Intensive Therapy Model Research Articles

PS05 A qualitative assessment of the impact of hidradenitis suppurativa on sexual function

Abstract Hidradenitis suppurativa (HS) is associated with significant physical and psychosocial morbidity. There are limited data in the literature on the impact of the condition on patients’ psychological, physical and emotional sexual functioning and wellbeing. A patient survey was collaboratively designed by dermatologists and a clinical psychologist to assess sexual function in HS. This was adapted from existing published scales assessing components of sexual functioning, as there is no validated tool for use in HS. Nineteen patients (10 men and nine women) with HS were surveyed. They had a mean age of 41 years and a mean Hurley stage of 2.2. Twenty-six per cent (n = 5) were current smokers. The mean body mass index of participants was 28 kg m−2. Seventy-nine per cent (n = 15) were in a current sexual relationship. Seventy-four per cent (n = 14) felt that HS affected their sexual relationships negatively and 50% (n = 8/16) documented that HS had prevented them starting a new sexual relationship. Eighty-four per cent (n = 16) reported that their HS caused them to avoid sexual intimacy. Sixty-three per cent (n = 12) suffered a degree of dyspareunia and 63% (n = 12) described that odour from HS lesions impacted negatively on sexual activity. Confidence with regard to emotional closeness with partners during sex was variable, with 31% (n = 5) reporting low confidence; 58% (n = 11) had low confidence when engaging in sexual activity. Fifty per cent (n = 9/18) felt sad when considering the impact of HS on their sexual life and 88% (n = 14/16) felt ashamed and stressed when considering being naked or intimate. Ninety-four per cent (n = 17/18) felt a degree of sexual unattractiveness due to HS, with 44% (n = 8/18) rating it as ‘extremely’ or ‘very much’. Eighty-nine per cent (n = 16/18) reported that HS had negatively impacted on the sexual quality of their lives, with 33% (n = 6) rating it as ‘extremely’ or ‘very much’. Sexual function in HS is an important, often overlooked component of quality of life. Sexual dysfunction is of particular concern in HS due to the location and nature of lesions, which are often close to or affect erogenous zones (Varney P, Guo W, Brown M et al. A systematic review and meta-analysis of sexual dysfunction in patients with hidradenitis suppurativa. Int J Dermatol 2022; 85:AB23). This study demonstrates that HS has a significant impact on patients’ psychosexual, physical and emotional sexual functioning and wellbeing. The Permission, Limited Information, Specific Suggestions, Intensive Therapy model is a useful, structured framework for clinicians to incorporate the discussion and management of sexual dysfunction into consultations, and clinicians should work with local psychological, sexual and biomedical services to address any identified morbidity.

Effect of Counseling Model on Sexual Dysfunction among Women with Diabetes and Their Sexual Quality of life

Background: Recent evidence indicates that diabetic women are at higher risk for developing sexual dysfunction compared to those without diabetes. Sexual dysfunction is a problem which affects overall quality of diabetic women lives. Aim of the study: to evaluate the effect of sexual counseling model on sexual dysfunction of women with diabetes & their sexual quality of life. Research design quasi experimental research design was used .Setting:the study was conducted at outpatient clinic & internal medicine department at Minia university hospital. Subjects a purposive sample of one hundred diabetic women who suffered from sexual dysfunctions. Tools of data collection: three tools were used as following: 1- A structured interviewing questionnaire, 2- The Female Sexual Function Index scale to measures sexual function, 3- The Female Sexual Quality of Life scale to measure the quality of sexual life of diabetic women. Results: the frequency of sexual dysfunction was more prevalent in diabetic women in which the mean age of studied women was (39.68 ± 6.2) years. There were statistically significant differences regarding to the Female Sexual Function Index total mean scores & regarding to Female Sexual Quality of Life total scores between pre and post six months of education. Conclusion & Recommendations: implementation of counseling sessions based on Permission, Limited information, Specific suggestions & Intensive therapy model had a significant effect in improving the sexual function and sexual quality of life among diabetic women in pre and after six months of sexual counseling soapplying ongoing educational programs based on the previous model for diabetic women in all available diabetic clinics with preparation of secure environment to discuss sexual problems with women freely was recommended.

Women, breast cancer survivorship, sexual losses, and disenfranchised grief – a treatment model for clinicians

Women who have survived breast cancer often suffer from short-term and long-term sexual side effects due to the different treatments that they undergo. The sexual side effects and altered sexual self-schema can affect their quality of life significantly and may result in a deep sense of loss. However, their intimate partners, family, friends, health care providers, and psychotherapists may not acknowledge this ambiguous loss. Hence, grief related to their loss may be disenfranchised – a kind of grief that is precipitated by a loss that cannot be socially sanctioned, openly acknowledged, or publically mourned. Using the permission giving, limited information, specific suggestions, and intensive therapy model as a framework, an assessment protocol and the Pillai-Friedman and Ashline treatment model are proposed for addressing the ambiguous losses and disenfranchised grief that may be experienced by breast cancer survivors.