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一项基于群组的虚拟正念干预措施,针对低性欲的中年和老年女性,在一项随机对照试点研究中降低了性困扰。

A virtual, group-based mindfulness intervention for midlife and older women with low libido lowers sexual distress in a randomized controlled pilot study.

机构信息

Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15217, United States.

Department of Obstetrics and Gynecology, University of British Columbia, Vancouver V5Z 4M2, Canada.

出版信息

J Sex Med. 2023 Jul 31;20(8):1060-1068. doi: 10.1093/jsxmed/qdad081.

Abstract

BACKGROUND

Distressing low libido is common among women and has significant negative impacts; mindfulness has shown promise to increase sexual desire in women with low libido, but existing interventions are not tailored to midlife and older women.

AIM

We adapted a mindfulness intervention to meet the needs of this population and conducted a pilot randomized controlled trial to assess feasibility and acceptability.

METHODS

Women aged ≥45 years with low libido were randomized to the mindfulness intervention or an education group that met over videoconferencing. The intervention included mindfulness instruction and practice, group discussion, and education on sexuality and aging. The education group included general information on menopause and health.

OUTCOMES

We defined feasibility by the number of screened women who enrolled and completed their group. We defined acceptability as satisfaction with the group and likelihood of recommending it to another woman with low libido. We assessed sexual function (Female Sexual Function Index) and sexual distress (Female Sexual Distress Scale-Revised) at 6 weeks postconclusion.

RESULTS

Of 81 women screened, 31 were randomized to mindfulness and 30 to education. Eighteen women in the intervention group and 23 in the control group attended at least 1 session. Time conflict was the main reason for nonattendance. Of the 41 women who started attending groups, 37 (90%) attended at least 5 sessions. In the mindfulness group, 73% of women were very or extremely satisfied. Women in the mindfulness group were more likely to recommend it to another person with low libido as compared with those in the education group (P = .031); 67% said that they would probably or definitely recommend it. There were no significant changes in sexual function in either group (mean Female Sexual Function Index score, 22.6 to 18.6 [P = .101] with mindfulness and 21.2 to 19.7 [P = .537] with education). Women in the mindfulness group had significant improvements in sexual distress (mean Female Sexual Distress Scale-Revised score, 27.1 to 19.7; P = .021) while women in the education group did not (19.0 to 15.8; P = .062).

CLINICAL IMPLICATIONS

Mindfulness may reduce sexual distress in older women with low libido.

STRENGTHS AND LIMITATIONS

This is the first trial testing mindfulness for midlife and older women with low libido.

CONCLUSION

A virtual mindfulness intervention for midlife and older women with low libido is feasible and acceptable and appears to improve sexual distress as compared with an education control; these findings provide data that can be used to design a larger clinical trial.

摘要

背景

性欲低下在女性中很常见,且会带来严重的负面影响;正念已被证明可提高性欲低下女性的性欲,但现有的干预措施并不针对中年和老年女性。

目的

我们改编了正念干预措施以满足这一人群的需求,并开展了一项试点随机对照试验以评估其可行性和可接受性。

方法

我们招募了年龄≥45 岁、性欲低下的女性,将其随机分配至正念干预组或通过视频会议进行的教育组。正念干预包括正念指导和实践、小组讨论以及关于性和衰老的教育。教育组包括关于绝经和健康的一般信息。

结果

在 81 名接受筛查的女性中,有 31 名入组并完成了分组。我们将可行性定义为参加分组并完成分组的筛查女性数量,将可接受性定义为对分组的满意度和向另一名性欲低下的女性推荐分组的可能性。我们在试验结束后 6 周评估了女性的性功能(女性性功能指数)和性困扰(女性性困扰量表修订版)。

结果

在 81 名接受筛查的女性中,有 31 名入组并完成了分组。我们将可行性定义为参加分组并完成分组的筛查女性数量,将可接受性定义为对分组的满意度和向另一名性欲低下的女性推荐分组的可能性。我们在试验结束后 6 周评估了女性的性功能(女性性功能指数)和性困扰(女性性困扰量表修订版)。在 81 名接受筛查的女性中,有 31 名入组并完成了分组。我们将可行性定义为参加分组并完成分组的筛查女性数量,将可接受性定义为对分组的满意度和向另一名性欲低下的女性推荐分组的可能性。我们在试验结束后 6 周评估了女性的性功能(女性性功能指数)和性困扰(女性性困扰量表修订版)。在干预组中,有 73%的女性非常满意或极其满意。与教育组相比,正念组的女性更有可能向另一名性欲低下的女性推荐该组(P=0.031);67%的女性表示她们可能或肯定会推荐。两组的性功能均无显著变化(平均女性性功能指数评分,正念组从 22.6 降至 18.6[P=0.101],教育组从 21.2 降至 19.7[P=0.537])。正念组女性的性困扰显著改善(平均女性性困扰量表修订版评分,从 27.1 降至 19.7;P=0.021),而教育组女性则无显著变化(从 19.0 降至 15.8;P=0.062)。

临床意义

正念可能会减轻中年和老年性欲低下女性的性困扰。

优势与局限

这是第一项针对中年和老年性欲低下女性的正念试验。

结论

针对中年和老年性欲低下女性的虚拟正念干预是可行且可接受的,与教育对照组相比,该干预似乎可改善性困扰;这些发现提供了可用于设计更大规模临床试验的数据。

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