POI and Philosophical Underpinnings

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Scholarly Paper 1: POI and Philosophical Underpinnings
Veterans face mental health problems due to exposure to trauma in conflict zones, negatively impacting their health-related quality of life. One of the most commonly diagnosed conditions in this population is post-traumatic stress disorder (PTSD) (Way et al., 2023). Mental health conditions can introduce challenges and complications that affect functionality in different areas of life, such as intimate relationships. Sexual dysfunction, particularly in men with PTSD, is a common outcome with the potential to affect intimate relationships and self-esteem; the consequent increased isolation can exacerbate their mental health problems (Way et al., 2023). Therefore, developing tailored interventions that will enhance their sexual function and prevent the negative impacts on relationships and quality of life is vital for this population. Analyzing the nature and scope of this problem and the application of philosophical views highlights the need for a comprehensive approach that incorporates analytical and continental perspectives and the four patterns of knowing in nursing.
Phenomenon of Interest
The phenomenon of interest in this research project is sexual dysfunction in male veterans diagnosed with PTSD. Sexual dysfunction encompasses a range of difficulties in sexual functioning, such as erectile dysfunction, low libido, and difficulties with arousal or orgasm (Gewirtz-Meydan & Lahav, 2020). This dysfunction can affect intimate relationships and cause difficulties that result in negative self-image and low self-confidence and self-esteem, making it hard for this individual to remain in relationships or start new ones (Singh et al., 2024). The population comprises male veterans diagnosed with PTSD. These are individuals who previously served in the military, particularly in conflict zones, and had exposure to the traumatic conflict environment. These traumatic events include injury and near-death experiences, loss of friends, and witnessing the impact of war on other people (Thomson, 2021). The occupation, therefore, exposes veterans to a significant additional risk of trauma, making it necessary to focus on them and address sexual dysfunction as an outcome of PTSD.
Exploring sexual dysfunction in male veterans diagnosed with PTSD is relevant to psychiatric mental health nurse practitioners (PMHNPs). PMHNPs play a crucial role in the mental health care of diverse populations. Therefore, understanding and addressing sexual dysfunction in the selected population aligns with their holistic approach to patient care. PTSD has multifaceted impacts on mental and emotional well-being, and its intersection with sexual dysfunction adds a layer of complexity demanding specialized attention. Comprehensive assessment, diagnosis, and management of mental health issues, including those related to trauma and sexual health, are integral components of PMHNP’s practice. PMHNPs can contribute to developing tailored interventions and treatment plans that encompass both mental health and sexual well-being. This research will offer evidence for PMHNPs to provide more effective care, fostering a holistic approach that considers the interplay between psychological and physiological health in this population.
Sexual dysfunction in veterans is a significant issue that contributes to poor quality of life, further burden of disease, and cost to the healthcare system. The condition complicates PTSD cases as it requires additional attention to address effectively. It puts additional strain on the limited healthcare resources and reduces the individual’s functionality. Sexual dysfunction and PTSD are often comorbid conditions, especially among veterans (Way et al., 2023). Accordingly, sexual dysfunction also often falls under the treatment and management plan of the primary diagnosis, making it difficult to estimate the specific financial impact on the healthcare system. Overall, PTSD cases cost the US healthcare system $232.3 billion annually; military personnel account for 18% of that cost despite being only 8% of the total population (Davis et al., 2022). Thus, sexual dysfunction in PTSD contributes to the high cost of the disorder. According to (Kolaja et al.,2021), 8% of veterans with PTSD have sexual dysfunction. These figures show that sexual dysfunction is relatively prevalent and contributes to the complications of PTSD. Accordingly, it is a major problem for the healthcare system that requires sufficient attention.
Philosophic Viewpoints
The analytical and continental philosophies are distinct approaches with divergent perspectives. The analytical tradition in nursing philosophy emphasizes clarity, precision, and logical positivism and analysis (Butts & Rich, 2022). It employs empirical evidence, conceptual clarity, and rigorous methodology to rationally solve problems and address issues in the field (Hall & Roussel, 2022). In contrast, the continental tradition embraces a more interpretive and holistic stance, emphasizing the interconnectedness of human experiences, cultural context, and the subjective nature of knowledge (Hall & Roussel, 2022). This viewpoint may incorporate existentialist, phenomenological, or hermeneutic perspectives, encouraging a deeper exploration of meaning and understanding. I resonate with the continental viewpoint as it aligns with the holistic nature of nursing, emphasizing the importance of context, culture, and individual experiences in shaping health and well-being. This philosophical approach embraces the complexity of human existence and allows for a more nuanced understanding of the diverse and dynamic nature of healthcare interactions.
Adopting a continental philosophical view influences the type of information and data I prioritize in investigating the topic by promoting a focus on qualitative aspects. This view emphasizes holistic and interpretive principles (Vrahimis, 2020; Burch, 2021). As a result, I am inclined to consider a broader spectrum of data that goes beyond quantitative metrics. Qualitative data, such as in-depth interviews, narratives, and subjective accounts, become essential to capture the lived experiences and individual nuances related to sexual dysfunction in this population. For example, qualitative interviews with male veterans can provide rich insights into the subjective meaning of sexual dysfunction in the context of PTSD, shedding light on personal coping mechanisms, relationship dynamics, and the impact of military culture. This approach allows me to explore the unique cultural, social, and contextual factors shaping the veterans’ experiences.
The analytical philosophical viewpoint offers valuable contributions in evaluating sexual dysfunction in PTSD cases among veterans. This perspective emphasizes clarity, precision, and systematic analysis of empirical data (Vrahimis, 2020). Thus, quantitative methodology aligns with this view. Prevalence rates, psychometric scales, and physiological markers become crucial in the analytical approach, offering measurable and objective insights into the scope and impact of sexual dysfunction. For instance, quantitative research may involve standardized surveys assessing the frequency and severity of sexual dysfunction symptoms among male veterans with PTSD. This data enables the identification of trends and associations that contribute to evidence-based interventions. Overall, the analytical tradition’s emphasis on rigor and empirical evidence contributes to an objective understanding of the scope of the problem.
Integrating the two philosophical viewpoints in advanced nursing practice offers a comprehensive and nuanced approach to understanding and addressing the sexual dysfunction phenomena. Sharifi‐Heris and Bender (2023) note that these views are not always conflicting as they remain largely complementary. The analytical tradition provides a structured framework for quantitative assessments to identify the prevalence rates, treatment outcomes, and statistical associations. This data-driven perspective informs evidence-based interventions and contributes to the development of standardized protocols. On the other hand, the continental viewpoint enriches the analysis by exploring the lived experiences, cultural context, and subjective dimensions of sexual dysfunction. Qualitative methods, therefore, help uncover the personal narratives of male veterans, providing insight into the meaning of sexual dysfunction in the context of PTSD. Consequently, integrating both philosophical views allows advanced nurse practitioners to develop a more holistic understanding of the phenomenon, ensuring that interventions are empirically sound and tailored to the individual’s unique experiences and cultural background.
Ways of Knowing
Applying the ways of knowing in nursing also provides a comprehensive exploration and understanding of the problem. Barbara Carper introduced a seminal framework that delineates four fundamental ways of knowing in nursing, providing a comprehensive foundation for the discipline: empirical knowing, aesthetic knowing, personal knowing, and ethical knowing (Berragan, 1998; Rutty, 1998). Empirical knowing involves the scientific understanding derived from objective, observable facts and evidence. In contrast, aesthetic knowing encompasses the appreciation of the artistry and creativity embedded in nursing care, acknowledging the subjective and intuitive elements of practice (Berragan, 1998). Personal knowing emphasizes the nurse’s self-awareness and understanding of personal values, beliefs, and biases, recognizing the influence of these aspects on patient care. However, ethical knowing involves the moral dimensions of nursing, guiding practitioners in making principled decisions and navigating the ethical complexities inherent in healthcare (Berragan, 1998). These four ways of knowing contribute to a holistic and multifaceted understanding of nursing practice. They foster a comprehensive and patient-centered approach to care.
These patterns apply to addressing the sexual dysfunction problem in veterans with PTSD. Empirical knowing requires evidence-based research methodologies to quantify the prevalence and impact of sexual dysfunction in this population (Berragan, 1998; Rutty, 1998). For instance, a quantitative study employing standardized scales can objectively measure the severity and frequency of sexual dysfunction symptoms. Aesthetic knowing is relevant when considering the unique subjective experiences of patients (Berragan, 1998; Rutty, 1998). Engaging in qualitative interviews can reveal the personal aspects of individuals’ struggles with intimacy, adding depth to the empirical data. Personal knowing entails the nurse’s self-awareness, acknowledging one’s biases and values (Berragan, 1998; Rutty, 1998). Hence, they can focus on culturally competent and objective care when addressing the sensitive nature of sexual dysfunction in veteran populations. Ethical knowing guides the nurse in navigating ethical dilemmas (Berragan, 1998; Rutty, 1998). Examples in this context include upholding confidentiality and respectful communication when discussing intimate issues and ensuring a principled and patient-centered approach to care. Integrating these ways of knowing provides a holistic understanding of sexual dysfunction in veterans with PTSD.
Conclusion
Addressing sexual dysfunction in male veterans diagnosed with PTSD requires a comprehensive and patient-centered approach that integrates analytical and continental philosophical viewpoints and the application of Carper’s four ways of knowing in nursing. Sexual dysfunction is prevalent among veterans with PTSD, with negative impacts on their well-being and quality of life. The analytical perspective offers a structured framework for quantitative assessments, allowing for evidence-based interventions and standardized protocols. On the other hand, the continental viewpoint enriches the analysis by exploring the subjective experiences and cultural context, ensuring a holistic understanding. Carper’s ways of knowing offer a multifaceted approach, incorporating empirical understanding, appreciation for the subjective elements of care, self-awareness, and ethical considerations. These approaches enable advanced nursing practitioners to navigate the complexities of sexual dysfunction in male veterans, tailoring interventions that address both the empirical evidence and the unique experiences of individuals.
 
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