The Effect of Hippotherapy on Quality of Life in Women with Multiple Sclerosis

Abstract

INTERVENTION: Intervention 1: Women with multiple sclerosis in the intervention group will receive Face‐to‐Face sexual health education in six sessions ‐90 minutes for 6 weeks with lecture, question‐and‐answer, and role‐playing methods. The sexual health promotion package was designed in 6 steps. 1‐ Identifying the related factors of sexual function of these women in a cross‐sectional study, 2‐ Conducting a qualitative study to explaining sexual function and its related factors in women with MS by conducting interviews with patients and key informants includes psychologists, neurologists, reproductive health, sexologists and a spouse, 3‐ Integrating quantitative and qualitative results using side‐by‐side method, 4‐Designing sexual health promotion strategies in these patients based on Integration results and literature review, 5‐ Prioritizing these strategies in a experts panel 6‐Using these strategies in designing a sexual health promotion package. These packages is based on the patients' needs and includes content for patients to learn about and deal with the psychological, physical, sexual symptoms of disease that affect sexual function, as well as education the communication and negotiation skills with the spouse, problem‐solving, education and counseling to enhance sexual intimacy, progressive muscle relaxation, self‐esteem, etc. Intervention 2: Control group: Women in the control group will not receive any intervention by the research team during the study. This group will attend a one‐day sex education workshop and receive a sexual health education package. CONDITION: Multiple Sclerosis. ; Multiple sclerosis PRIMARY OUTCOME: Sexual function. Timepoint: Before the intervention, immediately after the intervention and two months after the intervention. Method of measurement: Multiple Sclerosis Intimacy and Sexuality Questionnaire‐19 (MSISQ‐19). Sexual Quality of life. Timepoint: Before the intervention, immediately after the intervention and two months after the intervention. Method of measurement: sexual quality of life‐female (SQOL‐F) questionnaire. INCLUSION CRITERIA: Iranian Age of 18 to 50 years old Being married Confirmed diagnosis of MS by a neurologist based on McDonald's criteria Have sexual activity during the last six months In a stage of the disease, that is possible for her to perform routine activities including having a sexual relationship with her spouse (EDSS <7) Not pregnant or breastfeeding Selecting “oftenâ€� or “alwaysâ€� options in at least one question from the MSISQ‐19 Have no severe depression or severe fatigue (score less than 29 in the BDI‐II and score less than 5/1 in the FSS)