Sexual Quality of Life, Sexual Knowledge, and Attitudes of Older Adults on the Example of Inhabitants Over 60s of Bialystok, Poland

Psychometric Properties and Gender Invariance of the Portuguese (European) Version of the Aging Sexual Knowledge and Attitudes Scale

The sexuality of older people was understood as non-existent or as something outside the prevailing norm. In this sense, analysing people's sexual knowledge and attitudes towards older people is a challenge for theory and practice. The aim of this study is to translate and validate the Aging Sexual Knowledge and Attitudes Scale (ASKAS) for the Portuguese population. A sample of 994 Portuguese adults (70.9% women, n = 705) completed the ASKAS-PT along with a series of self-report measures. Confirmatory factor analysis and the psychometric properties of the Portuguese (European) version of ASKAS-PT were investigated, particularly reliability, temporal stability, and convergent and critical validity. This study also examined the gender measurement invariance of the ASKAS-PT. After confirmatory factor analysis, a two-factor model fit the Portuguese version best. Reliability and validity results also showed good results, and the ASKAS-PT appears to be a gender-invariant measure. Overall, the Portuguese version of the ASKAS showed good psychometric properties and appears to be a valid and reliable measure for assessing knowledge and attitudes about aging.

A comprehensive interventional program for promoting sexual function in postmenopausal women: Protocol for a mixed methods study

BACKGROUND

Menopause is a natural event in women's life that leads to physical, psychological, and social consequences. A fundamental health concern in postmenopausal women is problems with their sexual function. This study aims to design an interventional program to promote sexual function in postmenopausal women.

MATERIALS AND METHODS

This sequential exploratory mixed methods study will be conducted in three phases. The first phase will be a qualitative study with a content analysis approach. The participants will be selected using a purposive sampling in Isfahan, Iran. The data will be collected through in-depth interviews and field notes and analyzed using conventional content analysis. In the second phase, the intervention will be designed and finalized to promote sexual function in postmenopausal women using the results of qualitative study and literature review, asking experts' opinions, and holding specialized panels. In the third phase, the intervention will be implemented (in the form of a quasi-experimental study) and the effect of the intervention will be determined. In this phase, the data will be collected using the female sexual function index. Finally, an appropriate interventional program will be presented.

CONCLUSION

It is hoped to promote sexual function in postmenopausal women by conducting this study and implementing an appropriate interventional program that is culturally sensitive. If it is proved that the intervention is effective, a basis for health policy-making to promote sexual health in postmenopausal women can be provided by presenting evidence and increasing the knowledge in this field of health.

Reliability and Validity Evidence for Brief Sexual Attitudes Scale Among Filipino Men: A Confirmatory Factor Analysis

Background and Purpose: It is essential to address sexual health to ensure quality of life and sexual well-being; however, studies to measure sexual attitudes remain scarce. This study aimed to find reliability and validity evidence of the Brief Sexual Attitudes Scale (BSAS) using confirmatory factor analysis (CFA) among Filipino men. Methods: A cross-sectional study was conducted. Results: BSAS shows coefficient alpha of 0.90. CFA demonstrates goodness of fit (adjusted goodness-of-fit index = .82; goodness-of-fit index = .86; comparative fit index = .91; incremental fit index = .91; expected cross-validation index = 2.27; root mean square error of approximation = .08; [χ2 (213) = 927.45, p ≤ .001], χ2/df ratio = 4.35). Conclusions: BSAS is a valid and reliable questionnaire to assess sexual attitudes among Filipino men. Further research is needed to evaluate sexual attitudes in the promotion of sexual health across cultures.

Sexual Expression in Long-Term Care Institutions: Are We Ready for the Baby Boomer Generation?

Baby boomers were at the forefront of profound social changes in sexual attitudes and many have expressed a desire to remain sexually active throughout their life course. The purpose of this survey study was to assess the perceived preparedness of Ontario's long-term care (LTC) homes to meet the changing sexuality needs and expectations of LTC residents. We examined sexuality-related attitudes, including in the context of dementia, among 150 LTC administrators. Participants also completed a questionnaire assessing their experiences and perceptions regarding existing and anticipated supports, barriers, and priorities. Most participants demonstrated positive sexual attitudes; however, multiple challenges to meeting residents' sexuality needs were noted, including assessing capacity to consent, limited privacy, staff training, conflicting attitudes, and a lack of adequate policy and guidelines. Challenges are broad and significant and considerable attention is required to meet the expectations of the next generation of LTC residents, including gender and sexual minority elders.

Women's sexual health improvement: sexual quality of life and pelvic floor muscle assessment in asymptomatic women

Introduction

Problems related to the quality of sexual life in gynecological practice are usually neglected. This study aimed to highlight the significance of this area of concern and evaluate the usefulness of tools, such as patient-reported outcomes (PROs) and pelvic floor examination, to improve women's sexual wellbeing and to identify predictors of poor quality of sexual life during the well-woman annual visit.

Methods

A cross-sectional study was designed to examine 300 healthy women to determine whether the sexual quality of life (SQOL) questionnaire (on electronic devices) and pelvic floor muscle assessment (the vulva, anus, muscles, and periurethral (VAMP) protocol) of asymptomatic women during the annual bimanual examination (BME) help differentiate patients who would benefit from discussing sexual problems with a gynecologist. Dyspareunia was an exclusion criterion.

Results

The majority of subjects experienced high sexual wellbeing (82.0% with SQOL score of ≥84), with a mean of 85.7 points. SQOL scores were lower for psychiatric disorders or symptoms (37.0% of subjects), although they did not correlate with age, BMI, parity, contraception use, history of vulvovaginal symptoms, neurosurgical/orthopedic problems, and rectal, bowel, or bladder symptoms. Patients with dyspareunia (16.0% of participants, although they denied it during the face-to-face consultation) had a 3.6 times higher prevalence of low or moderate quality of sexual life. The VAMP protocol score was low in asymptomatic women, 33.0% met positive criteria (VAMP+, NRS ≥3) for pelvic floor dysfunction (overactivity), although at borderline levels. VAMP+ was positively correlated with chronic pain and genitourinary symptoms, but neither with dyspareunia nor incontinence, and was unrelated to the SQOL score (p = 0.151).

Conclusion

Women's sexual health is a global health priority. Finding a way to start a discussion with an asymptomatic patient is crucial to increasing patients' interest in disclosing a sexual health problem to be resolved. PROs or simple questions about sexual wellbeing direct the discussion mainly toward the at-risk group for sexual deterioration: those with mental health problems and women with dyspareunia. Dyspareunia is considered a predictor of decreased quality of sexual life, a major sexual disorder that should not be overlooked. Gynecological consultation should resolve concerns, identify the problem, and refer for professional sexual care if still needed.

The Prevalence of Andropause and Its Relationship With Sexual Quality of Life Among Older Iranian Men

Available evidence indicates insufficient knowledge about the status of andropause and sexual quality of life among Iranian older men. The study aimed to investigate the prevalence of andropause and its relationship with sexual quality among older adults. This descriptive-analytical study was conducted among 576 older people referred to urban health centers in Mashhad, Iran. The eligible samples were selected through the cluster sampling method. To collect data, the male andropause symptoms' self-assessment questionnaire and the sexual quality of life-male were used. Forty-seven of the respondents (n = 271) were diagnosed with a "moderate" level of andropause. A strong negative correlation was identified between the sexual quality of life and the severity of andropause (r = -.366, p < .001). Sexual quality of life and andropause was also affected by age, marital status, health status, and exercise. Thirty-six percent of the changes in the quality of sexual life of older men were influenced by the independent variables (adjusted R² = .36; R² = .40; R = .63). The findings indicated that andropause has highly prevailed among the participants. There was a meaningful association between andropause and sexual quality of life among older men. Further studies are recommended to investigate sexual orientation qualitatively and to discover other factors influencing andropause among adult men.

Effect of Sexual Knowledge, Attitude and Quality of Life on Marital Satisfaction of Aged Couples in South Iran: APIM-SEM Analysis

Marital satisfaction is important for health and well-being among aged couples. The aim of this study is to explore the relationship between knowledge, sexual attitude, and quality of life with marital satisfaction of aged couples of over 60 years in southern Iran. This APIM analytical study was performed on 510 aged couples in southern Iran in 2020. Proportionate stratified sampling was randomly performed in three stages relative to the aging population in main cities in the south Iran. Data collection tools included demographic information (age, education, occupation, living alone, type of disability, etc.), sexual knowledge and attitude scale (SKAS-10), quality of life scale (SF-12), and marital satisfaction questionnaire. Mean score of marital satisfaction, sexual attitude, sexual knowledge, and QoL (SF-12) was 49.71 (SD = 14.8), 27.5 (SD = 7.3), 24.7 (SD = 8.5), and 31.49 (SD = 3.2), respectively. The present study showed that sexual knowledge and attitude, quality of life, are among the estimators of marital satisfaction in aged couples.

Quality of sexual life of riparian women: Analysis of sexual practices and attitudes

OBJECTIVE

To analyse the sexual practices, attitudes, and sexual quality of life of Riparian woman and associated factors.

METHOD

A cross-sectional analytical study conducted among Riparian women using the Study of Sexual Behaviour (SSB) questionnaire. A bivariate analysis and binary logistic regressions were performed to identify factors associated with sexual quality of life.

RESULTS

A total of 138 women participated in the study (n = 138). Of the women, 34.1% and 33.3% reported pain and loss of interest during or after sex, respectively. In terms of practices during sex, women reported kissing (85.5%), cuddling (89.1%), mutual masturbation (37.2%), oral sex (34.8%), and anal sex (23.9%). However, the majority reported not using condoms during sex (63.0%). In terms of sexual quality of life, 39.9% of the women rated it as good. Higher education and early sexual initiation increase the chances of a "good" sexual quality of life.

CONCLUSION

Because Riparian women engage in some risky sexual behaviours, such as not using condoms, educational strategies on the prevention of sexually transmitted infections should be reinforced and incorporated in this population. This may help improve these women's sexual quality of life.

Relationship of sexual quality of life and mental well-being in undergraduate women in a Canadian university

As young women transition from adolescence to adulthood, they begin to explore their sexual identities and sexual relationships. The current literature supports the relationship between sexual quality of life (QOL) and mental well-being. However, this relationship has not yet been replicated in undergraduate women. In order to address this gap, the authors assessed the correlation between sexual QOL and mental well-being among a sample of women undergraduate students in Canada. The study design was cross-sectional in nature, and demographic information was collected, along with the completion of validated measures of sexual QOL and mental well-being. A total of 157 individuals participated. After removing those who did not meet inclusion criteria and those with > 90% incomplete responses, 124 valid survey responses remained for analysis. A hierarchical multivariable linear regression was conducted while controlling for age, sexual orientation, exercise, history of nonconsensual sexual contact, household income, and self-perceived health status. Every one-unit increase in sexual QOL was associated with a 0.35 increase in mental well-being (95% CI 0.105–0.428, p = .002). A history of unwanted or nonconsensual sexual activity had a significant negative correlation with mental well-being ( p = .027). The authors’ findings suggest a significant relationship between sexual QOL and mental well-being. There is a strong opportunity for universities to bolster the support services available to students, with a required focus on women with a history of nonconsensual sexual contact.

Yaşlanma Cinsel Bilgi ve Tutum Ölçeği: Türkçe Geçerlik ve Güvenirlik Çalışması

Objectives: It is designed to test the Turkish version of ASKAS's validity and reliability for use with older people, health professionals, and people who influence older people. Material and Method: Language and content validity, item analysis, exploratory and confirmatory factor analysis, and internal consistency coefficients were evaluated in this study. Results: It was decided to omit two items from the scale's knowledge subscale, and the three-factor structure of the attitude subscale was found to be within the range of acceptable fit indices. Conclusions: The Turkish version of ASKAS was determined to be valid, reliable, and applicable in practice.

Psycho-Social Factors Associated with Intimacy Needs in Divorced and Widowed Older Chinese Women

The rapidly ageing population, the growing rate of divorce, and the longer life expectancy of women compared with men have resulted in a large proportion of older Chinese women being alone. The sexual health and intimacy needs of this group of women are ignored due to traditional Chinese cultural values that undermine older adults' needs for sex and intimacy, and the subordinate position of women in society. The present study used a quantitative survey method to investigate bio-psycho-social factors associated with divorced and widowed older Chinese women's sexual health and intimacy needs in two cities in Shanghai and Wuhan. The conceptual framework of this study was guided by cognitive stress theory, attachment theory, gender theory, socioemotional selectivity theory, objectification theory, and activity theory. We adopted a model involving demographic, biological, psychological, and social factors to unearth the mechanism influencing divorced and widowed older Chinese women's sexual health and intimacy needs. Data were collected between October 2020 and March 2021 via face-to-face surveys. A convenience sample of 278 (N = 278) divorced and widowed older Chinese women was recruited (166 in Shanghai and 112 in Wuhan). Sexual health and intimacy needs were associated with current relationship status, financial status, physical health, attachment style, neuroticism, mental health, social support, prior marital conflict, and gender norm attitude. Sexual behaviour was associated with age, number of children, financial status, physical health, attachment style, neuroticism, prior marital conflict, gender norm attitude, sexual knowledge, sexual attitude, and intimacy attitude as predictors. Most participants in this study seemed to have found new intimate partners with whom to continue participating in sexual activities after their divorce or widowhood. The present study is one of the first examples of empirical research to examine the sexual health and intimacy needs of older Chinese women who are divorced or widowed. The findings generated by this study will inform the design and implementation of appropriate social programs for this demographic, and provide invaluable insight for social workers, educators, sex therapists, healthcare professionals, community workers, and policymakers working with this population.

Identifying themes relevant to sexual dissatisfaction of dual career couples: Design and effectiveness of a psycho-educational package - A mixed method study

BACKGROUND: Today, dual-career couples are becoming increasingly prevalent around the world. Due to the nature of the life of this group of people, their sexual and marital life can be damaged. OBJECTIVE: The aim of this study was to develop a psycho-educational model based on the lived experiences of dual career couples who are dissatisfied with sexual relations and its effectiveness on sexual satisfaction. METHODS: This research was done based on a mixed (qualitative and quantitative) method. The qualitative part was performed using the phenomenological method and 13 couples were selected for semi-structured interviews using the purposive sampling method. In a small part of this study, a single case plan (AB plan) was used, and three couples were selected from those who referred to counseling centers in Ardabil and underwent counseling interventions. In a small part, the Sexual Satisfaction Questionnaire was used to measure the changes of couples during the implementation of the intervention program. The information obtained in the qualitative part was analyzed through content analysis and the quantitative part was analyzed using visual analysis, clinical significance and recovery percentage. RESULTS: Based on the results obtained in the qualitative analysis section, the experiences of sexual dissatisfaction of dual-career couples can be classified into 10 main themes, 20 sub-themes and 30 categories that affect the sexual satisfaction of dual-career couples. The results of the quantitative section indicate that the designed psycho-educational model has led to an increase in sexual satisfaction of dual-career couples. CONCLUSION: Achieving sexual and marital satisfaction and finally mental health and reducing divorce is a process that begins with pathology in the cultural context and is achieved by emphasizing indigenous culture through developing a counseling package for appropriate intervention by therapists and counselors.

Sexual Quality of Life-Female (SQoL-F): Cultural Adaptation and Validation of European Portuguese Version

The Sexual Quality of Life-Female (SQoL-F) questionnaire was developed with qualitative data to assess the impact of sexual dysfunction in women. Objectives: the aim was to conduct a cross-cultural adaptation and psychometric analysis of a European Portuguese version of the Sexual Quality of Life-Female questionnaire. Methods: Methodological study of the processes of translation and cultural adaptation. This is a retrospective study in which nursing students participated. Data collection: Lime Survey platform in a convenience sample was carried out in two stages, the latter being re-testing data. The instrument analysed, presented as a latent variable, consisted of 18 items on a Likert scale. The study was approved by the Ethics Committee. Participants: the sample was 113 women, mean age 21.99 years (±3.76), attending classes in the first 4 years of the first cycle of nursing. Results: Reliability was analysed and stability was found in the test–retest (rs = 0.658) and in the intraclass coefficient (rs = 0.821). The internal consistency analysis showed an alpha value of 0.846. Discriminant validity analysis using the Mann–Whitney test revealed a higher score of the quality of sexual life of students living with parents/surrogates. Factor validity analysis was conducted using Oblimin rotation with four-, three- and two-factor tests. Parallel analysis of the empirical matrix compared to the random matrix showed that the instrument was unidimensional. Conclusions: the assessment of the properties of the SQoL-F is valuable, as the provision of a valid and reliable instrument contributes to the quality of subsequent studies, including for local and multicentre research.

Sexual quality of life and sexual self-efficacy among women during reproductive-menopausal transition stages and postmenopause: a comparative study

Sexual self-efficacy is essential for appropriate and desirable sexual function and sexual quality of life. This study aimed to compare sexual quality of life and sexual self-efficacy among women during reproductive-menopausal transition stages and postmenopause. This was a cross-sectional study of a sample of Iranian women. The sexual quality of life-female (SQOL-F) scale was used to measure sexual quality of life (SQOL) and sexual self-efficacy (SSE) was measured using the sexual self-efficacy questionnaire (SSEQ). Data were compared between the study groups using multiple linear regression. In all 340 women (170 in reproductive-menopausal transition stages and 170 postmenopause) were studied. The mean ages of reproductive-menopausal transition stages and postmenopausal women was 30.8 ± 6.55 and 56.3 ± 3.54 respectively (P < 0.001). Sexual self-efficacy and sexual quality of life were found to be significantly higher in reproductive-menopausal transition stages compared with postmenopause women (P < 0.001 and P = 0.017 respectively). Sexual and relationship satisfaction and sexual repression subscales differed significantly between the two groups (P = 0.001 and P < 0.001 respectively). Higher sexual self-efficacy contributed to higher sexual quality of life (P < 0.0001). Reproductive-menopausal transition stages women appear to enjoy higher levels of sexual self-efficacy and sexual quality of life. Given the importance of sexual quality of life, it is recommended to pay greater attention to sexual self-efficacy among postmenopausal women in order to improve sexual quality of life in this population.

Increased proportion of comorbidities but no deterioration of sexual quality of life during a 5-year follow-up in patients with axial spondyloarthritis in the biologic treatment era

OBJECTIVE

To explore patient perception of sexual quality of life (SQOL), an important category of QOL, in male and female patients with axial SpA (axSpA) after a 5 year follow-up.

METHODS

A broad spectrum of demographic, disease-related, treatment and SQOL data was collected at baseline and at the 5 year follow-up. SQOL was assessed by the SQOL-Female (SQOL-F) questionnaire. For statistical analysis, McNemar's tests, paired t-tests and multiple regression analyses were applied.

RESULTS

A total of 245 axSpA patients (168 men and 77 women) from outpatient clinics were examined (mean age 46 years, mean disease duration 11.9 years at baseline). Compared with baseline, the patients had lower CRP, lower Maastricht Ankylosing Spondylitis Enthesitis Scores, lower BASFI scores, less use of smoking and significantly more patients were treated with biologic DMARDs at the 5 year follow-up. Patient perception of SQOL was basically unchanged at the 5 year follow-up despite a significantly increased proportion of comorbidities, including cardiovascular, endocrine and gastrointestinal disease. A decrease in SQOL after 5 years was observed only in patients exercising <1 h/week at baseline (P = 0.048) and in patients >65 years old.

CONCLUSION

In our axSpA patients, no statistically significant changes in SQOL were observed over 5 years, despite a significant increase in comorbidities. Overall disease symptoms decreased, indicating better disease control. Increased use of biologic drugs at the 5 year follow-up may have contributed to this favourable outcome.

The effect of counseling based on the PLISSIT model on sexual quality of life of married women with multiple sclerosis referring to MS center in 2019: a randomized, controlled trial

Multiple sclerosis is the most common progressive neurological disability in young adults. Sexual quality of life is mainly attributed to feelings of sexual attraction, showing interest and participating in sexual activity. The PLISSIT model shows 4 levels of intervention: Permission, limited Information, Specific Suggestions, and Intensive Therapy. The purpose of this study was to investigate the effect of counseling based on the PLISSIT model on the sexual quality of life of married women with multiple sclerosis referring to MS center in 2019. This randomized controlled trial study was conducted on 62 married women with multiple sclerosis. In the experimental group, based on the PLISSIT model, face-to-face counseling was conducted weekly in 4 sessions and each session lasted between 45 and 75 min. The control group received no intervention. Due to ethical issues, after completing the research, an educational guide on the quality of sexual life was given to the control group. The data collection tool was a questionnaire of sexual quality of life containing 18 questions. Data were analyzed using descriptive statistics and SPSS software. The results showed that there was no significant difference between the two groups before the intervention (P > 0.05). However, 2 weeks and 2 months after the intervention, the overall level of sexual quality of life in the experimental group was significantly better than the control group (P < 0.05). This study showed that counseling based on the PLISSIT model could have better results on the quality of life in sex.

Decreased Sexual Desire among Middle-Aged and Old Women in China and Factors Influencing It: A Questionnaire-Based Study

Objective

This survey was designed and conducted with an aim to present data on sexual desire and activity in Chinese women.

Methods

Between October 2013 and December 2013, we surveyed 3000 women (aged 40–65 years) at Beijing No. 2 Hospital and the Yuetan Community Health Service Center using a questionnaire. The primary outcomes included determination of sexual desire in the past 4 weeks, reasons for stopping sexual activity, and postmenopausal syndrome. The secondary outcome was determination of factors for low sexual desire.

Results

A total of 2400 women (mean age 54.33 ± 6.25 years; mean menopausal age 50.11 ± 3.31 years) returned the questionnaire, with 58% of women reporting lowered sexual desire and 39.3% reporting stoppage of sexual activity. Compared with the postmenopausal group, the incidence of anxiety, depressive, somatic, and vasomotor symptoms was higher in the perimenopausal group. Muscle and joint pain (45.8%) and vaginal pruritus (21.5%) were the most commonly reported menopausal and vulvovaginal symptoms, respectively. The odds of decrease in sexual desire were significantly higher with older age, menopause, presence of gynecological disease, menopausal depression symptoms, menopausal vasomotor symptoms, and vulvovaginal atrophy; only cesarean delivery (odds ratio = 0.887, P=0.018) was associated with lesser reduction in sexual desire compared with the aforementioned factors.

Conclusion

This survey showed that a high proportion of Chinese middle-aged and old women have lowered sexual desire and activity. Lack of sexual desire is associated with multiple factors and affects the quality of life of women.

Sexual Competence in Higher Education: Global Perspective in a Multicentric Project in the Nursing Degree

Sexuality is an important issue in the university careers of nursing students to ensure that they provide comprehensive care. It is necessary according to the recommendation of the World Health Organization. However, research reveals deficiencies and the need for further development. The aim of the study is to describe the perspective of teachers and students on the content of sexuality in nursing education. The project aims to analyze the attitudes and beliefs of the students about the sexuality of their patients. Furthermore, the experience and sexual lives of the future nurses, as well the teaching of sexuality content in the curriculum, will be analyzed. As for the educators, their level of knowledge about sexuality and vision of sexuality education in undergraduate nursing education will be analyzed. This study is an exploratory and descriptive study with a quantitative-qualitative approach in a multi-center context. The sample is composed of students and professors of nursing courses from five universities (Portugal, Spain, Italy and United States). Questionnaires and semistructured interviews will be used for data collection. The results of the study will allow the inclusion of sexual competence in the curriculum from the beginning in higher education. This article describes the research protocol.

Effectiveness of emotional intelligence training program on marital satisfaction, sexual quality of life, and psychological well-being of women

CONTEXT

Emotional communications play an important role in having a satisfying relationship and a more successful marriage. If marriage does not provide suitable conditions to satisfy couple's needs, not only it does not help to mental health but also results in negative and irreversible effects.

AIMS

This research was performed with the aim of determining the impact of emotional intelligence training on marital satisfaction, sexual quality of life, and psychological well-being of women.

SETTINGS AND DESIGN

The present research is an experimental study conducted on 70 women referring to community health centers of Shahid Beheshti University of Medical Sciences in 2019.

SUBJECTS AND METHODS

The sampling was performed using multistage cluster sampling. Before implementing the training intervention, the research instruments (general questionnaire, Kansas Marital Satisfaction Scale, Iranian version of Sexual Quality of Life-Female questionnaire, and World Health Organization Five Well-Being Index) were provided to the participants in order to complete them. All participants recompleted the instruments immediately and 1 month after the training intervention.

STATISTICAL ANALYSIS USED

The significance level was considered as P < 0.05.

RESULTS

The mean scores of marital satisfaction in the control group had no significant difference before, immediately after, and 1 month after the intervention (P = 0.895). However, in the intervention group, over time, the mean scores of marital satisfaction increased (P = 0.001), and the difference between the two groups was significant (P < 0.001). The mean scores of sexual quality of life and psychological well-being had no significant differences before, immediately after, and 1 month after the intervention in the control group. However, in the intervention group, over time, the mean scores of sexual quality of life and psychological well-being firstly increased and then decreased (P < 0.001), and the difference between the two groups was significant (P < 0.001).

CONCLUSIONS

Training the components of emotional intelligence can be effective on enhancing marital satisfaction, sexual quality of life, and psychological well-being of women.

Factors Conditioning Sexual Behavior in Older Adults: A Systematic Review of Qualitative Studies

The sexual behavior of older adults, especially women, has undergone changes in recent years, though there are still certain stereotypes today related to pathophysiology, beliefs, culture and tradition that negatively affect older adults’ sexual activity. The aim of our review is to present the main qualitative studies analyzing how physiological and psychosocial factors affect sexual behavior in older adults. A systematic review of these qualitative studies was carried out. All stages of this review were carried out peer-to-peer in order to guarantee minimized bias. A bibliographical search was completed between February and April 2019, in Web of Science, Scopus, PubMed Medline, PsycINFO ProQuest and CINAHL. To analyze the findings of the selected qualitative studies, a “Thematic Synthesis Analysis” was performed, using Eppi-Reviewer 4 software (UCL Institute of Education, University of London, UK). The quality of the studies was assessed with a CASP-Qualitative-Checklist. A total of 16,608 references were screened and 18 qualitative studies were included in this review. The studies involved 2603 participants across seven countries, most being women (approximately 80%). We identified a wide variety of physiological and psychological factors that can influence the sexual behavior of older adults, such as the presence of pathologies (erectile dysfunction and menopause), the strength of spiritual beliefs, and patriarchal roles upheld by upbringings conveying that women’s role is to provide men with sexual pleasure. Biological age in relation to stereotypical models of sexual behavior, emphasized as a risk factor in the contraction of sexual diseases, seems to play a relevant role as a factor limiting sexual behavior in older adults.