Effectiveness of the PLISSIT Model-based Counseling on the Sexual Function of Couples during Pregnancy

Authors
Masumeh Heidari 1
Farkhondeh Amin Shokravi 2
Farid Zayeri 3
Seyed Ali Azin 4
1 1. Ph.D. Candidate of Department of Health Education and Health Promotion, Faculty of Medical Sciences, Tarbiat Modares University, Theran, Iran Email: masumeh.heidari@modares.ac.ir 2. Faculty member of Shahed university Email: heidari@shahed.ac.ir
2 Associate Professor, Department of Health Education and Health Promotion, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
3 Associate Professor, Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
4 Professor, Department of Health Promotion, Iranian Academic Center for Education, Culture and Research, ACECR, Tehran, Iran
Abstract
Aim: The aim of this study was to evaluate the impact of the PLISSIT model-based counseling on the sexual function of couples during pregnancy.
Methods: This quasi-experimental study was carried out in Tehran (Najmieh Hospital) on 88 couples who were randomly assigned to the control (44 couples) and intervention (44 couples) groups. The intervention group received sexual counseling based on a PLISSIT model by a trained midwife, and the control group received only routine services in prenatal care. Sexual functions of the couples were assessed by the Female Sexual Function Index (FSFI) and International Index Erectile Function (IIEF) questionnaires before counseling, 4 weeks after counseling, and at the end of the second trimester of pregnancy. Independent t-test and repeated measures analysis of variance (ANOVA) test were used for comparison of the scores within the groups.
Findings: No significant differences were found in the demographic variables of the subjects. The mean total scores of FSFI and IIEF were not different at baseline in the two groups. Repeated measure analysis showed significant differences between the two groups in the mean total scores of FSFI and IIEF after the intervention. Post intervention, the mean of the total score of sexual function of the couples was significantly higher in the intervention group compared with the control group (P<0.05).
Conclusion: Based on the results of this study, sex education for prenatal care would be effective, and we can claim that sexual function of couples during pregnancy may be enhanced by using the PLISSIT model.

Keywords

1. Bartellas E, Crane JM, Daley M, Bennett KA, Hutchens D. Sexuality and sexual activity in pregnancy. BJOG 2000; 107(8): 964-8. DOI: 10.1111/j.1471-0528
2. Gałazka I, Drosdzol‐Cop A, Naworska B, Czajkowska M, Skrzypulec‐Plinta V. Changes in the sexual function during pregnancy. J Sex Med 2015; 12(2): 445-54. DOI: 10.1111/jsm.12747
3. Pauleta JR, Pereira NM, Graça LM. Sexuality during pregnancy. J Sex Med 2010; 7(1): 136-42. DOI: 10.1111/j.1743-6109
4. Pauls RN, Occhino JA, Dryfhout VL. Effects of pregnancy on female sexual function and body image: A prospective study. J Sex Med 2008; 5(8): 1915-22. DOI: 10.1111/j.1743-6109
5. Gazafroodi KA, Najafi F, Kazemnejad E, Rahimikian F, Shariat M, Rahna ma P. Comparison of sexual function between nulliparous with multiparous pregnant women. Hayat. 2012; 18(5): 55–63.
6. Abdo CH, Oliveira WM, Moreira ED, Fittipaldi JA. Prevalence of sexual dysfunctions and correlated conditions in a sample of Brazilian women: Results of the Brazilian study on sexual behavior (BSSB). Int J Impotence Res 2004; 16: 160-6. DOI: 10.1038/sj.ijir.3901198
7. Naldoni LM, Pazmiño MA, Pezzan PA, Pereira SB, Duarte G, Ferreira CH. Evaluation of Sexual Function in Brazilian Pregnant Women. J Sex Marital Ther 2011; 37: 116-29. DOI: 10.1080/0092623X.2011.560537
8. Leite APL, Campos AAS, Dias ARC, Amed AM, De Souza E, Camano L. Prevalence of sexual dysfunction during pregnancy. RSBC 2009; 55(5): 563-8.
9. Jamali S, Mosalanejad L. Sexual dysfnction in Iranian pregnant women. IJRM 2013; 11(6): 479. DOI: 10.1590/S0104-42302009000500020
10. Bayrami R, Sattarzadeh N, Koochaksariie FR, Pezeshki MZ. Sexual dysfunction in couples and its related factors during pregnancy. J Reprod Infertil 2008; 9(3): 273-82.
11. Ebrahimian A, Heydari M, Saberi Zafar Ghandi MB, Delavari S. Comparing Sexual Dysfunctions in Men before and during Their Wives' Pregnancy. Sem Med Sci Mag 2012; 15(33): 19-25.
12. Nakic Rados S, Soljacic Vranes H, Sunjic M. Sexuality during pregnancy: what is important for sexual satisfaction in expectant fathers? J Sex & Marit Therap 2015; 41(3): 282-93. DOI: 10.1080/0092623X.2014.889054
13. Solberg DA, Butler J, Wagner NN. Sexual behaviour in pregnancy. N Engl J Med 1973; 288: 1098-103. DOI: 10.1056/NEJM197305242882105
14. Kenny JA. Sexuality in pregnant and breastfeeding women. Arch Sex Behav 1973; 2: 215-29.
15. Masters WH, Johnson VE. Human sexual response. Boston: Little, Brown 1966, p: 34-42.
16. Nichols FH, Humenick SS. Childbirth education: practice, research and theory. WB Saunders Company; 2000; p: 84-90
17. Onah H, Iloabachie G, Obi S, Ezugwu F, Eze J. Nigerian male sexual activity during pregnancy. Obstet Gynecol Int J 2002; 76(2): 219-23. DOI: 10.1016/S0020-7292(01)00579-3
18. Hassan ZR, Shafie K, Bashardoust N, Reihani M, Jaberi P. Study of the related factors in couples sexual relationship during pregnancy. JQUMS. 2002; 5(4): 62-7.
19. Serati M, Salvatore S, Siesto G, Cattoni E, Zanirato M, Khullar V, Cromi A, Ghezzi F, Pierfranceco B. Female sexual function during pregnancy and after childbirth. J Sex Med 2010; 7(8): 2782-90. DOI: 10.1111/j.1743-6109.2010.01893.x
20. Yeniel A, Petri E. Pregnancy, childbirth, and sexual function: perceptions and facts. Int Urogynecol J 2014; 25(1): 5-14.
21. Fok WY, Chan LYS, Yuen PM. Sexual behavior and activity in Chinese pregnant women. AOGS 2005; 84(10): 934-8. DOI: 10.1111/j.0001-6349.2005.00743.x
22. De Pierrepont C, Polomeno V. Role of the perinatal sexologist in the interdisciplinary perinatal health care team in Canada. Gynecol Obstet Fertil 2014; 42(7): 507-14. DOI: 10.1016/j.gyobfe.2014.05.012
23. Senkumwong N, Chaovisitsaree S, Rugpao S, Chandrawongse W, Yanunto S. The changes of sexuality in Thai women during pregnancy. J Med Assoc Thai 2006; 89(4): 124-9. 24. Ayaz S. Approach to sexual problems of patients with stoma by PLISSIT model: An alternative. Sex Disabil 2009; 27: 71-81. 25. Chun N. Effectiveness of PLISSIT model sexual program on female sexual function for women with gynecologic cancer. J Korean Acad Nurs 2011; 41: 471-80. DOI: 10.4040/jkan.2011.41.4.471 26. Mansour SE, Shebl AM, Waheda SM. The effect of sexual counseling program on pain level and sexual function among women with dyspareunia. J Educ Pract 2014; 5: 208-20.
27.Ayaz S, Kubilay G. Effectiveness of the PLISSIT model for solving the sexual problems of patients with stomas. J Clin Nurs. 2009; 18: 89-98. DOI: 10.1111/j.1365-2702.2008.02282.x 28. Vakilian K, Mirzaii K, NajmAbadi Reproductive health in Iran: International Conference on Population and Development Goals. Oman Med J 2011; 26: 143-7. DOI: 10.5001/omj.2011.36 29. Lankarani KB, Alavian SM, Peymani P. Health in the Islamic Republic of Iran: challenges and progresses. Med J Islam Repub Iran 2013; 27: 42-9. 30. Joulaei H, Motazedian N. Primary health care strategic key to control HIV/AIDS in Iran. Iran J Public Health 2013; 42: 540-1.
31.Afshar M, Mohammad-Alizadeh-Charandabi S, Merghati-Khoei ES, Yavarikia P. The effect of sex education on the sexual function of women in the first half of pregnancy: a randomized controlled trial. J Caring Sci 2012; 1(4): 173-81. DOI: 10.5681/jcs.2012.025
32. Mohammadi K, Heydari M, Faghihzadeh S. The female sexual function index (FSFI): validation of the Iranian version. Payesh 2008; 7(3): 269-78.
33. Rosen C, Brown J, Heiman SL, C. Meston, R. Shabsigh, D. Ferguson, R. D'Agostino, R. The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex & Marit Therap 2000; 26(2): 191-208. DOI: 10.1080/009262300278597
34. Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick J, Mishra A. The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology 1997; 49(6): 822-30. DOI: 10.1016/S0090-4295(97)00238-0
35. Pakpour AH, Zeidi IM, Yekaninejad MS, Burri A. Validation of a translated and culturally adapted Iranian version of the International Index of Erectile Function. J Sex & Marit Therap 2014; 40(6): 541-51.
36. Dupont WD, Plummer WD. Power and sample size calculations for studies involving linear regression. Controlled Clinical Trials 1998; 19(6): 589-601. DOI: 10.1016/S0197-2456(98)00037-3 37.Annon JS. The PLISSIT model: A proposed scheme for the behavioral treatment of sexual problems. J Sex Educ Ther 1976; 2: 1-15. DOI: 10.1080/01614576.1976.11074483
38. Sossah L. Sexual behavior during pregnancy: a descriptive correlational study among pregnant women. EJRMS 2014; 2(1): 16-27.
39. Babazadeh R, Mirzaii K, Masomi Z. Changes in sexual desire and activity
during pregnancy among women in Shahroud, Iran. Obstet Gynecol Int J 2013; 120(1): 82-4.
40. Mangeli M, Ramezani T, Mangeli S. The Effect of Educating about Common Changes in Pregnancy Period and the Way to Cope with Them on Marital Satisfaction of Pregnant Women. IJME 2009; 8(2): 305-13.
41. Bahadoran P, Mohammadi Mahdiabadzade M, Nasiri H, Gholami Dehaghi A. The effect of face-to-face or group education during pregnancy on sexual function of couples in Isfahan. Iran J Nurs Midwifery Res 2015; 20(5): 582.
42. Mohammadi N, Tizhosh M, Seyedshohadae M, Haghani H. Comparison of two methods of group training and individual training on knowledge and anxiety in patients hospitalized for coronary angiography. J Nurs Midwifery Tehran Univ Med Sci 2012; 18: 44-53.
43. Blorchi FF, Neshapori M, Abed SJ. Comparison of individual and group training, knowledge, attitudes and skills to care for patients with diabetic foot ulcers. Iran J Nurs 2009; 22: 33-41.
44.Von Sydow K. Sexuality during pregnancy and after childbirth: a metacontent analysis of 59 studies. J Psychosom Res 1999; 47: 27-49. DOI: 10.1016/S0022-3999(98)00106-8
45. Uwapusitanon W, Choobun T. Sexuality and sexual activity in pregnancy. J Med Assoc Thai 2004; 87: 45-9.
46. De Pierrepont C, Polomeno V, Bouchard L, Reissing E. What do we know about
perinatal sexuality? A scoping review on sexoperinatality - Part 1. J Gynecol Obstet Biol Reprod 2016; 45(8): 796. DOI: 10.1016/j.jgyn.2016.06.003
Health Education and Health Promotion
Volume 5, Issue 4
Autumn 2017
Pages 39-54