FUNDAMENTALS

WEEK 17: SPIRITUALITY AND

SEXUALITY

PREPARED BY: ALMA MARIE MENDOZA

BSN 1A

MRS. LEANY MAGPANTAY ATIENZA

SEXUALITY is a part of a person’s humaness and is vital for overall health. Sex
education is now paet of the curriculum, thus discussion of sexual health topics has
increased over the years.
• It has varied definitions. Expressions of an individual’s sexuality is influenced by
interaction among biological, sociological, psychological, spiritual, economic,
political, religious and other cultural factors.
• Sexuality differs from sexual health. According to WHO (n.d) sexual health is 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”.

SCIENTIFIC KNOWLEDGE BASE

• A basic understanding of sexual development, sexual orientation, contraception,
abortion and sexually transmitted infection or STI’s is necessary and sound scientific
base regarding sexuality.

SEXUAL DEVELOPMENT
• Sexuality changes as a person grows and develop. Each stage of development brings
changes in sexual functioning and the role of sexuality in relationships.
INFANCY AND EARLY CHILDHOOD – the first 3 years of life are
crucial in the development of gender identity ( Edelman and Mandle,
2014)
SCHOOL AGE YEARS – Parents, educators and peer groups serve as
role model and teachers about how man and woman can act with and
relate to one another, during school age years.
• They need accurate information from home and school about changes
in their bodies and emotions during this period and what to expect as
they move into puberty ( Edelman and Mandle, 2014)
PUBERTY/ ADOLESCENCE – The emotional changes during puberty
and adolescence are as dramatic as the physical ones. Adolescents
function within a powerful peer group, with the almost constant anxiety
of “ Am I normal?” and “Will I be accepted?”
 YOUNG ADULTHOOD – Young adults have matured physically but they continue to explore and mature
emotionally in relationship. At times, young adults require support and education or therapy to achieve mutually
satisfying sexual relationship.
MIDDLE ADULTHOOD – Changes in physical appearance during middle adulthood years sometimes lead to
concerns about sexual attractiveness.
• Anticipatory guidance regarding these normal changes, using vaginal lubrication and creating time for caressing
and tenderness ease concerns regarding sexual functioning.
OLDER ADULTHOOD – Sexuality in an older adulthood is an important aspect of health that is often overlooked
of the healthcare providers.

CHANGES OCCURS AS PEOPLE AGE:

1. The excitement phase prolongs in both men and women and is usually take longer for them to reach orgasm.
2. The refractory time following orgasm is also longer.
3. Both genders experience a reduced availability of sex hormones.
4. Men often have erections that are less firm and short acting .
5. Women usually do not have difficulty maintaining sexual function unless have a medical condition that impaires
their sexual activity.
6. The infrequency of sex in the older women is related to the age, health, and sexual function of their partner.
7. Women continue to experience changes related to menopause, and those with problems to urinary incontinence
often experience embarrassment during intercourse.
NURSING KNOWLEDGE BASE

FACTORS INFLUENCING SEXUALITY

• Sociocultural dimension of sexuality
• Decisional Issues
• Alterations in Sexual Health

SOCIOCULTURAL DIMENSION OF SEXUALITY

A. IMPACT OF PREGNANCY AND MENSTRUATION IN SEXUALITY

• Sexual interest and activity of women and their partners vary during pregnancy and
menstruation. Some cultures encourage sexual intercourse (menstruation and pregnancy)
but others strictly forbid it. Research has found no physiological contraindication during
menstruation or during most pregnancies.

B. DISCUSSING SEXUAL ISSUES

• Sexuality is a significant part of each person’s being yet sexual assessment and
intervention are not always included in the healthcare ( Ayaz, 2013, Ivarison, et al, 2013,
Soleecki et al., 2012; Steinki, et al., 2013)
DECISIONAL ISSUES
A. CONTRACEPTION
• Individuals make many decisions about their sexuality including use of contraception.
It varies in relation to the age, ethnicity, marital status, income, education, sexual
orientation, religious beliefs, and previous pregnancies of the woman.

B. PREVENTION OF STI’s
• Responsible sexual behavior includes knowing one’s sexual partner and the partner’s
sexual history, being able to openly discuss drug-use history with the partner, not
allowing drug or alcohol influence decision making and sexual practices and using STIs
and contraceptive protective devices.

ALTERATIONS IN SEXUAL HEALTH

A. INFERTILITY
• The inability to conceive after 1 year of unprotected intercourse. A couple who wants
to conceive but is unable to has special needs.
B. SEXUAL ISSUES
• Sexual abuse is a widespread health problems. Abuses crosses all gender,
socioeconomic, age and ethnic groups. Most often it is at the hands of a former
intimate partner or family member.
•Nurses are in ideal position to assess occurrences of sexual violence, help patients
confront these stressors and educate individuals regarding community services.
C. PERSONAL EMOTIONAL CONFLICTS
• Ideally, sex is a natural, spontaneous act that passes easily through a number of recognizable
physiological stages and ends in one or more orgasms.
D. SEXUAL DYSFUNCTION
• The absence of complete sexual functioning is common. The incidence of sexual dysfunction in the
general population is estimated to be as high as 40% in men and 60-80% of women (Butarro et al.,
2014)

PLISSIT MODEL
P- ermission to discuss sexuality issues
L- imited
I- nformation related to sexual health problems being experienced
S- pecific
S- uggestions - only when the nurse is clear about the problems
I- ntensive- T- herapy – referral to professional with advance training if necessary.
PLISSIT MODEL provides an approach that nurses can use to assess sexuality in patients (Ayaz,
2013)
SPIRITUALITY
•FAITH
– In addition of being component to spirituality the concept of faith has other definitions. It is cultural or institutional
religion such as Judaism, Buddhism, Islam or Christianity.
• RELIGION
– Religion is associated with the “state of doing” or specific system of practices associated with a particular
denomination, set or form of worship. It is a system of organizations, beliefs and worship that a person practices to
outwardly express spiritually. Many people practices a faith or belief in the doctrines and expression of a specific
religion or sect.
•HOPE
– A spiritual person’s faith brings hope. When a person hast something to look forward to, hope is present. People
express hope in all access of their lives to help them deal with life stressors

SPIRITUAL HEALTH
• People gain spiritual health by finding a balance between their values, goals and beliefs and the relationship within
themselves and others. Throughout life a person often grows more spiritually becoming increasingly aware of the
meaning, purpose and values of life. Spiritual belief changes as a person grows and develop. Spirituality begins
as children learn about themselves and their relationship with others, including high power.
FACTORS INFLUENCING SPIRITUAL HEALTH
- When illness, loss, grief or a major life changes occurs, people either use spiritual
resources to help them cope, or spiritual needs or concerns develop. SPIRITUAL
DISTRESS is “a state of suffering related to the impaired ability to experience meaning
in life through connections with life, self, others, the world or superior being.”
(Herdman and Kamitsuru, 2014).

A. ACUTE ILLNESS
– Sudden, unexpected illness creates spiritual distress. People often look for ways to
remains faithful to their beliefs or value system.
B. CHRONIC ILLNESS
– Many chronic illnesses threatens a person’s independence, causing fear, anxiety, and
spiritual, distress. Dependence on others for routine self-care needs often creates feelings
powerlessness.
C. TERMINAL ASSESSMENT
– It causes fear of physical pain, isolation, the unknown and dying. It creates uncertainty
about what death means, making patients susceptible to spiritual distress.
D. NEAR–DEATH EXPERIENCE (NDE)
– It is a physiological phenomenon of people who either have been close to clinical death
of have recovered after being declared death. However, some patients have a spiritual
sense of peace that enables them to face death without fear.
FICA
– an assessment tool.
F – Faith or belief
I – Importance and Influence
C – Community
A – Address (Interventions to address).

POTENTIAL NURSING DIAGNOSIS FOR SPIRITUAL HEALTH:

1. Anxiety
2. Ineffective coping
3. Complicated grieving
4. Hopelessness
5. Readiness for enhanced spiritual well-being
6. Spiritual Distress
7. Risk for Spiritual Distress
THANK YOU
FOR
LISTENING!!!