Nami Chun

doi:10.4040/jkan.2011.41.4.471

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Original Article
Effectiveness of PLISSIT Model Sexual Program on Female Sexual Function for Women with Gynecologic Cancer: Nami Chun; Journal of Korean Academy of Nursing 2011;41(4):471-480.
DOI: https://doi.org/10.4040/jkan.2011.41.4.471
Published online: August 31, 2011

Assistant Professor, College of Nursing, Sungshin Women's University, Seoul, Korea.

Address reprint requests to: Chun, Nami. College of Nursing, Sungshin Women's University, Dongseon-dong 3-ga, Seongbuk-gu, Seoul 136-742, Korea. Tel: +82-2-920-7523, Fax: +82-2-920-2091, nmchun@sungshin.ac.kr

• Received: January 25, 2011 • Accepted: August 4, 2011

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Abstract
NOTES
REFERENCES

Abstract

Purpose
The purpose of this study was to evaluate the effectiveness of the Permission, Limited Information, Specific Suggestions, Intensive Therapy (PLISSIT) model sexual program on female sexual function for women with gynecologic cancer.
Methods
The integrative 6-hr (two hours per session) program reflecting physical and psychosocial aspects of women's sexuality was developed based on Annon's PLISSIT model. Participants were 61 women with cervical, ovarian, or endometrial cancer. Of them, 29 were assigned to the experimental group and 32 to the control group. The women completed the Female Sexual Function Index (FSFI) including sexual desire, arousal, lubrication, orgasm, satisfaction, and pain. Independent t-test and repeated measured ANOVA were used to test the effectiveness of the program.
Results
Significant group differences were found on FSFI sub-domain scores including sexual desire, arousal, lubrication, orgasm, and satisfaction but not pain. Significant time differences were found on all domains except for pain in the experimental group repeated measured ANOVA.
Conclusion
The results indicate that the three-week PLISSIT model sexual program is effective in increasing sexual function for women with gynecologic cancer. Nurses may contribute to improving women's sexual function by utilizing the program. Strategies to relieve sexual pain need to be considered for greater effectiveness of the program.
Keywords: Gynecologic neoplasms; Sexual dysfunction; Program effectiveness

This study was supported by Sungshin Women's University research grant of 2009.

Figure 1

Research design.

Table 1

Program Outline

FSFI=Female sexual function Index; PLISSIT=Permission, Limited information, Specific suggestion, Intensive therapy; FAQ=Frequently asked questions.

Table 2

General and Medical Characteristics and Homogeneity between Experimental and Control Group (N=61)

Table 3

Differences in Pre-Post Female Sexual Function, Psychosocial and Physical Variables Between Experimental and Control Groups (N=61)

Exp.=Experimental group (n=29); Cont.=Control group (n=32); FSFI=Female sexual function index.

Table 4

Changes of Sexual Function Over Time in Women who Received the PLISSIT Model Sexual Program (N=29)

PLISSIT=Permission, limited nformation, Specific suggestion, intensive Therapy; FSFI=Female sexual function iIndex.

REFERENCES

1. Annon JS. The PLISSIT model: A proposed scheme for the behavioral treatment of sexual problems. Journal of Sex Education and Therapy. 1976;2:1–15.Article
2. Ayaz S, Kubilay G. Effectiveness of the PLISSIT model for solving the sexual problems of patients with stoma. Journal of Clinical Nursing. 2008;18:89–98. doi: 10.1111/j.1365-2702.2008.02282.x.Article PubMed
3. Bancroft J, Loftus J, Long JS. Distress about sex: A national survey of women in heterosexual relationship. Archives of Sexual Behavior. 2003;32:193–208. doi: 10.1023/A:1023420431760.PubMed
4. Brotto LA, Heiman JR, Goff B, Greer B, Lentz GM, Swisher E, et al. A psychoeducational intervention for sexual dysfunction in women with gynecologic cancer. Archives of Sexual Behavior. 2008;37:317–329. doi: 10.1007/s10508-007-9196-x.Article PubMed PDF
5. Chun N. A structural equation model on sexual function in women with gynecologic cancer. Journal of Korean Academy of Nursing. 2008;38:639–648. doi: 10.4040/jkan.2008.38.5.639.Article PubMed
6. Chun N. Predictors of sexual desire, arousal, lubrication, orgasm, satisfaction, and pain in women with gynecologic cancer. Journal of Korean Academy of Nursing. 2010;40:24–32. doi: 10.4040/jkan.2010.40.1.24.Article PubMed
7. Chun N, Kwon JY, Noh GO, Kim SH. Symptom clusters in women with gynecologic cancer. Clinical Nursing Research. 2006;14:61–70.
8. Cohen J. Statistical power analysis for the behavior sciences. 1988;2nd ed. Hillsdale, NJ, Lawrence Erlbaum Assoc.
9. Jensen PT, Groenvold M, Klee MC, Thranov I, Petersen MA, Machin D. Longitudinal study of sexual function and vaginal changes after radiotherapy for cervical cancer. International Journal of Radiation Oncology, Biology, Physics. 2003;56:937–949. doi: 10.1016/S0360-3016(03)00362-6.Article PubMed
10. Jun EY, Kim S, Chang SB, Oh K, Kang HS, Kang SS. The effect of a sexual life reframing program on marital intimacy, body image, and sexual function among breast cancer survivors. Cancer Nursing. 2011;34:142–149. doi: 10.1097/NCC.0b013e3181f1ab7a.Article PubMed
11. Katz A. Do ask, do tell, why do so many nurses avoid the topic of sexuality? American Journal of Nursing. 2005;105:66–68.
12. Krychman ML. Sexual rehabilitation medicine in a female oncology setting. Gynecologic Oncology. 2006;101:380–384. doi: 10.1016/j.ygyno.2006.03.001.Article PubMed
13. Ministry of Health and Welfare. Annual report of cancer statistics in Korea in 2008, the Korea central cancer registry, National Cancer Center. 2010;12;Seoul, Author.
14. Nichols FH, Humenick SS. Childbirth Education. 2000;2nd ed. Philadelphia, PA, W. B. Saunders.
15. Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R, et al. The Female Sexual Function Index (FSFI): A multidimensional self-report instrument for the assessment of female sexual function. Journal of Sex and Marital Therapy. 2000;26:191–208. doi: 10.1080/009262300278597.Article PubMed
16. Speer JJ, Hillenberg B, Sugrue DP, Blacker C, Kresge CL, Decker VB, et al. Study of sexual functioning determinants in breast cancer survivors. The Breast Journal. 2005;11:440–447. doi: 10.1111/j.1075-122X.2005.00131.x.Article PubMed
17. Stead ML. Sexual function after treatment for gynecological malignancy. Current Opinion in Oncology. 2004;16:492–495.Article PubMed
18. Stead ML, Brown JM, Fallowfield L, Selby P. Lack of communication between healthcare professionals and women with ovarian cancer about sexual issues. British Journal of Cancer. 2003;88:666–671. doi: 10.1038/sj.bjc.6600799.Article PubMed PMC PDF
19. Stewart DE, Wong F, Duff S, Melancon CH, Cheung AM. "What doesn't kill you makes you stronger": An ovarian cancer survivor survey. Gynecologic Oncology. 2001;83:537–542. doi: 10.1006/gyno.2001.6437.Article PubMed
20. Takahashi M, Kai I. Sexuality after breast cancer treatment: Changes and coping strategies among Japanese survivors. Social Science and Medicine. 2005;61:1278–1290. doi: 10.1016/j.socscimed.2005.01.013.Article PubMed
21. Schultz WC, Van De Wiel HB. Sexuality, intimacy, and gynecological cancer. Journal of Sex and Marital Therapy. 2003;29:121–128.Article PubMed
22. Wiegel M, Meston C, Rosen R. The female sexual function index (FSFI): Cross-validation and development of clinical cutoff scores. Journal of Sex and Marital Therapy. 2005;31:1–20. doi: 10.1080/0092623059- 0475206.Article PubMed
23. Yu HS. Predictors of female sexual dysfunction. 2003;Seoul, Seoul National University. Unpublished master's thesis.

Figure & Data

Figure 1

Research design.

Table 1

Program Outline

FSFI=Female sexual function Index; PLISSIT=Permission, Limited information, Specific suggestion, Intensive therapy; FAQ=Frequently asked questions.

Table 2

General and Medical Characteristics and Homogeneity between Experimental and Control Group (N=61)

Table 3

Differences in Pre-Post Female Sexual Function, Psychosocial and Physical Variables Between Experimental and Control Groups (N=61)

Exp.=Experimental group (n=29); Cont.=Control group (n=32); FSFI=Female sexual function index.

Table 4

Changes of Sexual Function Over Time in Women who Received the PLISSIT Model Sexual Program (N=29)

PLISSIT=Permission, limited nformation, Specific suggestion, intensive Therapy; FSFI=Female sexual function iIndex.

REFERENCES

1. Annon JS. The PLISSIT model: A proposed scheme for the behavioral treatment of sexual problems. Journal of Sex Education and Therapy. 1976;2:1–15.Article
2. Ayaz S, Kubilay G. Effectiveness of the PLISSIT model for solving the sexual problems of patients with stoma. Journal of Clinical Nursing. 2008;18:89–98. doi: 10.1111/j.1365-2702.2008.02282.x.Article PubMed
3. Bancroft J, Loftus J, Long JS. Distress about sex: A national survey of women in heterosexual relationship. Archives of Sexual Behavior. 2003;32:193–208. doi: 10.1023/A:1023420431760.PubMed
4. Brotto LA, Heiman JR, Goff B, Greer B, Lentz GM, Swisher E, et al. A psychoeducational intervention for sexual dysfunction in women with gynecologic cancer. Archives of Sexual Behavior. 2008;37:317–329. doi: 10.1007/s10508-007-9196-x.Article PubMed PDF
5. Chun N. A structural equation model on sexual function in women with gynecologic cancer. Journal of Korean Academy of Nursing. 2008;38:639–648. doi: 10.4040/jkan.2008.38.5.639.Article PubMed
6. Chun N. Predictors of sexual desire, arousal, lubrication, orgasm, satisfaction, and pain in women with gynecologic cancer. Journal of Korean Academy of Nursing. 2010;40:24–32. doi: 10.4040/jkan.2010.40.1.24.Article PubMed
7. Chun N, Kwon JY, Noh GO, Kim SH. Symptom clusters in women with gynecologic cancer. Clinical Nursing Research. 2006;14:61–70.
8. Cohen J. Statistical power analysis for the behavior sciences. 1988;2nd ed. Hillsdale, NJ, Lawrence Erlbaum Assoc.
9. Jensen PT, Groenvold M, Klee MC, Thranov I, Petersen MA, Machin D. Longitudinal study of sexual function and vaginal changes after radiotherapy for cervical cancer. International Journal of Radiation Oncology, Biology, Physics. 2003;56:937–949. doi: 10.1016/S0360-3016(03)00362-6.Article PubMed
10. Jun EY, Kim S, Chang SB, Oh K, Kang HS, Kang SS. The effect of a sexual life reframing program on marital intimacy, body image, and sexual function among breast cancer survivors. Cancer Nursing. 2011;34:142–149. doi: 10.1097/NCC.0b013e3181f1ab7a.Article PubMed
11. Katz A. Do ask, do tell, why do so many nurses avoid the topic of sexuality? American Journal of Nursing. 2005;105:66–68.
12. Krychman ML. Sexual rehabilitation medicine in a female oncology setting. Gynecologic Oncology. 2006;101:380–384. doi: 10.1016/j.ygyno.2006.03.001.Article PubMed
13. Ministry of Health and Welfare. Annual report of cancer statistics in Korea in 2008, the Korea central cancer registry, National Cancer Center. 2010;12;Seoul, Author.
14. Nichols FH, Humenick SS. Childbirth Education. 2000;2nd ed. Philadelphia, PA, W. B. Saunders.
15. Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R, et al. The Female Sexual Function Index (FSFI): A multidimensional self-report instrument for the assessment of female sexual function. Journal of Sex and Marital Therapy. 2000;26:191–208. doi: 10.1080/009262300278597.Article PubMed
16. Speer JJ, Hillenberg B, Sugrue DP, Blacker C, Kresge CL, Decker VB, et al. Study of sexual functioning determinants in breast cancer survivors. The Breast Journal. 2005;11:440–447. doi: 10.1111/j.1075-122X.2005.00131.x.Article PubMed
17. Stead ML. Sexual function after treatment for gynecological malignancy. Current Opinion in Oncology. 2004;16:492–495.Article PubMed
18. Stead ML, Brown JM, Fallowfield L, Selby P. Lack of communication between healthcare professionals and women with ovarian cancer about sexual issues. British Journal of Cancer. 2003;88:666–671. doi: 10.1038/sj.bjc.6600799.Article PubMed PMC PDF
19. Stewart DE, Wong F, Duff S, Melancon CH, Cheung AM. "What doesn't kill you makes you stronger": An ovarian cancer survivor survey. Gynecologic Oncology. 2001;83:537–542. doi: 10.1006/gyno.2001.6437.Article PubMed
20. Takahashi M, Kai I. Sexuality after breast cancer treatment: Changes and coping strategies among Japanese survivors. Social Science and Medicine. 2005;61:1278–1290. doi: 10.1016/j.socscimed.2005.01.013.Article PubMed
21. Schultz WC, Van De Wiel HB. Sexuality, intimacy, and gynecological cancer. Journal of Sex and Marital Therapy. 2003;29:121–128.Article PubMed
22. Wiegel M, Meston C, Rosen R. The female sexual function index (FSFI): Cross-validation and development of clinical cutoff scores. Journal of Sex and Marital Therapy. 2005;31:1–20. doi: 10.1080/0092623059- 0475206.Article PubMed
23. Yu HS. Predictors of female sexual dysfunction. 2003;Seoul, Seoul National University. Unpublished master's thesis.

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Effectiveness of PLISSIT Model Sexual Program on Female Sexual Function for Women with Gynecologic Cancer

J Korean Acad Nurs. 2011;41(4):471-480. Published online August 31, 2011

DOI: https://doi.org/10.4040/jkan.2011.41.4.471

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Effectiveness of PLISSIT Model Sexual Program on Female Sexual Function for Women with Gynecologic Cancer

Figure 1 Research design.

Figure 1

Effectiveness of PLISSIT Model Sexual Program on Female Sexual Function for Women with Gynecologic Cancer

Table 1

Program Outline

FSFI=Female sexual function Index; PLISSIT=Permission, Limited information, Specific suggestion, Intensive therapy; FAQ=Frequently asked questions.

Table 2

General and Medical Characteristics and Homogeneity between Experimental and Control Group (N=61)

Table 3

Differences in Pre-Post Female Sexual Function, Psychosocial and Physical Variables Between Experimental and Control Groups (N=61)

Exp.=Experimental group (n=29); Cont.=Control group (n=32); FSFI=Female sexual function index.

Table 4

Changes of Sexual Function Over Time in Women who Received the PLISSIT Model Sexual Program (N=29)

PLISSIT=Permission, limited nformation, Specific suggestion, intensive Therapy; FSFI=Female sexual function iIndex.

Table 1 Program Outline

FSFI=Female sexual function Index; PLISSIT=Permission, Limited information, Specific suggestion, Intensive therapy; FAQ=Frequently asked questions.

Table 2 General and Medical Characteristics and Homogeneity between Experimental and Control Group (N=61)

Table 3 Differences in Pre-Post Female Sexual Function, Psychosocial and Physical Variables Between Experimental and Control Groups (N=61)

Exp.=Experimental group (n=29); Cont.=Control group (n=32); FSFI=Female sexual function index.

Table 4 Changes of Sexual Function Over Time in Women who Received the PLISSIT Model Sexual Program (N=29)

PLISSIT=Permission, limited nformation, Specific suggestion, intensive Therapy; FSFI=Female sexual function iIndex.