Saint Mary’s University
Bayombong, Nueva Vizcaya
School of Health & Natural Sciences
NURSING DEPARTMENT
Course No. NCM 117 Lecture
Subject: Care of Client with Maladaptive Patterns of Behavior, Acute and Chronic
Yr. Level: BSN 3
Contact Hours/Credit Units: 4 fours/week(4units)_____________________________________
CHAPTER 17
SEXUAL DYSFUNCTION
l. Introduction
Sexual dysfunction should be assessed by a nonjudgmental health care provider using the
same history-taking and physical examination techniques for any other symptoms complex.
ll. Learning Objectives
1. Apply the moral and ethical-legal principles in dealing with the care of client with sexual
dysfunction.
2. Obtain a comprehensive psychiatric history and conduct a thorough assessment of mental
status of a client with sexual dysfunction.
3. Formulate a holistic nursing care plan for client with sexual dysfunction.
4. Execute a safe, appropriate mental health activity for client with sexual dysfunction.
5. Utilize effectively the therapeutic use of self in caring client with sexual dysfunction.
lll. Core Content of the Chapter
Sexual Aberrations
Paraphilias:
- sexual urges, fantasies and behaviors that are directed towards nonhuman objects.
- infliction of pain or humiliation to self, partner children or other nonconsenting individuals.
- onset may begin in childhood or early adolescence and more defined in adulthood.
- more among males during the preschool age/oedipal period.
Causes:
- hereditary tendencies
- environmental factors
- defense against unsatisfying relationship
- labelling
- guilt leading to sexual acting out
- preferred choice as a life-style.
Types of Paraphilias:
1. Fetishism – An object used to achieve sexual excitement and gratification.
2. Transvestism – A person wearing clothes of the opposite sex.
3. Exhibitionism - A repetitive act of exposing one’s genital to unsuspecting stranger.
4. Mixoscopia/Voyeurism – A person observing/peeping those who are naked, disrobing or
engaged in sexual activity
5. Sadism – A terrorizing act that involves pain, brutality, torture to gain pleasure.
6. Masochism - The need to be humiliated, accepting physical pain to experience sexual
excitement.
7. Protteurism - Touching or rubbing against a nonconsenting person.
8. Necrophilia – A sexual gratification engaging in a sexual relation with a corpse.
9. Necrosadism – A sexual stimulation and orgasm by mutilating corpses.
10. Transsexualism - The desire to acquire the sexual characteristics of the opposite sex.
11. Zoophilia - Arousal or desire for sexual contact with animals.
12. Bestiality – A sexual contact with animals.
13. Telephone scatologia – A gratification from or during lewdness on the telephone.
14. Pygmalionism - Aroused sexually by statues of females.
15. Sodomy - Oral intercourse between males.
16. Pedophilia - Pathological sexual interact with children.
17. Partialism - Exclusively focusing on the body parts that generates sexual arousal.
18. Coprophilia - Sexual arousal on contact with feces.
19. Klismaphilia - Sexual arousal generated by the use of enemas.
20. Urophilia - Sexual arousal on contact with urine.
21. Ephebophilia - Fondling and other type of sexual activities with children who are developing
secondary sexual characteristics.
22. Paraphilic coercive disorder – Aggressive act of sexual assault involving intercourse against
the persons will or without consent.
Sexual Dysfunction
- Is the inhibition or interference with the phases of the sexual response cycle.
(Excitement, Plateau, Orgasm and Resolution)
- Acquired and lifelong
Causes:
1. Biophysiological (diabetes, alcoholism, renal failure, drugs)
2. Intrapsychic (rape, cultural/religious taboos, stress, low self-esteem, altered body
image)
3. Interpersonal (hostility, poor communication, tension)
Types of Sexual Dysfunction
1. Sexual desire disorder – There is no sexual desire or aversion to sexual contact.
2. Sexual arousal disorder - The female cannot maintain the lubrication-swelling response of
sexual excitement and man cannot maintain an erection.
3. Orgasm disorder – The inability to complete the sexual response cycle. (Premature ejaculation)
4. Sexual pain disorder - Dyspareunia before, during and after sexual intercourse.
Vaginismus involuntary spasm in the outer third of the vagina.
5. Gender Identity Disorder - discomfort with one’s sex
Nursing Management: - Acceptance - Emphatic - Nonjudgmental
Intervention: - Psychotherapy - Antiandrogen - SSRI - Agents to lower testosterone level
IV. Activity:
Short Quiz
V. Bibliography:
Videbeck, S. (2020). Psychiatric-Mental Health Nursing. Wolters
Keltner, N., Bostrom C., & McGuiness T. (2012). Psychiatric Nursing. Elsevier Inc.
Prepared by:
Mrs. Rosalie C. Carreon, RN, MSN
Nursing Department
