暂无摘要。

BACKGROUND: Sexual changes in breast cancer occur after diagnosis and treatment, including a mastectomy. Sexual assertiveness is an effective factor in sexual satisfaction, which means the ability to convey sexual feelings, beliefs, and thoughts. Given the limited studies on sexual assertiveness in breast cancer and different client participation, this study was conducted to compare the effect of sexual counseling based on two models of PLISSIT (Permission, Limited Information, Specific Suggestion, Intensive Therapy) and BETTER (Bring Up, Explain, Tell, Time, Education, Record) on sexual assertiveness in women after mastectomy.
METHODS: This quasi-experimental intervention was conducted in 2021 in Mashhad, Iran. Seventy-eight mastectomized women with breast cancer were assigned to the BETTER (n = 39) and PLISSIT (n = 39) groups using permuted block randomization with a block size of 4 and an allocation ratio of 1:1. Both groups received four individual counseling sessions, one week apart. The research tools included a demographic information form and the Hulbert index of sexual assertiveness. Changes in the mean scores of sexual assertiveness between the two groups were evaluated before and four weeks after the intervention, and the mean changes were compared between the groups. Data analysis was conducted using the Kolmogorov-Smirnov test, independent t-test, paired t-test, and Chi-square tests using Statistical Package for the Social Sciences (SPSS) version 25 (P < 0.05).
RESULTS: The results of the study showed that before the intervention, there was no significant difference in the score of sexual assertiveness in both groups (P = 0.253). The mean score of sexual assertiveness changes before and after the intervention in the BETTER group (8.07 ± 4.9) was significantly higher than in the PLISSIT group (5.58 ± 4.7) (P < 0.001).
CONCLUSIONS: The results indicated that BETTER sexual counseling was more effective in increasing the sexual assertiveness of mastectomized women than PLISSIT counseling. Due to its simplicity and client-centeredness, this model can be used in breast cancer care programs.

Sexuality is an integral part of our existence. Multiple Sclerosis (MS) can complicate the lifelong course of sexual development and the ways in which one defines and expresses sexuality. Unfortunately, these issues are not adequately addressed by the health professionals involved in the rehabilitation process. Present research attempts to study the effect that can arise on the sexual and relational satisfaction of couples having a partner with MS after the implementation of a sexual rehabilitation program. 60 couples where one partner has MS and the other does not, were divided into three groups and accepted the PLISSIT (PLISSIT stands for Permission, Limited Information, Specific Suggestions, Intensive Therapy) sexual rehabilitation program as follows: Group a (n = 40, control group) completed self-referencing questionnaires at three times (initial measurement, after 10 weeks and 6 months later), group b (n = 40) did 10 weeks of sexual counselling and completed the same questionnaires at the same times and group c (n = 40) followed the PLISSIT programme and was evaluated in the same way at the same times. The implementation of PLISSIT improved Sexual Dysfunction (SD) levels, increased sexual satisfaction between partners along with general relational satisfaction. PLISSIT can be used by professionals involved in the management of the disease as a comprehensive psychosexual rehabilitation program for MS patients and their partners.

In-person, individual counseling using the PLISSIT model is a well-known approach to help people with sexual problems. Evidence suggests that Grouped Sexuality Education (GSE) can be as effective as in-person sexuality education. The efficacy of PLISSIT versus GSE has not previously been evaluated in women with Breast Cancer (BC). In this paper, we report on the effect of PLISSIT versus GSE on self-reported sexual behaviors experienced by women after a BC diagnosis (n = 75). The women were randomly allocated into three groups, with 25 women in each arm. Data analysis of the intention-to-treat population (n = 65) revealed efficacy of both GSE and PLISSIT in improving sexual behaviors (p < 0.0001) with a positive change in sexual capacity, motivation and performance after 6- and 12-weeks post-intervention follow ups. We found the GSE model showed a greater efficacy than the PLISSIT model. Due to the substantial needs faced by women with cancer and the cost associated with implementing the PLISST model, GSE seems to be more effective. We recommend GSE for Iranian communities where management of sexual problems is at an early stage and where the sexuality of women with cancer is routinely overlooked.

OBJECTIVE: Cancellation of university classes during the coronavirus disease 2019 pandemic challenges teaching inperson sexual history-taking skills to medical, physician assistant, and nursing students. We used commercial online electronic services for medical students to learn sexual history-taking skills.
METHODS: A total of 174 medical students viewed a lecture on sexual history taking and the PLISSIT model (Permission, Limited Information, Specific Suggestion, Intensive Therapy) and were then randomized into dyads. They arranged a time to meet online on Zoom with their partner, chose a simple sexual history case-history (male or female) from a small selection, and recorded the 5- to 6-minute sexual history within a 1-week time frame. Each student played a \"provider\" or \"patient\" and then switched roles with a new case. One of the course tutors, all sexual health practitioners, downloaded 10 videos randomly assigned to them asynchronously and viewed and commented on the interaction of each \"provider\" along with comments on what to improve in the sexual history. 2 weeks later after the remainder of the lectures in the course, a second, more complex set of 8 cases were provided, so students could move at their comfort pace and choose 1.
METHODS: Students were required to make 1 online post and 1 comment on another student\'s post for each case, on the experience, and associated issues arising, positive or negative. All comments were downloaded and analyzed by theme.
RESULTS: Major themes included developing comfort in using sexual language, using simpler sexual terms suitable for patients, feeling confidence and mastery, excitement using technology developing clinical skills, surprise watching their performances and body language, observation of how they appeared to the \"patient,\" organizing sexual histories and incorporating PLISSIT model, ability to ask about context and relationships, and seeing the exercise as building on existing clinical skills training. Some expressed anxiety and nervousness, which by the second case had largely or completely dissipated.
CONCLUSIONS: A readily replicable, secure, cheap cloud-based model to integrate sexual history training asynchronously was provided, with tutors\' comments, and student skills development, and performance evaluated. Ross MW, Newstrom N, Coleman E. Teaching Sexual History Taking in Health Care Using Online Technology: A PLISSIT-Plus Zoom Approach During the Coronavirus Disease 2019 Shutdown. Sex Med 2021;9:100290.

Discussing sexual health with healthcare patients and their partners is difficult and often avoided. The PLISSIT model is a framework to effectively initiate the conversation about sexual concerns. This rapid review and small meta-analysis explores and clarifies knowledge about the effectiveness of PLISSIT in resolving sexual dysfunction and glean insight into its utility as a social work intervention in a palliative care setting. Evidence from 15 interventional studies was synthesized. Cohen\'s d-index served as the meta-analytic effect size statistic for each individual study. Significant ds were converted to Cohen\'s U3 statistic to aid in practical interpretations. Between-study heterogeneity was evaluated with Cochran\'s Q statistic to examine possible relationships between effect sizes and moderator variables. Statistically and practically significant evidence revealed that PLISSIT is effective in treating sexual dysfunction (d = 1.00, U3 = 84%, 95% CI = 1.06, 1.08): 84% of participants who received PLISSIT interventions scored lower on sexual dysfunction measures than did the typical participant in the comparison condition. Study design and frequency of intervention delivery moderated the overall effect. The findings and inferences may be best thought of as developed hypotheses for future research testing.