The Effect of Sex Education and Counseling Based on the Ex-PLISSIT Model on Sexual Life in Primigravidas

Year 2024, Volume: 14 Issue: 2, 367 - 376, 28.06.2024

Nermin Altunbaş , Zehra Gölbaşı

https://doi.org/10.33808/clinexphealthsci.1305002

Abstract

Objective: This study was conducted to determine the effect of sexual education and counseling based on the Ex-PLISSIT model on sexual function, attitudes towards sexuality during pregnancy, sexual distress, and quality of sexual life in primigravidas.
Methods: This study was carried out on 62 primigravidas in a pretest posttest, a quasi-experimental control group. Primigravidas meeting the inclusion criteria were assigned to the groups by simple random sampling method. The intervention group received training and counseling sessions twice. The control group received routine care during the follow-up period. The results were compared with the evaluation forms 10 weeks after each training and counseling session. The forms were administered to the control group at the same time as the intervention group.
Results: The mean scores of the intervention and control groups’ attitude towards sexuality during pregnancy in the second test (95%CI=2.33-19.01; d=0.65, p=.013) and in the posttest (95%CI=2.28-19.34; d=0.64, p=.015) were statistically significantly different. Sexual life quality scale mean scores of the intervention and control groups were statistically significant in the second test (95%CI=8.27-18.54; d=1.33, p=.000) and the posttest (95%CI=12.14-22.01; d=1.76, p=.000) level was different. In addition, the mean scores of the intervention group were higher after sexual education and counseling based on the Ex-PLISSIT model.
Conclusion: In this study, sexual education and counseling based on the Ex-PLISSIT model positively affected primigravida’s attitudes towards sexuality and their quality of sexual life. Therefore, this model can be used as a cost-effective and simple counseling method to improve the sexual life.

Keywords

Ex-PLISSIT model, primigravida, sexual counseling, sexual education, sexual life

References

• Bjelica A, Cetkovic N, Pjevic AT, Segedi LM. The phenomenon of pregnancy-a psychological view. Ginekol Pol. 2018;89(2):102-106. DOI:10.5603/GP.a2018.0017.
• Aksoy A, Vefikuluçay Yılmaz D, Yılmaz M. Gebelikte cinsel yaşantiyi neler etkiler? Journal of Adnan Menderes University Health Sciences Faculty 2019;3(1):45-53.
• Jawed Wessel S, Santo J, Irwin J. Sexual activity and attitudes as predictors of sexual satisfaction during pregnancy: A multi‑level model describing the sexuality of couples in the first 12 weeks. Arch Sex Behav. 2019; 48:843-854. DOI:10.1007/s10508-018-1317-1.
• Khalesi ZB, Bokaie M, Attari SM. Effect of pregnancy on sexual function of couples. Afr Health Sci. 2018;18(2): 227-234. DOI:10.4314/ahs.v18i2.5.
• Alan Dikmen H, Gönenç İM, Özaydın P. Sexuality during pregnancy: Attitudes, self-efficacy and self-consciousness. Women & Health 2023;7(63):518-530. DOI:10.1080/03630242.2023.2234503.
• Bilge Ç, Mecdi Kaydırak M, Öner Ö, Balkaya NA. Gebelikte cinsel işlev ve cinsel memnuniyetin değerlendirilmesi. İnönü Üniversitesi Sağlık Hizmetleri Meslek Yüksekokulu Dergisi 2021;9(2):684-693. DOI:10.33715/inonusaglik.820979.
• Akyuz MD, Turfan EC, Oner SC, Sakar T, Aktay DM. Sexual functions in pregnancy: Different situations in near geography: A case study on Turkey, Iran and Greece. J Matern Fetal Neonatal Med. 2020; 33(2):222-229. DOI:10.1080/14767058.2018.1488164.
• Banaei M, Torkzahrani S, Ozgoli G, Azad M, Mahmoudikohani F, Yabandeh AP. Addressing the sexual function of women during first six month after delivery: A quasi-experimental study. Mater Sociomed 2018;30(2): 136. DOI:10.5455/msm.2018.30.136-140.
• World Health Organization. Sexual health and its linkages to reproductive health: An operational approach. Accessed [16 July 2023]. https://www.who.int/publications/i/item/978924151288.
• Brites L, Silva S, Andreoli L, Inês L. Effectiveness of reproductive health counseling of women with systemic lupus erythematosus: Observational cross-sectional study at an academic lupus clinic. Rheumatol Int 2021;41(2):403-408. DOI:10.1007/s00296020-04671-9.
• Almeida NG, Britto DF, Figueiredo JV, Moreira TMM, Carvalho REFL, Fialho AVM. PLISSIT model: Sexual counseling for breast cancer survivors. Rev Bras Enferm 2019;72(4):1109-1113. DOI:10.1590/0034-7167-2018-0525.
• Tuncer M, Yeşiltepe Oskay Ü. Sexual counseling with the PLISSIT model: A systematic review. J Sex Marital Ther 2022;48(3):309-318. DOI:10.1080/0092623X.2021.1998270 .
• Taylor B, Davis S. Using the extended PLISSIT model to address sexual healtcare needs. Nurs Stand. 2006;21(11):35-40. DOI:10.7748/ns2006.11.21.11.35.c6382.
• Barzandig RA, Jahdi NS, Nourizadeh R, Malakouti J, Mousavi S, Dokhtvasi G. The effect of counseling based on Ex-PLISSIT model on sexual dysfunction and quality of sexual life of married women with Multiple Sclerosis: A randomized controlled clinical trial. Sex Disabil. 2020;38(11):271-284. DOI:10.1007/s1119502009617-4.
• Dangesaraki MM, Maasoumi R, Hamzehgardeshi Z, Kharaghani R. Effect of the Ex-PLISSIT model on sexual function and sexual quality of life among women after hysterectomy: A randomised controlled trial. Sex Health. 2019;16(3):225-232. DOI:10.1071/SH18107.
• Rostamkhani F, Moghadam R, Khoei M, Jafari F, Ozgoli G. Effect of counseling using PLISSIT model on sexual function of pregnant women. PCNM. 2016;6(1):18-28.
• Khezreian F, Jalali A, Kaboudi M, Salari N. Counseling based on PLISSIT model and sexual function among pregnant women. Pharmacophore 2017; 8(2):50-53.
• Rosen R, Brown C, Heiman J. The female sexual function index (FSFI): A multidimensional self-report instrument fort the assessment of female sexual function. J Sex Marital Ther. 2000; 26(2):191-208. DOI:10.1080/009262300278597.
• Aygin D, Aslan FE. Kadın cinsel işlev ölçeğinin Türkçeye uyarlanması. Turkiye Klinikleri J Med Sci 2005; 25:393-399.
• Sezer NY, Erenel AŞ. Development of an attitude scale toward sexuality during pregnancy. J Sex Marital Ther. 2021; 47(5):492-507. DOI:10.1080/0092623X.2021.1911892.
• DeRogatis L, Clayton A, D’Agostino DL, Wunderlich G, Fu Y. Validation of the female sexual distress scale-revised for assessing distress in women with hypoactive sexual desire disorder. J Sex Med 2008; 5(2):357-364. DOI:10.1111/j.17436109.2011.02385.x.
• Aydın S, Onaran Öİ, Topalan K, Aydın ÇA, Dansuk R. Development and validation of Turkish version of the female sexual distress scale-revised. Sex Med 2016; 4(1):e43-50. DOI:10.1016/j.esxm.2015.12.003.
• Symonds T, Boolell M, Quirk F. Development of a questionnaire on sexual quality of life in women. J Sex Marital Ther. 2005;1(5):385-397. DOI:10.1080/00926230591006502.
• Tuğut N, Gölbaşı Z. Cinsel yaşam kalitesi ölçeği-Kadın Türkçe versiyonunun geçerlik ve güvenirlik çalışması. Cumhuriyet Tıp Dergisi 2010;32(2):172-180.
• Oh EJ, Kim MJ. Factors affecting the sexual function of pregnant women. Korean J Women Health Nurs 2019;25(1):73-85. DOI:10.4069/kjwhn.2019.25.1.73.
• Ziaei T, Keramat A, Kharaghani R, Haseli A, Ahmadnia E. Comparing the effect of extended plissit model and group counseling on sexual function and satisfaction of pregnant women: A randomized clinical trial. J Caring Sci 2022;11(1):1-8. DOI:10.34172/jcs.2022.06.
• Nejati B, Masoumi SZ, Parsa P, Karami M, Mortazavi A. Effect of counselling based on the PLISSIT model on pregnant women’s sexual satisfaction: A randomised controlled trial. Fam Med Prim Care Rev 2020;22(1):43-48. DOI:10.5114/fmpcr.2019.90163.
• Shahbazi Z, Khalili AF, Sattarzadeh N, Kamalifard M. The effect of sexual counseling based on PLISSIT model on sexual function of pregnant women: A randomized controlled clinical trial. IJWHR. 2018;7(3):372-379. DOI:10.15296/ijwhr.2019.6125.
• Azari Barzandig R, Sattarzadeh Jahdi N, Nourizadeh R, Malakouti J, Mousavi S, Dokhtvasi G. The effect of counseling based on EX-PLISSIT model on sexual dysfunction and quality of sexual life of married women with multiple sclerosis: A randomized controlled clinical trial. Sex Disabil 2020;38(2):271-284. DOI:10.1007/s11195-020-09617-4.
• Daneshfar F, Moghadam ZB, Khakbazan Z, Nabavi SM, Nayeri N, Ghasemzadeh S, Montazeri A. The influence of Ex-PLISSIT (extended permission, limited information, specific suggestions, intensive therapy) model on intimacy and sexuality of married women with multiple sclerosis. Sex Disabil 2017;35(4):399-414. DOI:10.1007/s11195-017-9482-z.
• Mohammadi Z, Maasoumi R, Vosoughi N, Eftekhar T, Soleimani M, Montazeri A. The effect of the EX‑PLISSIT model‑based psychosexual counseling on improving sexual function and sexual quality of life in gynecologic cancer survivors: A randomized controlled clinical trial. Supportive Care in Cancer 2022;30(11):9117-9126. DOI:10.1007/s00520-022-07332-8.
• Nazari S, Karamatkar M, Moghdehipanah H, Olfati F. The effect of ex‑PLISSIT model on sexual satisfaction in women with multiple sclerosis. Sex Disabil 2023;41(2):1-11. DOI:10.1007/s11195-023-09787-x.
• Shami M, Montazeri A, Taherah F, Behboodi Moghadam Z. The effect of sexual counseling based on ex‑plİssİt model on improving the sexual function of married women with systemic lupus erythematosus: A Randomized controlled trial. Sex Disabil 2023;41(2):451-466. DOI:10.1007/s11195-023-09776-0.
• Topatan S, Koç E. Gebelik döneminde yaşanan kadın cinsel sıkıntı durumu ve ilişkili faktörler. FÜ Sağ Bil Tıp Derg. 2020;34(1):13-19.
• Farnam F, Janghorbani M, Raisi F, Merghati Khoei E. Compare the effectiveness of PLISSIT and sexual health models on women’s sexual problems in Tehran, Iran: A randomized controlled trial. J Sex Med 2014;11(11):2679-2689. DOI:10.1111/jsm.12659.
• Çavuş E, Beyazıt F. Gebeliğin farklı evrelerinde cinsel aktiviteyi ve cinselliğe bağlı yaşam kalitesini etkileyen faktörlerin değerlendirilmesi. İstanbul Tıp Dergisi 2019;20 (3):234-240. DOI:10.4274/imj.galenos.2018.37267.
• Alizadeh S, Riazi H, Alavi Majd H, Ozgoli G. The effect of sexual health education on sexual activity, sexual quality of life, and sexual violence in pregnancy: A prospective randomized controlled trial. BMC Pregnancy Childbirth. 2021;26;21(1):334-345. DOI:10.1186/s12884-021-03803-8.
• Heidari M, Amin Shokravi F, Zayeri F, Azin SA, Merghati Khoei E. Sexual life during pregnancy: Effect of an educational intervention on the sexuality of Iranian couples: A quasiexperimental study. J Sex Marital Ther 2018;44(1):45-55. DOI:1.1080/0092623X.2017.1313799.