The Effect of Sexual Counseling Based on PLISSIT Model on Sexual Function and satisfaction of Pregnant Women: A Randomized Controlled Clinical Trial

Abstract

Abstract: Background and aim: Human sexuality is the most inherent emotions and deepest desires for the meaning of a relationship, and includes the dimensions of physiology, psychology, social, and sexual response. Sexual activity is a complex and unique phenomenon that is affected by various factors, including pregnancy. Pregnancy is one of the most sensitive periods in women's lives that is associated with physical, psychological and hormonal changes that affects on the sexual relationships, tendencies, sexual function, and sexual satisfaction of women and their sexual partner in relation to other social and cultural factors. The purpose of this study was to determine the effect of sexual counseling on the performance and sexual satisfaction of pregnant women. Materials and Methods: This study was conducted on 70 women aged 18- 35 years old, primigravida, during 16-20 weeks of pregnancy and referring to Ardabil-Iran health centers from April to June 2011. The participants were randomly allocated to two groups of intervention (35 people) and control (35 people). Intervention group received 1-4 sessions of sexual counseling based on the PLISSIT model. Sessions were held individually and once a week on sexual problems during pregnancy in the dimensions of activity and sexual desires, mental and physical changes during pregnancy, sexual response and position. Sexual function, sexual satisfaction, and sexual knowledge and attitude questionnaires were completed by the researcher through interviews with the participants before and four weeks after intervention. The initial outcome was the mean of overall score of sexual performance and sexual satisfaction of pregnant women. Data was analyzed using repeated measure ANCOVA. Results: 33 people in the intervention group and 35 in the control group were followed up and analyzed by the end of the study. The two groups (intervention and control) were similar in terms of socio-demographic characteristics and the base scores of general sexual performance, sexual satisfaction, and sexual awareness and attitude. Based on repeated measure ANCOVA test by controlling the baseline score after intervention, The intervention group compared with the control group, the mean score of the sexual performance was [the mean difference was adjusted with 95% confidence interval = 9.07 (7.24 to 10.90); p <0.001] and in all of its sub-scales, there was a significant increase in p <0.001, Mean score of sexual satisfaction in intervention group compared to control group [modified mean difference was: 10.07, 95% confidence interval = 11.7 to 13.02; p <0.001] significant increase was observed. Mean score of sexual awareness in the intervention group was significantly higher than the control [modified mean difference was: 2.77, 95% confidence interval = 2.35 to 3.19; p <0.001]. Also, the mean of attitude score in the intervention group was statistically significant in comparison to the control group [modified mean difference was: 11.06, 95% confidence interval = 9.16 to 12.96; p <0.001] Conclusion: In the present study sexual counseling based on the PLISSIT model in pregnant women was associated with promoting sexual function and sexual satisfaction, increasing sexual knowledge during pregnancy, and changing towards positive attitude of pregnant women. Therefore adding sexual counseling sessions based on the PLISSIT model to prenatal care -that is routinely provided in all health care centers of the country for pregnant women- can improve the sexual health of mothers and their sexual partner.