Sexual Disorders

1
Sexual Disorders

• Nurses role in assessing the problems
• Categories of sexual disorders
• Causes of the disorders
• Related issues

2
Issues involved

• Legal consent vs. coercion
• Moral norms, standards, values
• Effect level of functioning, self-concept,
  self-esteem, relationships with others
• Sexuality experience of ones sexual self
• Diverse sexual expression f (genetics,
  individual preferences, experiences, culture, and
  health)

3
Categories

• Sexual dysfunction disorders
• Sexual response cycle.
• Emotional, physiological, medications, chemicals
• Paraphilias
• Pedophilia, exhibitionism, voyeurism, incest,
  fetishism, frotteurism, sexual masochism, sexual
  sadism
• Lifelong, chr. disorder
• Gender identity disorders transexualism
• Depression due to difficulty finding an accepting
  partner

4
Criteria for gender identity disorder-Children

• A strong persistent cross-gender identification
  
• Stated desire or insistence that he/she is the
  other sex
• In boys, dressing in female attire in girls,
  wearing only masculine clothing
• Make-believe play or fantasies of being the other
  sex
• Desire to participate in games pastimes of
  other sex
• Prefers playmates of other sex
• Feelings of discomfort with own sex or
  inappropriateness in gender role of own sex

5
Criteria for gender identity disorder-Adolescents
Adults

• A strong persistent cross-gender identification
• Stated desire to be the other sex
• Frequently passes as the other sex
• Desires to be treated as the other sex
• Conviction that he/she has typical feelings
  reactions of other sex
• Feelings of discomfort with own sex or
  inappropriateness in gender role of own sex

6
Female sexual dysfunction
7
Male sexual dysfunction
8
Biological Causes of Sexual Disorders

• General illness cold, fatigue, influenza, renal
  and urologic disorders
• Severe and persistent dis DM, MS,
• Hormonal disorder hypopituitary dis. DM.
• Alcohol and drug use
• Pain arthritis, back pain, obesity, vaginal
  infection,
• Age
• Others radiation therapy

9
Drug-induced sexual dysfunction

• Alcohol libido, sperm production
• Tobacco small peripheral vasculature
• CNS depressants benzodiazepine ie Valium
• Barbiturates phenobarbital, secobarbital
• Antipsychotics Thorazine, Mellaril, Stelazine
• Antidepressants Elavil, Tofranil, Norpramin,
• Anticonvulsant Dilantin,
• Others Lithium, Marijuana, Cocaine, Inderal,

10
Psychological Causes of Sexual Disorders

• Ignorance, lack of knowledge
• Anxiety, fear of failure , poor body image
• Partners or selfs demand for performance
• Judgmental thought
• Poor relationship choices lack of trust, power
  struggles
• Childhood or adult sexual abuse or trauma
• Major life change, lose partner

11
Nursing diagnoses

• Altered family process
• Altered sexuality patterns
• Anxiety
• Ineffective coping
• Knowledge deficit
• Social isolation
• Potential for violence self-directed or other

12
Nursing Care

• Nurse-patient Relationship accepting, empathic,
  nonjudgmental,
• Self-awareness discuss feelings with colleagues
• Communication tech
• Sexuality comfort level, privacy
• Referrals commonly used
• Support groups for perpetrators and victims
• Legal obligation mandatory report of sexual
  abuse of children

13
Dealing with the sexually inappropriate client

• Set limit firm, clear, consistent
• Documentation
• clients behavior (from the 1st episode
  throughout the history)
• Ns actions taken
• Consult with supervisor getting support
• Removing self from any contact with the client
• Legal action

14
Tips for Communication

• Giving rationale for question
• Giving statements of generallynormally
• Identifying sexual dysfunction
• Identifying sexual myths
• Identifying feelings about masturbation,
  homosexuality
• Obtaining and giving information
• Closing the history other questions?

15
Conclusions

• Sexual dysfunctions r/t psychological,
  physiological, pharmacological factors
• Paraphilias involve sexual activity with objects,
  children, and consenting or nonconsenting adults
• Efforts to achieve sexual pleasure do not give
  individuals the right to violate the rights of
  others through coercion control
• Gender identity disorder in adults involves
  persistent discomfort with ones biological sex.
• N helps the pt to discuss his feelings about
  himself his problems. N s primary role is
  referral

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Schedule of the ATI test on Friday, 12/4

• ATI Psychiatric test - at McQuiry Hall, room
  321 NLRC from 800- 1000.
• For individuals time slot, please refer to Dr.
  Maos webpage
• Contact Dr. Mao if you need special accommodation