, experimentation, and instability in many areas of life, particularly in relation to sexual behavior.
• Adolescents and youth are one of the populations most impacted by sexually transmitted infections (STIs), including human immunodeficiency virus (HIV) and papillomavirus (HPV)
• Sociocultural differences are determinant of sexual behaviors, influencing the age of first intercourse, number of partners, coercive sexual culture and it can affect the probability of being engaged in risky sex

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Sexuality to all stages of life cycle

• Sexuality in older age concerns the sexual drive, sexual activity, interests, orientation, intimacy, self-esteem, behaviors, and the social perceptions concerning sexuality in older age.
• Older people engage in a variety of sexual acts from time to time for a variety of reasons.
• Desire for intimacy does not disappear with age, yet there are many restrictions placed on the elderly preventing sexual expressions and discouraging the fulfillment of sexual needs.
• Sexuality in older age is often considered a taboo yet it is considered to be quite a healthy practice; however, this stigma can affect how older individuals experience their sexuality.
• While the human body has some limits on the maximum age for reproduction, sexual activity can be performed or experienced well into the later years of life

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Factors Affecting Sexuality

• Quality of relationship
• Cognition and perception
• Culture, values and believe
• Self-concept
• Previous experience
• Environment
• Pregnancy
• Illness and diseases
• life circumstances
• Personality traits
• Biological makeup

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Risks and Alteration in Sexuality

• General health status (Chronic diseases)
• Sexual abuse
• Sexual dysfunction
• Impotence and ejaculatory dysfunction
• Dyspareunia

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Nursing Care Process

Assessment:

• History; About existent sexual problem
• Type and quality of relation among partners
• Level of knowledge
• Drug and other illness
• PLISSIT model

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PLISSIT model

• The model was created in 1976 by Jack S. Annon
• The PLISSIT Model offers nurses or case managers a concise framework for intervention to address patients' concerns at the earliest stages of their distress, and helps assure informed feedback to the healthcare team regarding the patients' sexual issues.

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Nursing Care Process

Nursing Diagnosis

• Ineffective sexuality pattern.

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• Sexual dysfunction

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• Rape trauma syndrome

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Nursing Care Process

Goal:

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• The person will resume previous sexual activity

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• The person will have alternative sexual activity

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Nursing Care Process

Nursing Interventions :

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• Establish trusting relationship
• Maintain privacy
• Active listening
• Clarify the patient that sexuality does not mean only intercourse
• Discuss alternative methods

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References

• Craven, R. F., & Hirnle, C. J. (2006). Fundamentals of nursing: Human health and function. (5th.ed.)p.1176-1262 New York: Lippincott.

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• Cox, H. C. et. al.(2002). Clinical application of nursing diagnosis. Philadelphia: Lippincott

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• Estes,M. E. Z. (2000) Health assessment & Physical examination (2^nd ed.). Delmar.

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• Katz, A. (2000). Birds do it, Bees do it, Lets talk about it. AWHONN lifelines, 4(5) 40-41

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• Harkreader, H. & Hogan, M. A. (2004) Fundamental of nursing: caring and

clinical Judgment (2^nd ed.). Sunders

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