Keywords: Sexual Arousal Disorder, Sexual Dysfunction, Sexual Stimulation, …show more content…
It has been used widely with adults (Wallace, 2008). The first step in using the PLISSIT model is to ask permission (P) to begin the sexual assessment of the older adult, followed by a series of open-ended questions designed to elicit the patient's concerns about sexual health. (Some have interpreted "permission" in the PLISSIT model to mean giving the patient permission to discuss sexuality. See "Do Ask, Do Tell," Sexually Speaking, July 2005.) Next, the nurse should provide the patient with limited information (LI) about normal and pathologic changes that may affect sexual health and try to dispel any misconceptions. Based on the patient's responses to the open-ended questions, the nurse then makes specific suggestions (SS) as part of a tailored plan of care. The last part of the model calls for intensive therapy (IT), which may be indicated for older patients with sexual problems other than those related to normal aging, disease, or environmental factors such as a lack of privacy. Patients recommended for therapy may include those who meet the criteria for sexual dysfunction as defined in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision, or those who have a disturbance in one or more phases of the sexual response cycle (desire, excitement, orgasm, resolution). The list of patients who require …show more content…
In these cases, specific suggestions may include a recommendation to caretakers to ensure that the patient has privacy in which to fulfill her or his sexual needs without imposing on others (Wallace, 2008).
Intensive therapy (IT), while not appropriate for all patients, may be necessary when a sexual problem or dysfunction requires more than nursing care. For example, psychotherapy might be indicated in adults who have been sexually abused, and the nurse should make the appropriate referral. Intensive therapy, in the form of behavior modification, might also be indicated in patients who exhibit hypersexual behavior that may be symptomatic of cognitive impairment, such as masturbating in public or making unwanted sexual advances toward other patients and staff members (Wallace, 2008). Interpreting the Results. There is no numeric score for the PLISSIT model; however, after using it to guide the assessment of patients like Mr. Ford; a nurse will be better prepared to develop a plan of care that focuses on interventions to improve sexual health (Wallace,