title: 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.
abstract: OBJECTIVE
  This study was conducted to evaluate the effectiveness of sexual counseling based on the Permission, Limited Information, Specific Suggestion, Intensive Therapy (PLISSIT) model on the Sexual Dysfunction (SD) of married sexually active women who suffer from Multiple Sclerosis (MS). This is the first sexual intervention applied by a midwife as a health professional on MS patients in Iran where the cultural and religious limitations are important challenging issues.
  
  
  METHODS
  This randomized clinical trial was carried out in Iranian Community of Support for MS Patients in Tehran, Iran. The participating women who had a definite diagnosis of MS and SD, Expanded Disability Status Scale (EDSS) scores <7, and aged 18-55 years were randomly assigned to experimental (EG, n=43) and control group (CG, n=45). Participants in the EG group received 4 weekly sexual counseling sessions based on the PLISSIT model (90-120min per session).
  
  
  METHODS
  Sexual function was assessed three times (before the intervention, and 2 months and 3 months after the intervention) using the Female Sexual Function Index (FSFI). Chi-square test, Fisher's exact test, and Repeated Measures ANOVA were employed to analyze the data.
  
  
  RESULTS
  The mean total FSFI score of the women in EG improved at 2 and 3 months after the intervention when it was compared with the FSFI score before the intervention (p<0.05). There was no significant difference in the total FSFI score when the data of 3 evaluations was compared in CG. A significant increase in the mean score of 6 subgroups was seen in EG (p<0.05) but not in CG.
  
  
  CONCLUSIONS
  According to this study, utilizing the PLISSIT model as a framework for sexual counseling can improve sexual function in women who are sexually active and suffer from SD due to MS.
authors.affiliation: School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: khakbaza@tums.ac.ir.
authors.forename: Zohreh
authors.initials: Z
authors.lastname: Khakbazan
authors.affiliation: School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: daneshfar1987@yahoo.com.
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Daneshfar
authors.affiliation: School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: behboodi@tums.ac.ir.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Behboodi-Moghadam
authors.affiliation: Neurology and Neuroscience Research and Clinical Department, Royan Institute, Tehran, Iran. Electronic address: seyedmassoodnabavi@gmail.com.
authors.forename: Seyed Massood
authors.initials: SM
authors.lastname: Nabavi
authors.affiliation: Faculty of Psychology, Tehran University, Tehran, Iran. Electronic address: s_gh_psy@yahoo.com.
authors.forename: Sogand
authors.initials: S
authors.lastname: Ghasemzadeh
authors.affiliation: Faculty of Health, Tehran University of Medical Science, Tehran, Iran. Electronic address: mehranab2000@yahoo.com.
authors.forename: Abbas
authors.initials: A
authors.lastname: Mehran
mesh_terms: D000293:Adolescent; D000328:Adult; D003469:Culture; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007492:Iran; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D012731:Sex Counseling / Q000379:methods*; D012725:Sexual Behavior; D012735:Sexual Dysfunction, Physiological / Q000209:etiology / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D018454:Spouses; D016896:Treatment Outcome; D055815:Young Adult
keywords: Multiple sclerosis; PLISSIT model; Sexual counseling; Sexual dysfunction; Women