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Öz

The Use of PLISSIT Model for Evulation of Sexual Problems of Individuals with Stoma This study was conducted to explore use of PLISSIT model for evaluation of sexual problems of individuals with stoma. Stomas are formed surgically, by exteriorizing the bowel to the abdominal surface. Individuals with stoma may suffer from many physiologic, psychological and social problems and all of them negatively affect sexual life and quality of life. In order to improve the quality of life of the person with stoma, sexual problems must be solved in addition to physiological and psychosocial problems. Although sexuality is known to be an important part of nursing care, it is known that nurses may have difficulty in handling this issue in practice. One of the methods for addressing sexual problems is the PLISSIT model. The PLISSIT model provides nurses or other health professionals a conceptual implementation possibility to plan and evaluate comprehensive care about the sexual problems of the individuals. The model provides four levels ((Permission, Limited Information, Specific Suggestions, Intensive Therapy) to sexual problems of individuals. The literature review suggests that nurses can use PLISSIT model as a guide for addressing sexual problems of individuals with stoma and plan nursing interventions according this model.

Anahtar Kelimeler

• Stoma; sexuality; nursing; PLISSIT model

STOMALI BİREYLERİN CİNSEL SORUNLARININ DEĞERLENDİRİLMESİNDE PLISSIT MODELİNİN KULLANIMI

Öz

Bu çalışma, stomalı bireylerin cinsel sorunlarının değerlendirilmesinde PLISSIT  modelinin kullanımını açıklamak amacıyla yapılmıştır. Stoma, ince veya kalın bağırsağın karın duvarına ağızlaştırıldığı yapay bir açıklıktır. Stomalı bireyler fizyolojik, psikolojik ve sosyal olmak üzere pek çok problemle karşılaşmakta olup, bu sorunlar bireyin cinsel yaşamını ve yaşam kalitesini olumsuz yönde etkileyebilmektedir. Stomalı bireyin yaşam kalitesini artırabilmek için fizyolojik, psiko-sosyal sorunlarının yanı sıra cinsel sorunlarının belirlenmesi ve çözümlenmesi gerekmektedir. Cinsellik hemşirelik bakımının önemli bir parçası olarak bilinmesine karşın, hemşireler uygulamada bu konuyu ele almada güçlük yaşayabilmektedirler. Cinsellikle ilgili sorunların ele alınmasında kullanılan yaklaşımlardan biri PLISSIT modelidir. Bu model, cinsel sorunu olan bireylerin ihtiyaçlarını belirlemede ve uygun girişimleri planlamada hemşirelere ve diğer sağlık profesyonellerine yol göstermektedir. Model, bireyin cinsel sorunlarına dört basamaklı (izin verme, sınırlı bilgi, özel öneriler, yoğun tedavi) bir yaklaşım sağlamaktadır. Literatür taraması, hemşirelerin stomalı bireylerin cinsel sorunlarını ele almalarında PLISSIT modelini rehber olarak kullanabileceklerini ve bu doğrultuda hemşirelik girişimlerini planlayabileceklerini ortaya koymaktadır.

Anahtar Kelimeler

• Stoma, cinsellik, hemşirelik, PLISSIT modeli

Kaynakça

1. Albaugh JA, Kellogg- Spadt K. Sexuality and Sexual Health: The Nurse’s Role and Initial Approach to Patients. Urol Nurs 2003;23(3):227-8.
2. Annon JS. PLISSIT Therapy. In: Corsini RJ, ed. Handbook of Innovative Psychotherapies. New York: Wiley & Sons; 1981. p.626-39.
3. Ayaz S. Approach to Sexual Problems of Patients with Stoma by PLISSIT Model: An Alternative. Sex Disabil 2009;27(2):71-81.
4. Ayaz S. Sexuality and Nursing Process: A Literature Review. Sex Disabil 2013;31(1):3-12
5. Ayaz S, Kubilay G. Effectiveness of the PLISSIT Model for Solving the Sexual Problems of Patients with Stomas. J Clin Nurs 2009;18(1):89-98.
6. Beck M, Justham D. Nurses’ Attitudes Towards the Sexuality of Colorectal Patients. Nurs Stand 2009;23(31):44-8.
7. Borwell B. Rehabilitation and Stoma Care: Addressing the Psychological Needs. Br J Nurs 2009; 18(4):20-5.
8. Brown H, Randle J. Living with A Stoma: A Review of the Literature. J Clin Nurs 2005;14(1):74-81.

9. Burch J. Psychological Problems and Stomas: A Rough Guide for Community Nurses. Br J Community Nurs 2005;10(5):224-7.
10. Cakmak A, Aylaz G, Kuzu MA. Permanent Stoma not only Affects Patients' Quality of Life but also That of Their Spouses. World J Surg 2010;34(12):2872-6.
11. Chun N. Effectiveness of PLISSIT Model Sexual Program on Female Sexual Function for Women with Gynecologic Cancer. J Korean Acad Nurs 2010;41(4):471-80.
12. Comb J. Role of the Stoma Care Nurse: Patient with Cancer and Colostomy. Br J Nurs 2003;12(14):852-6.
13. Cotrim H, Pereira G. Impact of Colorectal Cancer on Patient and Family: Implications for Care. Eur J Oncol Nurs 2008;12(3):217-26.
14. Dixon KD, Dixon PN. The PLISSIT Model, Care and Management of Patients’ Psychosexual Needs Following Radical Surgery. Lippincotts Case Manag 2006;11(2):101-6.
15. Grant M, McMullen CK, Altschuler A, Mohler MJ, Hombrook MC, Herrinton LJ, et al. Gender Differences in Quality of Life Among Long-term Colorectal Cancer Survivors with Ostomies. Oncol Nurs Forum 2011;38(5):587-96.
16. Haboubi NHJ, Lincoln N. Views of Health Professionals on Discussing Sexual Issues with Patients. Disabil Rehabil 2003;25(6):291-6.
17. Junkin J, Beitz JM. Sexuality and the Person with a stoma: Implications for Comprehensive WOC Nursing Practice. J Wound Ostomy Continence Nurs 2005;32(2):121-30.
18. Karadağ A, Menteş BB, Uner A, Irkorucu O, Ayaz S, Ozkan S. Impact of Stomatherapy on Quality of Life in Patients with Permanent Colostomies or Ileostomies. Int J Colorectal Dis 2003;18(3):234-8.
19. Katz A. Do Ask, Do Tell, Why Do So Many Nurses Avoid the Topic of Sexuality?. Am J Nurse 2005;105(7):66-8.
20. Kirkwood L. Postoperative Stoma Care and the Selection of Appliances. J Community Nurs 2006;20(3):12.
21. Manderson L. Boundary Breaches: The Body, Sex and Sexuality After Stoma Surgery. Soc Sci Med 2004;61(2):405-15.
22. Persson E, Hellström AL. Experiences of Swedish Men and Women 6 to 12 Weeks After Ostomy Surgery. J Wound Ostomy Continence Nurs 2002;29(2):103-8.
23. Ringhofer J. Meeting the Needs of Your Ostomy Patient. RN 2005;68(8):37-42.
24. Rubin R. Communication About Sexual Problems in Male Patients with Multiple Sclerosis. Nurs Stand 2005;19(24):33-7.
25. Sprunk E, Alteneder RR. The Impact of an Ostomy on Sexuality. Clin J Oncol Nurs 2000;4(2):85-8. Stevenson RWD. Sexual Medicine: Why Psychiatrists Must Talk to Their Patients About Sex. Can J Psychiatry 2004;49(10):673-6.
26. Symms MR, Rawl SM, Grant M, Wendel CS, Coons SJ, Hickey S, et al. Sexual Health and Quality of Life Among Male Veterans with Intestinal Ostomies. Clin Nurse Spec 2008;22(1):30-40.
27. Tan G, Waldman K, Bostick R. Psychosocial Issues, Sexuality and Cancer. Sexual Disabil 2002;20(4):2973
28. Taylor B, Davis S. Using the extended PLISSIT model to Address Sexual Healthcare Needs. Nurs Stand 2006;21(11):35-40. Williams J. Psychological Considerations in Gastrointestinal Nursing. Br J Nur 2005;14(17):931-5.