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Effectiveness of sexual counseling using PLISSIT model on sexual function of women with type 2 diabetes mellitus: results from a randomized controlled trial

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International Journal of Diabetes in Developing Countries Aims and scope Submit manuscript

Abstract

Background

Sexual problems are very common in patients with type 2 diabetes mellitus and due to its chronic nature may affect women's sexual quality of life.

Objectives

To study the effect of permission, limited information, specific suggestions, intensive therapy (PLISSIT) model sexual counseling on sexual function of women with type 2 diabetes.

Methods

This study is a randomized clinical trial that was conducted on 100 married women aged 35-55 year old with type 2 diabetes referred to endocrinology clinic. The subjects were randomly assigned to the intervention and control groups. In the intervention group, individual counseling was designed based on PLISSIT model, in at least three sessions. The control group received a general health training pamphlet at the end of the study. Before the first session and then 4 and 8 weeks after the intervention, questionnaires of demographic information, Brief Sexual symptom checklist for women (BSSC-W), and Female sexual Function Index (FSFI) were completed for two groups.

Results

Total FSFI score of the patients improved after sexual counseling (p < 0.001) and in subscales; sexual desire (p = 0.009), lubrication (p = 0.004), orgasm (p < 0.001), and sexual satisfaction (p < 0.001). Also sexual function in all subscales except for arousal (p = 0.181) and pain (p = 0.783) were increased significantly. Although pain was decreased significantly in intervention group over the time, no difference was seen between two groups (p = 0.783). The effect size of intervention to promote FSFI was determined 0.42.

Conclusion

Considering the effectiveness of a PLISSIT model sexual counseling on sexual function of women with type 2 diabetes, the results of the present study, can be used to promote sexual health of diabetic patients.

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References

  1. Bjerggaard M, Charles M, Kristensen E, Lauritzen T, Sandbaek A, Giraldi A. Prevalence of sexual concerns and sexual dysfunction among sexually active and inactive men and women with screen-detected type 2 diabetes. Sex Med. 2015;3:302–10.

    Article  Google Scholar 

  2. Vafaeimanesh J, Raei M, Hosseinzadeh F, Parham M. Evaluation of sexual dysfunction in women with type 2 diabetes. Indian J Endocrinol Metab. 2014;18:175–9.

    Article  Google Scholar 

  3. Copeland KL, Brown JS, Creasman JM, van den Eeden SK, Subak LL, Thom DH, et al. Diabetes mellitus and sexual function in middle-aged and older women. Obstet Gynecol. 2012;120(2 Pt 1):331–40. https://doi.org/10.1097/AOG.0b013e31825ec5fa.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Sharifiaghdas F, Azadvari M, Shakhssalim N, Roohi-Gilani K, Rezaei-Hemami M. Female sexual dysfunction in type 2 diabetes: a case control study. Med Princ Pract. 2012;21:554–9.

    Article  Google Scholar 

  5. Elyasi F, Kashi Z, Tasfieh B, Bahar A, Khademloo M. Sexual dysfunction in women with type 2 diabetes mellitus. Iran J Med Sci. 2015;40:206–13.

    PubMed  PubMed Central  Google Scholar 

  6. Fatemi SS, Taghavi SM. Evaluation of sexual function in women with type 2 diabetes mellitus. Diab Vasc Dis Res. 2009;6:38–9.

    Article  Google Scholar 

  7. Esposito K, Maiorino MI, Bellastella G, Giugliano F, Romano M, Giugliano D. Determinants of female sexual dysfunction in type 2 diabetes. Int J Impot Res. 2010;22:179–84.

    Article  CAS  Google Scholar 

  8. Celik S, Golbasi Z, Kelleci M, Satman I. Sexual dysfunction and sexual quality of life in women with diabetes: the study based on a diabetic center. Sex Disabil. 2014;33:233–41.

    Article  Google Scholar 

  9. Ziaei-Rad M, Vahdaninia M, Montazeri A. Sexual dysfunctions in patients with diabetes: a study from Iran. Reprod Biol Endocrinol. 2010;8:50. https://doi.org/10.1186/1477-7827-8-50.

    Article  PubMed  PubMed Central  Google Scholar 

  10. World Health Organization. The role of primary health-care providers in sexual and Reprod Health results from an intercountry survey, 2011. http://www.who.int/reproductivehealth/ publications/health_systems/9789241501002. Accessed 27 May 2018.

  11. Mash RJ, Rhode H, Zwarenstein M, Rollnick S, Lombard C, Steyn K, et al. Effectiveness of a group diabetes education programme in under-served communities in South Africa: a pragmatic cluster randomized controlled trial. Diabet Med. 2014;31:987–93.

    Article  CAS  Google Scholar 

  12. Annon J. PLISSIT therapy. In: RJ IC, editor. Handbook of innovative psychotherapies. New York: Wiley & Sons; 1981. p. 626–39.

    Google Scholar 

  13. Khakbazan Z, Daneshfar F, Behboodi-Moghadam Z, Nabavi SM, Ghasemzadeh S, Mehran A. The effectiveness of the Permission, Limited Information, Specific suggestions, Intensive Therapy (PLISSIT) model based sexual counseling on the sexual function of women with multiple sclerosis who are sexually active. Mult Scler Relat Disord. 2017;8:113–9.

    Article  Google Scholar 

  14. Saboula N, Sayed E, Shahin MA. Effectiveness of application of PLISSIT counseling model on sexuality for breast cancer’s women undergoing treatment. Am J Nurs Sci. 2015;4:218–30.

    Article  Google Scholar 

  15. Tutuncu B, Yildiz H. The influence on women’s sexual functions of education given according to the PLISSIT model after hysterectomy. Procedia Soc Behav Sci. 2012;47:2000–4.

    Article  Google Scholar 

  16. Steinke EE, Jaarsma T, Barnason SA, Byrne M, Doherty S, Dougherty CM, et al. Sexual counseling for individuals with cardiovascular disease and their partners: a consensus document from the American Heart Association and the ESC Council on Cardiovascular Nursing and Allied Professions (CCNAP). Circ. 2013;128:2075–96.

    Article  Google Scholar 

  17. Rostamkhani F, Ozgoli G, Merghati- Khoei E, Jafari F, Alavi-Majd H. Effectiveness of the PLISSIT-based counseling on sexual function of women. J Nurs Midwifery. 2012;22:1–9.

    Google Scholar 

  18. Nusbaum M, Rosenfeld JA. Sexual health across the lifecycle: a practical guide for clinicians. New York: Cambridge university press; 2004.

    Book  Google Scholar 

  19. Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R, et al. The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther. 2000;26:191–208.

    Article  CAS  Google Scholar 

  20. Mohammadi K, Heydari M, Faghizadeh S. The Female Sexual Function Index.(FSFI): Validation of the Iranian version. Payesh. 2008;8:269–78.

    Google Scholar 

  21. Rostamkhani F, Jafari F, Ozgoli G, Shakeri M. Addressing the sexual problems of Iranian women in a primary health care setting: a quasi-experimental study. Iran J Nurs Midwifery Res. 2015;20:139–46.

    PubMed  PubMed Central  Google Scholar 

  22. Farnam F, Janghorbani M, Raisi F, Merghati-Khoei E. Compare the effectiveness of PLISSIT and sexual health models on women’s sexual problems in Tehran, Iran: a randomized controlled trial. J Sex Med. 2014;11:2679–89.

    Article  Google Scholar 

  23. Doruk H, Akbay E, Cayan S, Bozlu M, Acar D. Effect of diabetes mellitus on female sexual function and risk factors. Arch Androl. 2005;51:1–6.

    Article  CAS  Google Scholar 

  24. Weinberger JM, Houman J, Caron AT, Anger J. Female sexual dysfunction: a systematic review of outcomes across various treatment modalities. Sex Med Rev. 2018;XX:XXX. https://doi.org/10.1016/j.sxmr.2017.12.004.

    Article  Google Scholar 

  25. Nejati B, Kazemi F, Masoumi S, Parsa P, Karami M, Mortazavi A. Efficacy of sexual consultation based on PLISSIT model (permission, limited information, specific suggestions, intensive therapy) on sexual function among pregnant women: a randomized controlled clinical trial. J Isfahan Med Sch. 2017;35:739–48.

    Google Scholar 

  26. Almeida NG, Britto DF, Fernandes LM, Rabelo CS, Fialho AVM. The first step of PLISSIT model with mastectomized women. J Sex Med. 2017;14:e381. https://doi.org/10.1016/j.jsxm.2017.10.040.

    Article  Google Scholar 

  27. Ayaz S, Kubilay G. Effectiveness of the PLISSIT model for solving the sexual problems of patients with stoma. J Clin Nurs. 2009;18:89–98.

    Article  Google Scholar 

  28. Chun N. Effectiveness of PLISSIT model sexual program on female sexual function for women with gynecologic cancer. J Korean Acad Nurs. 2011;41:471–80.

    Article  Google Scholar 

  29. Behboodi-Moghadam Z, Rezaei E, Khaleghi-Yalegonbadi F, Montazeri A, Arzaqi SM, Tavakoli Z, et al. The effect of sexual health education program on women sexual function in Iran. J Res Health Sci. 2015;15:124–8.

    PubMed  Google Scholar 

  30. Faghani S, Ghaffari F. Effects of sexual rehabilitation using the PLISSIT model on quality of sexual life and sexual functioning in post-mastectomy breast cancer survivors. Asian Pac J Cancer Prev: APJCP. 2016;17:4845–51.

    PubMed  Google Scholar 

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Acknowledgements

The researchers appreciate the collaboration of the participants in this study.

Funding

This study was funded by Alborz University of Medical Sciences.

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Authors and Affiliations

  1. Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran

    Maryam Mehrabi

  2. Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran

    Razieh Lotfi & Mitra Rahimzadeh

  3. Spinal cord Injury Research Center (BASIR), Neuroscience Institution, Tehran University of medical Sciences, Tehran, Iran

    Effat Merghati Khoei

Authors
  1. Maryam Mehrabi
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  2. Razieh Lotfi
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  3. Mitra Rahimzadeh
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  4. Effat Merghati Khoei
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Corresponding author

Correspondence to Razieh Lotfi.

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Ethical approval

The present study was approved by Abzums.Rec.1396.6 code at the Ethics Committee of Alborz University of Medical Sciences, as well as the registration number of IRCT2017070231662N4 in Iranian Clinical Trial System.

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The authors declare that there is no conflict of interest.

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Informed consent was obtained from all individual participants.

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Mehrabi, M., Lotfi, R., Rahimzadeh, M. et al. Effectiveness of sexual counseling using PLISSIT model on sexual function of women with type 2 diabetes mellitus: results from a randomized controlled trial. Int J Diabetes Dev Ctries 39, 626–632 (2019). https://doi.org/10.1007/s13410-019-00726-1

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  • DOI: https://doi.org/10.1007/s13410-019-00726-1

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