Sexuality and sexual health and GUIDANCE

1. ALL INDIA OF MEDICAL SCIENCES INSTITUTE , BHOPAL
SEMINAR
ON
SEXUALITY AND SEXUAL HEALTH
PRINCIPLES AND TECHNIQUES OF
COUNSELLING
SUBMITTED BY SUBMITTED TO
SHWETA THAKUR MRS LILY PODDER
MSC NURSING 1ST YEAR ASSOCIATE PROFESSOR
AIIMS BHOPAL AIIMS BHOPAL

2. GENERAL OBJECTIVE
• By the end of class, students will be able to understand in depth
about Sexuality and Sexual Health and will be able to apply this
knowledge in their practice.

3. SPECIFIC OBJECTIVE
• To define Sexuality
• To define Sexual Health
• To discuss about sexual growth and development
• To discuss about Gonad and Phenotypic sex
• To discuss about behavior and characteristics of individual at
different stages of development
• To discuss about sexual health and its characteristics.
• To discuss about components of sexual health

4. cont…..
• To discuss about factors affecting sexual health
• To explain about phases of sexual response cycle
• To discuss about sexual dysfunction
• To discuss about nursing role
• To discuss about laws and legal protection

6. INTRODUCTION • THE WORD SEX
DENOTES WHETHER A
PERSON IS MALE OR
FEMALE OR THE SEX
DIFFRENCE
• SEX– IS TERM MOST
COMMONLY USED TO
INDENTIFY BIOLOGIC
MALE OR FEMALE
STATUS.
• BUT SEXUALITY IS OPT
TO SEXUAL
BEHAVIOUR, GENDER
CONSCIOUSNESS AND
SEXUAL NATURE.

7. EPIDEMIOLOGY
• REPRODUCTIVE AND SEXUAL ILL-HEALTH ACCOUNTS FOR 20% OF THE
GLOBAL BURDEN OF ALL HEALTH FOR WOMEN AND 14% FOR MEN.

8. SEXUALITY
IT IS A BROAD TERM THAT REFERS TO ALL ASPECTS OF BEING
SEXUAL. IT IS A PART OF WHO A PERSON IS?
SEXUALITY INCLUDES A PERSON’S THOUGHTS AND FEELINGS
ABOUT THE BODY, A SENSE MALE AND FEMALENESS, ROMANTIC
OR EROTIC ATTACHMENT TOWARDS OTHERS AND ATTITITUDES
TOWARDS SEXUAL FUNCTIONING.

9. SEXUALITY
WHO AM I?

11. SEXUAL GROWTH AND
DEVELOPMENT
.

12. CHROMOSOMAL LINKAGE–
XY CHROMOSOMES
COMBINATION PRODUCES
MALE
XX CHROMOSOMES
COMBINATION PRODUCES
FEMALE

13. ESTABLISHMENT OF GONAL SEX
AT CONCEPTION , FETUSES ARE CONSIDERED
AS DIMORPHIC. THE SEXUAL DIFFRENTIATION
OCCURS BY 10-12TH WEEK OF GESTATION.
THE MALE DERTMINING FACTOR IS Y
CHROMOSOME LEAD TO DEVELOPMENT OF
THE INTERNAL TESTES FROM THE GONAD
MEDULLA, WITHOUT MALE FACTORS THERE IS
DEVELOPMENT OF INTERNAL OVARY FROM
GONAD CORTEX.

14. ESTABLISHMENT OF PHENOTYPIC SEX
WHEN THE ADDITION OF INTERNAL AND EXTERNAL
GENITIAL ORGAN DEVELOPS, RESULT IN ACTUAL
CHRACTERISTICS OF BIOLOGICAL SEX, HERE IS THE CRITICAL
TIME IN SEXUAL DIFFRENTIAION .EACH FETUS DEVELOP
BOTH WOLFFIAN AND MULLERIAN GENITAL DUCT SYSTEM
THE WOLFIAN DUCT SYSTEM IN PRESENCE OF
TESTOSTERONE GIVES RISE TO EPIDIDYMIS, THE VAS
DEFERENCE AND THE SEMINAL VESICLES IN MALE.
THE MULLERIAN DUCT GIVES RISE TO FEMALE FALLOPIAN
TUBE, UTERUS AND UPPER PART OF VAGINA.

15. DEVELOPMENT STAGES-
• INFANCY
• TODDLER
• PRESCHOOLER
• SCHOOL AGE
• Given gender assignment of
male/female.
• Continue to develop gender
identity .Able to identify own
gender.
• Become increasingly aware of
self .Explore own and playmates
body parts.
• Tends to have friends of same
gender, increased modesty and
desire for privacy.

16. Cont…….
• ADOLSCENT
• YOUNG ADULTHOOD
• MIDDLE ADULTHOOD
• LATE ADULTHOOD
• Primary and secondary sexual
characters develop. Masturbation is
common and develops interest in
relationship with interested
partner.
• Sexual activity is common. Establish
own life style and values
• Men and women experience
decrease hormone production.
• Sexual activity decreases due to
sexual organ atrophy.

17. ANY QUERY?

18. SEXUAL BEHAVIOUR

19. CHILDHOOD SEXUAL BEHAVIOUR
• CURIOSITY REGARDING THE
SEX ORGANS OF OPPOSITE
SEX.
• MASTURBATION
• QUESTION RELATED TO
PREGNANCY, CHILD BIRTH
AND QUESTION RELATED TO
SEXUAL MATTERS

20. ADLOSCENCE SEXUAL BEHAVIOUR
▪ SELF MASTURBATION
▪ SEX EXPERIMENT
▪ LOVE AFFAIR
▪ CHATTING
▪ WEB SURFING
▪ DESIRE FOR PARTNER
▪ PROBLEMS REGARDING
MARRIAGE,UNWED MOTHER OR
RAPE

21. ADULT SEXULAL BEHAVIOUR
▪ PROBLEMS OF ADJUSTMENT IN
SEXUAL BEHAVIOUR
▪ EXTRAMARITIAL AFFAIRS
▪ DIVORCE
▪ STD
▪ UNWANTED PREGNANCY

22. OLD AGE SEXUAL BEHAVIOURS
▪ LACK OF SEXUAL
STIMULATION
▪ DEGENRATION OF
ORGANS
▪ DEATH OF LIFE
PARTNER
▪ DISEASE RELATED
TO SEXUAL
GLANDS

24. SEXUAL HEALTH
INTEGRATION OF THE SOMATIC, EMOTIONAL,INTELLECTUAL
AND SOCIAL ASPECTS OF SEXUAL BEINGS IN WAY THAT
ENHANCE PERSONALITY, COMMUNICATION AND LOVE.
Sexual health- It is a state of physical, mental and social well-being
in relation to sexuality and not merely the absence of disease,
dysfunction or infirmity (WHO).
To maintain sexual health, there must be a constructive, effective
and deferential approach to sexuality and relations

26. CHARACTERISTICS OF SEXUAL HEALTH
• Knowledge about sexuality and sexual behavior
• Ability to express one’s full sexual potential
excluding sexual exploitation and abuse.
• Ability to make autonomous decisions about one’s own sexual life
• Experience of sexual pleasure.

27. COMPONENTS OF SEXUAL HEALTH
1. SELF CONCEPT
2. BODY IMAGE
3. GENDER IDENTITY
4. GENDER ROLE BEHAVIOUR
5. ANDROGYNY

28. FACTORS EFFECTING SEXUAL HEALTH

29. FACTORS
1) BIOLOGICAL
2) PSYCHOLOGICAL
3) ENVIRONMENT
4) HARMONES
5) SEXUAL HEALTH HISTORY
5) STRESS
6) EFFECTS OF MEDICATION

31. SEXUAL DYSFUNCTION
MALE
DYSFUNCTION—
i. ERECTILE
DYSFUNCTION
ii. RAPID
EJACULATION
iii. RETARTED
EJACULATION

32. FEMALE DYFUNCTION—
• Hyperactive sexual dysfunction.
• Sexual arousal disorder
• Orgasmic disorder
• Sexual pain disorder

33. OTHERS—
i. GENDER IDENTITY DISORDER- TRANSSEXUALISM, DUAL ROLE TRANSEXUALISM
ii. BEHAVIOUR DISORDER- HOMOSEXUALITY, BISEXUALITY
iii. PARAPHILLIAS- PREFERNCE FOR USE OF NON HUMAN OBJECT ---FETISHISM,
SADDISM,FROTTEURISM, VOYERISM ETC.

34. NURSING MANAGEMENT
• ASSESSMENT—
• HISTORY TAKING
• PHYSICAL EXAMINATION
• INFORMATION ABOUT CLIENT HEALTH STATUS
• DIAGNOSIS–
1) INEFFECTIVE SEXUAL PATTERN
2) SEXUAL DYSFUNCTION
3) PAIN RELATED TO INADEQUATE VAGINAL LUBRICATION OR EFFECTS OF THE GENITAL
SURGERY.
4) ANXIETY RELATED TO LOSS OF SEXUAL DESIRE OR FUNCTIONING
5) FEAR RELATED TO HISTORY OF SEXUAL ABUSE OR DYSPEREUNIA

35. NURSING INTERVENTIONS
1. MAINTAIN, RESTORE OR IMPROVE SEXUAL HEALTH.
2. INCREASE KNOWLEDGE OF SEXUALITY AND SEXAUL HEALTH.
3. PREVENT OCCURING OR SPREAD OF STDS
4. PREVENT UNWANTED PREGNANCY
5. INCREASED SATISFACTION WITH LEVEL OF SEXUAL FUNCTIONING.
6. IMPROVE SEXUAL SELF CONCEPT.
7. PROVINDING SEXUAL HEALTH TEACHING.
8. SEX EDUCATION
9. RESPONSIBLE SEXUAL BEHAVIOUR
10. COUNSELING FOR ALTERED SEXUAL FUNCTION

37. SDG 5-GENDER EQUALITY
• SDGs also call for
provisioning of sexual
health services into national
strategies and programmes,
to be measured by
indicators such as access to
and use of contraception,
availability, accessibility and
acceptability of quality
sexual and reproductive
health (SRH) services,
knowledge about sexual
and reproductive health
rights (SRHR), adolescent
fertility, quality of care,
prevention of STIs and
abortion.

38. AREAS HERE YOU CAN SEEK HELP
https://www.nhp.gov.in/sexual-health_pg
NATIONAL SEXUAL HEALTH PORTAL OF INDIA. – SEXUAL RIGHTS
http://naco.gov.in/sti-rti-services
Adolescent family health clinics- Initiated in 2006 under RCH 2
SASH – SOCIETY FOR ADVANCEMENT OF SEXUAL HEALTH
https://www.sash.net/
AIIMS BHOPAL
https://aiimsbhopal.edu.in/index_controller/facultyDetails?sid=172&id=56
IISB https://iisb.org/

39. COMMITTEES IN AIIMS BHOPAL

40. LEGAL ASPECTS IN SEXUAL HEALTH
• Article 377– of Indian panel courts call for maximum punishment of life imprisonment for
all sexual acts against human nature(primarily interpreted to be homosexuality, especially
sadonomy, including between consenting adults.
• Section 375– In April 2013, the Indian parliament introduced amendments to the IPC
making various changes to the anti rape laws in India. The offence of rape under section
375 have made both penile and non penile insertion into bodily orifices of a women by a
man an offence. The section has also clarified that penetration means ‘”penetration to any
extent” and lack of physical resistance is immaterial for constituting an offence .
• Expect in certain aggravated situation, the punishment will be imprisonment not less than
7 years but which may extent to imprisonment for life and shall else be liable to fine.
• -- The union health ministry, which has drawn a new guidelines for treating rape victims,
has asked all hospitals to set up a designated rooms for forensic and medical examination
of victims besides out lawings the two finger test performed at them.
• -- The DHR( dept. Of health research) has also drafted a new manual to address the
psychosocial impact of sexual violence including counselling that the victims should receive
to the well.
• SECTION 376A- SEXUAL offence leading to death ,shall be punishable upto 20 years which
may extend life time
• Protection of women from domestic violence act 2005

41. RESEARCH ARTICLE
• INFERTILITY AND SEXUAL DYSFUNCTIONS: A SYSTEMATIC
LITERATURE REVIEW
• Andrej Starc
• CONCLUSION-
• This study aimed to investigate whether infertility and its
treatment affect couple sexuality. Couples report less
satisfaction with sexuality. Since lower satisfaction and
dysfunctions are closely connected with infertility and its
treatment, couples might benefit from sexual therapy and
support during the process of infertility treatment.

42. Psychological and Interpersonal Dimensions of Sexual
Function and Dysfunction
Lori Brotto
• Conclusion: Overall, research strongly supports the routine clinical
investigation of psychological factors, partner-related factors, context,
and life stressors. A biopsychosocial model to understand how these
factors predispose to sexual dysfunction is recommended.

43. Sexual Aging: A Systematic Review of Qualitative Research on the
Sexuality and Sexual Health of Older Adults
Matija Sinković1, Lauren Towler2
CONCLUSION
Negative stereotypes regarding the sex lives of older adults persist,
despite sexuality being an important factor that influences the quality of
life. Research is needed into male sexual desire and pleasure, culture-
specific and sexual/gender identities and their effect on outcomes such as
help-seeking behavior and sexual satisfaction, and sexual risk-taking in
older adults.

44. References
• https://www.google.com/search?q=sexuality+and+sexual+health&rlz
• Starc A, Trampuš M, Pavan Jukić D, Rotim C, Jukić T, Polona Mivšek A. INFERTILITY AND
SEXUAL DYSFUNCTIONS: A SYSTEMATIC LITERATURE REVIEW. Acta Clin Croat. 2019
Sep;58(3):508-515. doi: 10.20471/acc.2019.58.03.15. PMID: 31969764; PMCID:
PMC6971809.
• Brotto L, Atallah S, Johnson-Agbakwu C, Rosenbaum T, Abdo C, Byers ES, Graham C, Nobre
P, Wylie K. Psychological and Interpersonal Dimensions of Sexual Function and Dysfunction.
J Sex Med. 2016 Apr;13(4):538-71. doi: 10.1016/j.jsxm.2016.01.019. Epub 2016 Mar 25.
PMID: 27045257.
• https://nhrc.nic.in/sites/default/files/sexual_health_reproductive_health_rights_SAMA_PL
D_2018_01012019_1.pdf
• https://www.google.com/search?q=POSH+COMMITTEE+BHOPAL+AIIMS&tbm
• https://sdgs.un.org/goals
• https://www.google.com/search?q=TESTES+AND+OVARY&tbm
• https://www.google.com/search?q=ADULT+SEXUAL+BEHAVIOUR&rlz
• https://www.nhp.gov.in/sexual-health_pg

45. Counselling

46. GENERAL OBJECTIVE
• By the end of seminar , Students will be able to understand in depth
about counselling, its principles and techniques.

47. SPECIFIC OBJECTIVES
• To define counselling
• To discuss about need of counselling
• To enlist principles to be followed in counselling technique
• To enlist techniques of counselling

48. Contents
•Introduction
•Definition of Counselling
•Need of Counselling
•Principle of Counselling
•Technique of Counselling

49. Counselling
INTRODUCTION
• Counselling is a helping Process where one person explicitly and purposefully
gives his or her time, attention and skills to assist a client to explore the situation
identify and act upon solutions with in the limitations of their given
environment.
• Counselling is the process of Consultation, mutual interchange of opinions
deliberating together.

50. Counselling
DEFINITION
Counselling is a helping relationship that includes someone seeking help, someone
willing to give help who is capable or trained to help ,in a setting that permits help to be
given and received.
Cormier and Hacknly, 1987
Counselling is a mutual consultation and deliberation. This involves a minimum of two
persons ,the counsellor and the client who come to the counsellor for consultation. In
other words , counselling is talking to a professionally trained person who can help in
expressing pent up feelings and worries ,who can provide an insight into them and who
can help the client in finding solution to his her problems.
Webester Dictionary

51. Need of Counselling
• To help individuals become self-sufficient, self-dependent,
and self-directed
• To adjust themselves efficiently to the demands of a better
meaningful life.
• To help people gain an insight into the origin.
• To alter maladjusted behaviour.
• Identify the individual’s problem and explore different areas
of solution.
• Orient the students in career planning, educational
programming and direction towards long term aims.

52. Cont. Need of Counselling
• Achievement of positive mental health.
• Resolutions of problems.
• Improving personal effectiveness.
• Maximizing change of behavior.
• Decision making as a goal of nursing.
• Modification of behavior as a goal.
• Self development.
• Self realization.

53. PRINCIPLES TO BE
FOLLOWED IN
COUNSELLING TECHNIQUE
ACCEPTANCE LEAD
CLARIFICATIO
N
REASSURANCE ADVICE
RESTATEMEN
T

54. Principles for Counselling
• Communicate personal warmth and make the client feel welcome
and valued as individuals.
• Act with care and respect considering the individual and cultural
differences and diversity of human experience.
• Be honest and trustworthy in all of the individual’s professional
relationships, being open, friendly and not defensive.
• There is no single way to counsel.

55. Principles for Counselling
• Respect the confidence with which the individual is entrusted.
• Be empathetic and sense the feelings and experience of another
person.
• Promote the safety and wellbeing of individuals, families, and
communities.

56. Principles for Counselling
• Seek to increase the range of choices and opportunities for the
clients.
• Practice within the scope of the individual competence.
• Treat colleagues and other professionals with respect.
• Focus on finding solutions to the existing problems and future
decisions of the individual.

58. Techniques of Counselling
• DIRECTIVE COUNSELLING
• Also called as counselor-centered Counseling.
• Process of listening to member’s problem, deciding with the member
what should be done, and then encouraging and motivating the
person to do it.
• This type of counseling is more useful where the individual wants
information and advice for choice of a career. This approach does not
focus its attention on personality development

59. Techniques of Counselling
1. DIRECTIVE COUNSELLING
2. NON DIRECTIVE COUNSELLING
3. ECLECTIC COUNSELLING
4. SHORT TERM COUNSELLING
5. LONG TERM COUNSELLING
6. CLINICAL COUNSELLING
7. PSYCHOLOGICAL COUNSELLING
8. PSYCHOTHERAPEUTIC COUNSELLING

60. Cont.Techniques of Counselling
9. STUDENT COUNSELLING
10. PLACEMENT COUNSELLING
11. MARRIAGE COUNSELLING
12. VOCATIONAL COUNSELLING
13. INDIVIDUAL COUNSELLING
14. GROUP COUNSELLING
15. BEHAVIOUAL COUNSELLING

61. Conclusion
• Counselling is a method that helps the client to use a problem solving
process to recognize and manage stress and that facilitates
interpersonal relationships among client family, health care team.
• Counselling is a process by means of which the helper expresses care
and concern towards the person with a problem and facilitates the
personal growth and brings change through self knowledge.
• Counselling enjoys a predominant role in the present day life.
Counselling services are aimed at enabling peoples to acquire ability
which promotes self direction and self realization. So counselling is
very important in day to day life.