Razi Journal of Medical Sciences

fa مقایسه اثربخشی درمان ذهن‌آگاهی، پسخوراند زیستی و روش ترکیبی بر کیفیت زندگی جنسی مردان دارای انزال زودرس Comparison of the Effectiveness of Mindfulness Therapy, Biofeedback and Combined Method on Sexual Quality of Life in Men with Premature Ejaculation روانشناسی بالینی Clinical Psychiatry پژوهشي Research <div style="text-align: justify;">زمینه و هدف: زود انزالی یا انزال سریع رایج‌ترین مشکل جنسی است که اثرات روان‌شناختی زیادی بر روی رابطه همسران دارد. بنابراین، هدف از پژوهش حاضر مقایسه اثربخشی درمان ذهن‌آگاهی، پسخوراند زیستی و روش ترکیبی بر کیفیت زندگی جنسی مردان دارای انزال زودرس بود.  روش کار: روش پژوهش نیمه تجربی با طرح پیش‌آزمون- پس‌آزمون با گروه گواه بود. جامعه آماری شامل تمامی مردان دارای انزال زودرس در دامنه سنی 50-30 50-30 ساله بودند که در سال 1401 به کلینیک اختلالات جنسی نجات شهر تهران مراجعه کرده‌اند. از جامعه آماری مذکور تعداد 32 مرد مبتلا به انزال زودرس و دارای شرایط ورود به پژوهش با روش نمونه&rlm;گیری هدفمند وارد مطالعه شدند. سپس به‌صورت تصادفی در سه گروه آزمایش و یک گروه گواه (هر گروه 8 نفر) قرار گرفتند. از پرسش نامه کیفیت زندگی جنسی مردان (SQOL-M) جهت جمع‌آوری اطلاعات و به‌عنوان پیش‌آزمون، پس‌آزمون و پیگیری استفاده شد. گروه آزمایش یک، مداخله ذهن آگاهی را به مدت 8 جلسه 90 دقیقه‌ای دریافت کردند و گروه آزمایش دوم پسخوراند زیستی را به مدت  8 جلسه 20 دقیقه‌ای دریافت کردند و گروه آزمایش سوم روش ترکیبی (ترکیب دو روش ذهن آگاهی و پسخوراند زیستی) را به مدت  8 جلسه 90 دقیقه‌ای دریافت کردند؛ درحالی‌که گروه گواه آموزشی دریافت نکردند و در فهرست انتظار بودند. داده¬ها با استفاده از روش تحلیل واریانس با اندازه‌گیری مکرر و آزمون تعقیبی بونفرونی بونفرونی در نرم¬افزار SPSS23  تجزیه و تحلیل شدند. یافته‌ها: گروهها از نظر متغیرهای جمعیت شناختی تفاوت آماری معناداری نداشتند. نتایج نشان داد که بین گروههای آزمایش و گروه کنترل تفاوت معنیدار وجود داشت؛ و هر سه مداخله درمان ذهنآگاهی، پسخوراند زیستی و روش ترکیبی باعث افزایش کیفیت زندگی جنسی (93/50=F) مردان دارای زود انزالی شده و تاثیر این مداخلات درمانی در مرحله پیگیری نیز پایدار بوده است (05/0P<). همچنین، یافته‌ها نشان داد که روش درمان ترکیبی در بهبود کیفیت زندگی جنسی (70/7 =IJ) مردان دارای زود انزالی به‌طور معنی‌داری اثربخشی بیشتری از مداخله ذهن‌آگاهی و پسخوراند زیستی دارد (05/0P<). نتیجه‌گیری: با توجه به یافتههای پژوهش حاضر مداخلۀ ذهن‌آگاهی، برنامه پسخوراند زیستی و و روش ترکیبی میتوانند برای بهبود کیفیت زندگی جنسی مردان دارای زود انزالی کارآمد باشند؛ و توصیه میگردد که درمانگران و مشاوران در راستای بهبود کیفیت زندگی جنسی مردان مبتلا به انزال زودرس در کنار سایر مداخلات درمانی از این درمانها استفاده کنند. </div> <div style="text-align: justify;">Background & Aims: Premature ejaculation is the most prevalent sexual disorder, which has many psychological effects on couples' relationships (Barbonetti et al., 2019). The prevalence of the disorder is 32 to 38 percent (Gillman et al., 2019).  ; And in Iran, it is reported between 15 and 25 percent (Sarabi et al., 2022). According to the definition of DSM-5, premature ejaculation is the time less than 1 minute between vaginal entrance and ejaculation   (American Psychiatric Association, 2013). The sexual performance of men with premature ejaculation has influence on their sexual quality of life (Couto et al., 2022). The sexual quality of life includes a person's feelings and thoughts about sexual attractiveness, sexual interest and participation in sexual relations self (Salehi et al., 2022). In recent years, various treatments have been used to improve the sexual quality of life of  men with premature ejaculation (Lin et al., 2019). In this research, mindfulness therapy, biofeedback and combined method (the combination of two methods of mindfulness therapy and biofeedback) have been used. mindfulness therapy is a behavioral intervention based on attention and focus on self (Goldberg et al., 2019). The next treatment method is biofeedback, which a person is able to control by receiving feedback from self body physiological and neuropsychological symptoms and functions (Wang et al., 2019). According to the role the sexual quality of life in the lives of  men with premature ejaculation, A study is needed that examines the effect of training mindfulness therapy, biofeedback and combined method on sexual quality of life in men with premature ejaculation. to be able to consider ways to increase the sexual quality of life in men with premature ejaculation. So, the present study aimed the effectiveness of mindfulness therapy, biofeedback and combined method on sexual quality of life in men with premature ejaculation. Methods: The method of this research was semi-experimental with a pretest-posttest design with a control group. The statistical population of the research included all men 30 to 50 years with premature ejaculation referred to Nejat sexual disorders clinic in Tehran in 2022. The criteria for entering the present study included willingness to participate in the study, being in the age range of 30 to 50 years, low Sexual Quality of Life Questionnaire-Male score (less than average),  not suffering from chronic physical and psychological diseases (according to the information contained in the file), and not taking psychiatric drugs. Exclusion criteria included absent of more than two sessions in the training sessions, and receiving simultaneous treatment interventions. Based on Cohen's formula, 32 men with premature ejaculation were selected based on the entry and exit criteria and by purposive sampling. Then, using a random method, they were assigned to 4 groups (8 people) the mindfulness therapy, biofeedback and combined method. The first experimental group received the mindfulness intervention with Kabat-Zinn approach (2005) in eight 90-minute sessions, the second experimental group received the biofeedback intervention with Seo et al approach (2005) separately in eight 20-minute sessions, the third experimental group received the combined method (The combination of mindfulness and biofeedback) with Seo et al approach Engman et al (2010) in eight 90-minute sessions, and the control group was in the waiting list. The research Instrument included a Sexual Quality of Life Questionnaire-Male. The data were analyzed using repeated measure analysis of variance and Bonferroni post hoc test in SPSS23.  Results: In the present study, 32 men with premature ejaculation participated in four experimental and control groups (8 people in each group). The mean and standard deviation of age in the mindfulness therapy group was 35.40±6.69, in the biofeedback group it was 33.11±5.91, in the combined method group it was 35.14±7.52, and in the control group it was 33.73±6.16 years. In the following, the assumptions underlying the repeated measure analysis of variance were checked. First, the Kolmogorov-Smirnov test was used to investigate the normality of research variables. The Kolmogorov- Smirnov test showed that the values obtained were higher than 0.05, and the distribution of scores was normal. The results of the Levene test also indicate that the assumption of homogeneity of variances of error for research variables was verified. Finally, the results of Mauchly's W test showed that the test assumption was established concerning the significance level. Therefore, the use of the repeated measure analysis of variance was unimpeded. The results in Table 1 showed that there was a significant difference between the experimental groups and the control group. Also, the mindfulness therapy, biofeedback and combined method interventions had a significant positive effect on the sexual quality of life of men with premature ejaculation (P<0.05). Finally, Bonferroni post hoc test was used for comparing the experimental groups and control group. The results are reported in Table 2. Based on the results in Table, The mean difference of the combined method group in sexual quality of life variable was more than the mindfulness therapy group and the biofeedback group (P<0.05).    Conclusion: This study aimed to the effectiveness of mindfulness therapy, biofeedback and combined method on sexual quality of life in men with premature ejaculation. The repeated measure analysis of variance showed that interventions had a significant effect on the sexual quality of life of men with premature ejaculation. The results of Bonferroni post hoc test showed that the effectiveness of combined method on sexual quality of life was more than mindfulness therapy and biofeedback. The result is consistent with Omidvar et al (2021), Ahmadi et al (2019), Derakhshan (2018), Ramesh et al (2016), Stanton et al (2019), Stanton et al (2020), and Stephenson et al (2020) studies. It is concluded that men with premature ejaculation became aware of mindfulness therapy, biofeedback and combined method techniques, and they were asked to apply the techniques that were introduced in this methods to the problems. Therefore, their sexual quality of life increased.</div> درمان ذهن‌آگاهی, پسخوراند زیستی, روش ترکیبی, کیفیت زندگی جنسی, انزال زودرس Therapy, Biofeedback, Combined Method, Sexual Quality of Life, Premature Ejaculation 1 12 http://rjms.iums.ac.ir/browse.php?a_code=A-10-7656-2&slc_lang=fa&sid=1 Mehdi Sarafraznasab مهدی سرافرازنسب 3900319475328460088367 0009-0002-6877-6385 No PhD Student, Department of Psychology, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran دانشجوی دکتری، گروه روانشناسی، واحد شهرکرد، دانشگاه آزاد اسلامی، شهرکرد، ایران Reza Ahmadi رضا احمدی rozgarden28@yahoo.com 3900319475328460088368 3900319475328460088368 Yes Associate Professor, Department of Psychology, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran دانشیار، گروه روانشناسی، واحد شهرکرد، دانشگاه آزاد اسلامی، شهرکرد، ایران Ahmad Ghazanfari احمد غضنفری aghazan5@yahoo.com 3900319475328460088369 3900319475328460088369 No Associate Professor, Department of Psychology, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran دانشیار، گروه روانشناسی، واحد شهرکرد، دانشگاه آزاد اسلامی، شهرکرد، ایران Sarah Moghdisi سارا مقدسی 3900319475328460088370 0009-0002-6877-6385 No Bachelor degree, Department of Psychology, Kharazmi University, Tehran, Iran کارشناسی، گروه روانشناسی، دانشگاه خوارزمی، تهران، ایران