Bagherinia Marzieh, Dolatian Mahrokh, Mahmoodi Zoherh, Ozgoli Giti, Majd Hamid Alavi, Haseli Arezoo
Reproductive Health, Clinical Research Development Center, Motazedi Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Reprod Health. 2025 Jun 5;22(1):96. doi: 10.1186/s12978-025-02050-w.
Suburban women are often recognized as a vulnerable group in terms of health and access to related services. This study aimed to design and test a model of social determinants of health affecting the sexual quality of life (SQOL) of marginalized women, based on the World Health Organization (WHO) framework.
This descriptive-analytical study was conducted in two phases. In the first phase, a conceptual model was developed using literature review and expert consensus. In the second phase, the model was tested in a cross-sectional study involving 560 randomly selected married women of reproductive age from marginalized areas of Kermanshah, Iran (2021–2023). The data were collected using the demographic questionnaire, the Sexual Quality of Life-Female (SQOL-F), the Socioeconomic Status Scale, the Mental Health, Domestic Violence, the Unhealthy Behavior Checklist, the General Health Questionnaire (GHQ), the Female Sexual Function Index (FSFI), Enrich Marital Satisfaction Scale (EMS), the Perceived Social Support Scale (PSSS), the Spiritual Health (SH), the Self-Esteem Scale, the Genital Self-Image Scale, the Access to Health Questionnaire, and the International Physical Activity Questionnaires (IPAQ). The data were analyzed in SPSS and LISREL 8.
Based on the results of the path analysis and the presented model, among the structural factors of the socio-economic status (β = 0.46), among the intermediate factors is the self-esteem (β = 0.52) and among the contextual factors, duration of marriage (β=-0.22) had the strongest overall causal and significant relationship with the quality of sexual life in marginalized women.
The designed model highlights the current status of quality of sexual life of marginalized women and reveals the related gaps and challenges. Therefore, policy makers can utilize these results as a guide for future planning. In addition, the results can help researchers to design appropriate clinical trials to improve the quality of sexual life of the target population.
郊区妇女在健康及获得相关服务方面常被视为弱势群体。本研究旨在基于世界卫生组织（WHO）的框架，设计并测试一个影响边缘化妇女性生活质量（SQOL）的健康社会决定因素模型。
本描述性分析研究分两个阶段进行。第一阶段，通过文献综述和专家共识建立一个概念模型。第二阶段，在一项横断面研究中对该模型进行测试，该研究涉及从伊朗克尔曼沙赫边缘化地区随机选取的560名育龄已婚妇女（2021 - 2023年）。使用人口统计学问卷、女性性生活质量量表（SQOL - F）、社会经济地位量表、心理健康、家庭暴力、不健康行为清单、一般健康问卷（GHQ）、女性性功能指数（FSFI）、婚姻满意度丰富量表（EMS）、感知社会支持量表（PSSS）、精神健康（SH）、自尊量表、生殖器自我意象量表、获得健康问卷和国际身体活动问卷（IPAQ）收集数据。数据在SPSS和LISREL 8中进行分析。
基于路径分析结果和所提出的模型，在社会经济地位的结构因素中（β = 0.46），在中间因素中自尊（β = 0.52），在背景因素中，婚姻持续时间（β = -0.22）与边缘化妇女的性生活质量总体因果关系最强且具有显著相关性。
所设计的模型突出了边缘化妇女性生活质量的现状，并揭示了相关差距和挑战。因此，政策制定者可将这些结果作为未来规划的指导。此外，这些结果可帮助研究人员设计适当的临床试验以改善目标人群的性生活质量。
