The Effect of Sexual Counseling Based on Ex-PLISSIT Model on the Intimacy and Sexuality of Married Women with Multiple Sclerosis: A Randomized Controlled Trial

Abstract

Abstract: Introduction: Multiple sclerosis (MS) is one of the most common chronic inflammatory diseases of the nervous system, which occurs predominantly in young adults and commonly seen in women. This disease causes various tensions, including sexual problems, with the consequent reduction in the quality of life of the affected person and ultimately causing incompatibility and major problems in the marital life of individuals. The aim of this study was to evaluate the effect of counseling based on the PLISSIT model on sexual intercourse of married women with multiple sclerosis. Methods: This randomized clinical trial study was performed on 70 married women referring to MS association of Tabriz. Then, using convenience sampling, 35 women with MS between the ages of 18 - 45 were selected for the control group and 35 for the intervention group. The data were collected using demographic questionnaire, Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19)، Sexual quality of life questionnaire, Fatigue Severity Scale(FSS), and Beck Depression Inventory-Short Form Items (BDI-13). A neurologist rated the level of disability using Expanded Disability Status Scale (EDSS). Using block randomization, the participants with score of 4 or 5 in each item of MSISQ-19 were assigned into a counselling and a control group with block sizes of four and six and the allocation ratio of 1:1. The intervention group attended acounselling session or more sessions if need, based on Ex-PLISSIT model. Data were analyzed by SPSS software (Version 25). Independent t-test, and ANCOVA were used to analyze the data. Results: In this study, the two groups did not differ significantly in terms of demographic and disease characteristics (p> 0.05). Before intervention, there was no significant difference between the two groups in relation to sexual dysfunction, but two months after the intervention, there was a significant difference between the two groups in terms of primary SD, tertiary SD and total score of Multiple Sclerosis intimacy and sexuality. Before and after intervention, there was no significant difference between the two groups in relation to sexual quality of life and its subscales. Conclusion: Considering the effect of sexual counseling based on the Ex-PLISSIT model on primary and tertiary SD, using this approach as a clinically useful and effective method is recommended for MS women with SD.