Primary healthcare professionals in Australia are accountable for delivering high quality healthcare services encompassing different domains, including sexual health care. It has been reported that sexual health team members are entailed to take part in different sexual healthcare activities for promotion of sexual wellbeing of the patients. Such activities have the focus on adequate screening and accurate assessments, active counseling and providing detailed education on sexual practices. The present essay is based on the case study of Justin that aims to describe the necessary healthcare activities required to be carried out by sexual health team members. Justin has been known to practice unsafe sex along with experimenting with his sexuality. Due to the unsafe sex practices, Justin is at high risk of developing different sexually transmitted infections (STI’s). The present essay has three components in it that revolve around sexual health nursing practices. The first section of the essay describes the relevant assessments that are needed for Justin. The next section of the essay describes the role of sexual health team members involved in the care of the patient. The last section highlights the educational needs for the patient to promote his wellbeing. A summary of the main points drawn from the essay is presented at the end of the essay.
Sexual health has been noted to be a crucial element of overall wellbeing and health of individuals. Within the scope of healthcare practice with patients who are known to engage in unsafe sexual practices, a thorough assessment is needed since the risk of suffering sexually transmitted infections (STIs) is high. A comprehensive assessment in this regard is to include a sexual health history, a risk assessment, a physical assessment and particular diagnostic tests (Bdair & ConsTantino, 2017). In the present case, the healthcare professional is to perform such a sexual health assessment with Justin to understand the healthcare needs for the patient.
The primary risk factors for developing STIs are anonymous sexual partner, sexual activities with individual suffering from STI, sharing drug use paraphernalia, unprotected sexual activity, anal or oral sex, sexual activities with blood exchange and sexual activities with more than one partners (Harding & Manry, 2017). A sexual health history would be the first component of the assessment to be carried out for Justin. The history would need to focus on information relevant to sexual health of Justin and would encompass age of commencing sexual activities, current sexual activities involved in, effect of sexual activities on daily life, previous treatments for symptoms, drug abuse history and previous diagnosis of episodes of poor health (Helu-Brown & Aranda, 2016). Other information to be gathered includes immunization history, history of sexual assault, use of safety precautions while having sexual practices and history of medications. Justin is to be asked for understanding cardinal signs and symptoms of STIs such as urinary abnormality, pain with intercourse, ano-genital inflammation an irritation, and abnormal discharge (Carter et al., 2014).
A thorough risk assessment provides key information regarding the potentially exposed sites for infection, and such an assessment forms the basis for supporting clinical judgments in relation to diagnostic tests, referral services and patient education. It has been highlighted that a risk assessment draws from key knowledge of the functioning of the immune system in relation to modes of transmission of STIs, and the association between sexual conduct and protective measure use. Apart from physical assessment and health history findings, the risk assessment for Justin must include date of last sexual contact; sex of contacts; number of partners in past six months; number of partners in past two months; types of sexual contact; how sexual partners are communicated; drug or sexual abuse of sexual partners and possible occupational exposure to blood borne infections (Friedman et al., 2014).
A physical assessment for Justin would be a head-to-toe approach as a result of the the healthcare professional would use inspection technique for assessing signs of STIs. Physical assessment would include inspection of throat and mouth; palms, forearms and trunk; inspection of external areas; palpation of the inguinal nodes; inspection of urinary meatus and urine specimen examination. The routine diagnostic screening for Justin would need to include Chlamydia, gonorrhea, HIV and syphilis. Additional tests that might be considered on the basis of the risk assessment and symptoms include gonorrhea swab for culture and sensitivity, Hepatitis A, B and C serology and Gonorrhea/Chlamydia (GC/CT) NAAT swabs (Forbes & Watt, 2015).
Sexual healthcare is a holistic specialty in the contemporary era, and has major implications for professional care practice. The appropriate processes and principles of sexual health care are to be adhered to by health care workers while caring for patients presenting with varied sexual health concerns. In the present case for Justin, the role of sexual health team members in caring for the patient would be diverse. The key members of the sexual heath team would be physicians, nurses, primary care workers and counselors (Naidoo & Wills, 2016). The overall role of the sexual health team members would be directed by four main aims. The first role would be to provide accurate and updated information, advice, education and counseling to the patient. The second role would be to carry out a partner notification to assure that the care plan is adhered to. This would be aligned with the need of providing ongoing counseling and support to the partner as well. The third role would be to provide diagnostic testing discussion, and post-testing counseling and discussion. The fourth role would be to provide adequate follow-up psychological care and counseling for the patient (Edelman, Mandle & Kudzma, 2017).
From analysis of literature it can be understood that the primary responsibility of the sexual health team members would be to provide information on the adverse effects of poor sexual practices on physical and mental wellbeing. Counseling and education is to be provided for further minimizing the risk of infections. The significance of care follow up is to be stressed upon. A safe environment is to be provided as a result of which Justin is able to discuss his concerns and ask questions. A comprehensive assessment is to be carried out to understanding other sexual, emotional or social difficulties. Justin is to be assured that all patient information would be kept in a confidential manner and the same would be used only for a rational purpose. Taking a lead in sexual health promotion would be appreciated (Khadr et al., 2018).
Certain considerations are to be maintained while communicating with Justin and engaging in sexual health conversation. The patient is to be made comfortable before starting off with any conversation since sensitive questions might be asked. It is necessary to establish rapport with Justin and make therapeutic relationship the basis for care. Questions are to be asked in a non-judgmental manner and assumptions regarding the patient’s background are to be avoided. Culturally sensitivity is to be assured while caring for Justin and the care preferences of the person are to be acknowledged (Larsson, Ross, Tumwine & Agardh, 2016).
From the given case scenario it is evident that Justin has limited knowledge regarding sexual health and its implications for overall wellbeing. Justin is found to be taking part in unsafe sexual practices and experimenting with his sexuality which denotes that he does not consider sexual health as a state of mental and social wellbeing in relation to sexuality. Justin does not have a respectful and positive approach to sexual relationships and sexuality due to lack of awareness regarding the health risks he could be subjected to (hetv.org, 2018). The main focus of education need of Justin would be to provide him with information regarding positive sexual health. Justin is to be educated that sexual health is to be considered as the ability to enjoy and embrace own sexuality through safe practices. Further, Justin is to be explained that sexual health is an integral part of own emotional and physical health. Having a healthy sexual life implies that one understands that sexuality is to be considered as a natural part of life and one must not experiment with it in an unsafe manner. In addition, one must be able to experience satisfaction, intimacy and please as desired within a safe limit. Sexual health is highly complex and there lies an evident connection with other health aspects. This is not limited to the reproductive years; rather the implications are for the whole lifespan (Curtis, 2018).
Due to the fact that Justin is at high risk of suffering from STI, he is to be educated adequately regarding transmission of STIs and preventive measures for the same. Health education providers are to demonstrate positive attitude about sexuality along with focusing on the benefit off enjoying a healthy sexual life. The main components of education sessions that are to be held for Justin include information about STI, prevention of STI, health sexuality, symptoms and treatment of STI. The basic information regarding STI would include the process of transmission of STIs between individuals as a result of unsafe sexual contact. The health consequences of STI are also to be taught to Justin. The association between STI and HIV is also to be taught to the patient along with the behavior that is responsible for spreading of both. The successive topic for health education would be prevention of STI which is perhaps the most crucial education need for Justin. He is to be taught about the usage of condoms and how the same can be used in a correct and consistent manner. This is especially in relation to new partners since Justin has multiple sexual partners. However, there lies a chance that an infection might spread in spite of using a condom. Condoms might be providing protection to a certain level, but complete protection might not be possible (betterhealth.vic.gov.au, 2018). Justin is to be further educated to limit the number of sexual partners since having multiple partners implies that he is at risk of developing STIs. Individuals who have the perception that sexual activity is to be enjoyed in committed relationship are at less risk of suffering from infection. Moreover, Justin needs to learn negotiating skills which can help him avoid situations of getting involved in sexual acts (patient.info, 2018).
Patient education about safer sex is of prime importance in relation to the education need of Justin. Safer sex is about all sexual practices that are effective in reducing the risk of transmission of STIs. Certain forms of sexual practices put individuals at higher risk of suffering from undesirable outcomes. For example, sexual activity that involves penetration possesses more risk of STIs those activities without penetration. Sexual activities are themselves of high risk since infectious agents such as hepatitis B and HIV are more likely to pass through anal sex. In case Justin engages in unsafe sexual practices with sex toys, he is to be educated about the need of using clean and washed toys and using barriers such as while using the same (Smith & Angarone, 2015). Justin is to be educated about developing communication skills through which he can communicate effectively with the sexual partner. This rationale is that Justin needs to identify sexual partners who present STI symptoms and might engage in unsafe sexual practices themselves. Research indicates that recreational drugs and alcohol are significant driving factors for losing inhibitions among individuals. Thus, Justin might be presenting more chances of engaging in unsafe sex is he use recreational drugs. He is therefore to be educated about avoiding usage of such drugs and limit the intake of alcohol (Helu-Brown & Aranda, 2016).
Individuals involved in unsafe sexual practices are to be taught adequately about the symptoms of STI and possible first-line treatment measures. Justin is to be taught about what to look for as symptoms of STIs developed. Some of the notable symptoms of STIs are painful urination, lower abdominal pain, discharges from penis, testicular pain, anal itching, painful bowel movements, headache, fatigue, swollen lymph glands, fever and shortness of breath. In this regard it would be essential to educate him to refer to clinic services when deemed appropriate. The rationale is that early treatment provision can reduce the chances of further complications due to STIs. Medications for combating the early signs and symptoms of STIs are to be taught to Justin (Wills, 2014).
Conclusion
Sexual healthcare team members including nurses are to engage in making appropriate professional judgments for delivering care to Justin in the field of sexual health. Sexual health assessment and education are to be carried out in a supportive environment that enhances patient’s knowledge. The underlying aim is to enable sexual practice changes of the individual. Patient education is a prime area where professionals are to demonstrate appropriate skills and knowledge in communicating with the patient. Sensitive communication is to be fostered while delivering care to such patients. Holistic and evidence-based sexual health promotion would possibly promote the general health and wellbeing of patients who engage in unsafe sexual practices and experiment with their sexuality.
References
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