Sexual health

This section focuses on sexual health in diabetes care:

What is sexual health?

A working definition of sexual health presented on the World Health Organization website is:

"A state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled." (World Health Organization, 2002).

The RCN (2000) definition of sexual health is not dissimilar:

"The physical, emotional, psychological, social and cultural well being of a person's sexual identity, and the capacity and freedom to enjoy and express sexuality without exploitation, oppression, physical or emotional harm."

Just as health is a matter of perception, where each person defines health differently, sexual health is also subjective. To one person, sexual health might mean freedom from infection; to another, sexual health is about feeling comfortable and secure within a relationship. Regardless of the individual's personal expression of their sexual health, supportive and responsive care should reflect the expressed concerns of the patient with diabetes. This emphasises the importance of knowing what help a patient can receive from within the local NHS and independent care provision.

What do we mean by sexuality?

It is a common misconception that sexuality is merely the expression of a physiological drive, resulting in sexual activity. Whilst sexual behaviour is an element of sexuality, it is only one aspect. Sexuality involves more than just the biological and physiological components of sexual behaviour and reproduction; it incorporates psychological and sociological aspects. The psychological aspects include self-concept, self-esteem and body image, whilst sociological aspects include cultural influences and social roles (Webb, 1988). When caring for patients with diabetes, aspects of care relating to sexuality must be addressed, as diabetes can lead to a number of challenging issues for the patient.

An individual's sexuality adapts in response to maturational, physiological, social and psychological events. The RCN (2000) describes sexuality and sexual health as "a legitimate area of nursing activity", and as such, recognising an individual's sexuality is an essential aspect of holistic care. Supportive help should form part of your plan of care, reflecting the patient's sexuality at age 15 may be very different to their sexuality at age 35, 55 or 75. Admission to hospital or a diagnosis of diabetes will challenge an individual's self-concept, self-esteem and social relationships. The focussed patient care outcome in this context is to promote sexual health.

Visit the key issues section to find out more about sexual health and diabetes.

References

Full details of the bracketed citations in the text above and, in many cases, links to the actual documents are available in the reference list within this resource. Go to the Reference list.