Comparision the Effectiveness of Counseling based on two models of PLISSIT and BETTER on Sexual function and Sexual self-disclosure of women after childbirth

Comparision of the effectiveness of sexual couseling based on PLISSIT and BETTER models on sexual function and sexual self-disclosure of women after childbirth

A total of 80 women with score 28 or less than 28 in FSFI questionnaire between 4weeks to 6 months after chilldbirth randomly divided into two groups of PLISSIT and BETTER by table of random numbers.

A total of 80 women with history of sexual problem between 4weeks to 6 months after chilldbirth, will be randomized into one of the groups. subjects were allocated to each group ofPLISSIT and BETTER randomly by Table of random numbers. First group will receive PLISSIT model and BETTER model will be implemented for the second group. Both groups will participate in two sessions. All enrolled subjects will be assessed for demographic characteristics, sexual function, sexual self-disclosure, stress, depression and anxiety.Not blinded.

Inclusion criteria:Giving a written consent; Having literacy; Being iranian and living in Mashhad; Having a single child in recent pregnancy; Age 20-45 years; Married and having an intact marriage; Participate in study from 4weeks to 6 months after delivery; Having sex sfter delivery; Score 28 or less than in FSFI questionnaire; Do not have chronic medical history that affect on sexual function; Term pregnancy.Exclusion criteria: Alcohol and other form of drug abuse; Severe mental disorder; Participate in sexual educational sessions outside the study enviroment; Taking medications that affect sexual function in woman or her husband; Prostatic and sexual dysfunction in husband; Postpartum complications inrecent delivery; History of surgical procedures or pelvic radiotherapy.

PLISSIT model (Permission, Limited Information, Specific Suggestions, Intensive Therapy):The subjects in this group will receive five 60-90 minute therapy sessions.St1: Permission; client freely talks about her sexual concerns. Permission also is given to those non-problematic sexual behaviors which subject has already experienced. St2: Limited Information; therapist provides patient with limited information about the given problem. St3: Specific Suggestions; specific recommendations are offered enabling patient to manage her sexual problems. The fourth stage: Intensive Therapy; psycho-sexual therapy is performed by the researcher or Co-I psychiatrist.BETTER treatment model:The subjects in this group will receive five 60-90 minute therapy sessions.BETTER model include 6 steps.St1: Bring up;the counselor simply speaks to the client about sexual issues and tells them that he can talk quite comfortable. In fact, this step is to give the client a chance to talk about sexual issues and identify her attitudes. St2: Explain; The consultant explains the importance and impact of sexual issues on quality of life, and also tells the reader that it is completely free to talk about this. It helps to normalize sexual discourse and reduce feelings of shame.St3: TELL; The consultant assures the client that she will provide all his information to solve her problem. St4:Time; The counseling time is determined on the basis of the patient's preference. St5: Educate; The counselor will educate the patient about the complications of childbirth, the effects of childbirth on sexual matters.St6: Record; Interventions and therapeutic outcomes are recorded.At the end one month after the last sessions, the degree of sexual self-disclosure and sexual function score Sex is measured.

sexual function; sexual self-disclosure

The initial selection of samples was a multistage cluster. From the five health centers of Mashhad, two comprehensive health services were selected randomly (centers number 1 and 3). Then, among the centers of health center number one, two centers (one in city and the other is the margin) through the lottery. For the health center number three, we also work the same way. Of the 4 centers selected (2 centers are in the margin area and 2 centers in the non-marginal area of ​​Mashhad) we select one health center by lottery, which collects 4 base stations. Of all 4 centers and 4 bases, 10 eligible samples are selected as unpredictable. In order to prevent the exchange of information, Participants in centers and sub-bases receive counseling in two different ways.