건강문제와 간호Ⅰ (sexual health) [A]

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Ⅰ. Case: Alice
1. Describe Alice's sexual history using the 5Ps
⑴ Partners
⑵ Practices
⑶ Prevention of pregnancy
⑷ Protection from sexually transmitted infections (STIs)
⑸ Past history of STIs
2. The nurse needs to obtain consent from Alice to order screening tests for Chlamydia. Alice tells the nurse, “I don't know why I need to do additional test. I have not had STI screening yet because I do not want to have a pelvic exam. I am afraid of having my blood drawn with a needle.” If you are a nurse, what would information you would provide to Alice?
3. The nurse found Alice has not yet received Human Papilloma Virus (HPV) vaccination. Alice tells the nurse, “I have not heard of the HPV vaccination when I grew up. I thought it is too late to get vaccinated. I am worried about side effects as well. If I get vaccinated, do I still need to get PAP test every year? I hate getting that test and it would be nice if I no longer need to do it after receiving vaccination.” Please plan health education to help Alice using the information in the CDC webpage.
4. Alice says, “My boyfriend does not like using condoms. I think taking birth control pill is better manageable option for me now, but I don't like dealing with all the GI symptoms I am having now.” Please plan contraceptive counseling for Alice.
5. Alice's test result shows she is positive for chlamydia. Alice is upset and says, “I can not believe how I can have chlamydia. I have been monogamous with my partner and neither of us has any symptoms.” What would the nurse explain to Alice?

Ⅱ. Case: John
6. You are a nurse working with John. Describe assessment and intervention plan for John using PLISSIT model.
⑴ Obtaining Permission from the client to initial sexual discussion
⑵ Providing the Limited Information needed to function sexually
⑶ Giving Specific Suggestions for the individual to proceed with sexual relations
⑷ Providing Intensive Therapy surrounding the issues of sexuality for the client

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Case: Alice
Alice, 18 years-old, presents to community health clinic and meets with the nurse, She requests a change in her oral cotraceptive because it sometimes makes her nauseated. Alice reports taking her oral contraceptive since age 16 for menstrual cycle regulation. She became sexually active 6 months ago and reports a history of two sexual partners, most recently her current boyfriend of 4 months. She reports occasional condom use and consistently taking her oral contraceptive when she brushes her teeth in the morning. Her last menstrual period was 10 days ago. She denies any history of complaints of pain, lesions or vaginal discharge.

영어로는 성(性)을 sex와 sexuality로 표현한다. 그러나 우리나라에서는 둘 다 성으로 번역을 한다. 하지만 엄밀히 말하면 두 단어의 개념은 구분할 필요가 있다. sex의 어원은 라틴어의 sexus에서 비롯된다. sexus라는 말은 인간을 남성과 여성으로 나눌 때의 성이 여기에 포함된다. 다시 말해서 sex는 생물학적 성으로 우리가 남성의 생식기, 즉 음경을 가졌으냐, 아니면 여성의 생식기인 질을 가졌느냐에 의해서 결정되는 성이다.
sexuality는 훨씬 더 큰 개념이다. 생물학적 성뿐만 아니라 우리가 속해있는 사회나 문화에 따라 남성으로서 혹은 여성으로서 어떻게 생각하고 느끼는지에 관해서도 포함된 개념이다. 이것을 우리는 사회적 혹은 심리적 성(gender)이라 한다.

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