Effect of Psychosexual Counseling Based on the Schover Bio-Psycho-Social Model on Sexual Self-Concept and Sexual...

Hysterectomy may lead to psychological and sexual challenges that extend beyond physical recovery. This randomized controlled trial evaluated the effect of psychosexual counseling based on the Schover bio-psycho-social model on sexual self-concept (primary outcome) and sexual distress among women after hysterectomy.

In this parallel randomized controlled trial, 100 married women aged 18-49 years who had undergone total or subtotal hysterectomy for benign conditions were randomly assigned (1:1) to an intervention group receiving four weekly 90-min group counseling sessions based on the Schover model or to a control group receiving routine postoperative care. Sexual self-concept (MSSQ-SF) and sexual distress (FSDS-R) were assessed at baseline and 1-month post-intervention. Analysis of covariance (ANCOVA) adjusted for baseline scores was performed (SPSS v22; α = 0.05).

After adjustment, significant between-group differences were observed. The intervention group showed higher adjusted mean sexual self-concept scores compared with controls (51.3 vs. 44.0), F _{(1, 97)} = 45.82, p < 0.001, η²ₚ = 0.32 (95% CI = [0.19, 0.46]). Sexual distress scores were significantly lower in the intervention group than in controls (29.1 vs. 42.0), F _{(1, 97)} = 53.21, p < 0.001, η²ₚ = 0.35 (95% CI = [0.22, 0.48]).

Psychosexual counseling grounded in the Schover bio-psycho-social model significantly improved sexual self-concept and reduced sexual distress among women after hysterectomy. Incorporating structured psychosexual counseling into postoperative care may support sexual rehabilitation in this population.