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۴۷

چکیده

درک بیشتر از اختلال میل/ برانگیختگی جنسی با استفاده از بررسی تجارب این بیماران سرنخ های زیادی را برای پیدا کردن آنچه این اختلال را به وجود می آورد و آنچه برای درمان به آن نیاز است، در اختیار می گذارد. بدین منظور پژوهش حاضر با هدف بررسی تجارب زیسته زنان مبتلا به اختلال میل/ برانگیختگی جنسی انجام شد. طرح پژوهش کیفی و با استفاده از روش پدیدارشناسی صورت گرفت. مشارکت کنندگان شامل 30 نفر از زنان مبتلا به اختلال میل/ برانگیختگی جنسی مراجعه کننده به مراکز خدمات روان شناختی شهر اصفهان بودند که به روش مبتنی بر هدف و بر اساس قانون اشباع داده انتخاب شدند. ابزار پژوهش مصاحبه حضوری نیمه ساختاریافته بود. بر حسب نتایج، تجارب این بیماران در 5 مقوله محوری عوامل فردی با مضامین اصلی (ویژگی های روان شناختی، نگرش های ناکارآمد و فقدان مهارت)، ناکارآمدی زندگی زناشویی با مضامین اصلی (فرایند ازدواج، تعارضات زناشویی، همسر بازدارنده و ناهخوانی جنسی)، عوامل محیطی اجتماعی با مضامین اصلی (عوامل فرهنگی اجتماعی، تاریخچه رشدی و سبک زندگی ناسالم)، پیامدها و ملاحظات درمانی (با مضامین اصلی موانع و محدودیت های درمان، عوامل تسهیل گر و انتظارات و خواسته های درمانی) به دست آمد.

Lived experiences of women with sexual arousal disorder; A qualitative study

Introduction Low sexual desire is the most commonly reported and diagnosed sexual problem among women and the most frequent reason that the couples lokking for sex therapy (Thomas & Gurevich, 2021). Female sexual interest/arousal disorder (FSIAD) is characterized by low sexual desire, few/no sexual thoughts, no initiation of sexual behavior and lack of: receptivity to partner initiation, pleasure during sexual activity, responsive desire to erotic cues, and difficulties with physical sexual arousal (American Psychiatric Association, 2022). At least 3 of these symptoms must persist for a minimum of 6 months Studies show that women with HSDD experience significant declines in their physical health (general health, physical functioning, and bodily pain) and psychological well-being (social functioning, emotional role, and mental health). Women's sexual discomfort is associated with low relationship satisfaction and the partner's sexual problems (Lim-Watson, Hays, Kingsberg, Kallich and Murimi-Worstell, 2022). Also, women who have distress in addition to sexual interest/arousal disorders, had lower psychological well-being, lower relationship satisfaction, two person relationship s, more severe libido disorders, and more sex dysfunction (Hendrickx, Janssen and Enzlin, 2016). Compared to partners of women coping with sexual dysfunction, partners of women with FSIAD report lower sexual and intercourse satisfaction and more sexual discomfort and partnered women with FSIAD report greater distress than their unpartnered counterparts (Hogue, Rosen, Bockaj, Impett, and Muise, 2019 ). The etiology of FSIAD is multifactorial and includes biological, psychological, and interpersonal and sociocultural factors (McCarthy, Koman and Cohn, 2018). Although FSIAD is described in the DSM-5 and ICD-10, these descriptions are not based on systematic qualitative description and review of patients' reported problems. Studies conducted on psychiatric patients have also shown that many of these patients believe that the description of disorders is focused on the external symptoms of the disease and pay little attention to their internal experiences. In many cases, the diagnostic description is far from what the patients understand about their physical, emotional and psychological experiences, and they have a feeling of being incomprehensible or neglected. Although understanding the diagnostic criteria is beneficial, therapists should know that these criteria do not accurately reflect the patient's inner world (Hackmann, Balhara & et al, 2019). According to these cases, it seems necessary to use the lived experiences of patients in every treatment process and especially in the design of treatment for FSIAD. Methods and Materials The present study was qualitative and using descriptive phenomenological approach. Participants included 30 women with FSIAD referred to psychological service centers in Isfahan who were selected by purpose - based method and according to theoretical saturation . The research instrument was a semi - structured interview. Interviews with open - ended questions "Describe your experiences of sexual desire disorder? " and " What changes has this disease caused in your life ? " It started and the next questions were asked based on the interview path and the answers of the interviewees. The duration of the interview lasted between 45 and 90 minutes. To analyze the data, Collaizi analysis method was used. Thus , after interviewing the participants of the research , the text of the conversations was rewritten word for word and reviewed several times in order to understand the experiences and perceptions of the participants . In the second step, information related to the purpose of the research was specified. In the third stage, in order to formulate meanings and extract concepts, the important phrases of each interview were identified and an attempt was made to extract a concept from each phrase that represented the key concepts of the p

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