The purpose of this study was to determine the score of sexual quality of life-female and its relationship with sexual function and distress and other demographic variables in married clinically employed women. Exploring in all clinical occupational groups in different hospitals that can be generalized to the whole clinical community and the use of standard instruments for research was the strength of this study. The present study showed that most of the participants obtained a high mean score (indicating a favorable SQOL) from the SQOL-F questionnaire, which was similar to the results of Samimi et al. (30) and Dugan et al.(36). But, the mean score of SQOL in the study of Ahmadian et al., Which examined the relationship between sleep disorders and SQOL in rotating shift nurses (29) and the study of Cybulski et al., Which examined the SQOL in adults (6) ,was lower than the mean score of SQOL of the present study. Probably the reason for this discrepancy was the assessment only among a specific group (rotational shift nurses or adults).
The results of our study showed a strong, direct, and significant relationship between the total score of sexual function and the SQOL score and it turned out that most of the participants did not have good sexual function. More than half of people with bad sexual function did not have a good sexual quality of life, too. In 2016, Stamatiou et al. examined sexual dysfunction in 88 women aged 20 to 65 working in Greek hospitals and found that 69.31% of participants had sexual dysfunction. There was a significant difference between the sexual function scores of medical and administrative staff (P < 0.05), but there was no significant difference between the quality of life scores of the two groups (P < 0.05)(25). In that study, different instruments were used to evaluate the sexual function of individuals compared to our study, but in general, it was found that the high prevalence of sexual dysfunction among medical professionals, did not have a significant impact on the quality of life of this group of employees. In the present study, although the results showed low (bad) sexual function in most people, but totally, more than 50% of them reported a good SQOL. This can indicate that a number of items affects SQOL.
According to the results of the present study, the next item affecting the SQOL of clinically employed women was sexual distress. The results showed that there was a strong inverse and significant relationship between the total score of sexual distress and the SQOL score of the individuals. Most participants experienced less distress in sex, but the majority of the people who reported sexual distress did not have good sexual function and SQOL in their relationship either. In Jon. L. Shifren et al.'s study in
2008 surveyed Sexual Problems and Distress in United States Women, the prevalence of any age-related sexual dysfunction was 43.1%, of which 22.2% was defined as gender-related personal distress (37). Also according to the study of Witting et al. (2008), the proportion of women who reported both dysfunction and sexual distress, depends on the type of dysfunction, Was from 7–23% and women with distress or sexual dysfunction reported more maladaptation to their sexual partner than women without the disorder (21). In this regard, the present study also showed that there is a significant inverse relationship between sexual distress and sexual function scores, in a way that participants with a higher sexual distress score had worse sexual function and the greater their sexual distress was, the worse their sexual function and the poorer their SQOL was reported.
In the present study, similar to other studies, an inverse relationship was observed between aging and SQOL (29, 30), but at the age of over 50, the SQOL score had improved. According to the results of Miriam K, age was the strongest factor in the models of this study; Which was initially negatively related to the SQOL (consistent with other studies). In such a way that with increasing age, the sexual quality of life decreased, but in old age, this relationship was reversed; And it was found that the SQOL of the elderly was affected differently by the quality and not the quantity of sex. These findings show that people in old age can reduce the effect of age on SQOL by acquiring skills and strategies, especially in a positive relationship(7). The results of our study also confirm this study.
In the study of Ahmadian et al., the work experience of the participants showed an inverse correlation with the SQOL, in a way that with increasing work experience, the SQOL decreased. This can be related to their age and the occurrence of other factors such as job stress and overlapping job and family responsibilities (29). This finding has also been reported in the Samimi et al.'s study (30). In the current study, there was a significant relationship between work experience and SQOL (P = 0.001) and a higher percentage (51.5% = 52 people) of people with more than 16 years of work experience had low SQOL score. Probably the reason of the lower SQOL in this group can be related to aging.
Based on the results of the study, there was a statistically significant relationship between shift work and sleep quality at night with SQOL. Moreover, the lowest SQOL score belonged to people with fix night shifts and very poor sleep quality. Since the participants in this study were medical staff with different work shifts, including night work, and due to the low SQOL score in people with night shifts, the low SQOL score in people with very poor sleep quality can be justified. Frequent studies have shown that people with night shift jobs have trouble sleeping (23, 29). Using the Pittsburgh Questionnaire, Boughattas et al. reported that sleep quality in night shift nurses is poorer than in day shift nurses. Moreover, they showed that the quality of life of night shift nurses is lower than day shift nurses (24). In this respect, it is in line with the recent study.
In the present study, multiple linear regression analysis showed the variables of education and job type, desire, satisfaction, pain, total sexual function score, and sexual distress that had a significant relationship with the sexual quality of life score, are affecting factors in clinical employed women’s sexual quality of life. Though, based on the results of Samimi et al. only the variables of education level, duration of marriage, and sleep status were determined as predictors of women's sexual quality of life(30). Perhaps the discrepancy between their results and the present study is due to the lack of consideration of all related factors to SQOL (including sexual function and distress).
In this study, according to the sexual theme of the study, women's shyness in expressing private issues in their lives, the possibility of non-response or incorrect response to options was not far from expectation. Other limitations of this study include the use of self-reporting instruments due to under-reporting. In addition, the large number of questions and questionnaires did not provide enough time for the staff to answer the questions due to the crowded wards. For this purpose, after identifying the qualified staff with the cooperation of educational supervisors and department heads, questionnaires were distributed among the mentioned individuals along with small gifts, and the next day the researcher collected them.
It is noteworthy that few studies have been conducted on the study of variables related to the sexual quality of life in women, so the authors of this article in some cases to compare with previous studies and research had to compare the sexual quality of life with sexual dysfunction and satisfaction. Such a comparison may not be correct in all cases.