Word Count of Assignment: 3240
Understanding patient sexuality and associated issues that can arise after a cardiac event: A reflection of practice.
This assignment reflects on my role as a student nurse on a cardiac ward. Using theory to analyse missed opportunities in addressing patient’ sexuality; I have focussed on why communication was ineffective and ways to improve my future practice. To first understand sexuality I have selected definitions which I believe to be inclusive and holistic. A person’ sexuality is formed by their individualism, culture, upbringing and social influence of the period in which they develop (Tiefer 1995.) Sexuality is a lifelong process, from birth until death and each individual’s perception of their sexuality is likely to evolve with their experiences (Carabine 2004.) Johnson and Chang (2008) recognised that sexuality can be displayed through a broad range of social emotional, spiritual, sensual and physicals means. It may be expressed as feelings, attitudes and beliefs, needs, desires and fantasies. The term encompasses emotional intimacy and any form of sexual activity or habit including pro-creational, recreational and relational practices and can be with or without the goal of achieving please, for example wearing perfume to feel feminine and with or without the intimacy of a partner or partners (Tiefer 1995.) A preference to engage or dismiss the above can also be considered an aspect of sexuality. Sexuality takes many forms, for what might be a source of warmth and attraction for another may be fear and hate (Mauk 2012.) Some of the literature focusses in on sexual orientation for examples individuals expressing heterosexuality, homosexuality, bisexuality or celibacy to name a few. I think it is important to note that the practices individuals undertake my not lead to the claiming of a sexual identity (Carabine, 2004.) For example a man who has sexual intercourse with other men may reject to identify himself a homosexual. Sexual identity can be assumed, attributed, chosen and claimed or actively rejected (Weeks, 2003) Sexuality is dependent on the capacity and freedom to express any element of the tem without judgement, fear, exploitation, oppression, physical or emotional harm (Zgourides, 1995.)
Sexual problems are highly prevalent among patients who have experienced a major cardiac event and can have adverse effects on quality of life and well-being (Briggs, 1994.) These issues, such as reduced sexual activity, interest, satisfaction and performance can cause people great concern (Jaarsma, 2002.) Unfortunately evidence suggests that nurses are not assessing patient’s needs nor can they provide health advice about sexual concerns (Albarran and Bridger, 1997.) However, such information can alleviate worries and clarify misconceptions. Nurses must overcome any barrier preventing patients from receiving information as it is pivotal in our role of delivering holistic care (Steinke and Patterson-Midgley, 1998.) Transactional analysis explores the causes of ineffective communication and aids an understanding of why I, like many other health care workers, failed to approach patients about challenging subjects of sexuality. The theory also provides strategies to facilitate effective communication in the future (Ellis, 1995.) In the 1950’s the psychiatrist Eric Berne developed the term ‘Transactional Analysis,’ to group together his theories on psychoanalysis and psychotherapy. Berne proposed that any exchange of communication, between two or more people can be broken down into a series of single transactions. Each transaction is formed from a stimulus and a response (Lister-Ford 2002.) At the core of Transactional Analysis is Berne’s Ego State theory, a model showing three ego states, Parent, Adult and Child (see Appendix 1.) Each state is irrespective of age and has a consistent pattern of characteristic attitudes, thoughts, behaviours and language. Our...