SEXUALITY

 Sexuality is part of persons personality and is important

for overall health. It is the process by which people
experience and express themselves as sexual beings, which
determine by anatomy , physiology, relationship with
other, the culture in which a person lives,and
developmental experience.
 DEFINITION :- Sexuality is the quality or state of being
sexual especially sexual orientation and behaviour.

 HUMAN SEXUALITY refers to peoples sexual interest

and attraction to other, as well as their capacity to have
erotic experience and responses.
 SEXUAL DEVELOPMENT
THROUGHOUT LIFE
 1. INFANCY AND EARLY CHILDHOOD
 2. SCHOOL-AGE YEAR
 3. PUBERTY/ ADOLESCENCE
 4. YOUNG ADULTHOOD
 5. MIDDLE ADULTHOOD
 6. OLDER ADULTHOOD
 1. INFANCY AND EARLY
CHILDHOOD
 While many people believe that sexual development does not
become an important issue until puberty and adolescence, children
begin showing sexual behaviour and interest in their sexual
functioning from infancy. Babies are continually exploring their
bodies to learn about them.
 The first three years of life are very important in the development of
gender identity. The child identifies with the parent of same-sex and
develops a relationship with the parent of the opposite sex.
 Children became aware of differences between the sexes and begin
to perceive that they are either male or female.
 2. SCHOOL AGE YEARS
 Sex education often begins as simple anatomy lessons during the
toddler years. But during the school-age years, the child might start
asking specific questions about the physical and emotional aspects
of sex.
 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.
 Menstruation or nocturnal emission is sometimes frightening for
uninformed children. Some children view them as dreadful diseases
or disorders.
 3. PUBERTY/ ADOLESCENCE
 Puberty is the process of physical changes through which a child's
body matures into an adult body capable of sexual reproduction. It is
initiated by hormonal signals from the brain to the gonads: the
ovaries in a girl, the testes in a boy.
 During the teen years, the hormonal and physical changes of puberty
usually mean persons start noticing an increase in sexual feelings.
 The adolescent functions within a powerful peer group. They have
the anxiety of "Am I normal" "Will I be accepted". They need
accurate information regarding body changes, sexual activity,
emotional aspects, Sexually Transmitted Infections(STIS),
contraception and pregnancy.
 4. YOUNGE ADULTHOOD
 During the young adulthood period , youth engage in increase cross
sex interaction, experiment with adult sexualities , and being to sort
into different romantic and career trajectories.
 Although young adult have matured physically, they continue to
explore and mature emotionally, intimacy and sexuality are issue for
all young adult.
 Sexual activity is often defined as a basic need and healthy sexual
desire may be channelized into forms of intimacy throughout life.
 5. MIDDLE ADULTHOOD
 The period of middle adult cannot be defined under a specific time
limit .cognitive , physical and psycho-social changes take place all
time throughout ones life span, yet middle adulthood is a
particularly sensitive time for both men and women as their bodies
continue to change even more than usual.
 Changes in physical appearance in middle adulthood may lead to
concern about sexual attractiveness.
 Decreased level of oestrogen may result in decreased sexual desire,
as men age they are likely to experience an increase in the
postejaculatory refractory period and delayed ejaculation.
 6. OLDER ADULTHOOD
 Many people want and need to be close to other as they grow older.
For some, this include the desire to continue an active, satisfying sex
life. With ageing, that may mean adapting the sexual activity to
accommodate physical ,health, and other changes. There are many
different ways to have sex and be intimate alone or with a partner.
 Older adult sexual activity depends upon their health status, past and
present life situations and status of marital relationship. for
example many older women are widowed or divorced and lack
sexual partner which account for their decreased sexual activity
 SEXUAL HEALTH

 Sexuality differs from sexual health. according the world

health organization (WHO) sexual health is a state of
physical, emotional,mental, and social, wellbeing in
relation to sexuality ; it is not merely the absence of
disease, dysfunction or infirmity.
 SEXUAL ORIENTATION
 A persons sexual identity or self- identification as bisexual,
heterosexual, homosexual , pansexual, etc.

 Peoples sexual orientation is their emotional and sexual attraction to

particular sexes or genders, which often shapes their sexuality
TYPES OF SEXUAL ORIENTATION
 1. HETEROSEXUAL :- This sexual preference means that an
individual feels attraction on an emotional, romantic or sexual level
to people of the opposite sex.
 2. HOMOSEXUAL :- Homosexuality refers to those with a sexual
preference for people of the same sex.
 3.Bisexual :- means when one feels emotional romantic sexual or
affective attraction towards both
 4. PANSEXUAL :- Not limited in the sexual choice concerning
biological sex, gender, or identity.
FACTORS AFFECTING SEXUALITY
 Various
factors are affecting sexuality.they include :- 1.
SOCIOCULTURAL DIMENSION OF SEXUALITY
 2. DECISIONAL ISSUES
 3.ALTERATION IN SEXUAL HEALTH
1. SOCIOCULTURAL DIMENSION OF
SEXUALITY
 Cultural rules and regulation influence sexuality. Culture, gender,
education , socioeconomic status and religion influence sexuality.
Society plays an important role in shaping sexual values and
attitudes.

 1. FAMILY :- children view parents as their role models. If parents

can share affection and with other family members , when children
become adult , they can give and receive affection
 2.CULTURE :- Different culture differ concerning which body part
they find to be erotic or sexiest. In some culture legs are erotic.
Bodyweight may be a determinant of sexual attractiveness.
 3.RELIGION :-Religion provide guidelines for sexual behaviour
and influences sexual expression.

 4.PREGNANCY AND MENSTRUATION :- Sexual interest of

women and their partners vary during pregnancy and menstruation .
Some culture encourage sexual intercourse during pregnancy and
menstruation but other culture strictly forbid it. In hindu culture ,
women avoid cooking and worship during menstruation.
 5. DISCUSSING SEXUAL ISSUES :- Sexuality is an important part
of individual life but sexual assessment and interventions are not
included in health care.
Nurses usually avoid discussing sexual issues with patients because
they have different values than their patient . If nurses are
uncomfortable in discussing a topic related to sexuality , the patient is
unlikely to share their sexual issues.

 6. PERSONAL AND EMOTIONAL CONFLICTS :- Nurses meet

patient who have problem with one or more of the stages of sexual
activity . For example , some women and men who are on
antidepressants usually report that their ability to reach orgasm is
negatively affected.
 2. DECISIONAL ISSUES
 Individuals decide their sexuality nurses can help patient to make
decisions regarding contraception and abortion
 1. CONTRACEPTION :- Choice for the methods of contraception
varies concerning the age , income, marital status, education, and
previous pregnancies of woman.
 2. ABORTION :- almost half of the unintended pregnancies end in
abortion , half of all pregnancies in the united state are unplanned.
The majority of unplanned pregnancies occur in teenagers.
3.ALTERATION IN SEXUAL HEALTH
 1.INFERTILITY :- Infertility is the inability to conceive after one
year of unprotected intercourse . Some experience a sense of failure
and may feel their bodies are defective

 2. SEXUAL DYSFUNCTION :- Sexual dysfunction is defined as

the inability to fully enjoy sexual intercourse. Sexual dysfunction
are disorder that interfere with a full sexual response cycle. These
disorders make it difficult for the person to have sexual intercourse,
sexual dysfunction , also called psychosexual dysfunction.
 FEMALE SEXUAL DYSFUNCTION :- A. primary or pre organism
dysfunction
B. Secondary or organism dysfunction
C. Dyspareunia
 MALE SEXUAL DYSFUNCTION :- A. primary erectile
dysfunction
B. secondary erectile dysfunction
c. premature ejaculation.
 PREVENTION OF SEXUALLY
TRANSMITTED INFECTION
 1. Abstinence is considered to be 100% effective in preventing the
transmission of STIS. Responsible sexual behaviour helps to prevent STIS.
 2. Limit the number of sexual partners.
 3. Use condoms.
 4. Abstain from sexual activity with a partner known to have or suspected
of having STIS.
 5. Report to a health care facility whenever in doubt about possible
exposure.
 6. When an STI is diagnosed, notify all partners and encourage them to
seek immediate treatment.
 7. Avoid unnecessary transfusions of blood or blood
 PREVENTION OF UNWANTED
PREGNANCY
1. REVERSIBLE METHOD OF BIRTH CONTROL

 Copper T intrauterine device (IUD): The intrauterine device is a

small device that is "T" shaped. It is placed inside the uterus to
prevent pregnancy. It can remain in uterus for upto 10 years.
 Hormonal Methods
 1. Implant: It is a single, thin rod that is inserted under the skin of a
women's upper arm. It contains a hormone progestin that is released
into the body over3 years. It helps to prevent pregnancy.
 2. Injection: Women get injections of the hormone progestin after
every three months to prevent pregnancy.
 3. Combined oral contraceptives: Combined oral contraceptives
contain the hormones estrogen and progestin is taken at the same
time each day.4. Progestin only pill: The progestin-only pill contain
only one hormone, progestin, is taken at the same time each day.
 5. Patch: The skin patch is worn on the upper body (but not on the
breast ) Patch releases hormones progestin once a week for three
weeks. During the fourth week, a patch is not wear, due to menstrual
period.
 . Hormonal vaginal contraceptive ring: This ring releases the
hormones progestin and estrogen. It is placed inside your vagina.
The ring is wear for three weeks and for the fourth wee
 Barrier Methods
 1. Diaphragm or cervical cap: Diaphragm or cervical cap are barrier
methods which are placed inside the vagina to cover the cervix to block
sperm.it is inserted into vagina before sexual intercourse
 2. Sponge: The contraceptive sponge contains spermicide and is placed in
the vagina where it fits over the cervix. It works for up to 24 hours, and must
be left in the vagina for at least 6 hours after the last act of intercourse
 3. Male condom: It is worn by the man, latex condoms ,the most common
type, help prevent pregnancy, and HIV and other STDs.
 4. Female condom: It is worn by the woman and it prevents the sperms from
getting into woman body. it can be inserted upto eight hours before sexual
intercours.
 5. Spermicides: Spermicides helps to kill the sperms and it come in several
forms like foam, gel, cream, film, suppository, or tablet, etc. They are placed
in the vagina one hour before intercourse.
 EMERGENCY CONTRACEPTIVE :- 1.copper IUD
:- 2. Emergency contraceptive
tablets.

 PERMANENT METHOD OF BIRTH CONTROL :-

1. Female sterilization ( tubal ligation )
2. Male sterilization ( Vasectomy )
 SEXUAL ABUSE :- the actual or threatened physical intrusion of a
sexual nature, whether by force or under unequal or coercive condition.
 PREVENTION OF ABUSE :-
1. If warning signs or risky behavior is suspected, raising concerns with
other adults can be the first step for protection.
2. 2. Staying silent, because don't have proof, may leave an individual
exposed to danger.
3. 3. Speaking directly to the adult you are worried about can, in some
cases, lead that person to seek specialized help.
4. 4. If abuse is suspected, reaching out to protective authorities could
lead to the protection of individuals
5. 5. Filing a report can result in holding the person who is abusing and
getting them treatment so that they will be able to stop abusive
behaviors
 SEXUAL HARASSMENT

 Sexual harassment is any unwelcome conduct of a sexual

natures that might reasonably be expected or be perceived
to cause offense or humiliation,when such conduct
interferes with work, is made a condition of employment
or creates an intimidating , hostile or offensive work
environment.
 PREVENTION OF HARASSMENT AT WORKPLACE :-
 1. Develop an anti harassment policy together with employee.
 2. communicate the policy to all employee
 3.investigate and deal with all complaints of harassment.
 4. Provide education and information
 5. circular the information and open communication and guidance
 6. information session , personal meeting , group discussion ,
problem solving groups can prove very effective.
 Provide protection and support for the employees
 Take action to eliminate the problem
 DEALING / MANAGING
INAPPROPRIATE SEXUAL BEHAVIOR
 Inappropriate sexual behavior include sexual conversation or
content. Comments and jokes of a personal or sexual nature.
inappropriate touching or grabbing. Explicit sexual behavior.
 MANAGEMENT
 1. Talk about behavior.
 a. Talk to the person about their behavior and what you or others expect.
 b. Let them know if behavior is not appropriate, if they don't know, they can't
change it.
 c. Let them know how the behavior makes other feel
 2. Provide feedback about behavior.
 3. Explain sexual behavior to other people. Let family, friends, and visitors know
ahead of time that inappropriate behavior or sexual remarks.
 4. Identify the triggers for the inappropriate behavior and try to prevent.
 5. Manage the environment (Some individuals have limited insight
and awareness about sexually disinherited behavior, and / or very
limited capacity to change behavior due to severe cognitive and
behavioral impairments. If this is the case nurses need to use
strategies to manage the environment.
 6. Provide supervision and structure. Provide one-to-one support and
supervision in any "at risk" situations. Provide cues and prompts
about appropriate or inappropriate behavior.
 7. Plan Ahead. If a person has a history of severe disinherited sexual
behavior, it is essential that you plan ahead regarding personal
safety.
 NON- PHARMACOLOGIC
INTERVENTION
 1. Distract/redirect modify environment.
 2. Reinforce positive behavior. Don't reinforce negative behavior.
 3. Treat co-morbid psychiatric disorders.
 4. Behavior management therapies includes; Supportive.
psychotherapy and Behavior Modification.
 PHARMACOLOGICAL
MANAGEMENT
 Goal is to suppress sexual fantasies, sexual urges and behaviors such
as Antidepressants, Anticonvulsants Antipsychotics and Hormonal
agents.