Effectiveness of Online Versus Telephone Counseling of Rational-Emotional-Behavioral Therapy on Sexual Function of Women Undergoing Cardiac Rehabilitation: A Randomized Clinical Trial
DOI:
https://doi.org/10.31661/gmj.v11i.2396Keywords:
Cardiovascular Diseases, Rational-Emotional-Behavioral Therapy, Cardiac Rehabilitation, Sexual Activities, Internet-Based Intervention, CounselingAbstract
Background: Sexual function in patients with cardiovascular disease (CVDs) is often associated with anxiety and irrational beliefs. Moreover, 60-78% of patients with CVDs report sexual problems. Some studies suggest that sexual counseling is necessary for these patients but is not usually provided for them. Online or telephone counseling may be helpful during the covid-19 pandemic, but studies on its application to sexual function appear to be limited. This study aimed to investigate the effectiveness of online vs. telephone counseling of rational-emotional-behavioral therapy (REBT) on the sexual function of women undergoing cardiac rehabilitation. Materials and Methods: In this randomized clinical trial study, 46 women diagnosed with CVDs under rehabilitation were assigned into online and telephone groups. Overall, eight 60-min intervention sessions were held (once a week). The Female's Sexual Function Index (FSFI) questionnaire was completed by the women at baseline, week 8th, and follow-up week 12th (main outcome). Results: FSFI scores between the two groups at baseline (online: 13.28±2, telephone: 12.68±1.52, P=0.254) compared to week 12th (online 28.86±2.44, telephone, 26.6±2.10, P=0.002) were significantly different. As for within-group comparison in baseline compared to week 12th statistically significant difference was observed in all subscales of FSFI (P<0.05). Conclusion: Online and telephone REBT counseling can improve the sexual function of women undergoing cardiac rehabilitation, but online counseling appears to be more effective. Thus, this method is recommended to improve the sexual function of these women during the covid-19 pandemic
References
De Marvao A, Alexander D, Bucciarelli-Ducci C, Price S. Heart disease in women: a narrative review. Anaesthesia. 2021;76(Suppl 4):118-30. https://doi.org/10.1111/anae.15376PMid:33682102 Bakhshayeh S, Sarbaz M, Kimiafar K, Vakilian F, Eslami S. Barriers to participation in center-based cardiac rehabilitation programs and patients' attitude toward home-based cardiac rehabilitation programs. Physiother Theory Pract. 2021;37(1):158-68. https://doi.org/10.1080/09593985.2019.1620388PMid:31155986 Aghababaei S, Heshmatian T, Roshanaei G, Rohani Mahmoodabadi SM, Refaei M. Sexual Function and Related Factors in Lactating Women with Decreased Sexual Desire referred to Sonqor Health Centers in 2018. The Iranian Journal of Obstetrics, Gynecology and Infertility. 2021;24(2):23-32. Lin CY, Broström A, Ã…restedt K, MÃ¥rtensson J, Steinke EE, Pakpour AH. Using extended theory of planned behavior to determine factors associated with help-seeking behavior of sexual problems in women with heart failure: a longitudinal study. J Psychosom Obstet Gynaecol. 2020;41(1):54-61. https://doi.org/10.1080/0167482X.2019.1572743PMid:30829094 Maseroli E, Scavello I, Vignozzi L. Cardiometabolic Risk and Female Sexuality-Part I. Risk Factors and Potential Pathophysiological Underpinnings for Female Vasculogenic Sexual Dysfunction Syndromes. Sex Med Rev. 2018;6(4):508-24. https://doi.org/10.1016/j.sxmr.2018.02.009PMid:29730315 Mornar Jelavić M, KrstaÄić G, PerenÄević A, Pintarić H. Sexual Activity in Patients with Cardiac Diseases. Acta Clin Croat. 2018;57(1):141-8. https://doi.org/10.20471/acc.2018.57.01.18PMid:30256023 PMCid:PMC6400344 Murphy PJ, Noone C, D'Eath M, Casey D, Doherty S, Jaarsma T, et al. The CHARMS pilot study: a multi-method assessment of the feasibility of a sexual counselling implementation intervention in cardiac rehabilitation in Ireland. Pilot Feasibility Stud. 2018;4:88. https://doi.org/10.1186/s40814-018-0278-4PMid:29988602 PMCid:PMC6027553 Farquhar JM, Stonerock GL, Blumenthal JA. Treatment of Anxiety in Patients With Coronary Heart Disease: A Systematic Review. Psychosomatics. 2018;59(4):318-32. https://doi.org/10.1016/j.psym.2018.03.008PMid:29735242 PMCid:PMC6015539 Kazemi Rezaei SV, Kakabraee K, Hosseini SS. The effectiveness of emotion regulation skill training based on dialectical behavioral therapy on cognitive emotion regulation and quality of life of patients with Cardiovascular Diseases. Journal of Arak University of Medical Sciences. 2019;22(4):98-111. https://doi.org/10.32598/JAMS.22.4.90 Khodadad Hatkeh Poshti Z, Hassanzadeh R, Emadian S. The Effectiveness of Emotional Schema Therapy on Neuroticism and the Life Style of Cardiovascular Patients. Journal of Babol University of Medical Sciences. 2021;23(1):46-52. Nekonam A, Etemadi S, Pornaghash Tehrani S. The effectiveness of excited family therapy approach on improving Sexual Satisfaction and Marital stress in patients with Coronary artery bypass graft. Journal of psychologicalscience. 2018;17(65):61-77. Richards SH, Anderson L, Jenkinson CE, Whalley B, Rees K, Davies P, et al. Psychological interventions for coronary heart disease: Cochrane systematic review and meta-analysis. Eur J Prev Cardiol. 2018;25(3):247-59. https://doi.org/10.1177/2047487317739978PMid:29212370 Dos Santos André F, Regina Maria VL. Sexuality of postinfarction patients: diagnosis, results and nursing intervention. J Clin Nurs. 2014;23(15-16):2101-9. https://doi.org/10.1111/jocn.12345PMid:25040761 Ellis A. The evolution of Albert Ellis and rational emotive behavior therapy. In: Zeig JK. The Evolution of Psychotherapy. 1st Edition. New York: Routledge; 2019. p. 69-82. https://doi.org/10.4324/9781315791906-5 Nequee F, Oraki M, Janbozorgi M, Alipoor A. The effectiveness of cognitive-behavioral intervention based on stress-induced immunization training on psycho-physiological and psychological characteristics of patients with coronary artery bypass surgery (CABG). Medical Science Journal of Islamic Azad Univesity-Tehran Medical Branch. 2021;31(2):195-204. https://doi.org/10.52547/iau.31.2.195 Byrne M, Doherty S, Fridlund BG, MÃ¥rtensson J, Steinke EE, Jaarsma T, et al. Sexual counselling for sexual problems in patients with cardiovascular disease. Cochrane Database Syst Rev. 2016;2(2):Cd010988. https://doi.org/10.1002/14651858.CD010988.pub2PMid:26905928 PMCid:PMC6464754 Ozaki Y, Nagao K, Saigo R, Tai T, Tanaka N, Kobayashi H, et al. Sexual Problems among Japanese Women: Data from an Online Helpline. Sex Med. 2015;3(4):295-301. https://doi.org/10.1002/sm2.83PMid:26797064 PMCid:PMC4721042 Hyde EK, Martin DE, Rieger KL. Factors shaping the provision of sexual health education for adults with acute coronary syndrome: A scoping review. Patient Educ Couns. 2020;103(5):877-87. https://doi.org/10.1016/j.pec.2019.11.017PMid:31767244 Rabbe S, Blankart CR, Franz WM, Hager L, Schreyögg J. Impact of a telemonitoring intervention in patients with chronic heart failure in Germany: A difference-in-difference matching approach using real-world data. J Telemed Telecare. 2021:1357633x20984024. https://doi.org/10.1177/1357633X20984024PMid:33557666 Xiao C. A Novel Approach of Consultation on 2019 Novel Coronavirus (COVID-19)-Related Psychological and Mental Problems: Structured Letter Therapy. Psychiatry Investig. 2020;17(2):175-6. https://doi.org/10.30773/pi.2020.0047PMid:32093461 PMCid:PMC7047000 Dewitte M, Otten C, Walker L. Making love in the time of corona - considering relationships in lockdown. Nat Rev Urol. 2020;17(10):547-53. https://doi.org/10.1038/s41585-020-0365-1PMid:32820239 Lopes GP, Vale FBC, Vieira I, da Silva Filho AL, Abuhid C, Geber S. COVID-19 and Sexuality: Reinventing Intimacy. Arch Sex Behav. 2020;49(8):2735-8. https://doi.org/10.1007/s10508-020-01796-7PMid:32696154 PMCid:PMC7373209 Pascoal PM, Carvalho J, Raposo CF, Almeida J, Beato AF. The Impact of COVID-19 on Sexual Health: A Preliminary Framework Based on a Qualitative Study With Clinical Sexologists. Sex Med. 2021;9(1):100299. https://doi.org/10.1016/j.esxm.2020.100299PMid:33482611 PMCid:PMC7837091 Alavinia SE, Lamir AR, Khajei R, Barjaste Yazdi A. Effect of Cardiac Rehabilitation Program Based on Combined Training on VEGF/Endostatin Gene Expression Ratio in Patients with Acute Coronary Syndrome. Journal of Medical Council of Iran. 2020;38(3):187-93. Ranjbaran M, Chizari M, Matori Pour P. Prevalence of female sexual dysfunction in Iran: Systematic review and Meta-analysis. Journal of Sabzevar University of Medical Sciences. 2016;22(Special Issue):1117-25. Haji Mohammad Hoseini M, Ghanbari Afra L, Ghanbari Afra M, Goudarzi Rad M. Impact of Self-care Educational Program on Sexual Function among Ischemic Heart Disease Patients. Journal of Vessels and Circulation. 2020;1(1):13-8. https://doi.org/10.29252/jvesselcirc.1.1.13 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. J Sex Marital Ther. 2000;26(2):191-208. https://doi.org/10.1080/009262300278597PMid:10782451 Ryding EL, Blom C. Validation of the Swedish version of the Female Sexual Function Index (FSFI) in women with hypoactive sexual desire disorder. J Sex Med. 2015;12(2):341-9. https://doi.org/10.1111/jsm.12778PMid:25487161 Mohammadi K, Heydari M, Faghihzadeh S. The female sexual function index (FSFI): validation of the Iranian version. Payesh. 2008;7(3):269-78. Arip M. The effect of REBT Structured Group Counseling towards the psychology aspects of adolescents of divorced parent. Advances in Environmental Biology. 2016;10(4):44-50. Wijayanti A, Sugiharto DYP, Wibowo ME. The effectiveness of rational emotive behavior therapy (rebt) group counseling to reduce cheating behavior. Jurnal Bimbingan Konseling. 2019;8(2):102-7. Zahrakar K, Kasaee A. The Effectiveness of Training Based on Rational-Emotional-Behavioral Therapy on Career Decision-Making Self-Efficacy. International Clinical Neuroscience Journal. 2019;6(2):69. https://doi.org/10.15171/icnj.2019.14 Åžahin E, Güleç Keskin S, Terzi M. The effect of a psychoeducation program based on the rational emotional behavioral approach in individuals with multiple sclerosis diagnosis: A randomized controlled trial. Perspect Psychiatr Care (in press). 2021. https://doi.org/10.1111/ppc.12949PMid:34558061 Grove AB, Kurtz ED, Wallace RE, Sheerin CM, Scott SM. Effectiveness of a Rational Emotive Behavior Therapy (REBT)-Informed Group for Post-9/11 Veterans with Posttraumatic Stress Disorder (PTSD). Mil Psychol. 2021;33(4):217-27. https://doi.org/10.1080/08995605.2021.1897496PMid:34334948 PMCid:PMC8324018 Kabadayi F, Yuksel G. Rational-Emotive Behavior Therapy for Dysfunctional Anger: A Case Study. Journal of Rational-Emotive & Cognitive-Behavior Therapy. 2021;39(4):522-37. https://doi.org/10.1007/s10942-020-00384-x Sommers-Flanagan J, Sommers-Flanagan R. Counseling and psychotherapy theories in context and practice: Skills, strategies, and techniques. 3rd Edition. John Wiley & Sons; 2018. Abrams M. REBT and sexual problems. In: Dryden W, Bernard ME. REBT with diverse client problems and populations. Springer Cham; 2019. p. 127-47. https://doi.org/10.1007/978-3-030-02723-0_7 Moon JR, Huh J, Song J, Kang IS, Park SW, Chang SA, et al. The effects of rational emotive behavior therapy for depressive symptoms in adults with congenital heart disease. Heart Lung. 2021;50(6):906-13. https://doi.org/10.1016/j.hrtlng.2021.07.011PMid:34411872 Murphy PJ, Mc Sharry J, Casey D, Doherty S, Gillespie P, Jaarsma T, et al. Sexual counselling for patients with cardiovascular disease: protocol for a pilot study of the CHARMS sexual counselling intervention. BMJ Open. 2016;6(6):e011219. https://doi.org/10.1136/bmjopen-2016-011219PMid:27342240 PMCid:PMC4932312 Grieger R, Alexander KA. REBT with couples. In: Dryden W, Bernard ME. REBT with diverse client problems and populations. Springer Cham; 2019. p. 265-82. https://doi.org/10.1007/978-3-030-02723-0_13 Farzandipour M, Farkhian A, Nabovati E, Mir AK, Anvari Tafti S, Rajabi Moghadam H. Smartphone-based application for training outpatient cardiac rehabilitation: Design and usability evaluation. Koomesh. 202;22(4):686-95. https://doi.org/10.29252/koomesh.22.4.686 Farajkhoda T, Ashrafi F, Bokaie M, Zareei Mahmoodabadi H. Online Compared to Face-to-Face Sexual Intimacy Enhancement Training Program Counseling with Cognitive-Behavioral Approach on Sexual Intimacy in Pregnant Women. J Sex Marital Ther. 2021;47(5):446-59. https://doi.org/10.1080/0092623X.2021.1895388PMid:33691602 Raisi M, Jahan F, Moazedian A. Comparison the Effectiveness of Online Text Messenger-Based Cognitive-Behavioral Therapy and Telephone-Based Cognitive-Behavioral Therapy on Persistent Depression Desorder. Rooyesh-e-Ravanshenasi Journal (RRJ). 2021;10(5):139-50. Bagheri I, Memarian R, Hajizadeh E, Pakcheshm B. The effect of sex education on patients and their spouses satisfaction after myocardial infarction. Jorjani Biomed J. 2014;2(1):46-0.
