Comments: Pazitsanzo zazikuluzikuluzi, kulolerana (kuchuluka kwa zolaula zomwe zimayambitsidwa ndi kusangalala) ndikuchotsa zokhudzana ndi "chiwerewere chovuta" (kugonana / zolaula). Mkulu libido sanali! Ofufuzawo akuti opereka chithandizo chamankhwala amayang'ana kwambiri kutaya chisangalalo, zizindikiritso zakudzipatula ndi zovuta zina, osati pafupipafupi kapena pagonana. YBOP yakhala ikunena izi kwazaka zambiri. Sikuti aliyense amene ali ndi vuto logonana lomwe limayambitsa zolaula amakhala osokoneza bongo, ngakhale ena mwaubongo womwewo amasintha (mwachitsanzo, kulimbikitsa) mosakayikira amapezeka m'magulu onse awiriwa. Komanso, ochita kafukufuku akuwoneka kuti akuganiza kuti omwe ali ndi vuto lalikulu (omwe adanenapo za "vuto lalikulu la chiwerewere") sangakhudzidwe ndi zolaula zawo. Izi zitha kukhala zopanda chiyembekezo. Kubwezeretsa ogwiritsa ntchito zolaula nthawi zambiri amafotokoza kuti mavuto amakula pakapita nthawi. Pomaliza, "chidwi chachikulu" chokhudza zolaula chinaneneratu kuti chikufuna thandizo ... zomwe zikusonyeza kuti manyazi akugonana sakuyendetsa iwo omwe akufunikira thandizo.
Kudalirika
Kafukufukuyu adayang'ana kuwunika kuphatikiza kwa zizindikiritso zamavuto okhudzana ndi chiwerewere (PH), pakafukufuku (n = 58,158) omwe akuwatsata anthu akudzifunsa ngati ali osokoneza bongo. Kafukufukuyu adaloleza kuyesa kwamitundu itatu yamalingaliro omwe amagwiritsidwa ntchito polemba PH. Kusanthula kwama factor kwa azimayi ndi abambo kunapereka gulu lotanthauzira lazizindikiro lomwe lili ndi zinthu zinayi. M'mabuku ena obwera pambuyo pake, zinthu izi zidagwiritsidwa ntchito ngati olosera zakusowa kwa thandizo la PH. Zomwe zimayambitsa zoyipa komanso zoopsa zimaneneratu zakusowa thandizo, ndi zoyipa monga cholosera chofunikira kwambiri kwa amayi ndi abambo. Izi zidaphatikizaponso, mwa zina, zizindikiritso zakudzipatula komanso kutaya chisangalalo. Zomwe Zolakalaka Zogonana zidaneneratu molakwika kufunika kwa chithandizo, ndikuwonetsa kuti kwa anthu omwe akuwatsata chilakolako chogonana chimabweretsa zochepa PH. A Coping factor sananeneratu kuti adzafunika thandizo. Zotsatira zikuwonetsa kuti kuphatikiza kwa zizindikilo kuchokera ku mitundu yosiyanasiyana ya zamalingaliro kumawonetsa bwino kupezeka kwa PH. Chifukwa chake, chida choyezera kuwunika kukhalapo ndi kuuma kwa PH kuyenera kukhala ndi kuphatikiza koteroko. Mwachidziwitso, kafukufukuyu akuwonetsa kuti mtundu wofunikira kwambiri wa PH ndiwofunikira, kuposa malingaliro omwe alipo a PH.
1. Introduction
Kugonana kwamavuto (PH) kumatha kufotokozedwa ngati kukumana ndi mavuto chifukwa chazakugonana komanso / kapena chizolowezi chogonana pafupipafupi, kutanganidwa, malingaliro, malingaliro, zolimbikitsa, kapena malingaliro osatheka kuwongolera [1,2]. Kuchuluka kwa PH kuyerekezeredwa kuti ndi ochepera 2% ya anthu [3], ndi kuyerekezera m'magawo ena ochepa mpaka 28% [4,5]. Kufalikira kowirikiza kawiri kapena katatu mwa amuna kuposa akazi kwapezeka [3,6]. Kukhalapo kwa PH komanso kuthekera koti athe kupeza PH kumatsutsana kwadzaoneni [7,8,9,10]. Makamaka, zomwe zimapangitsa kuti munthu adziwe matendawa zimatsutsidwa, ndipo ena amati matenda opatsirana a PH amangofotokoza za kugonana kosavomerezeka [11]. Ngakhale panali zovuta kutanthauzira PH, momwe kuwunika komwe kukukumana nako kukuchitira umboni [12,13,14,15], asing'anga awonetsa kuti vutoli limadziwika bwino ndi makasitomala awo [16,17,18], zikhale zodwala kapena ayi. Chifukwa cha kusokonezeka kwamalingaliro ndi kusowa kwa kafukufuku, atha kukhala molawirira kwambiri kuti afotokozere za chipatala. Chifukwa chake, tanthauzo logwira ntchito la PH lomwe tafotokoza pamwambapa limatanthauza zovuta zamakhalidwe [12] kuposa kuchipatala.
M'zaka zaposachedwa, mitundu ina yotsutsana yaumulungu yakhazikitsidwa kuti ikhazikitse PH ngati matenda azachipatala. Njira zenizeni zodziwitsira zakonzedwa potengera mitundu itatu iyi. PH imawonedwa ngati (1) chizolowezi chogonana [19,20,21,22,23,24], (2) matenda opatsirana pogonana [25,26,27], kapena (3) kukakamizidwa kuchita zachiwerewere [28,29]. Kugonana monga matenda opatsirana kumadziwika ndi zizolowezi zauchizolowezi, monga kutanganidwa, kusokonezedwa ndi machitidwe azakugonana tsiku ndi tsiku, kulephera kusiya, kupitiliza ngakhale zovuta, kulekerera, komanso zizindikiritso zakutha [23,24]. Matenda a Hypersexual akuti adanenedwa, kenako nkuwakanidwa, ngati matenda a DSM-5. Mtundu wake wodziwitsa uli ndi njira zingapo zakugonana, ngakhale sizili kulolera komanso kusiya [25]. Kutengera kafukufuku wodziwika [30], njira zogonana zogwiritsidwa ntchito kupirira [25] (zofunikira A2 ndi A3) zidaphatikizidwa ngati gawo la matenda opatsirana pogonana. Ngakhale kukanidwa kwa matendawa kuti aphatikizidwe mu DSM-5 [31], muyeso wokhala ndi zinthu zothana ndi vuto limakhalabe gawo la Hypersexual Behaeve Inventory [32], chida chomwe chimakonda kugwiritsidwa ntchito poyesa PH. Kuchuluka kwa anthu ochita zachiwerewere omwe amapezeka ndi chida ichi [4,33] akuwonetsa kuti mayanjano pakati pa kuthana ndi chiwerewere amathanso kukhala ovuta kwa anthu ena omwe sanakhudzidwe kwambiri ndi PH. Matenda osokoneza bongo, matenda omwe angolandiridwa kumene a ICD-11 [28], amasiyana ndimatenda omwe amapezeka pakugonana makamaka pakuphatikiza kwa chizindikiro chimodzi ndi malangizo. Chizindikirocho chimatsindika kupitiliza kwa machitidwe obwereza ogonana ngakhale kutaya chisangalalo [28]. Maupangiriwa akuyenera kuchenjeza za kupambanitsa, makamaka zakutanganidwa ndi kugonana [28] ndi mavuto okhudzana ndi kudzimva kuti ndi wolakwa komanso manyazi [29].
Njira zingapo zomwe zagwiritsidwa ntchito m'mitundu itatu yoyezera matenda a PH sizinaphunzire mokwanira. Criterium ya kutayika kwachisangalalo sinakufufuzidwe konse; kufalikira kwakukulu kwa kulolerana ndi zizindikiritso zopezeka kunapezeka pakati pa odwala ndi odwala omwe amalandila chithandizo chokhudzana ndi kugonana [23], koma mu kafukufuku m'modzi wofufuza izi, gulu lofanizira lomwe silinakhudzidwe ndi PH silinaphatikizidwe. Vuto lofananirako lakapangidwe kafukufuku limapezeka m'maphunziro angapo okhudzana ndi kugonana ndi PH pomwe zotsatira zake zimanenanso kuti, mofananamo ndi chizolowezi chomwa mankhwala osokoneza bongo, kuchuluka kwakanthawi kogonana kumaneneratu za kuchitika kwa PH [34,35,36]. Komabe, pamene magulu ofananira oyenerera anaphatikizidwa m'maphunziro akulu, magwiridwe antchito apamwamba sanasiyanitse pakati pa PH ndi chilakolako chachikulu chogonana popanda kupsinjika [37,38]. Zotsatira zotsutsanazi zokhudzana ndi mayendedwe azakugonana zikusonyeza kuti (1) kuchuluka kwa PH kudzapezeka mwa anthu wamba pakati pa omwe ali ndi chiwerewere chambiri [36,37,38] ndikuti (2) mwa iwo omwe kungakhale koyenera kudziwa ngati ali pachiwopsezo cha PH, kuchuluka kwakugonana sikungakhale chisonyezo chosankha [39]. Izi siziphatikizapo kapena kupatula kuchuluka kwakanthawi kwakugonana ngati gawo la matenda a PH, koma zikuwonetsa kuti kuchuluka kwakanthawi kogonana sikungagwiritsidwe ntchito posankha PH kuchokera kuzinthu zina, zosagwirizana ndi zochitika, makamaka pafupipafupi kwambiri popanda zovuta.
Pakafukufuku wofufuza za intaneti yayikulu kwambiri, gawo loyamba limatengedwa kuti zitsimikizire kuti ndi mitundu iti yazithunzithunzi zosiyanitsa zomwe ndizosiyanitsa PH ndi zina. Zizindikirozi zidzakhala ndi mphamvu yayikulu yosankha ndipo zithandizira kukhala zodalirika [40,41] kuti mumvetsetse ndikuyesa PH. Chifukwa chake, cholinga chofunikira kwambiri phunziroli ndikuwunika ndikuyesa mawonekedwe osiyanasiyana ndikukhazikitsa zomwe zingagwiritsidwe ntchito bwino kuyesa PH. Pachifukwa ichi, timagwiritsa ntchito chitsanzo chomwe magulu ang'onoang'ono angayerekezeredwe [42]. Kuphatikiza apo, tikufuna kuti tifufuze ngati kuchuluka kwa zizindikiritso zomwe zilipo mwa anthu kumawonjezera mwayi woti athe kupeza thandizo la PH. Ngati ndi choncho, zikuwonetsa kuti zizindikilozi zitha kukhala gawo la chida chomwe sichimangokhala ndi tsankho komanso chitha kuyeza kuuma kwa PH. Powuma pang'ono, kuwunika kwa njira zothandizira kutha kuchitidwa ndipo kupita patsogolo kwachipatala kumatha kuyesedwa [43]. Phunziroli, chidwi chapadera chidzaperekedwa pakusiyana pakati pa amuna ndi akazi chifukwa sizingaganizidwe kuti amayi ndi abambo amakumana ndi PH chimodzimodzi.
2. Zida ndi njira
2.1. Chiwerengero cha Anthu
Ku Netherlands, kuda nkhawa ndi kuchuluka kwa anthu ogonana [44] zidapangitsa kuti pakhale kafukufuku papulatifomu yapaintaneti yothandizidwa ndi amisala, www.sekwede.nl, yemwe anali ndi nthawi yosonkhanitsa deta ndi PsyNed, Psychologen Nederland (Psychologists Netherlands) ndipo ali ndi NCVS, Nederlands Centrum Voor Seksverslaving (Dutch Center for Sex Addiction). Kafukufukuyu adalunjika kwa iwo omwe akukayikira zakusokonekera ndikugonana ndipo cholinga chake chinali kupatsa ophunzirawo kudziyesa koyamba za momwe angakhalire PH. Monga momwe mawu oti "chizolowezi chogonana" ayenera kuti amatanthauza zambiri kwa omwe akutenga nawo mbali, ena mwa iwo amaphatikizapo kupsinjika pomwe ena amangofotokoza zakusagonana kosakondera [38], titha kuyembekezeranso kuti omwe sanazunzidwe ndi PH, koma ali ndi chilakolako chofuna kugonana popanda kupsinjika, adzafuna kudziwa kuchokera ku kafukufukuyu.
2.2. Kafukufuku ndi Zitsanzo
Kafukufuku yemwe adapeza kafukufukuyu adapeza mayankho a omwe anali nawo 58,158 pakati pa Julayi 2014 ndi Julayi 2018. Cholinga choyamba cha kafukufukuyu chinali kupereka mayankho kwa omwe atenga nawo gawo pa PH. Asanachite kafukufukuyu, ophunzirawo adadziwitsidwa kuti zomwe adapeza zitha kugwiritsidwanso ntchito pakafukufuku wasayansi. Zambiri sizinatoleredwe ndi njira yakufufuzira m'malingaliro, ndipo kafukufuku wapano wakhazikitsidwa pambuyo posonkhanitsa deta. Zomwe zidasanjidwazo zidasankhidwa ngati zachiwiri, phunziroli limawerengedwa kuti silivomerezedwa ndi komiti yovomerezeka ya Open University Netherlands. Pofuna kuteteza anthu osadziwika, ma adilesi a IP sanalembedwe koma adasinthidwa kukhala nambala yosadziwika. Kafukufuku womaliza analibe chidziwitso chomwe chingapezeke kwa omwe atenga nawo mbali. Kafukufuku wokwanira kwathunthu adasungidwa kuti awunikidwe, koma sanaphatikizidwe pomwe (1) omwe anali mgulu la 17−21 kapena ocheperako (n = 17,689) chifukwa kuvomerezedwa ndi makolo sikungapezeke, (2) omwe adatenga nawo mbali adawonetsa kuti amaliza kafukufukuyu kwa wina (n = 3467), ndi (3) ma adilesi a IP sanagwiritsidwe ntchito koyamba (n = 3842). Pazonse, 33,160 omaliza omaliza adaphatikizidwa pakupenda, komwe 25,733 (77.8%) adadzazidwa ndi amuna ndi 7427 (22.4%) ndi akazi. Ponseponse, 7583 (22.9%) omwe adatenga nawo gawo awonetsa chidwi chofuna thandizo la PH. Kusanthula koyambirira kwa nkhokwe yomweyi kudasindikizidwa mu Dutch [39]; kusanthula kumeneku sikunagwiritse ntchito kapangidwe kameneka kafukufuku waposachedwa ndi kusanthula kwapadera kwa amayi ndi abambo.
2.3. Kafukufuku Wofufuza
Kufufuzaku kuyenera kuwonedwa ngati kofufuzira chifukwa zomwe adazipeza zisanakhazikitsidwe. Izi zikutanthauza kuti mawonekedwe ndi kuchuluka kwa zinthu zomwe zagwiritsidwa ntchito mu kafukufukuyu sizikanatsimikiziridwa kale ndi ofufuza. Ngakhale zili choncho, zinthu zingapo zofunikira zokhudzana ndi PH zaphatikizidwa mu kafukufukuyu, pofotokoza zofunikira za mitundu itatu yodziwira za PH. Ponena za kutsimikizika kwa zotsatira za kafukufukuyu, kafukufuku wotsimikizira adzafunika kuti apitilize kufufuza zomwe apeza. Kafukufukuyu atapeza kuyankha kwakukulu kwa omwe akutenga nawo gawo pazakugonana, chitsanzochi chitha kuwerengedwa kuti ndichapadera pa kafukufuku wa PH chifukwa nthawi zambiri zimakhala zovuta kusonkhanitsa zambiri kuchokera kwa omwe akutenga nawo mbali ndi PH (mwachitsanzo, [36]). Pofufuza zitsanzo za omwe akutenga nawo mbali okayikira zakusilira chizolowezi chogonana, timangokhala ochepa [42] kwa omwe ayenera kudula okwanira ayenera kukhazikitsidwa, chifukwa ndi gulu ili lomwe chiopsezo chodziwitsidwa bwino ndichachikulu kwambiri ndipo zotulukapo zosazindikira ndizowopsa kwambiri [45]. Ngakhale kulibe chitsimikizo kuti kuchuluka kwa anthu omwe amafufuzidwako kulidi kwa iwo omwe akukayikira za msinkhu wawo wogonana, kuyambitsa kwa kafukufukuyu kumatsindika momveka bwino cholinga chake monga kudziyesa koyamba kwa omwe akutenga nawo gawo pazakugonana; kumaliza kafukufukuyo, komwe kumafunika kulandira mayankho, kumawonetsa chidwi pazotsatira zake ndikuwonetsa kuti anthu omwe akhudzidwawo adakwaniritsidwa.
2.4. Zizindikiro Zazonse Zovuta Kugonana
Chiwerengero cha zizindikilo zomwe ndi gawo lazoyeserera zamitundu yonse itatu yozindikira matenda a PH imakhala ndi (1) kutanganidwa kwambiri ndi zogonana ("Ndimakhala nthawi yayitali pachilichonse chokhudzana ndi kugonana"), (2) alephera kuyesa kusiya (" Sindingathe kuleka ngakhale ndimayesera kawirikawiri ”), (3) kupitiriza ngakhale zovuta (" Ndikupitilizabe ngakhale ndikudziwa kuti sizabwino kwa ine "), ndi (4) kupezeka kwa zoyipa (" Kulakalaka kwanga kugonana yandwononga zambiri ”). Mayankho pazinthu zinayi izi amagawidwa monga "0 (ayi)" kapena "1 (inde)".
2.5. Zizindikiro Zogonana
Makhalidwe omwe amangogwiritsidwa ntchito ngati zisonyezo zakugonana koma osagwiritsidwa ntchito ngati zisonyezo muzinthu zina zowunikira ndi (1) kulolerana ("Ndikufuna kugonana kwambiri", mayankho amagawidwa ngati "inde" kapena "ayi") , ndi (2) zizindikiro zakusiya ("Ndikayesera kuyima ndimakhala wamanjenje komanso wosakhazikika," kuchuluka kuyambira "0 (konse)" mpaka "4 (nthawi zonse)").
2.6. Zizindikiro Zosokonezeka Za Hypersexual
Zizindikiro zomwe zitha kulumikizidwa ndi matenda okhudzana ndi matenda opatsirana pogonana zimakhudza zinthu zisanu ndi chimodzi zomwe zingathetsere kafukufukuyu (mwachitsanzo, "Sindikumva kukhumudwa ndikatha kuchita zogonana" kapena "Ndikufuna kugonana kuti igwire bwino ntchito", mayankho amagawidwa ngati "0 ( ayi) ”kapena" 1 (inde) ").
2.7. Chizindikiro Chakugonana Mokakamizidwa
Chizindikiro chimodzi chokha chomwe chimaphatikizidwa ndi chizolowezi chogonana chomwe chimayankha kupitiliza mchitidwe wogonana ngakhale kutayika kwachisangalalo ("Ndikumva kuti ndilibe kanthu nditagonana", mayankho amagawidwa ngati "0 (ayi)" kapena "1 (inde)" ).
2.8. Kufunika Kothandizidwa
Zinthu ziwiri zinayesa kufunikira kwa chithandizo: 1) "Ndikufuna kulandira chithandizo chamankhwala payekha kapena pagulu", ndi 2) "Ndikufuna kutenga nawo mbali pamaphunziro opezeka pa intaneti". Mayankho adasankhidwa kukhala "0 (ayi)" kapena "1 (inde)". Yankho lotsimikizika limagawa wofunsidwayo kukhala mgulu la "Kukumana ndi kufunikira thandizo pamavuto chifukwa cha PH", ma code ngati "0 (ayi)" kapena "1 (inde)".
2.9. Oyendetsa
Gulu la ma covariate asanu ndi limodzi omwe atha kukhala oyenera adasankhidwa kuchokera ku kafukufukuyu kuti akhale nawo pagululi. Izi zikuphatikiza zinthu zomwe zitha kukhala zokhudzana ndi PH koma sizinatchulidwe mwachindunji pamitundu itatu yonse yazidziwitso ya PH. Kwa ma covariate ambiri, pakhala kafukufuku m'mayanjano ndi PH. Ma covariate asanu ndi m'modzi ndi (1) Orgasm frequency ("Nthawi zambiri ndimakhala ndi vuto:" 0 (osachepera kamodzi patsiku) / 1 (ofanana kapena kangapo patsiku) ") [34,35]; (2) Nthawi yomwe mumawonera zolaula ("Mumawononga nthawi yochuluka bwanji tsiku lililonse mukuonera zolaula?", Magawo asanu ndi amodzi oyankha kuyambira "konse" ndi "0 mpaka 30 min" mpaka "4 mpaka 6 h") [44]; (3) Kuonera zolaula zowopsa kwambiri ("Ndimayang'ana zolaula zochulukirapo: 0 (Ayi, sindimayang'ana zolaula) / 1 (Ayi, ndimaonera zolaula zochepa kwambiri) / 2 (Ayi, ndimawonanso zolaula) / 3 (Inde, ndimaonera zolaula kwambiri) "; (4) Onerani zolaula limodzi ndi kugwiritsa ntchito mankhwala osokoneza bongo (" Ndimagwiritsa ntchito zolimbikitsa musanayang'ane zolaula (mwachitsanzo, mowa) ", mayankho asanu kuyambira" 0 (sindichita / sindionera zolaula) ”mpaka“ 4 (nthawi zonse) ”; (5) Zovuta za anthu (" Wina wandiwuza kuti ndiyime ", amayankha m'magulu a" 0 (inde) "kapena" 1 (ayi) ”) [17]; and (6) Paraphilic lathu (chinthu chimodzi: "Ndimagwiritsa ntchito zachilendo zachiwerewere (mwachitsanzo, kugonana ndi nyama kapena ana)", magulu asanu oyankha kuyambira "0 (konse)" mpaka "4 (nthawi zonse)") [34]. Ponena za "Orgasm frequency", "Nthawi yogwiritsira ntchito zolaula", ndi "Zachilendo zogonana" (malingaliro am'mawu), kafukufuku wakale adawonetsa mayanjano ena ndi PH, koma mayanjanowa adakhalabe ofanana. Ponena za "Penyani zolaula mukamagwiritsa ntchito mankhwala osokoneza bongo" komanso "Zolaula kwambiri", pakhala pali kafukufuku wocheperako, koma zisonyezo ziwirizi zikugwirizana ndi kuchuluka kwa PH monga momwe amalingalira pamalingaliro okhudzana ndi chiwerewere motero amaphatikizidwa ngati ma covariates. "Kupanikizika pagulu" sikunafufuzidwenso mochulukira koma akuti akuti ndi gawo limodzi la PH ndi akatswiri azakugonana [17] zomwe zikuyenera kuphunziridwa mochuluka. The covariates Age and Gender amaphatikizidwanso pazowunikirazi: Zaka zimagawidwa m'magulu asanu ndi limodzi kuyambira "22 mpaka 31" mpaka "achikulire kuposa 60"; Age imagwiritsidwa ntchito ngati chosinthira pakuwunika komaliza kwamachitidwe (onani Gawo 2.8). Jenda (wogawa kuti "mkazi" kapena "mamuna") amagwiritsidwa ntchito pofufuza kuti aone ngati mayankho azimayi ndi abambo ndi ofanana pofufuza za amuna ndi akazi mosiyana ndikuyerekeza zotsatira (onani Gawo 2.10).
2.10. Kusanthula Kwasanthu
Kafukufuku wofufuza adapangidwa kuti afufuze zisonyezo za PH zomwe zikupezeka pazosonkhanitsidwa. Chisamaliro chapadera chidaperekedwa pamalingaliro amitundu; Kukhazikitsa kuti ndizizindikiro ziti zomwe zimaloledwa palimodzi zomwe zimaloledwa kutanthauzira bwino zizindikirazo komanso kuti zitheke kuwunika momwe zinthu ziliri. Kafukufuku wotsatira adzafunika kuti atsimikizire zotsatira zowunika za kafukufukuyu.
Kusanthula kunachitika mosiyana kwa azimayi ndi abambo momwe mayankho a amuna ndi akazi amayenera kukhala osiyana ndipo chinali cholinga chathu kuti tifufuze za kusiyana kumeneku. Kuwunika kosiyananso kumapewa chiopsezo chofuna kukondera amuna kapena akazi. Mafupipafupi ndi njira zofananira kapena njira ndi zolakwika zofananira za zomwe zidaphatikizidwazo zidafotokozedwa m'magulu anayi osiyanasiyana: (1) azimayi omwe akusowa thandizo, (2) amuna omwe akusowa thandizo, (3) azimayi osafunikira thandizo, ndi (4) amuna osafunikira thandizo . Kufufuza kwa curve ophatikizika kwaphatikizidwa kuti azindikire mphamvu yakusankhira kusiyanasiyana kosiyanasiyananso pozindikira omwe akusowa thandizo kuchokera kwa iwo omwe safuna thandizo ku PH. Zotsatira zakusanthula uku ndizomwe zili pansi pamiyeso yazokhota (AUC) zomwe zimapereka mphamvu yakusankhira pakusintha kulikonse, pamitengo yayikulu kwambiri kuposa 0.5 yoyimira zizindikiro zomwe, zikafika, zitha kugwiritsidwa ntchito kuyesa PH. Ma AUC amayandikira pafupi ndi 1 amatanthauza zizindikilo ndi mphamvu yakusankha.
Kuti mutanthauzire bwino zosinthazo, zomwe zimayambira pazomwe zidasinthidwa zidafufuzidwa koyamba ndikuwunika zinthu (EFA) kenako ndikuwunikira kosintha (CFA). EFA idachitidwa kuti ikhazikitse kuchuluka kwa zinthu. Gawo lochepa komanso losankhidwa mwachisawawa lidagwiritsidwa ntchito pofufuza, ndi ma EFA apadera a akazi (n = 1500, 20.2%) ndi amuna (n = 5000, 19.4%). Kapangidwe kazinthu zosinthidwako kanasamaliridwa pogwiritsa ntchito polychoric kulumikizana masanjidwe monga cholowa cha EFA [46]. Kuti mudziwe kuchuluka kwa zinthu, makonzedwe abwino ndi kusanthula kofananako adagwiritsidwa ntchito ndipo kuphatikiza kwa zizindikirazi kunayesedwa [47]. Mtengo wa cutoff wazinthu zojambulidwa za 0.30 udagwiritsidwa ntchito kudziwa kuti ndi chinthu chiti chomwe chinali chosinthika. Monga zinthu zomwe zimaganiziridwa kuti zikugwirizana, kusinthasintha kwa oblique kunayikidwa [48].
Pambuyo pa EFA, CFA idachitidwa pazotsalira zonsezo, mosiyana ndi azimayi (n = 5927, 79.8%) ndi amuna (n = 20,733, 80.6%), kuti ayese momwe zinthu zomwe zidakhazikitsidwa ndi EFA zikugwirizira bwino zatsopanozo. Njira zotsatirazi zinagwiritsidwa ntchito poyesa mtunduwo: fanizo loyenerera (CFI) (> 0.95), mizu yotanthauza zolakwika zapafupifupi (RMSEA) (<0.06), mizu yokhazikika imatanthauza zotsalira (SRMR) (<0.08) [49]; kuyesa kwa chi-squared kumakhala kofunikira nthawi zonse ndi zazikulu zazikulu kotero kuti sikunagwiritsidwe ntchito ngati muyeso woyenera pano. Zilembo za Cronbach zidayezedwa pazinthu zokhazikitsira kuwunika kwawo kosasintha. Ponena za kutsimikizika kwa zinthu-zomwe zimagwiritsidwa ntchito ngati zowonjezera-ziyenera kudziwika kuti, potengera momwe kafukufukuyu adafufuzira, palibe kafukufuku wokhudzana ndi kusiyanasiyana komwe kungachitike; Komanso, chitukuko cha zinthuzo sichinali gawo la njira yotsimikizirira popeza kafukufukuyu anali atamalizidwa kale kafukufukuyu asanakhazikitsidwe. Izi zikutanthauza kuti kutsimikizika kwa zoperekazo sikunayesedwe kwambiri ndikuti zomwe zatsimikiziridwa kuti kafukufukuyu zikuyenera kutsimikiziridwa ndikutsatira.
Pambuyo pa CFA, kusanthula kwamachitidwe kunachitika kuti kuwunika kulosera kwa zinthu zomwe zakhazikitsidwa. Zomwe zidagwiritsidwa ntchito ndi CFA zidagwiritsidwa ntchito, mosiyana kwa azimayi ndi abambo, ndizosintha mosiyanasiyana "Kukumana ndi kufunikira thandizo kwa PH" komanso olosera zamomwe zidakhazikitsidwa ndi CFA komanso "Age"; zosintha zomwe sizinakwere bwino pazinthu zilizonse zimaphatikizidwanso ngati ma covariate kuti athe kuwunika mphamvu zawo zodziwitsira pakufunika thandizo. Ma ratios ratios (OR) okhala ndi chidaliro cha 99% (CI) akuti, ndipo zinthu kapena ma covariate amawerengedwa kuti ndi ofunikira ngati p <0.01; Kusiyanasiyana uku kwa mulingo wabwinobwino wa alpha wa 0.05 kunasankhidwa kuti kufotokozere kukula kwake kwazitsanzo zazikulu komanso momwe kafukufukuyu amafotokozera. Komanso, mfundo za AUC pazinthu zomwe zidakhazikitsidwa adayesedwa kuti athe kuyeza mphamvu zawo posankha PH kuchokera kuzinthu zina. Ziwerengero zikuwonetsedwa posonyeza kuyanjana pakati pa kuchuluka kwa zisonyezo zomwe zilipo pazinthu zonsezi komanso mwayi wopeza thandizo la PH. Ngati kuwonjezeka kwa mphotho ya subscale kwadzetsa chiwonjezeko chachikulu pakufuna thandizo, izi zidatengedwa kuwonetsa kuti kuopsa kwake ndikotheka ndipo kuyenera kufufuzidwa. Pazosanthula zonse, malo owerengera otseguka R, mtundu 3.6.1 (R Foundation for Statistical Computing, Vienna, Austria) adagwiritsidwa ntchito ndi phukusi la "pROC" pakuwerengera kwa AUC, phukusi la "psych" la EFA ndi " lavaan ”phukusi la CFA [46,50,51].
3. Zotsatira
3.1. Makhalidwe a Ophunzira
Gulu 1 imawonetsa mawonekedwe azitsanzo zomwe zidagawika mwa akazi (n = 7427, 22.4%) ndi amuna (n = 25,733, 77.8%) ndi omwe akutenga nawo mbali akusowa thandizo (n = 7583, 22.9%) ndi iwo omwe safuna thandizo (n = 25,577, 77.1%). Komanso, mfundo za AUC zimanenedwa mu Gulu 1 kuwunika mphamvu ya chizindikiritso cha munthu aliyense posankha pakati pa omwe akutenga nawo mbali pakufunika thandizo ndi omwe sakufuna thandizo ku PH. Mtengo wa AUC wochepera 0.5 wa "Age" kwa azimayi ukuwonetsera apa kuti azimayi achichepere nthawi zambiri amakhala akusowa thandizo kuposa azimayi achikulire. Malingaliro onse a AUC anali osiyana kwambiri ndi 0.5 (yokhala ndi alpha yoyikidwa pa 0.01) kupatula "M'badwo" wa amuna.
Gulu 1
Kufotokozera za zitsanzo zowerengera amuna ndi akazi ndikukumana ndi kufunikira kothandizidwa pamavuto achiwerewere (PH).
| Zosintha Zosonyeza ndi Covariates | Amakumana ndi Kusowa Kuthandizidwa kwa PH. Akazi: n (%) (mwa Onse 958) Amuna: n (%) (mwa Onse 6625) | Sakufuna Thandizo kwa PH. Akazi: n (%) (mwa Onse 6469) Amuna: n (%) (mwa Onse 19,108) | AUC Akazi Amuna |
|---|---|---|---|
| Kutanganidwa ndi kugonana | 611 (63.8%) 4736 (71.5%) | 2827 (43.7%) 9700 (50.8%) | 0.60 0.60 |
| Adalephera kusiya | 696 (72.6%) 5401 (81.5%) | 2428 (37.5%) 9232 (48.3%) | 0.68 0.67 |
| Zotsatira zoyipa | 478 (49.9%) 3826 (57.7%) | 1223 (18.9%) 5205 (27.2%) | 0.66 0.65 |
| Pitirizani ngakhale zili zolakwika zotsatira | 759 (79.2%) 5704 (86.1%) | 2392 (37.0%) 9668 (50.6%) | 0.71 0.68 |
| kulolerana | 691 (72.1%) 3439 (51.9%) | 3908 (60.4%) 7702 (40.3%) | 0.56 0.56 |
| Kuchotsa (osiyanasiyana: 0-4), kutanthauza (SD) | 1.92 (1.34) 1.78 (1.19) | 1.08 (1.25) 1.14 (1.19) | 0.68 0.66 |
| Amafuna kugonana kuti agwire ntchito | 631 (65.9%) 3615 (54.6%) | 3369 (52.1%) 9277 (48.6%) | 0.57 0.53 |
| Kusokonezedwa ndi kugonana | 679 (70.9%) 3914 (59.1%) | 3982 (61.6%) 9503 (49.7%) | 0.55 0.55 |
| Muzimva wamphamvu | 454 (47.4%) 1893 (28.6%) | 2376 (36.7%) 4939 (25.8%) | 0.55 0.51 |
| Osachepera nkhawa | 502 (52.4%) 2479 (37.4%) | 2386 (36.9%) 5492 (28.7%) | 0.58 0.54 |
| Kuda nkhawa pang'ono | 390 (40.7%) 1493 (22.5%) | 1530 (23.7%) 2526 (13.2%) | 0.59 0.54 |
| Kuchita bwino ndi moyo | 407 (42.5%) 1626 (24.5%) | 2131 (32.9%) 4274 (22.4%) | 0.55 0.51 |
| Kutaya zosangalatsa | 513 (53.5%) 3958 (59.7%) | 1496 (23.1%) 6035 (31.6%) | 0.65 0.64 |
| Nthawi zambiri | 529 (55.2%) 4174 (63.0%) | 3368 (52.1%) 11,858 (62.1%) | 0.53 0.52 |
| Nthawi yogwiritsira ntchito zolaula (maola), amatanthauza (SD) | Mphindi 21 (20 min) Mphindi 42 (37 min) | Mphindi 15 (17 min) Mphindi 32 (33 min) | 0.59 0.58 |
| Zolaula kwambiri (zamtundu: 0-3), kutanthauza (SD) | 2.02 (1.12) 2.22 (0.77) | 1.70 (1.16) 2.09 (0.79) | 0.58 0.55 |
| Gwiritsani ntchito mankhwala osokoneza bongo mukamaonera zolaula (osiyanasiyana: 0–4), amatanthauza (SD) | 1.43 (0.87) 1.34 (0.72) | 1.29 (0.76) 1.30 (0.68) | 0.55 0.51 |
| Kupanikizika pagulu | 423 (44.2%) 2136 (32.2%) | 1006 (15.6%) 2760 (14.2%) | 0.64 0.59 |
| Zachilendo zachiwerewere (osiyanasiyana: 0–4), amatanthauza (SD) | 0.51 (0.96) 0.37 (0.77) | 0.28 (0.71) 0.23 (0.61) | 0.56 0.54 |
| Zaka, kutanthauza (SD) | Zaka 31 miyezi 6 (zaka 8 ndi miyezi 11) Zaka 36 miyezi 2 (zaka 11 miyezi 8) | Zaka 32 miyezi 4 (zaka 9 miyezi 4) Zaka 36 miyezi 3 (zaka 12 miyezi 4) | 0.47 0.50 |
Ambiri mwa amuna (25.7%) kuposa azimayi (12.9%) adafunikira thandizo ku PH. Zinthu zambiri zimawonetsa mikhalidwe yapamwamba ya AUC kwa akazi kuposa amuna, kutanthauza kuti zinthuzi payekha zimasala akazi kuposa amuna. Komabe, mfundo za AUC nthawi zambiri zimafanana ndi azimayi ndi abambo, pomwe pali kusiyana kwakukulu komwe kumapezeka "Kupanikizika pagulu" (azimayi: 0.64, amuna: 0.59) ndi "Osadandaula kwenikweni" (azimayi: 0.59, amuna: 0.54). Zinthu zokhudzana ndi kupirira (kupatula "Kufunika kogonana kuti mugwire ntchito") ndi "Kulekerera" zidawonetsa kusiyana kwakukulu kwambiri pazambiri pomwe azimayi amavomereza izi kuposa amuna. Kwa amuna ndi akazi onse, chinthu cholankhula "Kupitiliza kwa machitidwe achiwerewere ngakhale zotsatirapo zoyipa" chinali ndi mtengo wapamwamba kwambiri wa AUC ndipo potero mphamvu yayikulu kwambiri yosankha, motsatana 0.71 ya akazi ndi 0.68 ya amuna. Nthawi zambiri, zopitilira theka la zitsanzo za azimayi ndi abambo zimapeza "ofanana kapena kangapo patsiku" pa "Orgasm frequency".
3.2. Zotsatira za EFA
Kusanthula Kwazinthu Zofufuza ndi kuzungulira kwa oblique kunapereka mawonekedwe azinthu zinayi kwa akazi ndi abambo. M'magawo onse awiriwa, kusanthula kofananira ndi maupangiri abwino adalozera yankho lazinthu zinayi. Kusanthula kofananira ndikulingalira kosakondera [47] ndikuwunikiraku, kuwunika kofananira ndi kuwongolera koyenera kudawonetsa kulumikizana, zomwe zidapangitsa kuti mayankho omveka bwino azinthu zinayi azimayi ndi abambo. Kapangidwe kameneka kamaperekedwa mu Gulu 2; pachimodzi chilichonse mwazinthu, komanso ma eigenvalue, kusiyanasiyana kofotokozedwa, ndi alpha ya Cronbach akuphatikizidwa patebulo. Pazonse, 52.8% yazosiyanazi zidafotokozedwa ndi zomwe zimakhudza akazi ndi 29.7% ya amuna. Kwa amuna, "Kutanganidwa kwambiri ndi kugonana" sikunapitirire malire a 0.30, komanso "Orgasm frequency" yosinthika. Kwa akazi, mitundu iwiriyi imadzaza kwambiri pa "Chilakolako Chagonana". Zina zomwe zidapangidwa zinali zofananira kwa amayi ndi abambo, makamaka "Zotsatira zoyipa", "Kulimbana", ndi "Kwambiri". "Zovuta pagulu" zidawonetsa kusiyana kwakukulu pakunyamula (pa "Zoyipa") pakati pa akazi ndi abambo.
Gulu 2
Zojambula pazosintha pazowunikira (EFA). Zizindikiro zokhala ndizodzaza molimba mtima pazomwe zilimo.
| Zizindikiro Zotheka za PH | Zotsatira Zoipa Akazi / Amuna | Kupirira Akazi / Amuna | Zoopsa Akazi / Amuna | Chilakolako cha kugonana Akazi / Amuna |
|---|---|---|---|---|
| Kulephera kusiya | 0.69/0.61 | |||
| Zotsatira zoyipa | 0.65/0.43 | |||
| Pitirizani ngakhale zovuta | 0.86/0.69 | |||
| Kutaya zosangalatsa | 0.55/0.51 | |||
| Kupanikizika pagulu | 0.75/0.31 | |||
| Kutaya | 0.51/0.44 | |||
| Kusokonezedwa ndi kugonana | 0.68/0.44 | |||
| Muzimva wamphamvu | 0.76/0.41 | |||
| Osachepera nkhawa | 0.83/0.68 | |||
| Kuda nkhawa pang'ono | 0.90/0.62 | |||
| Kuchita bwino ndi moyo | 0.61/0.39 | |||
| Zolaula kwambiri | 0.80/0.69 | |||
| Nthawi yogwiritsira ntchito zolaula | 0.84/0.60 | |||
| Gwiritsani ntchito mankhwala osokoneza bongo mukamaonera zolaula | 0.38/0.30 | |||
| Zachilendo zachiwerewere | 0.39/0.35 | |||
| Amafuna kugonana kuti agwire ntchito | 0.70/0.56 | |||
| kulolerana | 0.52/0.39 | |||
| Kutanganidwa ndi kugonana | 0.41/0.29 | |||
| Nthawi zambiri | 0.47/0.22 | |||
| Kufotokozera kosiyanasiyana | 16.8% / 9.6% | 15.6% / 7.9% | 10.9% / 6.7% | 9.4% / 5.5% |
| Zosintha zonse | Akazi: 52.8% | Amuna: 29.7% | ||
| Eigenvalue | 3.19/1.82 | 2.97/1.49 | 2.01/1.28 | 1.79/1.05 |
| Alpha wa Cronbach | 0.64/0.62 | 0.76/0.68 | 0.64/0.56 | 0.61/0.46 |
3.3. Zotsatira za CFA
Zotsatira za CFA zatsimikizira yankho la EFA. Mitundu ya azimayi ndi abambo inali yosiyana ndi "Chilakolako Chagonana", monga momwe tafotokozera pazotsatira za EFA. Pofuna kupanga zinthu zina, onani Gulu 2 (mozemba). Kukwanira kwa CFA kwa azimayi kunali kwabwino: CFI: 0.98, RMSEA: 0.041 (95% CI: 0.040−0.043), SRMR: 0.056. Zomwe zimayambira kuyambira 0.50 ("Kugwiritsa ntchito mankhwala osokoneza bongo") mpaka 0.87 ("Zachilendo zogonana"). Kwa amuna, mfundo zoyenera zinali zabwino: CFI: 0.96, RMSEA: 0.044 (95% CI: 0.043−0.045), SRMR: 0.057. Zowonjezera zazinthu kuyambira 0.45 ("Kugwiritsa ntchito mankhwala") mpaka 0.81 ("Pitirizani ngakhale zitakhala zovuta"). Mtengo wa alpha wa Cronbach pazinthu zambiri - womwe umagwiritsidwa ntchito ngati subscales - umakhala wokayika pazikhalidwe pakati pa 0.56 ("Kwambiri" kwa amuna) ndi 0.68 ("Kulimbana" ndi amuna); chinthu chokhacho cha "Coping" cha azimayi chikuwonetsa mtengo wovomerezeka wa 0.76. Phindu la 0.46 la "Chilakolako Cha Kugonana" kwa amuna limapereka kulumikizana pakati pa "Kufunika kogonana kuti kugwire ntchito" ndi "Kulekerera".
3.4. Zotsatira Zogwiritsira Ntchito
Kugwirizana kwakanthawi, 99% kudalira kwakanthawi ndi p-kuwonjezeka kwa zinthu ndi ma covariate omwe adagwiritsidwa ntchito pazokonzanso zimaperekedwa Gulu 3.
Gulu 3
Zotsatira zakusintha kwa zinthu pogwiritsa ntchito "Kukumana ndi kufunikira thandizo" monga kusintha kwamachitidwe.
| Zinthu / ma Covariates (osiyanasiyana) | Women OR (99% CI) | Women p-Talirani | Men OR (99% CI) | Men p-Talirani |
|---|---|---|---|---|
| Pewani | 0.03 (0.02 - 0.04) | 0.05 (0.04 - 0.06) | ||
| Zotsatira zoyipa (0-6) | 1.95 (1.84 - 2.10) | 1.95 (1.88 - 2.01) | ||
| Kulimbana (0-5) | 1.05 (0.98 - 1.12) | 0.066 | 1.02 (0.99 - 1.05) | 0.100 |
| Zowopsa (0–4) | 1.20 (1.02 - 1.41) | 0.003 | 1.10 (1.01 - 1.21) | 0.005 |
| Chilakolako Cha kugonana (0–4 / 0-2) | 0.87 (0.79 - 0.97) | 0.85 (0.80 - 0.91) | ||
| Kutanganidwa ndi kugonana (0-1) | 1.32 (1.18 - 1.46) | |||
| Pafupipafupi (0-1) | 0.89 (0.80 - 0.99) | |||
| Zaka (0-6) | 1.02 (0.89 - 1.14) | 0.735 | 1.02 (0.98 - 1.06) | 0.156 |
Chodziwikiratu ndi kuchuluka kwakuchuluka kwa zinthu "Zotsatira zoyipa", zomwe zikuwonetsa mphamvu yayikulu pakulosera motsimikiza kufunikira kwa thandizo la PH. "Kulimbana" sikulosera kwamtsogolo kwa azimayi kapena abambo. "Wowonjezera" ndiwonetseratu zabwino kwa amayi ndi abambo, kuwonetsa kuti kuchuluka kwamphamvu pazinthuzi kumawonjezera mwayi wopeza thandizo. "Chilakolako chogonana" chimakhala chodziwikiratu kwa amayi ndi abambo, kutanthauza kuti kuchuluka kwakukulu kumaneneratu kuthekera kochepa kopezera thandizo. Kwa amayi, izi zikutanthauza kuti mphambu yayikulu pachizindikiro china chilichonse "Kufunika kogonana kuti igwire ntchito", "Kulekerera", "Kuthamanga kwa ziwalo", ndi "Kutanganidwa ndi kugonana" kumaneneratu za mwayi wocheperako wosowa thandizo la PH. Kwa abambo, izi zikutanthauza kuti kuchuluka kwa "Kufunika kogonana kuti mugwire ntchito" ndi "Kulekerera" kumaneneratu za mwayi wochepa wofunikira thandizo. "Mafupipafupi a Orgasm", ophatikizidwa ngati covariate pakuwunika kwa amuna, anali wolosera zamtsogolo pomwe covariate "Kutanganidwa ndi kugonana" inali chiwonetsero chazomwe zithandizire pakufunika thandizo kwa amuna.
3.5. Kuyeza kwa Kukula kwa PH
Chithunzi 1 imapereka kuyanjana pakati pazinthuzi ndikukumana ndi kufunikira thandizo kwa PH, kwa amayi ndi abambo. Kwa amuna, komanso ma covariates "Orgasm Frequency" ndi "Kutanganidwa ndi kugonana" komanso kuyanjana kwawo ndikusowa thandizo kumaperekedwa Chithunzi 1 (mu gawo lachiwerewere). Chinthu chilichonse chimafotokozedwa ndi zinthu zina zomwe zakhazikitsidwa pamiyeso yawo yapakati (mwachitsanzo, pa "Zoyipa Zoyipa" ili ndilo pakati pa 0 mpaka 6 lomwe ndi 3). Makamaka, kuyanjana pakati pa "Zoyipa" ndikukumana ndi kufunikira thandizo kukuwonetsa kuwonjezeka kwakukulu pakufuna thandizo pakakhala zisonyezo zambiri pazomwe zilipo, ndikuwonetsa kuti ndi zizindikiritso zambiri za "Zoyipa Zoyipa" zomwe zilipo pali kuwonjezeka kwakukulu pakupeza mwayi wothandizidwa ndi PH.
Mgwirizano wapakati pa zisonyezo zomwe zilipo pachinthu chilichonse (ndi ma covariate awiri a amuna) ndi mwayi wopeza thandizo la PH.
Makhalidwe a AUC pachimodzi ndi zina mwazomwe zimaperekedwa Gulu 4, onetsani kuti "Zotsatira Zoyipa" ndichofunikira kwambiri posankha omwe akukumana ndi kusowa thandizo kwa iwo omwe sakufunikira thandizo, kwa azimayi (AUC: 0.80) komanso amuna (AUC: 0.78). Mphamvu zakusankhazi zitha kuonedwa kuti ndizovomerezeka kwa abwino kwambiri [52]. Mfundo zina za AUC ndizotsika ndipo zikuwonetsa mphamvu zopanda tsankho [52]. Dziwani kuti kwa amuna "Chilakolako chogonana" chimangokhala ndi "Kufunika kogonana kuti mugwire ntchito" ndi "Kulekerera"; "Kuchuluka kwa ziwalo" ndi "Kutanganidwa ndi kugonana" ndi gawo limodzi la "Chilakolako cha Kugonana" kwa amayi, koma zizindikirozi zimawerengedwa ngati magawo awiri a amuna.
Gulu 4
Makhalidwe a AUC ndi chidaliro cha 99% chimadalira pazinthu ndi ma covariates kuti athe kupeza thandizo la PH.
| Zinthu / ma Covariates | Women AUC (99% CI) | Men AUC (99% CI) |
|---|---|---|
| Zotsatira Zoipa | 0.80 (0.79 - 0.83) | 0.78 (0.77 - 0.78) |
| Kupirira | 0.60 (0.59 - 0.62) | 0.57 (0.56 - 0.58) |
| Zoopsa | 0.60 (0.58 - 0.62) | 0.58 (0.57 - 0.59) |
| Chilakolako cha kugonana | 0.61 (0.59 - 0.63) | 0.56 (0.55 - 0.56) |
| Mafupipafupi (amuna) | 0.51 (0.50 - 0.51) | |
| Kutanganidwa ndi kugonana (amuna) | 0.60 (0.60 - 0.61) | |
| Age | 0.47 (0.46 - 0.49) | 0.50 (0.49 - 0.51) |
4. Kukambirana
Zotsatira zazikulu za kafukufukuyu zikuwonetsa kuti "Zoyipa Zoyipa", zomwe zimakhala ndi zisonyezo zisanu ndi chimodzi, zikuwonetseratu zakusowa thandizo kwa PH. Pachifukwa ichi, tikufuna kutchula "Kubwezeretsa" (kukhala wamanjenje komanso wosakhazikika) ndi "Kutaya chisangalalo". Kufunika kwa zizindikirozi posiyanitsa PH ndi zinthu zina kwalingaliridwa [23,28] koma sichinakhazikitsidwepo kafukufuku wamphamvu. Mwa zizindikiro zina zinayi zomwe ndi gawo la "Zotsatira Zoyipa", "Kulephera kusiya", "Pitirizani ngakhale zitakhala zovuta", ndi "Kupezeka kwa zoyipa" zidakhazikitsidwa kale ngati olosera za PH [23,26,29] ndipo chifukwa chake ndi gawo la mitundu itatu yozindikira matenda a PH. Kufunika kwa "Kukakamizidwa kwa anthu" mogwirizana ndi PH kwadziwika [17] ndipo mwina khalidweli limalumikizidwa ndi kusadzidalira [53]. M'malamulo opatsirana pogonana, zimatchulidwa kuti mavuto omwe amabwera chifukwa chodzichititsa manyazi komanso kudziimba mlandu sakusonyeza kuti ali ndi vutoli [28]. Kuwunikanso mosamalitsa za "Kupanikizika kwachikhalidwe cha anthu" ndikofunikira kuwonetsa ngati zikuwonetsa kupitilira muyeso kapena ngati kukakamizidwa pagulu kumachitika chifukwa cha zovuta zina (kutayika kwaubwenzi, kutha kwa banja [54]). Mayanjano omwe ali ndi malingaliro sanayesedwe phunziroli koma atha kutengapo gawo lofunikira poyambira ndikupitilira PH. Popeza mphamvu yakusankhana ya "Zoyipa", izi zitha kugwiritsidwa ntchito kuyesa PH mu kuchuluka kwa anthu omwe akukayikira za kuzunzidwa ndi PH. Komanso, pakakhala zisonyezo zambiri za "Zotsatira zoyipa", mwayi wopezeka pakufunika thandizo ukuwonjezeka. Izi zikusonyeza kuti kuuma kwa PH kumatha kutengera zomwe zimapangitsa izi. Ziyenera kutchulidwa kuti, potengera kusasinthasintha kwamkati, kukula kwa chinthuchi kukhala chida choyezera kuyenera kugwiritsa ntchito zinthu / zizindikilo zochulukirapo kuti athe kuyesa bwino zotsatira zoyipa. Kafukufuku wowonjezereka amafunikira kuti tipeze zizindikiritso zomwe zingawonjezeredwe pazoyipa zoyipa kuti zisinthe kusinthasintha kwamkati.
Zotsatira zikuwonetsanso gulu lazinthu zisanu zomwe zidasungidwa pansi pa "Kulimbana". Zinthu izi zimayankhula makamaka zokhudzana ndi zogonana (mwachitsanzo, "Ndimatha kuthana ndi zovuta tsiku lililonse ndikamagonana"). "Kulimbana" sikunaneneratu mozama zakusowa thandizo kwa amayi kapena abambo, kunena kuti "Kulimbana" sikungagwiritsidwe ntchito kusiyanitsa omwe akusowa thandizo kuchokera kwa anthu omwe sakufuna thandizo. Kafukufuku wathuyu satipatsa chitsimikizo chotsimikizika chokhudza mayanjano omwe ali ndi PH chifukwa zinthu zokhudzana ndi "Kulimbana" zimayang'aniridwa ndi zomwe zimachitika atagonana, ndipo kugonana komwe kumagwiritsidwa ntchito polimbana ndi PH kungakhale gawo lofunikira poyambitsa kugonana [33]. Tikulangiza kuti, choyamba, kafukufuku wofunikira pa PH ndikuthana nawo [33] imanenedwa ndikuti, kachiwiri, mayanjano ena pakati pa kugonana omwe amagwiritsidwa ntchito ngati kuthana ndi PH amawerengedwa zisanachitike zenizeni zokhudzana ndi kuthana ndi PH. Zotsatira zathu zitha kufotokozera, komabe, kuchuluka kwakukulu kwa zabwino zabodza zomwe zimapezeka ndi Hypersexual Behaeve Inventory- [4,5], chida chophatikizira sikelo ya "Coping" [26] kuyesa PH. Njira yodalirika yofufuzira zakugonana komwe imagwiritsidwa ntchito kuthana ndi PH imaperekedwa ndi kafukufuku wazitsanzo [55], popeza kafukufukuyu amalola kuyesa kwakanthawi kwakanthawi kochepa kwa anthu omwe akuvutika ndi PH [56].
Chinthu chachitatu chomwe chidakhazikitsidwa mu kafukufuku wathu chinali "Chilakolako Cha Kugonana", kuphatikiza zisonyezo monga "Kulekerera" ndi "Kufunikira kugonana kuti mugwire". "Chilakolako chogonana" chimaneneratu molakwika zakusowa thandizo kwa amayi ndi abambo. Izi zikutanthauza kuti munthu akafuna kugonana (kuti agwire ntchito), kapena akufuna kugonana mochulukirapo, mwayi wopeza thandizo umachepa. Kwa akazi, "Chilakolako chogonana" chimaphatikizaponso "Kutanganidwa ndi kugonana" ndi "Orgasm frequency". Kwa amuna, zisonyezozi zidawonjezedwa ngati ma covariate pazowunikirazi, ndipo zotsatira zake zikuwonetsa kuti, kwa amuna, "Kutanganidwa ndi kugonana" kumalumikizidwa ndi mwayi waukulu woti athe kupeza thandizo pomwe "Orgasm frequency" imagwirizanitsidwa ndi mwayi wochepa kufuna thandizo. Zotsatirazi zikugwirizana ndi kafukufuku wakale wokhudza chilakolako cha kugonana [37,38], koma ndizosiyana ndi ziyembekezo kutengera momwe anthu amagonana. Pofanizira kugwiritsa ntchito mankhwala osokoneza bongo, anthu omwe amagwiritsa ntchito "machitidwe ena pafupipafupi (mwachitsanzo, kutchova juga kapena kugonana) atha kuyembekezeredwa kuti atha kukhala pachiwopsezo chachikulu chotenga chizolowezi chamakhalidwe [24,57]. Pazitsanzo zomwe zilipo pano, omwe akutenga nawo mbali pafupipafupi anali pachiwopsezo chokhala ndi vuto lachiwerewere, pomwe timangoganiza kuti kutha pakati pamavuto osagwirizana ndi kugonana [37,58] sichingakhazikitsidwe. Mofananamo, "Kulekerera" (kufuna kugonana mochulukira) sikungagwiritsidwe ntchito kuyesa PH; monga gawo la "Chilakolako Cha Kugonana", ndizolakwika za PH. Kafukufukuyu akuwonetsa kuti choyamba ndicho "Zoyipa" zomwe zimawonetsa ngati chiwerewere chimakhala chovuta. Kuchulukitsa chilakolako chogonana komanso kuchuluka kwakanthawi pazakugonana sizizindikiro zabwino za PH mwa zitsanzo za anthu okayikira za mtundu wawo wa PH.
Chomaliza chomwe chidawululidwa mu data yathu, "Kwambiri", chimakhala ndi zizindikilo zinayi zothana ndi "Zachilendo zogonana", "Gwiritsani ntchito mankhwala osokoneza bongo mukamaonera zolaula", "Zolaula", ndi "Nthawi yogwiritsira ntchito zolaula". Zizindikirozi zimayang'ana njira yomwe ikuchulukira yokhudza kuwonera zolaula komanso zofananira. Kwa amayi ndi abambo, "Kwambiri" ndikulosera zamtsogolo pakufunika thandizo. Komabe, mphamvu yakusankha ya "Extreme" ndiyochepa, ndipo momwe iliri pano izi sizingaganizidwe ngati chisonyezo chabwino cha PH. Maphunziro ena akuyenera kuchitidwa kuti awone kuyanjana pakati pa machitidwe achiwerewere kwambiri ndi PH.
Pachitsanzo ichi, kuchuluka kwa amuna omwe adafunikira thandizo anali owirikiza kawiri kuposa azimayi. Komabe, mayankho onse azimayi ndi abambo anali ofanana phunziroli. Tikuwona kuti kusiyana pakati pa amuna ndi akazi pazizindikiro zosiyana kunali kotchuka kwambiri pa "Kupanikizika kwa anthu" komanso kuthana ndi zovuta; Zizindikirozi zidakonzekeretsa kwambiri PH kwa azimayi kuposa amuna, ndipo kufufuza kwina kuli koyenera kuti mufufuze za kusiyana kumeneku.
Tikufuna kutchula zoperewera za phunziroli: (1) PH imayesedwa ndi "kukumana ndi kufunika kwa chithandizo cha PH", njira yokhayo yodziyesa pawokha yomwe ingakhudzidwe ndi chikhalidwe cha anthu motero osakhala chisonyezo cha vuto lalikulu [28]. Kuopsa kopitilira muyeso khalidwe lachiwerewere chifukwa cha chikhalidwe cha anthu [8,9,10,11,15] titha kuzipewa pakuphatikizanso kuwunika kwa omwe akutenga nawo mbali pazachipatala [16]; (2) Kudalirika kwa ma subscales nthawi zambiri sikukhala kwakukulu, zomwe zikutanthauza kuti kusamala kuyenera kuwonedwa potanthauzira zotsatira zofufuza za kafukufukuyu; kafukufuku wotsatira akuyenera kuyang'ana pakupanga ndalama zochulukirapo zomwe zimalumikizidwa kwambiri kuti zitheke kusasintha kwamkati; Chofunika, kafukufukuyu amathanso kupititsa patsogolo mphamvu zakusankhana zama subscales (ngakhale zili zokwanira mokwanira pankhani ya "Zotsatira zoyipa"); (3) Kusagwirizana kwa chitsanzocho pokhudzana ndi mchitidwe wogonana womwe umalumikizidwa ndi PH (mwachitsanzo, zolaula kapena kubera mwachinyengo) zitha kukhala zosokoneza zotsatira ndipo zikuyenera kuganiziridwa pakufufuza kwina; (4) Chitsanzocho, ngakhale chinali chachikulu, chinali ndi anthu omwe adziyankha okha omwe sanatchule zifukwa zawo. Komabe, kuchuluka kwa azimayi ndi abambo mu kafukufukuyu omwe amafunikira thandizo la PH, komanso kuyambitsa kwa kafukufukuyu komwe kumafotokoza momveka bwino cholinga chake chopereka kuwunika koyambirira kokhudzana ndi chiwerewere, kukuwonetsa kuti mayankho adasankhidwadi mosakayikira za msinkhu wawo wa PH; (5) Kafukufukuyu sanasiyanitse kusiyana pakati pa amuna ndi akazi kuposa akazi-amuna dichotomy; kafukufuku wotsatira akuyenera kulingalira kuphatikiza magawo ena osiyana siyana achikhalidwe; ndipo (6) Comorbidity siinafufuzidwe mu kafukufukuyu pomwe, kumbali inayo, amadziwika kuti ndi chinthu chodziwika bwino cha PH (mwachitsanzo, mu vuto losinthasintha zochitika) [59] zomwe ziyenera kukumbukiridwa pakufufuza kotsatira.
Ngakhale zoperewera zomwe zatchulidwazi, tikuganiza kuti kafukufukuyu amathandizira pakupanga kafukufuku wa PH ndikuwunikanso malingaliro atsopano (ovuta) okhudzana ndi chiwerewere pagulu. Timatsindika kuti kafukufuku wathu adawonetsa kuti "Kubwezeretsa" ndi "Kutaya chisangalalo", monga gawo la "Zotsatira Zoyipa", zitha kukhala zizindikilo zofunikira za PH. Mbali inayi, "Orgasm frequency", monga gawo la "Chilakolako Chagonana" (kwa akazi) kapena ngati covariate (ya amuna), sanawonetse mphamvu yakusankha kusiyanitsa PH ndi zina. Zotsatira izi zikusonyeza kuti pakakhala zovuta zokhudzana ndi chiwerewere, chidwi chiyenera kuyang'ana kwambiri pa "Kuchotsa", "Kutaya chisangalalo", ndi zina "Zoyipa" za chiwerewere, osati kwambiri pafupipafupi kapena pa "kugonana kwambiri" [60] chifukwa makamaka ndi "Zoyipa" zomwe zimakhudzana ndikukumana ndi chiwerewere ngati zovuta. Kutengera ndi kafukufuku wapano, tikulimbikitsa kuti muphatikize zinthu zomwe zikugwirizana ndi izi mu chida choyezera cha PH. Izi zikutanthauza kuti mawonekedwe amitundu yozindikira ayenera kuphatikizidwa muchida chimodzi [14]. Zopeka, izi zitha kutanthauza kuti kuphatikiza kophatikizika kwamalingaliro amakono a PH ndikofunikira komwe kumangoganizira za vuto lachiwerewere pokhudzana ndi chikhalidwe cha anthu komanso kukhala athanzi.
5. Zotsatira
Kafukufukuyu akuwonetsa kuti chinthu "Zotsatira zoyipa" chidzakhala choyenera kwambiri pakuwunika moyenera PH ndikusankhira PH kuchokera kuzinthu zina. Mwa izi, mwa zina, zizindikiro za "Kuchotsa" ndi "Kutaya chisangalalo" zomwe m'mbuyomu zimangotchulidwa kuti ndi chimodzi mwazinthu zitatu zaku PH. Ponena za chiphunzitso, izi zikutanthauza kuti PH mwina siyiyenera kugawidwa pamalingaliro omwe alipo ngati chizolowezi chogonana, chiwerewere, kapena chizolowezi chogonana koma atha kuwonedwa bwino kuchokera kuzowona bwino. Ponena za zochitika zamankhwala, zotsatira za kafukufukuyu zikuwonetsa kuti zizindikiritso zofunikira zogwiritsidwa ntchito m'njira zosiyanasiyana zowunika za PH zitha kulumikizidwa bwino kuti apange chida chowunikira kupezeka kwa PH. Kafukufuku wamtsogolo wopanga ndi kutsimikizira chida choterocho chiyenera kuchitidwa moyenera monga momwe chidzagwiritsidwire ntchito, kupewa kupepesa mopitirira muyeso za mchitidwe wogonana wopanda vuto. Kusiyana kwa kusiyana pakati pa amuna ndi akazi mu PH kuyenera kuganiziridwa, ndipo zida zowunikira PH ziyenera kukhala zosiyana kwa akazi ndi abambo.
Zopereka za Wolemba
Kulingalira, PvT, AT, G.-JM, ndi JvL; njira, PvT, PV, ndi RL; mapulogalamu, PvT; kutsimikiza, PvT, PV ndi RL; kusanthula kwamankhwala, PvT; kufufuza, AT; zothandizira, AT; kusungidwa kwa deta, AT, PvT; kulemba-kukonzekera koyambirira, PvT; kulemba-kuwunikanso ndikusintha, PvT, AT, G.-JM, PV, RL, ndi JvL; kuwona, PvT; kuyang'anira, JvL; kuyang'anira ntchito, PvT; kupeza ndalama, NA. Olemba onse awerenga ndikuvomereza zomwe zalembedwa pamanja.
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