The Effect of Sexual Counseling With the PLISSIT Model on Sexual Function and Sexual Quality of Life in Women With Multiple Sclerosis: A Randomized Controlled Study

Multiple sclerosis (MS) is a chronic autoimmune, inflammatory, demyelinating and/or neurodegenerative disease of the central nervous system. Plaques seen in patients with MS can lead to various symptoms (1). Sexual dysfunction, one of these symptoms, is common in MS patients and negatively affects their quality of life. Sexual dysfunction in MS can be classified as primary, secondary and tertiary. Primary sexual dysfunction is due to the effects of demyelinating lesions on the spinal cord or brain. Secondary dysfunction is due to the physical disorders associated with MS and the side effects of drugs. They indirectly affect the sexual response. Fatigue, loss of attention and concentration, difficulties with movement, coordination disorders, muscle stiffness, bladder and bowel dysfunction, muscle weakness, lower extremity weakness, tremor, pain and drug side effects can be counted as examples of these side effects. Tertiary sexual disorder is the cultural, social and psychological effects of MS. Although sexual dysfunction is a common problem in MS, it is difficult to diagnose and treat because it is not mentioned or questioned. There is no reliable specific treatment for sexual dysfunction for women with MS, but a multidisciplinary approach involving physicians, nurses, sexual therapists, and psychologists is one of the most important components of care for MS patients. It is necessary to provide enough information to the patients about sexual dysfunctions and to enable them to learn the effect of MS on sexuality and current practices in a clear and easy way (3,4). It is recommended that health professionals use models in order to comprehensively evaluate sexuality and focus on solving sexual problems (5,6). The use of models in the evaluation of sexuality guides health professionals in facilitating the history-taking process and determining sexual problems. The P-LISS-IT model, one of the recommended models for sexual counseling, provides four levels of approach to each problem of the individual: P (Permission): Allowing, Ll (Limited Information): Giving limited information, SS (Specific Suggestions): Giving specific suggestions, IT (Intensive Therapy) is expressed as Intensive Therapy (6). Although there are a limited number of studies showing that sexual counseling based on the PLISSIT model is effective in solving sexual problems in patients with MS, uncertainty about the long-term effects of sexual counseling continues (7-10). In this study, an alternative to the treatment of sexual problems of women with MS was investigated by comprehensively evaluating women with MS with sexual problems in a randomized controlled design in line with the PLISSIT model, examining the long-term effectiveness of sexual counseling by comparing it with the control group, and evaluating the results with concrete, valid and reliable tools. an opportunity to develop a solution approach will be provided. In addition, due to the limited number of studies, it is thought that it will make an important contribution to the literature. In this study, the following hypotheses will be tested; 1. Sexual functions of women with MS given sexual counseling based on the PLISSIT model are better than women in the control group. 2. Sexual life quality of women with MS who received sexual counseling based on the PLISSIT model is better than women in the control group.