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SEXUALITY – HUMAN NEED

Ns. HAFNA ILMY MUHALLA, S. Kep., M. Kep., Sp. Kep. M.B.


PRODI D-III KEPERAWATAN FAKULTAS VOKASI UNIVERSITAS AIRLANGGA
2nd semester, 2018

SEXUALITY DIMENSI SEKSUAL


BASIC CONCEPT AND
NURSING CARE • Sexuality
• Human sexual response
• Sex roles
• Sexuality and health
HAFNA ILMY MUHALLA • Development of sexuality
• Sexual dysfunction
• Gender identity
PRODI D-III KEPERAWATAN
FAKULTAS VOKASI
• Nursing process
UNIVERSITAS AIRLANGGA • Needs
2018

SEXUALITY
• All aspects of being male or female: Genital
SEXUALITY, SEX AND sex, feeling, attitudes, beliefs, behavior
SEX ROLE • An essential part of one’s personality.

SEXUALITY SEXUALITY
sexuality includes a person’s attitudes How to feel about him self
toward relationships with people of the
How to communicate his feeling
same sex, relationships with those of the
opposite sex, and about touching and Includes touching, hugging, soft attitude:
being touched. The way people dress, signs, dressing, word, think, experiences,
talk, and relate to others. value, fantasy and emotion

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SEXUALITY – HUMAN NEED
Ns. HAFNA ILMY MUHALLA, S. Kep., M. Kep., Sp. Kep. M.B.
PRODI D-III KEPERAWATAN FAKULTAS VOKASI UNIVERSITAS AIRLANGGA
2nd semester, 2018

SEXUALITY SEXUALITY (WHO, 2006a)


• “…a central aspect of being human throughout life encompasses
Biological aspect sex, gender identities and roles, sexual orientation, eroticism,
Cultural aspect pleasure, intimacy and reproduction. Sexuality is experienced
and expressed in thoughts, fantasies, desires, beliefs, attitudes,
Psychological aspect values, behaviors, practices, roles and relationships. While
sexuality can include all of these dimensions, not all of them are
Spiritual aspect always experienced or expressed. Sexuality is influenced by the
Sociological aspect interaction of biological, psychological, social, economic,
political, cultural, legal, historical, religious and spiritual factors.”

SEX
SEX IS
Biological characteristics, male and female

Anatomical and physiological

Physical sexual activity

WHO, 2018

SEX ROLES
Are culturally determined patterns
associated with being male and female.
DEVELOPMENT OF
These patterns are developed as a result of
cultural expectations, customs, norms,
SEXUALITY
habits, and traditions.

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SEXUALITY – HUMAN NEED
Ns. HAFNA ILMY MUHALLA, S. Kep., M. Kep., Sp. Kep. M.B.
PRODI D-III KEPERAWATAN FAKULTAS VOKASI UNIVERSITAS AIRLANGGA
2nd semester, 2018

DEVELOPMENT OF SEXUALITY DEVELOPMENT OF SEXUALITY


• Begin with conception Baby (0-12 month) Toddler (1-3 yo)
• First 6 weeks of fetal development (no autonomic • Gender determination • A continuing of
difference) • Self diversification with other gradually developing gender
• Sensitive to touch on external genital identity
• At 7 to 8 weeks, testes develop (high level of • An erection on baby boy’s genitals • Able to identify his
gender
testosterone) • A vaginal lubrication on baby girl
• Began to imitate the
• Feeling pleasure and comfortable
• Feelings, attitudes, behavior related to sexuality toward interaction with others by
tactile stimulation
parent action of the
same sex
are learned in the family
Rozali, www.esaunggul.ac.id

DEVELOPMENT OF SEXUALITY DEVELOPMENT OF SEXUALITY


Pre-school (4-5 yo) School (6-12 yo) Teenager (12-18 yo) Early Adulthood (18-40 yo)
• An increasing awareness of • They have a strong identification to his
himself parent of the same sex • The characteristics of sex begin to • Sexual activity is occurs
• Explore the limbs (self and • They take a fancy to be friends with the develop • the adopted lifestyles and
playmates) same sex • Begin to menarche values have been strong
• Learn the name of the limbs • An increasing self awareness • Developing a pleasure relationship • Pair share task of finance and
correctly • Learn the gender concept and role • Begin to take a sexual activity, ex house chores
• Learn to control of feelings and • Begin to appreciate the personal things, ex masturbation • Experiencing threats to body
behavior mode image due to aging
• Identifying the sexual orientation
• Likes to a different sex of parent • Begin to thing of sexual behavior, • Seeking health care without his
• Asking how the baby was created reproduction and sexual matter at 8-9 yo
parent

Rozali, www.esaunggul.ac.id Rozali, www.esaunggul.ac.id

DEVELOPMENT OF SEXUALITY
Middle adult (40-65 yo) Late Adult (>65 yo)

• Decreasing hormone production • Decreasing sexual activity


• Woman: Having menopause (40- • Decreasing vaginal
55 yo) secretion
• Man: Having a gradual
climacterically
• The breast has atrophy
• Sperm was decrease
GENDER IDENTITY
• Begin to strengthen a moral and
ethical standards • The man take a longer
time to erect and ejaculate

Rozali, www.esaunggul.ac.id

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SEXUALITY – HUMAN NEED
Ns. HAFNA ILMY MUHALLA, S. Kep., M. Kep., Sp. Kep. M.B.
PRODI D-III KEPERAWATAN FAKULTAS VOKASI UNIVERSITAS AIRLANGGA
2nd semester, 2018

GENDER IDENTITY GENDER IDENTITY


•Gender Identity • Sexual Orientation
Is how one views ones’ self as male or female • An individual’s preference for ways of expressing
sexual feelings
in relationship to others
• A dynamic lifelong process of growth
How the person decides to express sexuality
• Heterosexuality, homosexuality, bisexuality, trans-
in behaviors with others sexuality
Nurse must assess on gender identity and • Nurse must respect all individuals, regardless of sexual
gender role orientation

SEXUAL HEALTH
• “…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. Sexual health requires a
SEXUAL HEALTH and positive and respectful approach to sexuality and sexual
relationships, as well as the possibility of having pleasurable
SEXUAL RIGHT and safe sexual experiences, free of coercion, discrimination
and violence. For sexual health to be attained and
maintained, the sexual rights of all persons must be
respected, protected and fulfilled.” (WHO, 2006a)

THE CHARACTERISTICS OF SEXUAL HEALTH THE CHARACTERISTICS OF SEXUAL HEALTH

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SEXUALITY – HUMAN NEED
Ns. HAFNA ILMY MUHALLA, S. Kep., M. Kep., Sp. Kep. M.B.
PRODI D-III KEPERAWATAN FAKULTAS VOKASI UNIVERSITAS AIRLANGGA
2nd semester, 2018

KEY CONCEPTUAL ELEMENTS OF


THE CHARACTERISTICS OF SEXUAL HEALTH
SEXUAL HEALTH

• Sexual health is about well-being, not merely the


absence of disease.
• Sexual health involves respect, safety and freedom
from discrimination and violence.
• Sexual health depends on the fulfilment of certain
human rights.

KEY CONCEPTUAL ELEMENTS OF


SEXUAL RIGHTS
SEXUAL HEALTH
Rights critical to the realization of sexual health
• Sexual health is relevant throughout the individual’s
lifespan, not only to those in the reproductive years, but include:
also to both the young and the elderly. • the rights to equality and non-discrimination
• Sexual health is expressed through diverse sexualities • the right to be free from torture or to cruel,
and forms of sexual expression. inhumane or degrading treatment or punishment
• Sexual health is critically influenced by gender norms, • the right to privacy
roles, expectations and power dynamics.

SEXUAL RIGHTS SEXUAL RIGHTS


• the right to decide the number and spacing of
• the rights to the highest attainable standard of one's children
health (including sexual health) and social security
• the rights to information, as well as education
• the right to marry and to found a family and enter • the rights to freedom of opinion and expression,
into marriage with the free and full consent of the
and
intending spouses, and to equality in and at the
dissolution of marriage • the right to an effective remedy for violations of
fundamental rights.

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SEXUALITY – HUMAN NEED
Ns. HAFNA ILMY MUHALLA, S. Kep., M. Kep., Sp. Kep. M.B.
PRODI D-III KEPERAWATAN FAKULTAS VOKASI UNIVERSITAS AIRLANGGA
2nd semester, 2018

SEXUALITY
Expressed by individuals of all ages

A way to show feminine or masculine qualities (clothing


SEXUAL NEED AND styles, hairstyles, hobbies and interests, sexual habit,
gestures)

RESPONSES May be expressed by: sexual intercourse, caressing, touching,


holding hands, masturbation

Is a right of all residents to experience

HUMAN NEEDS THE AFFECTING FACTORS OF


RELATED TO SEXUALITY SEXUALITY

TENDER SENSUA
INTIMACY
NESS LITY
ATTACH PROCRE
CARING
MENT ATION

PHASES OF HUMAN SEXUAL


HUMAN SEXUAL RESPONSE
RESPONSE

Is combination of physiological responses


AROUSAL/
and emotional responses (thoughts and EXCITEMENT
PLATEAU ORGASM RESOLUTION

feelings)
DUNNING, 2003

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SEXUALITY – HUMAN NEED
Ns. HAFNA ILMY MUHALLA, S. Kep., M. Kep., Sp. Kep. M.B.
PRODI D-III KEPERAWATAN FAKULTAS VOKASI UNIVERSITAS AIRLANGGA
2nd semester, 2018

SEXUAL PROBLEMS

DYSFUN DISCRIMI
VIOLENCE
CTION NATION

SEXUAL PROBLEMS ABUSE


COERCI
ON

SEXUAL DYSFUNCTION
SEXUAL DYSFUNCTION IN MAN

PRIMER SECONDARY
UN-ORGASM HABITUAL

ABNORMALITY OF SEXUAL
SITUATIONAL
FUNCTION

SEXUAL DYSFUNCTION IN MAN


SEXUAL DYSFUNCTION IN WOMAN

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SEXUALITY – HUMAN NEED
Ns. HAFNA ILMY MUHALLA, S. Kep., M. Kep., Sp. Kep. M.B.
PRODI D-III KEPERAWATAN FAKULTAS VOKASI UNIVERSITAS AIRLANGGA
2nd semester, 2018

FACTORS OF SEXUAL PROBLEMS


BIOLOGICAL
(Physical health, neurobiology, endocrine function)

PSYCHOLOGICAL (anxiety, depression)


NURSING PROCESS
RELATIONAL (current and past) and SEXUALITY
CONTEXTUAL (life stressors)

SAMJ, June 2014, Vol. 104. No. 6

NURSING CONSIDERATION NURSING CONSIDERATION


• Nurse must not express shock or disapproval • Talking and listening to clients is important to
promotes intimacy
regarding a client’s sexual practices
• Do not change beliefs and attitudes • Do not embarrassed to talk about sexuality
• It is imperative to deal
• It is necessary to suspend in order to spare • with one’s own feelings in order to decrease the
the client any judgment
client’s discomfort

ASSESSMENT ASSESSMENT
• Sexuality is a sensitive matter • The conducive discussion will be achieve:
• Assure privacy and maintain confidentiality
• Nurse must sensitive to cultural and religious • Use simple, direct language
differences • Provide explanations in terns understood by the client
• While do assessment, establish an atmosphere • Allow time for the clients’ questions
that encourages the client to freely discuss his or • Demonstrate respect by adopting a nonjudgmental
attitude
her concerns • Use open-ended questions to elicit more information

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SEXUALITY – HUMAN NEED
Ns. HAFNA ILMY MUHALLA, S. Kep., M. Kep., Sp. Kep. M.B.
PRODI D-III KEPERAWATAN FAKULTAS VOKASI UNIVERSITAS AIRLANGGA
2nd semester, 2018

ASSESSMENT ASSESSMENT
• Preparing for the sexual assessment:
• Review the clients’ medical history Physical
• Greet the client and explain the assessment techniques that you Interview
will be using examination
• Assess the client’s anxiety level, and provide reassurance that
this is normal
• Ensure that the room temperature is warm and comfortable Supporting
• Use a quiet room that will be free from interruptions examination
• Have the client void prior to the examination

Possible Effects of Injury or Illness on Possible Effects of Injury or Illness on


Sexuality Sexuality

Disfiguring surgery may cause a person to feel: Surgery can have both physical and/or psychological
effects: removal of prostate or testes, amputation of a
unattractive and ugly to others, mutilated and limb, removal of uterus; ovaries; breast, colostomy,
deformed, unworthy of love or affection ileostomy

Disorders that cause Disorders affecting the ability


Chronic illness and certain Disorders affecting the ability
impotence: diabetes mellitus, to have sex: stroke, nervous
medications can affect sexual to have sex: COPD,
spinal cord injuries, multiple system disorders, heart
functioning circulatory disease, arthritis
sclerosis, alcoholism disease

DIAGNOSIS DIAGNOSIS

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SEXUALITY – HUMAN NEED
Ns. HAFNA ILMY MUHALLA, S. Kep., M. Kep., Sp. Kep. M.B.
PRODI D-III KEPERAWATAN FAKULTAS VOKASI UNIVERSITAS AIRLANGGA
2nd semester, 2018

INTERVENTIONS INTERVENTIONS

IMPLEMENTATION Guidelines for The Nurse Aide in


Dealing with Resident Sexuality
Important things:
Assist to maintain sexual identity by dressing
• Communication and education residents in clothing appropriate for men or women
• Self-awareness
Assist with personal hygiene

Guidelines for The Nurse Aide in Guidelines for The Nurse Aide in
Dealing with Resident Sexuality Dealing with Resident Sexuality
Assist to prepare for special activities by “dressing
up”: selecting attractive clothing, fixing hair,
Help to develop a positive self-image
applying cosmetics, wearing a special perfume or
aftershave Show acceptance and understanding for resident’s
expression of love or sexuality: provide privacy,
Help to develop a positive self-image always knock prior to entering a room at any time,
assure privacy when requested

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SEXUALITY – HUMAN NEED
Ns. HAFNA ILMY MUHALLA, S. Kep., M. Kep., Sp. Kep. M.B.
PRODI D-III KEPERAWATAN FAKULTAS VOKASI UNIVERSITAS AIRLANGGA
2nd semester, 2018

Guidelines for The Nurse Aide in Dealing


with Resident Sexuality
EVALUATION
Use:
Never expose the resident
• Observation
Accept the resident’s sexual relationship • Expressions of intimacy
• Communication
Provide protection for the non-consenting resident
• Open-minded
Be firm but gentle in your rejection of a resident’s sexual advances • Nonjudgmental

DAFTAR PUSTAKA DAFTAR PUSTAKA


• Rozali, Yuli Asmi. 2018. Seksualitas Sebagai kebutuhan Dasar Manusia. www.esaunggul.ac.id • Rozali, Yuli Asmi. 2018. Seksualitas Sebagai kebutuhan Dasar Manusia.
www.esaunggul.ac.id
• Rowland, David. L and Incrocci, Luca. 2008. Handbook of Sexual and Gender Identity
Disorders. Wiley. John Wiley & Sons, Inc. • Rowland, David. L and Incrocci, Luca. 2008. Handbook of Sexual and Gender Identity
• Hatzimouratidis, K., Eardley, I., Giuliano, F., Moncada, I., Salonia, A. 2015. Guidelines on Disorders. Wiley. John Wiley & Sons, Inc.
Male Sexual Dysfunction: Erectile Dysfunction and Premature Ejaculation. European • Hatzimouratidis, K., Eardley, I., Giuliano, F., Moncada, I., Salonia, A. 2015.
Association of Urology. Guidelines on Male Sexual Dysfunction: Erectile Dysfunction and Premature
• Boa, R. 2014. Female Sexual Dysfunction. S Afr Med Journal. 2014:104 (6):446. South Africa. Ejaculation. European Association of Urology.
• DeLaune Sue C, Ladner Patricia K. 2002. fundamental of Nursing: Standards and Practice. • Boa, R. 2014. Female Sexual Dysfunction. S Afr Med Journal. 2014:104 (6):446.
2nd Edition. Delmar, Thomson Learning, Inc. NY. South Africa.
• Meston C, Bradford A. 2007. Sexual Dysfunctions in Women. ResearchGare. Annual Review • DeLaune Sue C, Ladner Patricia K. 2002. fundamental of Nursing: Standards and
of Clinical Psychology. PubMed. Practice. 2nd Edition. Delmar, Thomson Learning, Inc. NY.

SELESAI

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