DOI QR코드

DOI QR Code

Effects of Sexual Rehabilitation Using the PLISSIT Model on Quality of Sexual Life and Sexual Functioning in Post-Mastectomy Breast Cancer Survivors

  • Faghani, Safieh (Babol University of Medical Sciences) ;
  • Ghaffari, Fatemeh (Babol University of Medical Sciences)
  • Published : 2016.11.01

Abstract

Background and Objectives: As one of the most common treatments for breast cancer, mastectomy has adverse effects on the quality of sexual life and sexual functioning in the impacted women. Various strategies have therefore been proposed to resolve their sexual problems. The present study was conducted to determine the effect of sexual rehabilitation using the PLISSIT model in post-mastectomy breast cancer survivors. Materials and Methods: The present quasi-experimental study was conducted on a population of post-mastectomy breast cancer survivors and their husbands. Sample size was calculated as 50 each for intervention and non-intervention groups. The former received sexual counseling based on the PLISSIT model consisting of four levels of intervention: permission, limited information, specific suggestion and intensive therapy, presented in four 90-minute sessions. Data were collected using the Sexual Quality of Life-Female (SQOL-F) questionnaire and the Female Sexual Function Index (FSFI). Results: No significant differences were observed in the mean quality of sexual life scores between the intervention and control groups (P>0.05) before the intervention; however, a significant difference emerged between the groups after the intervention (P<0.01). Thus the mean score for sexual functioning in the intervention group was $26.3{\pm}3.76$ before and $30.0{\pm}4.38$ after the intervention (P<0.0001). In the control group, however, the difference between the pre- and post-intervention mean scores was not statistically significant (P=0.713). Conclusion: The present study showed that nurses can use the PLISSIT model in conjunction with chemotherapy and radiotherapy to teach coping and problem-solving skills to women with breast cancer and their husbands and to encourage their participation in group programs for expressing their feelings and attitudes about their current sex life and thus help enhance quality of sexual life and sexual functioning in this group.

Keywords

Sexual rehabilitation;the quality of sexual life;sexual functioning;breast cancer;mastectomy

References

  1. Abdollahzadeh F, Moradi N, Pakpour V, et al (2014). Un-met Supportive Care Needs of Iranian Breast Cancer Patients. Asian Pac J Cancer Prev, 15, 3933-38. https://doi.org/10.7314/APJCP.2014.15.9.3933
  2. Aizer AA, Chen MH, Mccarth EP, et al (2013). Marital status and survival in patients with cancer. J Clin Oncol, 31, 3869-76. https://doi.org/10.1200/JCO.2013.49.6489
  3. Akbari ME, Khayamzadeh M, Khoshnevis S, Nafisi N, Akbari A (2012). Five and ten years survival in breast cancer patients mastectomies vs. breast conserving surgeries personal experience. Iran J Cancer Prev, 1, 53-6.
  4. Alder J, Zanetti R, Wight E, et al (2008). Sexual dysfunction after premenopausal stage I and II breast cancer: do androgens play a role? J Sex Med, 5, 1898-906. https://doi.org/10.1111/j.1743-6109.2008.00893.x
  5. Alvandi Jam A, Afshari A, Talebi M, Abbasi R (2015). The effect of Sexual rehabilitation on (Sexual) quality of life for hemodialysis patients referred to dialysis center in Labafinejad Hospital. Sci J Hamdan Univ Med Sci, 22, 45-52.
  6. Amori N, Aghajani M, Asgarian FS, Jazayeri M (2016). Epidemiology and trend of common cancers in Iran (2004-2008). Eur J Cancer Care (Engl), doi: 10.1111/ecc.12449.
  7. Andersen B (1990). How cancer affects sexual functioning. Oncol, 4, 81-8.
  8. Arroyo JM, Lopez ML (2011). Psychological problems derived from mastectomy: a qualitative study. Int J Surg Oncol, 10, 1-8.
  9. Ayaz S, Kubilay G (2009). Effectiveness of the PLISSIT model for solving the sexual problems of patients with stoma. J Clin Nurs, 18, 89-98. https://doi.org/10.1111/j.1365-2702.2008.02282.x
  10. Bakht S, Najafi S (2010). Body image and sexual dysfunctions: comparison between breast cancer patients and healthy women. Procedia Soc Behav Sci, 5, 1493-97. https://doi.org/10.1016/j.sbspro.2010.07.314
  11. Chun N (2011). Effectiveness of PLISSIT model sexual program on female sexual function for women with gynecologic cancer. J Korean Acad Nurs, 41, 471-80. https://doi.org/10.4040/jkan.2011.41.4.471
  12. Cohen MZ (2004). Using the BETTER model to assess sexuality. Clin J Oncol Nurs, 8, 84-6. https://doi.org/10.1188/04.CJON.84-86
  13. Desimone M, Spriggs E, Gass JS (2014). Sexual dysfunction in female cancer survivors. Am J Clin Oncol, 37, 101-6. https://doi.org/10.1097/COC.0b013e318248d89d
  14. Faghani S, Mohammadian R, Rahmani A, et al (2015). Supportive Care Needs of Iranian Cancer Survivors and Relationships with Social Support. Asian Pac J Cancer Prev, 16, 6339-45. https://doi.org/10.7314/APJCP.2015.16.15.6339
  15. Lotfi Kashani F, Vaziri SH, Hajizadeh Z (2014). Sexual skills training, body image and sexual function in breast cancer. Procedia Soc Behav Sci, 159, 288-92. https://doi.org/10.1016/j.sbspro.2014.12.374
  16. Farnam F, Janghorbani M, Raisi F, Merghati-Khoei E (2014). Compare the effectiveness of PLISSIT and sexual health models on women's sexual problems in Tehran, Iran: a randomized controlled trial. J Sex Med, 11, 2679-89. https://doi.org/10.1111/jsm.12659
  17. Fouladi N, Pourfarzi F, Ali-Mohammadi H, et al (2013). Process of coping with mastectomy: A qualitative study in Iran. Asian Pac J Cancer Prev, 14, 2079-84. https://doi.org/10.7314/APJCP.2013.14.3.2079
  18. Gilbert E, Ussher JM, Perz J (2010). Sexuality after breast cancer: a review. Maturitas, 66, 397-407. https://doi.org/10.1016/j.maturitas.2010.03.027
  19. Goldfarb S, Dickler M, Sit L, et al (2009). Sexual dysfunction in women with breast cancer: prevalence and severity. ASCO Annual Meeting Proceedings, 27, 9558.
  20. Harirchi I, Montazeri A, Zamani Bidokhti F, Mamishi N, Zendehdel K ( 2012). Sexual function in breast cancer patients: a prospective study from Iran. J Exp Clin Cancer Res, 31, 20. https://doi.org/10.1186/1756-9966-31-20
  21. Hatzichristou D, Rosen RC, Broderick G, et al (2004). Clinical evaluation and management strategy for sexual dysfunction in men and women. J Sex Med, 1, 49-57. https://doi.org/10.1111/j.1743-6109.2004.10108.x
  22. Hazrati M, Poor Keiani M, Abaszade A, Jaafari P(2008). The effect of rehabilitation in quality of life in women after mastectomy. Armaghane danesh, 12, 89-99.
  23. Hill EK, Sandbo S, Abramsohn E ( 2011). Assessing gynecologic and breast cancer survivors' sexual health care needs. Cancer, 117, 2643-51. https://doi.org/10.1002/cncr.25832
  24. Annone JS (1981). PLISSIT therapy.In: Corsini RJ,Hand book of Innovative Psychotherapies, New York, Wiley.
  25. Khajehaminian F, Ebrahimi M, Kamali M, Dolatshahi B, Younesi SJ (2014). Sexual functioning after mastectomy surgery-A qualitative study. Iran J Breast Dis, 7, 50-8.
  26. Latini DM, Hart SL, Coon DW, Knight SJ (2009). Sexual rehabilitation after localized prostate cancer: current interventions and future directions. Cancer J, 15, 34-40. https://doi.org/10.1097/PPO.0b013e31819765ef
  27. Li Q, Gan L, Liang L, Li X, Cai S (2015). The influence of marital status on stage at diagnosis and survival of patients with colorectal cancer. Oncotarget, 6, 7339-47. https://doi.org/10.18632/oncotarget.3129
  28. Maasoumi R, Lamyian M, Khalaj Abadi Farahani F, Montazeri A (2013). Women's perception of sexual socialization in Iran: A qualitative study. J Qualitative Res Health Sci, 2, 221-33.
  29. Maasoumi R, Lamyian M, Montazeri A (2013). The sexual quality of life-female (SQOL-F) questionnaire: translation and psychometric properties of the Iranian version. Reprod Health, 10, 1-6. https://doi.org/10.1186/1742-4755-10-1
  30. Mansour SE, Shebl AM, Waheda SM. (2014). The effect of sexual counseling program on pain level and sexual function among women with dyspareunia. Nurse Educ Pract, 5, 208-20.
  31. Maughan KL, Lutterbie MA, Ham PS (2010). Treatment of breast cancer. Am Fam Physician, 81, 1339-46.
  32. Mohammadi Kh, Heydari M, Faghihzadeh S (2008). The Female Sexual Function Index (Fsfi): Validation Of The Iranian Version. Payesh, 7, 269-78.
  33. Montazeri A, Vahdaninia M, Harirchi I, et al (2008). Quality of life in patients with breast cancer before and after diagnosis: an eighteen months follow-up study. BMC Cancer, 8, 1-6. https://doi.org/10.1186/1471-2407-8-1
  34. Nabila-El S, Marwa A Sh (2015). Effectiveness of application of PLISSIT counseling model on sexuality for breast cancer's women undergoing treatment. American J Nurs Sci, 4, 218-30. https://doi.org/10.11648/j.ajns.20150404.21
  35. Nabila-El SS, Nho JH (2013). Effect of PLISSIT model sexual health enhancement program for women with gynecologic cancer and their husbands. J Korean Acad Nurs, 43, 681-9. https://doi.org/10.4040/jkan.2013.43.5.681
  36. Nosrait M, Rahmani A, Naghibi F, Razavi A (2007). A study on the effects of education on marital life satisfaction of women undergone hysterectomy in urmia chosen hospitals, 2008. J Urmia Nurs Midwifery Fac, 5, 129-36.
  37. Panjari M, Bell RJ, Davis SR (2011). Sexual function after breast cancer. J Sex Med, 8, 294-302. https://doi.org/10.1111/j.1743-6109.2010.02034.x
  38. Poorkiani M, Abbaszadeh A , Hazrati M, et al (2010). The effect of rehabilitation on quality of life in female breast cancer survivors in Iran. Indian J Med Paediatr Oncol, 31, 105-9. https://doi.org/10.4103/0971-5851.76190
  39. Pumo V, Milone G, Iacono , et al ( 2012). Psychological and sexual disorders in long-term breast cancer survivors. Cancer Manag Res, 4, 61-5.
  40. Raggio GA, Butryn ML, Arigo D, Mikorski R, Palmer SC (2014). Prevalence and correlates of sexual morbidity in long-term breast cancer survivors. Psychol Health, 29, 632-50. https://doi.org/10.1080/08870446.2013.879136
  41. Robinson J, Forrest A, Pope-Ellis C, Hargreaves AT (2011). A pilot study on sexuality in rehabilitation of the spinal cord injured: Exploring the woman's perspective. S Afr J Occup Ther, 41, 13-17.
  42. Rosen R, Brown C, Heiman J (2000). The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther, 26, 191-208. https://doi.org/10.1080/009262300278597
  43. Rostamkhani F, Ozgoli G, Khoei EM, Jafari F, Majd HA (2012). Effectiveness of the PLISSIT-based counseling on sexual function of women. J Nurs Midwifery Shahid Beheshti Univ Med Sci, 22, 1-9.
  44. Rostamkhani F, Jafari F, Ozgoli G, Shakeri M (2015). Addressing the sexual problems of Iranian women in a primary health care setting: A quasi-experimental study. Iran J Nurs Midwifery Res, 20, 139-46.
  45. Rutte A, Van Oppen P, Nijpels G ( 2015). Effectiveness of a PLISSIT model intervention in patients with type 2 diabetes mellitus in primary care: design of a cluster-randomised controlled trial. BMC Fam Pract, 16, 1-9. https://doi.org/10.1186/s12875-014-0212-7
  46. Sharif F, Abshorshori N, Hazrati M, Tahmasebi S, Zare N (2012). Effect of peer-lead education on quality of life of mastectomy patients. Health Qual Life Outcomes, 11, 703-10.
  47. Speck RM, Gross CR, Hormes JM, et al (2010). Changes in the body image and relationship scale following a one-year strength training trial for breast cancer survivors with or at risk for lymphedema. Breast Cancer Res Treat, 121, 421-30. https://doi.org/10.1007/s10549-009-0550-7
  48. Torre La, Bray F, Siegel RL, et al ( 2015). Global cancer statistics, 2012. CA Cancer J Clin, 65, 87-108. https://doi.org/10.3322/caac.21262
  49. Tutuncu B, Yildiz H (2012). The influence on women's sexual functions of education given according to the PLISSIT model after hysterectomy. Procedia Soc Behav Sci, 47, 2000-4. https://doi.org/10.1016/j.sbspro.2012.06.939
  50. Ussher JM, Perz J, Gilbert E (2012). Changes to sexual well-being and intimacy after breast cancer. Cancer Nurs, 35, 456-65. https://doi.org/10.1097/NCC.0b013e3182395401
  51. Van Meijel B, Gamel C, Van Swieten-Duijfjes B, Grypdonck MH (2004). The development of evidence-based nursing interventions: methodological considerations. J Adv Nurs, 48, 84-92. https://doi.org/10.1111/j.1365-2648.2004.03171.x
  52. Vaziri S, Lotfi Kashani F (2012). Sexuality after breast cancer: need for guideline. Iran J Cancer Prev, 5, 10-5.
  53. Wang F, Chen F, Huo X , et al ( 2013). A neglected issue on sexual well-being following breast cancer diagnosis and treatment among Chinese women. PLoS One, 8, 1-7.