Patricia Weerakoon

Sexuality and the Patient with a Stoma

The formation of a stoma consequent to abdominal surgery represents a major change in a persons life, and results in complex emotional, social, and physical concerns including sexuality. The establishment of a stoma affects sexuality directly by disruption of nerve and blood supply to the genitals and indirectly by the effect on body image, self esteem, and by virtue of its position, problems with management of the stoma during sexual activity. Research indicates that the extent of these concerns are dependent on the disease state preceding the surgery and the type of stoma established as well as the ability of the patient to adapt to the changes. Health professionals play an important role in education and counselling stoma patients. They should therefore by sensitised to the issue and develop the competence to deal with it as needed.

‘They’re taking the place of my hands’: perspectives of people using personal care

This study investigated the experience of personal support provided by paid service providers. Numerous studies have investigated personal care assistance). However, there is a paucity of research on the experience of receiving personal assistance delivered by formal services. People who were using formal personal care services (participants) were engaged in in‐depth interviews about their experiences. The results of a thematic analysis of transcript data are reported. Findings indicate that the participants wanted their personal autonomy facilitated when they received assistance. This was achieved when the carer replaced the participant’s ‘hands’ and followed the choices and preferences of the participant when providing assistance. A number of barriers prevented participants from achieving self‐determination. This included the carer’s attitudes and aversions to tasks, formal training and rules and regulations set down by the personal care service providers.

Online sexuality education and health professional students' comfort in dealing with sexual issues

A study of comfort level for discussing sex- and sexuality-related topics in a sample of allied health professional students shows an improvement in their comfort level after completing an online sexuality unit. This finding supports the argument that modern technology can offer an excellent opportunity and means to develop personal and professional skills in sex-related issues. Raising the comfort levels of health professional students will better prepare them for professional interaction on sexual issues they could encounter with their clients. Future research examining different ways to build not only comfort levels but also professional communication skills is warranted. Current and future research would aid in development of new programs based on distant education platforms, which could provide effective ways of appropriate sexual-interventions education for health professionals in clinical settings.

E-learning in sexuality education.

The use of computers in learning and communication is not new to health professional education.However, the rapid developments in technology and the increasing competence of students in computer- and web-based learning make the need for health professional education to take the next step to e-learning a necessity rather than a choice. This paper describes an e-learning unit in sexuality developed in response to a felt need for a flexible online unit in the topic. The use of online tools for e-learning in sexuality are discussed and course evaluation presented. The need for a strong pedagogic model and the careful development of learning activities to utilize the facilities available for assessment, feedback and especially synchronous and asynchronous communication are discussed as they apply to the sexuality unit.

A study of attitudes toward sexuality issues among health care students in australia.

SUMMARY This study examined the attitudes of 1132 higher education students enrolled in health profession education degree programs. Students were asked to indicate their anticipated level of comfort in a variety of interactions including working with a lesbian client or a homosexual male, and asking a client about his or her sexual orientation. Students also indicated whether they perceived their degree program had dealt adequately with these issues. High levels of discomfort were identified in our large sample of students. Approximately 30% of the sample indicated they would be uncomfortable working with a lesbian client and 27% of the sample indicated that they would feel uncomfortable if working with a male homosexual client. There were significant differences for these two items depending on the students gender. Female students indicated significantly higher levels of comfort in dealing with homosexual male clients than did their male counterparts. Male students indicated significantly greater comfort in dealing with lesbian clients. More than half of our sample indicated that they would not be comfortable asking about a clients sexual orientation. Over 75% of senior-year students believed that their degree program had not adequately dealt with these issues. The impact of homophobia and discomfort on the quality of care health professionals provide for lesbian and gay clients and the role of educational strategies to reduce this are discussed.

International perspective on teaching human sexuality.

ObjectiveThe authors outline international training programs in human sexuality.MethodsThe authors reviewed the international literature and Internet resources to identify key training opportunities and curricula, with particular emphasis on training opportunities for psychiatrists.ResultsThe authors outline key resources and training courses outside the United States.ConclusionTraining in human sexuality, sexology, and sexual medicine is evolving across many clinical disciplines, but courses remain limited in number and far apart geographically.

Self-evaluation of skills as a method of assessing learning needs for continuing education

Identification of self-perceived learner needs is important in continuing education programmes for health professionals. This paper describes the use of a self-evaluation skill inventory as a method of determining priorities for continuing education of a category of middle-level health professionals.

A literature review on vulvodynia and distress

Distress about a sexual problem is a necessary part of diagnosing female sexual dysfunction. It is an important way to distinguish between a sexual problem and normal sexual variation and has implications for treatment seeking, motivation for therapy and prognosis. The concept of distress, however, has not been clearly defined and is complex and poorly understood. Furthermore, there has been limited research into distress related to genital pain disorders. This paper explores the concept of distress within the field of vulvodynia research, specifically the distress that results from genital pain. Due to the limited research into distress relating specifically to genital pain this review will contextualise the available literature within the larger context of distress related to other female sexual dysfunctions. The discussion includes the current and future Diagnostic and Statistical Manual definitions for genital pain, as well as general definitions of distress. It also explores distress in the genital pain and general female sexual dysfunction literature and discusses its diagnostic, research and clinical implications.

Alterations in grip strength during male sexual arousal.

Although it is known that alterations in grip strength occur under a number of conditions, little is known about relationships between grip strength and sexual arousal. This relationship was investigated in 30 healthy heterosexual males, who viewed both erotic and nonerotic videos. A questionnaire was used to assess the extent of sexual arousal. The grip strengths of both hands were measured with a five-position (P1–P5) dynamometer, before and after watching the videos. After watching the erotic video, there was a statistically significant reduction in grip strength for the P2 position, with nonsignificant overall reductions in grip strength for all other positions tested. No such effect was observed in control tests. The results indicate that during sexual arousal, the neural system is likely to reduce the output to muscles not directly related to sexual function, presumably to enhance the physiological responses of sexual arousal.

Effects of sexual arousal on vibrotactile detection thresholds in aged men with and without erectile dysfunction

BACKGROUND Erectile dysfunction (ED) is a common problem in ageing men. Abnormalities in sexual arousal may contribute to its development, and to the failure of pharmacological therapies. However, there are few objective ways of assessing arousal. Sexual arousal has been shown to affect vibrotactile detection thresholds (VDT) in young, healthy men. The present study assessed the effects of sexual arousal on VDT in middle-aged men with and without ED in order to determine whether differences exist between the groups and if such differences may be useful in the evaluation of ED. METHODS VDT in the right index finger of 15 heterosexual men (mean age 74.3 +/- 6.0 years) who had been formally diagnosed with ED (ED group) and 16 men (mean age 68.0 +/- 6.6 years) who reported no sexual dysfunction in the past 6 months (erectile function (EF) group) were measured before and after watching erotic and control videos using a forced-choice, staircase method at frequencies of 30, 60 and 100 Hz. A mechanical stimulator was used to produce the vibratory stimulus. Results were analysed using repeated-measures analysis of variance. RESULTS There was no significant effect of watching the erotic video on VDT in subjects in the ED group. In the EF group, VDT was significantly lower at 60 and 100 Hz after watching the erotic video. There was no change in VDT after watching the control video in either group. CONCLUSION In response to sexual arousal, VDT in ageing men with normal erectile function decrease, whereas VDT in ageing men with ED remain unchanged.