Effect of the EX-PLISSIT model on sexual function and sexual quality of life among women after hysterectomy: a randomised controlled trial
Marieh Mahmoodi Dangesaraki A , Raziyeh Maasoumi B C , Zeinab Hamzehgardeshi D and Roghieh Kharaghani A EA Department of Midwifery, School of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran.
B Department of Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
C Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
D Sexual and Reproductive Health Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
E Corresponding author. Email: r.kharaghani@zums.ac.ir
Sexual Health 16(3) 225-232 https://doi.org/10.1071/SH18107
Submitted: 1 June 2018 Accepted: 1 January 2019 Published: 8 May 2019
Abstract
Background: After hysterectomy, most patients experience psychological problems and sexual dysfunction that can affect their sexual quality of life (QOL). This study determined the effects of counselling based on the Extended Permission-Limited Information-Specific Suggestion-Intensive Therapy (EX-PLISSIT) model on sexual function and sexual QOL after hysterectomy among women attending hospitals in Sari, northern Iran. Methods: A randomised controlled trial was conducted between 2016 and 2017. Of 354 women undergoing hysterectomy, 80 women without anxiety, stress or depression who showed signs of sexual dysfunction were selected and, using blocked randomisation, were assigned to the intervention and control groups. The intervention group received two 1-h counselling sessions each week based on the EX-PLISSIT model. The control group received no counselling. Mood and sexual function and quality of life were measured using established tools (i.e. Depression, Anxiety and Stress Scale, Female Sexual Function Index (FSFI), and the Sexual Quality of Life – Female (SQOL-F)). Eight weeks after completion of counselling, outcomes were compared between the intervention and control groups using independent t-tests and Chi-squared, Mann–Whitney U, Wilcoxon, and Fisher tests. Results: There were no significant differences between the two groups in terms of demographics and most other outcome variables. However, there were significant differences between the intervention and control groups in terms of sexual functioning (median (interquartile range (IQR) FSFI score 32.45 (28.47–33.52) vs 23.85 (20.52–26.45) respectively) and sexual quality of life (median (IQR) SQOL-F score 107.50 (91–108) vs 87 (62.75–96.25), respectively) at the 8-week follow-up (P < 0.001 for both). Conclusion: Use of the EX-PLISSIT model is recommended to sexual health care professionals.
Additional keywords: gynaecologic surgeries, Iran, sex education, sexual counselling.
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