Deck 25: Sexual Function and Intimacy

Question 1

A female patient offhandedly says she does not want to have sex with her husband anymore.During further discussion,she tells you that since her stroke vaginal dryness has made sex painful.You have just completed PLISSIT training.You should:

A) listen to her concern, ask if she would like further information, and then provide information concerning commercially available vaginal lubricants.
B) tell her to "grin and bear it." Vaginal dryness is a side effect of the stroke and nothing will change the situation.
C) discuss the topic further with the patient. If she seems depressed as well, mention it to her doctor.
D) both a and c.

Answer 1

D
Providing a suggestion for a lubricant is considered a specific suggestion.Further exploration may also result in finding out that this statement is related to depression.

Question 2

During your initial evaluation,you say to your client,"People who have had strokes sometimes have concerns or questions about how they will be affected sexually.Do you have any concerns or questions in this area?" Using the Permission,Limited Information,Specific Suggestions and Intensive Therapy (PLISSIT)model,this would be an example of:

A) permission.
B) limited information.
C) specific suggestions.
D) intensive therapy.

Answer 2

A
The practitioner must be proactive to provide patients with permission.Waiting for the patient to bring up sexual issues is not enough;the therapist must let the patient know that expressing sexual concerns is acceptable.The simplest way to do this is to ask.

Question 3

A male patient is on an antihypertensive medication and is managing incontinence associated with a neurogenic bladder problem he developed after his stroke.He is married and was sexually active prior to the stroke.The patient makes rude,sexually suggestive remarks to you during a therapy session.You should:

A) ignore his remarks.
B) tell him the remarks make you feel uncomfortable and to stop it or you will not treat him any longer.
C) tell him the remarks are not appropriate and to stop. Then ask if there is an issue or problem about which he needs further information and assist him in discussing the issue.
D) tell him you will tell his wife what he has said and chastise him.

Answer 3

C
Flirting,sexual jokes,and innuendos are often a patient's way of indirectly expressing doubts and concerns about sexuality after disability.

Question 4

A patient asks you for advice concerning positioning for sex now that she has hemiplegia.You just reviewed this information in a staff inservice and feel you can help the patient and her husband solve the problem.You should:

A) offer suggestions for optimal positioning and comfort and educational resources, so the couple can resume their sexual relationship.
B) tell the couple that they should wait until the patient is at home to try anything.
C) suggest that they probably should not try having sex until the woman's blood pressure resolves.
D) advise them to have a platonic relationship and forget about sex for now.