Post Abortion Women's Life Style: Impact of Counseling Based on PLISSIT Model

Hanan Elzeblawy Hassan^1, , Walaa Khalaf Gooda² and Noha Nasser Nashed³

¹Professor of Maternal and Newborn Health Nursing, Faculty of Nursing, Beni-Suef University, Egypt

²Lecturer of Maternal & Newborn Health Nursing, Faculty of Nursing, Beni-Suef University, Egypt

³Nurse Specialist at Beni-Suef University Hospital

Cite this paper:
Hanan Elzeblawy Hassan, Walaa Khalaf Gooda and Noha Nasser Nashed. Post Abortion Women's Life Style: Impact of Counseling Based on PLISSIT Model. American Journal of Nursing Research. 2025; 13(4):89-96. doi: 10.12691/ajnr-13-4-1

Abstract

Background: Counseling on post-abortion care is vital for reproductive health, utilizing structured models for informed decision-making. The PLISSIT model (Permission, Limited Information, Specific Suggestions, Intensive Therapy) offers a stepwise approach to address women's concerns regarding psychological, emotional, and social complications post-abortion. Its effective implementation can mitigate post-abortion complications and improve women's knowledge, emotional adaptation, and lifestyle. Aim: The current study was conducted to evaluate the impact of counseling based on PLISSIT model on post abortion women's life style. Subjects & Methods: Design: A quasi-experimental (pre- and post-test) research design was used. Sample &Settings: A convenient sample of 92 women who had abortions affiliated obstetrics & gynecology unit at Beni-Suef University Hospital. Tools: (1) women's knowledge regarding abortion and management sheet; (2) women's lifestyle after abortion Questionnaire; (3) information technology Questionnaire; (4) abortion counseling based on the PLISSIT model. Results: 15.2% of the studied women had satisfactory knowledge regarding modern educational information on abortion pretest which improved posttest to become 80.4%. Also, 88% of the studied women had unhealthy lifestyle regarding weight and exercise which improved posttest to become 27.2%. Moreover, 3.3% of the studied women had good level of impact of social networking sites after abortion which improved posttest to become 76.1%. The mean total knowledge of the studied women about abortion during pretest was 20.73±6.33 which improved posttest to become 34.04±6.76. Conclusion: In the pretest, no correlation was found between total knowledge, lifestyle, and the impact of social networking sites on women post-abortion. However, the posttest revealed a correlation between total knowledge and the impact of social networking sites. Furthermore, positive correlations were identified between total knowledge and overall lifestyle, and between overall lifestyle and the total impact of social networking sites on women post-abortion. Recommendations: Developing an educational program to enhancing women’s knowledge regarding the using of social media properly, maximizing its advantages, introducing women to the most trustworthy and legitimate social media sites, and showing them how to use these resources to improve women’s life style after abortion.

Keywords:
Post Abortion Life Style Counseling PLISSIT Model

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]	World Health Organization.(2012). Safe abortion, technical and policy guidance for health system (2nd ed.) World Health Organization. https://apps.who.int/iris/handle.10665.70914.
[2]	Mostafa H., Yousef F., Hassan H. (2018). Health Related Quality of Life Educational Interventions: Effect on Chronic Hepatitis C Patients'. Saudi Journal of Nursing and Health Care, 1(2): 56-67.
[3]	Hassan H., Gooda W., Ahmed T., Farag D. (2025). Marital, Sexual Satisfaction and Quality of Life among Post-hysterectomy Women: Impact of Nursing Counseling Guided by BETTER Model. Egyptian Journal of Health Care, 16 (1): 99-116.
[4]	Nady F., Said M., Youness E., Hassan H. (2017). Impact of Tailored Educational Program of Quality of Life Improvement on Women Undergoing Breast Cancer Treatment at El-Minia Region, Egypt. American Research Journal of Gynaecology, 1(1): 1-17.
[5]	Hassan H. (2020). Quality of Life with Gestational Diabetes. American Research Journal of Public Health, 3(1): 1-4.
[6]	Emem E., Hassan H. (2017). Correlation between Quality Of Life and Dysmenorrhea among Nursing Schools Students. International Journal of Nursing Science, 7(6): 123-132.
[7]	Nady F., Said M., Youness E., Hassan H. (2018). Effect of Nursing Intervention Program on Quality of Life Improvement for Women Undergoing Gynecological and Breast Cancer Treatment. Assuit Scientific Nursing Journal, 6(15): 62-77.
[8]	Hassan H. (2020). Evidence-Based Practice in Midwifery and Maternity Nursing for Excellent Quality of Care Outcomes. American Journal of Nursing Research, 8(6): 606-607.
[9]	Mohammed F., Shahin M., Youness E., Hassan H. (2018). Survivorship in Women Undergoing Gynecological and Breast Cancer Treatment in Upper Egypt: The Impact of Quality of Life Improvement Educational Program”. American Research Journal of Gynaecolog 2(1): 1-28.
[10]	Nady F., El-Sherbiny M., Youness E., Hassan H. (2018). Effectiveness of Quality of Life Planned Teaching Program on Women Undergoing Gynecologic Cancer Treatment. American Research Journal of Oncology, 1(1): 1-17.
[11]	Hassan H & Farag D. (2019). The impact of polycystic ovary syndrome on women’s quality of life: Nursing guidelines for its management. Clinical Nursing Studies, 7(3):42-57.
[12]	Feizollahi, N., Nahidi, F., Sereshti, M., Nasiri, M., & Azadpour, A. (2020): Evaluation of Quality of Life in Women with Abortion Experience in Tehran 2015 - 2016. Advances in Nursing and Midwifery, 29(1), 8-15. Retrieved from file: ///C:/Users/ Windows%20Company/Downloads/114120200102%20(1).pdf.
[13]	Hassan H. (2019). The Impact of Evidence-Based Nursing as The Foundation for Professional Maternity Nursing Practices. Open Access Journal of Reproductive System and Sexual Disorder, 2(2): 195-197. OAJRSD.MS.ID.000135.
[14]	Hassan H., Ahmed W., Ahmed Arafa A. (2019). Physical Activity and Menstrual Disorders Аmong School Girls in Southern Egypt. International Journal of Studies in Nursing, 4(3): 54-59.
[15]	Mohamed W., Hassan H. (2020). Effect of Instructional Supportive Guideline for Improving Women's Awareness towards Endometriosis. American Journal of Nursing Research, 8(1): 38-47.
[16]	Hassan H., Abd-ELhakam F., Kasem E. (2025). Androgen-related Alopecia and Infertility: Impact of Lifestyle Modifications. International Journal of Clinical Research and Reports, 4(2): 1-6.
[17]	Hassan H., Abd-ELhakam F., Ali E. (2025). Effect of Life Style Modification Implemented Program among Infertile Women with Poly Cystic Ovary Syndrome on Obesity and Menstrual Regulation. Journal of Clinical and Laboratory Research, 8(2): 1-7.
[18]	Rinehart, W., Rudy, S., & Drennan, M. (1998): GATHER guide to counseling. Population reports. Series J, Family planning programs, 234(48):1-31
[19]	Malk R., Fahem E., Hassan H., Soultan A. (2022). Efficacy of Training Program on Nurses Performance regarding Preventive Measures of Venous Thromboembolism among Critical Pregnant Women. Egyptian Journal of Health Care, 13(2): 401-413.
[20]	Ali M., Elshabory N., Hassan H., Zahra N., Alrefai H. (2018). Perception about Premarital Screening and Genetic Counseling among Males and Females Nursing Students. IOSR Journal of Nursing and Health Science, 7(1): 51-57.
[21]	Hassan H., Saber N., Sheha E. (2019). Comprehension of Dyspareunia and Related Anxiety among Northern Upper Egyptian women: Impact of Nursing Consultation Context Using PLISSIT Model. Nursing & Care Open Access Journal, 6(1): 1-19.
[22]	Hassan H., Gamel W., Sheha E., Sayed M., Arafa A. (2019). Menstrual disorders Necessitating Counseling among Students in Beni-Suef University. Clinical Nursing Studies, 7(2): 29-36.
[23]	Hassan H., Eid S., Hassan A., Abou-Shabana K. (2022). Pre-Gynecological Examination: Impact Counseling on Women’s Pain, Discomfort, and Satisfaction. American Journal of Public Health Research, 10(2): 63-75
[24]	Abou-Shabana K., Hassan A., Eid S., Hassan H. (2022). Effect of Counseling Sessions on Women’s Satisfaction during Gynecological Examination. Journal of Obstetrics Gynecology and Reproductive Sciences, 6(4): 1-10.
[25]	Eid S., Abou-Shabana K., Hassan A., Hassan H. (2023). Effect of Pre-Gynecological Examination Counseling Sessions on Relieving Women’s Pain, Discomfort and Enhancing their Satisfaction. Journal of Nursing Science - Benha University, 4(1): 751-768.
[26]	Ramadan E., Eldesokey A., Hassan H. (2020). Effect of an Educational Package on Knowledge, Practices, and Attitude of Premenopausal Women Regarding Sexuality. American Journal of Nursing Research, 8(5): 495-505.
[27]	Qian, J. L., Pan, P. E., Wu, M. W., Zheng, Q., Sun, S. W., Liu, L., ... & Yu, X. Y. (2021): The experiences of nurses and midwives who provide surgical abortion care: A qualitative systematic review. Journal of advanced nursing, 77(9), 3644-3656.
[28]	Dutta, A. P. (2025): From Chaos to Clarity: How Social Work Skills Can Change Your Life. Notion Press. ‏632(5)5426378.
[29]	Lee, L., Ma, W., Davies, S., & Kammers, M. (2023): Toward optimal emotional care during the experience of miscarriage: an integrative review of the perspectives of women, partners, and health care providers. Journal of Midwifery & Women's Health, 68(1), 52-61.‏
[30]	Musik, T., Grimm, J., Juhasz-Böss, I., & Bäz, E. (2021): Treatment options after a diagnosis of early miscarriage: expectant, medical, and surgical. Deutsches Ärzteblatt International, 118(46), 789.‏
[31]	Foster, A. M., Arnott, G., Hobstetter, M., Zaw, H., Maung, C., Sietstra, C., & Walsh, M. (2016): Establishing a referral system for safe and legal abortion care: a pilot project on the Thailand-Burma border. International Perspectives on Sexual and Reproductive Health, 42(3):7836.
[32]	Ramadan, A., Abo Shabana, K., & Mossa, S. (2021): Assessment of post abortion woman lifestyle. Egyptian Journal of Health Care, 12(3), 831-842.
[33]	Attali, L., Voillot, P., Fournet, P., & Agostini, A. (2024): Experiences of women with medical abortion care reflected in social media (VEILLE study): Noninterventional retrospective exploratory Infodemiology study. JMIR Infodemiology, 4, e49335.
[34]	Zolfaqari, Z., Ayatollahi, H., Ranjbar, F., & Abasi, A. (2024): Acceptance and use of mobile health technology in post-abortion care. BMC Health Services Research, 24(1).
[35]	Turesheva, A., Aimagambetova, G., Ukybassova, T., Marat, A., Kanabekova, P., Kaldygulova, L., & Atageldiyeva, K. (2023): Recurrent pregnancy loss etiology, risk factors, diagnosis, and management. Fresh look into a full box. Journal of Clinical Medicine, 12(12), 4074.
[36]	Haghighi, M., Oladbaniadam, K., Mohaddesi, H., & Rasuli, J. (2022): Individual counseling in mothers bereaved by pregnancy loss. Journal of Education and Health Promotion, 11(1), 209.
[37]	Keshavarz, Z., Karimi, E., Golezar, S., Ozgoli, G., & Nasiri, M. (2021): The effect of PLISSIT based counseling model on sexual function, quality of life, and sexual distress in women surviving breast cancer: A single-group pretest–posttest trial. BMC Women's Health, 21(1).
[38]	Saeed, S., Jain, S., Emma, N., Afzali, H., Razaqi, N., Ahmadi, M., & Lucero-Prisno III, D. E. (2022): Knowledge and attitude towards abortion among women in= Afghanistan. Razi International Medical Journal, 2(2), 52-62.
[39]	Nashed N., Hassan H., Gooda W. Impact of Post Abortion Counseling Based on PLISSIT Model on Women's Life Style. Egyptian Journal of Health Care, 2025; 16 (2): 1009-1028.
[40]	Turner, K. L., Pearson, E., George, A., & Andersen, K. L. (2018): Values clarification workshops to improve abortion knowledge, attitudes and intentions: A pre-post assessment in 12 countries. Reproductive Health, 15(1).
[41]	Ngo, A., Nguyen, V. T., Phan, H., Pham, V., Ngo, C., Nguyen, L., & Ha, T. (2023): Effectiveness of mHealth intervention on safe abortion knowledge and perceived barriers to safe abortion services among female sex workers in Vietnam. mHealth, 9, 3-3.
[42]	Hamadneh, J., & Hamadneh, S. (2023): The impact of an online educational program to reduce second-hand exposure to smoke among nonsmoking pregnant women; a hospital-based intervention study. Heliyon, 9(4), e13148.
[43]	Bannour, B., Bannour, R., & Bannour, I. (2023): Knowledge, attitude and practices on second hand smoke exposure among pregnant women. Population, Medicine, 5(Supplement). 918(53). 732.
[44]	Mostafa, M., Morsy, H., & Abdo Hussien, A. (2022): Effect of health belief model based educational package on lifestyle among gestational diabetic women. Egyptian Journal of Health Care, 13(4), 1277-1292.
[45]	Han, Y., Sung, H., Kim, G., Ryu, Y., Yoon, J., & Kim, Y. S. (2024): Effects of a web-based weight management education program on various factors for overweight and obese women: Randomized controlled trial. JMIR Cardio, 8, e42402.
[46]	Mirian, Z., AbdiShahshahani, M., Noroozi, M., Mostafavi, F., & Beigi, M. (2023): Effect of intervention based on the 5a self-management model on the improvement of behaviors related to women's reproductive health after legal abortion. Scientific Reports, 13(1).
[47]	Kibira, S. P., Stillman, M., Makumbi, F. E., Giorgio, M., Nabukeera, S., Nalwoga, G. K., & Sully, E. A. (2023): Lived experiences and drivers of induced abortion among women in central Uganda. PLOS Global Public Health, 3(12), e0002236.
[48]	Farag D. & Hassan H. Maternal Postpartum Sleep disturbance and Fatigue: Factors Influencing. ARC Journal of Nursing and Healthcare, 2019; 5(2): 33-46.
[49]	Hassani, R., Fadlalmola, H., Said, T., AlZahrani, B., & Mariod, A. (2023): Effect of a psycho-awareness-training program on women's attitude and psychosomatic status post-abortion in Jazan, Saudi Arabia. Afr J Reprod Health, 27(8), 58-64.
[50]	Hassan H., Ebrahim R., Mohammed M., Abd-ELhakam F. (2022). Female Genital Mutilation: Impact on Knowledge, Attitude, Sexual Score Domains and Intention of Females in Northern Upper Egypt. Archives of Medical Case Reports and Case Study, 6(5): 1-8.
[51]	Hassan H., Mohammed M., Abd-ELhakam F., Ebrahim R. (2023). Female Genital Mutilation: Study Sexual Issues. Journal of Gynecology and Women’s Health, 24(4): 1-8.
[52]	Hassan H., Ali R., Abd El Salam S., Kamal H. (2021). Impact of an Educational Program on Sexual Dysfunction Associated With Cervical Cancer. Journal of Cancer Research and Treatment, 9(2): 22-31.
[53]	Hassan H., Ramadan S., Ali R., Kamal H. (2021). Sexual Issues among Cervical Cancer Survivors' Women in Northern Upper Egypt. Journal of Advanced Trends in Basic and Applied Science, 1(1): 1-11.
[54]	Masaud H., Abd Rabo R., Ramadan S. Hassan H. (2021). Impact of Protocol of Nursing Intervention on Sexual Dysfunction among Women with Cervical Cancer. Journal of Nursing Science Benha University, 2(2): 203-224.
[55]	Heera, K., Shrestha, M., Pokharel, N., Niraula, S. R., Pyakurel, P., & Parajuli, S. B. (2021): Women’s empowerment for abortion and family planning decision making among marginalized women in Nepal: A mixed method study. Reproductive Health, 18(1).
[56]	Charlton, B. M., Everett, B. G., Light, A., Jones, R. K., Janiak, E., Gaskins, A. J., & Austin, S. B. (2020): Sexual orientation differences in pregnancy and abortion across the Lifecourse. Women's Health Issues, 30(2), 65-72.
[57]	Huss, B. (2021): Well-being before and after pregnancy termination: The consequences of abortion and miscarriage on satisfaction with various domains of life. Journal of Happiness Studies, 22(6), 2803-2828.
[58]	Hill, J., McGinn, J., Cairns, J., Free, C., & Smith, C. (2020): A mobile phone–based support intervention to increase use of Postabortion family planning in Cambodia. JMIR mHealth and uHealth, 8(2), e16276.
[59]	Araban, M., Karimy, M., Mesrabadi, J., & Zamani-Alavijeh, F. (2014). The impact of educational intervention on health-promoting lifestyle: A randomized controlled trial. Iranian Red Crescent Medical Journal, 16(6), e19259.
[60]	Fakhri, M., Hamzehgardeshi, Z., & Hajikhani Golchin, N. A. (2021). The effect of counseling on lifestyle improvement in reproductive health: A systematic review. Journal of Education and Health Promotion, 10, 218.
[61]	Samila, I. A., & Mboineki, J. F. (2024): Knowledge level and constructs of the theory of planned behaviour (TPB) to the practice of unsafe abortion among postnatal mothers attending Mkonze health center, Dodoma region, Tanzania. BMC Public Health, 24(1)67.