Health - Psychosexual Adjustment Flashcards Preview

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Flashcards in Health - Psychosexual Adjustment Deck (14)
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1
Q

By the end of the session students should be able to:
§ Identify dimensions of sexuality
§ Understand common misconceptions and barriers to communication
about sexuality in a medical setting
§ Outline models for undertaking psychosexual assessment
§ Discuss key principles of sexual intervention / rehabilitation

A

d

2
Q

Sexuality incorporates a multitude of dimensions:

  • personality
  • values
  • body image
  • communication
  • gender

Sexual Health is the state of physical, ______, mental and ______ well-being relating to sexuality. It is NOT the absence of _______ and dysfunction

Sexual dysfunction is the various ways in which an individual is ______ to _______ in a sexual relationship to the extent they would wish.

This is a REAL problem and whilst things might return to normal after a while…sexual function sometimes does not…and lingers for a long time…

A
emotional
social
disease
unable
participate
3
Q

Impact of illness and/or treatment of sexuality can occur at different stages of the sexual response cycle.

Name these phases and some examples

A

Desire

  • altered masculinity and femininity
  • body image
  • depression
  • fatigue
  • nausea
  • hormone imbalance

Arousal

  • erectile dysfunction
  • dyspareunia (painful intercourse)
  • nerve injury
  • anxiety/depression
  • hormone imbalance

Orgasm

  • ejaculation disorders
  • altered orgasmic sensations
  • delayed orgasm

Resolution

  • post-coital bleeding or pain
  • reduced enjoyment
4
Q

Despite the very real problem of changes in sexual functioning, only _____ of women said doctors discussed post-treatment sexual changes with them (self-report data), another study (observed consults) found that it was discussed ____% of the time.

Further, most doctors think that sexual activity is important to discuss after a heart attack, yet only ____% actually do it. ____% of doctors don’t feel comfortable discussing it. Other barriers include ____, confidence, and lack of _______ in regular care.

A

half
25

24

50
time
protocols

5
Q

What is the conspiracy of silence?

A
  • clinicians wait for patients to voice their concerns
  • patients wait for doctors to bring it up
  • clinicians and patients want the topic to be brought up
6
Q

The greatest barriers to good sexual life are ______, ________ and _________.

Other barriers for doctors include:

  • low priority
  • embarrassment
  • not my responsibility
  • lack of knowledge/skills
  • lack of resources/interventions

barriers for patients

  • too old
  • too sick
  • too single
A

anxiety
misinformation
ignorance

7
Q

When sex is discussed, it is important to consider it’s various domains…what are these 4 domains?

What does this mean when creating a model for sexual health?

A
  • Physical
  • Psychological
  • Relationship
  • Cultural

–> need for an integrated bio-psycho-social model to assess and manage sexual difficulties

8
Q

PROMIS Global Satisfaction with Sex Life scale allows for a ________ assessment of overall satisfaction with sex life, _______ status, or functional abilities.

It is appropriate for use across _____ types.

It is quick and _____ to administer

In the past 30 days...
1. How satisfied?
2. How much pleasure?
3. Hoe enjoyable?
Etc
A

subjective
relationship

cancer

easy

9
Q

BETTER model

This is an acronym for a strategy for doctors to use in their consults

A

Bring up the issue

Explain that sexuality is part of QoL

Tell the patient that there are resources to address their concerns

Timing might not be right at the moment, but they can talk about it anytime

Educate patients on sexual side effects

Record that the conversation has taken place

10
Q

The PLISSIT Model for assessment

–> most commonly used model

A

Permission (100%)
- sex is something you can talk about

Limited
Information (100%)
- provide information on sexual changes during treatment - resource booklets, etc

Specific
Suggestions (50%)
- provide strategies to deal with changes
eg: vaginal moisturisers, lubricants, dilators
eg: oral meds, injection therapy, vacuum erection devices, penile implants

Intensive
Therapy (10%)
- referral to a specialist if required

11
Q

Breaking the cycle of silence involves

A

…addressing some of the barriers
eg: providing training to clinicians, and resources to offer patients

Clinicians need to bring it up so the patient knows about the issue(s) and what to expect, and specific suggestions have to be made regarding possible interventions

12
Q

Whilst it is not a mandatory part of training, clinicians can becomes skilled through…

Psycho education resources - an example given…

A

module a part of their professional development

For example, RCT conducted of an educational booklet to improve communication about psychosexual changes in women undergoing radiotherapy for gynaecological and anorectal cancer
–> women with the booklet had greater knowledge of the side effects and higher adherence of the use of a dilator (important for sexual functioning and for future doctor examinations)

13
Q

Principles for intervention:

§ Introduce routine clinical assessment for sexual morbidity (_____ up the conversation)

§ Include _______ (if possible/desired)

§ Intervene _____ (when medically safe)

§ Consider _________ (the techniques that are recommended - do them before!)

§ Encourage sex despite low ______ (plan specific times and stick to them, the desire will come)

§ Establish sexual rehabilitation _______ and ______ network

§Promote renegotiation / _______ of sexual practices (satisfaction is possible)

§ Foster _______ expectations: extent of & timeline for recovery (it takes a while!)

§ Prepare patients to manage _______ (important to start with the most effective, least invasive treatment)

§ Normalise _______ process (fertility, erection, etc)

§ take into account _______ and individual differences

A
open
partners
early
prehabilitation
libido
pathways
referral
flexibility
realistic
failures
grieving
cultural
14
Q

Sex is just another form of…

All individuals have the right to…

All health professionals can support patients/couples…

Post-treatment sexual function and satisfaction…

Intimacy is…

sexual rehabilitation is an…

A

…communication

…experience good sexual health (according to their needs and preferences)

…in their psychsexual recovery…

…can be improved, but it might take a long time…

…always possible

…essential component of health care