Comparing the Effect of Extended PLISSIT Model and Group Counseling on Sexual Function and Satisfaction of Pregnant Women: A Randomized Clinical Trial.

Introduction: Changes in the performance and sexual satisfaction of women during pregnancy can be one of the important factors involved in the emergence of sexual problems in women. This study aimed to compare the effect of Extended Permission, Limited Information, Specific Suggestion, Intensive Therapy (Ex-PLISSIT) and group counseling on sexual function and satisfaction of pregnant women. Methods: A randomized clinical trial was conducted on 111 pregnant women from 2016 to 2018 in Zanjan, Iran. Eligible participants were selected through convenience sampling method and allocated into three groups Ex-PLISSIT model, group counseling and control group, using block randomization method. Sexual function and sexual satisfaction were evaluated via the Female Sexual Function Index (FSFI) and Hudson's sexual satisfaction questionnaire at baseline and four weeks after the last counseling session. Data were analyzed using SPSS ver. 13 and ANCOVA, ANOVA, Wilcoxon, Chi-squared, Mann-Whitney U, and Kruskal Wallis test. Results: Median (Interquartile range) of the participants' sexual function in the Ex-PLISSIT group was 25.9(4) in the counseling group, 26(5.5), in the control group, and 25.8(4.8) at the baseline. These scores changed to 28.9(5.4), 27.9(5.1), and 25.2(4.3) at the 4-week follow-up, respectively. These differences were statistically significant. Moreover, there was a statistically significant difference in the mean sexual satisfaction scores between the three groups, at the follow up period. Conclusion: Providing sexual counseling by any approach during routine prenatal care by community midwives may improve couples' sexual health.

Effect of communication skills based group counseling on mothers' sex dialogue with their adolescent daughters.

Background Sex dialogue is one of the most critical and challenging topics between mothers and adolescents. The knowledge and skills of mothers in sex dialogue with their daughters are essential. The purpose of this study is to determine the effect of group counseling based on communication skills on mothers through their sex dialogue with their daughters. Methods A randomized controlled field trial was conducted on 168 couples of mothers and their daughters selected by the stratified matching method and randomly divided into two control and intervention groups. The mothers in the intervention group participated in a communication-based consultation in groups consisting of 6-12 people for 6-7 weekly sessions, each one lasting 60 min. The data collection tool was a Persian-translated questionnaire by Jaccard for sex dialogue between mother and daughter. The data were analyzed using Chi-square (χ2), ANOVA with repeated measures and modified post hoc Bonferroni tests. Results There was a significant difference in the mean score of mother-daughter sex dialogue 1 week after intervention between the intervention (34.48 ± 8.74) and control (40.44 ± 9.49) groups (p = 0.001) and 1 month after the intervention between the intervention (30.41 ± 10.07) and control (42.47 ± 9.62) groups (p < 0.001). Conclusion Through applying communication skills, an increase in mother-daughter sex dialogue frequency was observed after group counseling. Therefore, it is suggested to promote mother-daughter communication skills by accessing the mothers via schools, health centers and with the aid of midwifery counselors, midwives and other trained caretakers.

Bio-psycho-social factors affecting sexual self-concept: A systematic review.

BACKGROUND: Nowadays, it is believed that mental and emotional aspects of sexual well-being are the important aspects of sexual health. Sexual self-concept is a major component of sexual health and the core of sexuality. It is defined as the cognitive perspective concerning the sexual aspects of 'self' and refers to the individual's self-perception as a sexual creature. OBJECTIVE: The aim of this study was to assess the different factors affecting sexual self-concept. METHODS: English electronic databases including PubMed, Scopus, Web of Science and Google Scholar as well as two Iranian databases including Scientific Information Database and Iranmedex were searched for English and Persian-language articles published between 1996 and 2016. Of 281 retrieved articles, 37 articles were finally included for writing this review article. RESULTS: Factors affecting sexual self-concept were categorized to biological, psychological and social factors. In the category of biological factors, age gender, marital status, race, disability and sexual transmitted infections are described. In the psychological category, the impact of body image, sexual abuse in childhood and mental health history are present. Lastly, in the social category, the roles of parents, peers and the media are discussed. CONCLUSION: As the development of sexual self-concept is influenced by multiple events in individuals' lives, to promotion of sexual self-concept, an integrated implementation of health policies is recommended.

The effect of group counseling based on self-awareness skill on sexual risk-taking among girl students in Gorgan, Iran: a randomized trial.

Background Sexual puberty in adolescents occurs before their mental and emotional maturity and exposes them to high-risk sexual behaviors. Because sexual risk-taking occurs before adolescents become involved in a sexual relationship, this study was conducted to identify the effect of group counseling based on self-awareness skill on sexual risk-taking among female high school students in Gorgan in order to suggest some preventative measures. Methods The present parallel study is a randomized field trial conducted on 96 girl students who were studying in grades 10, 11 and 12 of high school with an age range of 14-18 years old. Sampling was done based on a multi-stage process. In the first stage, through the randomized clustering approach, four centers among six health centers were selected. In the second stage, 96 samples were collected through consecutive sampling. Finally, the samples were divided into two intervention and control groups (each one having 48 subjects) through the simple randomized approach. It has to be noted that no blinding was done in the present study. The data were collected using a demographic specifications form and the Iranian Adolescents Risk-Taking Scale (IARS). The consultation sessions based on self-awareness skill were explained to an intervention group through 60-min sessions over 7 weeks. The pretest was conducted for both groups and the posttest was completed 1 week and 1 month after the intervention by the intervention and control groups. Finally, after the loss of follow-up/drop out, a total of 80 subjects remained in the study; 42 subjects in the intervention group and 38 subjects in the control group. Data analyses were done using SPSS v.16 along with the Freidman non-parametric test and the Mann-Whitney and Wilcoxon tests. Results The results showed that the sexual risk-taking mean scores in the intervention group (10.54 ± 15.64) were reduced by applying 1-week (8.03 ± 12.82) and 1-month (4.91 ± 10.10) follow-ups after the intervention. This reduction was statistically significant (p = 14%). However, no statistically significant difference was observed in the control group. Conclusion Group counseling based on self-awareness skill decreased the sexual risk-taking in girl students of the high school. As prevention is prior to treatment, this method could be proposed as the prevention of high-risk sexual behavior to healthcare centers and educational environments and non-government organizations (NGOs) interacting with adolescents.

"Konkoor Giant", a narrative of high school female students from Gorgan, Iran.

Background The university entrance exam or Konkoor is a determining event for the Iranian adolescents and their families. It is considered as the most important opportunity for adolescents for creating their ideal futures. Hence, regarding the importance of this exam and its accompanying pressures during the critical and stressful adolescence period, this study describes adolescents' perspective about what make them worried about the university entrance exam. Methods This study is based on responses of 500 high school female students to an open-ended question completed in their class. In total 482 adolescents wrote down their answers. Using quantitative content analysis, these statements were analyzed. Results The findings showed that three categories including "individual" category (87.90%) with three subcategories; Konkoor's outcome, readiness for Konkoor, self-blame, and "family" category (7.12%) with three subcategories; consequences of failure, family expectations, family conflicts, and "religious- socioeconomic" category (4.98%) with three subcategories; religion, financial status, educational policies as the main adolescents concern sources about the university entrance exam. Conclusion Considering the high concerns of female adolescents about the university entrance exam and the pressures that they receive from their families, society, and even themselves, modifying the educational policies, applying some measures to promote knowledge, and gaining required skills to deal with different aspects of such concerns are necessary for adolescents and their parents.

The relationship between self-esteem and sexual self-concept in people with physical-motor disabilities.

BACKGROUND: Self-esteem is the value that the individuals give themselves, and sexual self-concept is also a part of individuality or sexual-self. Impairment or disability exists not only in the physical body of disabled people but also in their attitudes. Negative attitudes affect the mental health of disabled people, causing them to have lower self-esteem. OBJECTIVES: This study aimed to examine the relationship between self-esteem and sexual self-concept in people with physical-motor disabilities. PATIENTS AND METHODS: This cross-sectional study was conducted on 200 random samples with physical-motor disabilities covered by Isfahan Welfare Organization in 2013. Data collection instruments were the Persian Eysenck self-esteem questionnaire, and five domains (sexual anxiety, sexual self-efficacy, sexual self-esteem, sexual fear and sexual depression) of the Persian multidimensional sexual self-concept questionnaire. Because of incomplete filling of the questionnaires, the data of 183 people were analyzed by the SPSS 16.0 software. Data were analyzed using the t-test, Man-Whitney and Kruskal-Wallis tests and Spearman correlation coefficient. RESULTS: The mean age was 36.88 ± 8.94 years for women and 37.80 ± 10.13 for men. The mean scores of self-esteem among women and men were 15.80 ± 3.08 and 16.2 ± 2.90, respectively and there was no statistically significance difference. Comparison of the mean scores of sexual anxiety, sexual self-efficacy, sexual self-esteem, sexual fear and sexual depression among men and women showed that women scored higher than men in all domains. This difference was statistically significant in other domains except the sexual self-esteem (14.92 ± 3.61 vs. 13.56 ± 4.52) (P < 0.05). The Kruskal-Wallis test showed that except for sexual anxiety and sexual self-esteem, there was a statistical difference between other domains of people's sexual self-concept and degree of disability (P < 0.05). Moreover, Spearman coefficient showed that there was only a correlation between men's sexual anxiety, sexual self-esteem and sexual self-efficacy with their self-esteem. This correlation was positive in sexual anxiety and negative in two other domains. CONCLUSIONS: Lack of difference in self-esteem of disabled people in different degrees of disability and in both men and women suggests that disabled people should not be presumed to have low self-esteem, and their different aspects of life should be attended to, just like others. Furthermore, studies should be designed and implemented based on psychological, social and environmental factors that can help disabled people to promote their positive sexual self-concept through marriage, and reduce their negative self-concept.

Self-esteem, general and sexual self-concepts in blind people.

BACKGROUND: People with visual disability have lower self-esteem and social skills than sighted people. This study was designed to describe self-esteem and general and sexual self-concepts in blind people. MATERIALS AND METHODS: This was a cross-sectional study, conducted in the Isfahan University of Medical Sciences in 2013-2014. In this study, 138 visually impaired people participated from Isfahan Province Welfare Organization and were interviewed for measuring of self-esteem and self-concept using Eysenck self-esteem and Rogers' self-concept questionnaires. The correlation between above two variables was measured using Statistical Package for the Social Sciences (SPSS) software by Pearson correlation test. RESULTS: Mean [± standard deviation (SD)] age of patients was 30.9 ± 8 years. The mean (±SD) of general self-concept score was 11 ± 5.83. The mean (±SD) of self-esteem score was 16.62 ± 2.85. Pearson correlation results showed a significant positive correlation between self-esteem and general self-concept (r = 0.19, P = 0.025). The mean of sexual self-concept scores in five subscales (sexual anxiety, sexual self-efficacy, sexual self-esteem, sexual fear, and sexual depression) were correspondingly 11 ± 4.41, 19.53 ± 4.53, 12.96 ± 4.19, 13.48 ± 1.76, and 5.38 ± 2.36. Self-esteem and self-concept had significant positive correlation with sexual anxiety (r = 0.49; P < 0.001) (r = -.23; P < 0.001) and sexual fear (r = 0.25; P = 0.003) (r = 0.18; P = 0.02) and negative correlation with sexual self-efficacy (r = -0.26; P = 0.002) (r = -0.28; P = 0.001) and sexual-esteem (r = -0.34; P < 0.001) (r = -0.34; P < 0.001). CONCLUSION: Self-esteem and self-concept had significant correlation with sexual anxiety and sexual fear; and negative correlation with sexual self-efficacy and sexual-esteem.

Comprehensive view of the human mating process among young couples in isfahan-iran: an explanatory mixed-method study.

BACKGROUND: Heterosexual relationship is the main component of mate selection. Regardless of the importance of mate favorites, little is known about exact valued criteria in potential mates. OBJECTIVES: This study was designed to comprehensively explain the theoretical view of the human mating process. MATERIALS AND METHODS: This was as an explanatory mixed-method study. The first phase was a cross-sectional quantitative study with two Farsi-modified versions of instruments: preferences concerning potential mates and factors of choosing a mate; content analysis was the second phase. The quantitative phase of this study consisted of 202 dating couples, decided to get married. The qualitative phase consisted of 28 participants who acquired the extreme scores (highest and lowest) in the first phase. RESULTS: Average age of marriage for women and men was 23.04 and 26.41 respectively; the actual age difference was 3.37 years (women younger than men). The results of this study in support of evolution-based theory explained that, age is a preference and choosing an older husband and a younger wife is due to having reproductive capacity. Also, they mentioned that appearance is necessary for men because of sexual attraction, not as a prediction for the next generation appearance. In both phases of this study, both genders had a strong emphasis on "chastity" in a potential mate. Results showed that, men preferred a mate who was a good housewife, capable of cooking, and women preferred a mate with "Good earning capacity", "Good financial prospect" "university education", "Favorable social status" and "Industriousness". CONCLUSIONS: The results confirmed that for a comprehensive view in human mating process, we need a combined theoretical approach as well as qualitative and quantitative study to explore the real meaning of each preference in a mate.