The Effect of Sexual Counseling Based on EX‑PLISSIT Model on Improving the Sexual Function of Married Women with Systemic Lupus Erythematosus: A Randomized Controlled Trial

Abstract

Systemic Lupus erythematosus (SLE) is a multisystem autoimmune disease. This disease triggers sexual dysfunction due to physiological, cognitive and mental effects. Since sexual function is often ignored in these patients, this study aimed to investigate the effect of sexual counseling based on EX‑PLISSIT model on improving the sexual function of married women with SLE. This clinical trial was conducted on 101 married women suffering from SLE (18–49 years) residing in Tehran. Randomization was performed by random block allocation with six blocks in a rheumatology clinic. A demographic questionnaire, the Depression, Anxiety, Stress Scales-21 Items (DASS-21), and the female sexual function index were used to collect the data. The intervention group received counselling sessions every week while the control group (n = 55) received routine care for the disease. Eight and twelve weeks after completion of counselling sessions, outcomes compared between the intervention and control groups, using independent ttest, paired t-test, repeated measures and Chi-squared test. The scores of sexual function in both groups did not differ significantly before the intervention ( p > 0.05). At the first follow-up session, the score of all sexual function domains except sexual pain increased significantly in the intervention group while a significant reduction was observed in all domains of sexual function in the control group ( p < 0.05). In the second follow-up, sexual function significantly increased in the intervention group whereas it significantly decreased in the control group ( p < 0.05). According to the findings of this study, counseling based on EX-PLISSIT model positively affected the sexual function of women with SLE. Therefore, this model can be used as a cost-effective and simple counseling method to improve the sexual functions.

The Effect of Sex Education and Counseling Based on the Ex-PLISSIT Model on Sexual Life in Primigravidas

“…It was seen in the literature that other studies based on the Ex-PLISSIT model were conducted in different sample groups such as Multiple Sclerosis, Systemic Lupus Erythematosus and postpartum women. In these studies, it was determined that counseling was effective in improving sexual function (29)(30)(31)(32)(33). It is thought that the randomized controlled studies and the shorter measurement intervals compared to our study may have an effect on the results.…”

“…In addition, the low education level of the spouses negatively affected the sexual attitudes of the pregnant women (5). In support of this, lack of knowledge is emphasized as the most important factor in the emergence of sexual problems (33). For this reason, there is a need for training and counseling programs to create positive attitudes and raise awareness about sexuality during pregnancy.…”

“…total of 62 primigravidas participated in this study (Intervention group: 32, Control group: 30). The mean age of the intervention group was 27.50 (SD=3.75; range 17-34), and the mean age of the control group was 27.00 (SD=4.28; range[22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38]. The individual characteristics, sexual characteristics, thoughts and knowledge levels of the primigravidas participating in the study were similar, and no statistically significant difference was found between the groups (p>.05) (Table…”

Efficacy of lifestyle interventions in the management of systemic lupus erythematosus: a systematic review of the literature

“…We assessed the full text of 199 potentially relevant records, and finally included 102 studies. Of these, forty were categorized as studies on mental health [ 21 – 60 ], and thirty-nine as studies on physical activity and exercise [ 61 – 99 ]. Fifteen articles studied the effects of diet and nutrition [ 100 – 114 ], whereas seven studies examined the reduction of harmful exposures [ 115 – 121 ].…”

“…One of these RCTs evaluated disease activity, and did not find that the intervention (biofeedback-assisted CBT) had any effect [ 24 ]. The other two RCTs showed that counseling may have a positive effect on anxiety [ 59 ] and sexual function [ 60 ], respectively. Table 1 shows the included studies of LoE 1 and 2.…”