A clinical trial of the effect of sexual health education on the quality of life of married Muslim women in Iran

Exploring the association between sexual motivation and quality of life in China and the United Kingdom

Previous research suggests that different sexual motivations may be associated with different sexual behaviours and levels of sexual satisfaction, and these may vary with cultural differences. As such, sexual motivations and cultural factors might also be associated with quality of life (QoL); however, this has not yet been explored. Using a biopsychosocial approach, this study aimed to explore associations between sexual motivation and quality of life between participants in the United Kingdom and China. 276 participants (143 British, 133 Chinese, mean age = 21.5 years) completed an anonymous online survey including validated measures for sexual motivation (YSEX?-SF) and QoL (WHOQOL-BREF). In multivariable linear regressions, pleasure motivations for sex were associated with increased physical health QoL (aOR = 0.20, 95%CI:.15-.65), while love and commitment motivations were associated with increased psychological health QoL (aOR = 0.13, 95%CI:.01-.43). Both love and commitment motivations (aOR = 0.21, 95%CI:.09-.35) and pleasure motivations (aOR = 0.20, 95%CI:.08-.36) were associated with increased social support QoL. A significant interaction was found between emotional motivations and culture (p = 0.037) such that among individuals from China, emotional motivations (i.e., love and commitment and expression) were positively associated with psychological QoL. This suggests culture may differentially affect how sexual motivations are associated with QoL and warrants further consideration in future research.

The effects of sexual counseling and pelvic floor relaxation on sexual functions in women receiving vaginismus treatment: a randomized controlled study

INTRODUCTION AND HYPOTHESIS

The purpose of this study is to determine the effects of sexual counseling and pelvic floor relaxation on sexual functions in women receiving vaginismus treatment.

METHODS

A total of 34 women at the vaginismus treatment stage, including 17 in the experiment group and 17 in the control group, were included in the study with a randomized controlled design. In addition to the routine treatment protocol, women in the experiment group were provided with pelvic relaxation and sexual counseling based on the Information, Motivation, Behavior (IMB) model consisting of four sessions. The control group received the routine treatment protocol. The assessments were made at the 3rd week and 2nd month after coitus. The women filled out an Information Form, the validated Female Sexual Function Index (FSFI), and the Vaginal Penetration Cognition Questionnaire (VPCQ).

RESULTS

The mean age of the women was 27.59±5.32, and their mean duration of marriage/relationship was 33.44±12.11 months. After the treatment statistically significant increases were observed in the total FSFI scores and the desire, arousal, and pain dimension scores of the experiment group in comparison with the control group (p<0.05). In the VPCQ total scores, there was a significant reduction in the experiment group in comparison with the control group and after the treatment in comparison with before the treatment (p<0.01).

CONCLUSIONS

The sexual counseling based on the IMB model and pelvic relaxation interventions provided to the women who were receiving vaginismus treatment affected their sexual function positively. It may be recommended to conduct comparative studies with a broader sample and different models.

Sexual quality of life and sexual self-efficacy among women during reproductive-menopausal transition stages and postmenopause: a comparative study

Sexual self-efficacy is essential for appropriate and desirable sexual function and sexual quality of life. This study aimed to compare sexual quality of life and sexual self-efficacy among women during reproductive-menopausal transition stages and postmenopause. This was a cross-sectional study of a sample of Iranian women. The sexual quality of life-female (SQOL-F) scale was used to measure sexual quality of life (SQOL) and sexual self-efficacy (SSE) was measured using the sexual self-efficacy questionnaire (SSEQ). Data were compared between the study groups using multiple linear regression. In all 340 women (170 in reproductive-menopausal transition stages and 170 postmenopause) were studied. The mean ages of reproductive-menopausal transition stages and postmenopausal women was 30.8 ± 6.55 and 56.3 ± 3.54 respectively (P < 0.001). Sexual self-efficacy and sexual quality of life were found to be significantly higher in reproductive-menopausal transition stages compared with postmenopause women (P < 0.001 and P = 0.017 respectively). Sexual and relationship satisfaction and sexual repression subscales differed significantly between the two groups (P = 0.001 and P < 0.001 respectively). Higher sexual self-efficacy contributed to higher sexual quality of life (P < 0.0001). Reproductive-menopausal transition stages women appear to enjoy higher levels of sexual self-efficacy and sexual quality of life. Given the importance of sexual quality of life, it is recommended to pay greater attention to sexual self-efficacy among postmenopausal women in order to improve sexual quality of life in this population.

Health-Care Professionals' Assessments of, and Recommendations for, Sexual-Health Education and Service Provision for Young People in Tehran

Background: Only limited Sexual Health and Relationships Education (SHRE) is provided in Iranian schools and universities while research has highlighted demand and need for improved SHRE among young adults. We explored health-care professionals' (HCPs) assessments of, and recommendations for, SHRE and service provision for young people in Tehran.

Design and Methods: Semi-structured interviews were conducted with a sample of 17 HCPs based in Tehran and verbatim transcripts were analyzed using thematic analysis.

Results: Participants confirmed the need for improved SHRE and service provision for young adults. HCPs described how a lack of reliable educational resources for young adults, taboo and cultural barriers, and a lack of trust and confidentiality prevented young people from accessing information and services. They unanimously supported education and services to be augmented, and provided recommendations on how this could be achieved.

Conclusions: A number of positive suggestions for the improvement of SHRE and Iranian sexual health services in Iran were identified.

A qualitative assessment of the sexual-health education, training and service needs of young adults in Tehran

BACKGROUND

Sexual Health and Relationships Education (SHRE) provides individuals with knowledge and skills to manage risky behaviors and take informed decisions to protect themselves against STIs, and unintended pregnancy. Only minimal SHRE is provided in Iranian schools and universities and previous research has highlighted needs and demands for improved SHRE and sexual services in Iran. This study explored young, Iranian adults' experience of, and need for sexual health education, sexual skills training and sexual healthcare services, as well their views on how to augment and improve existing provision.

DESIGN AND METHODS

Semi-structured interviews were conducted with a sample of 25 young adults who lived in Tehran, Iran and had volunteered to participate in the study. Transcripts were analyzed using thematic analysis.

RESULTS

Participants explained their needs and demands for sexual health education and sexual healthcare. They unanimously expressed their dissatisfaction with available SHRE and sexual health care provision. They highlighted barriers to gaining sexual health information and seeking advice and healthcare, including a lack of reliable resources, taboo and cultural barriers, lack of trust and protected confidentiality. This has resulted in ambiguities and misconceptions, including those regarding the cause and transmission of STIs and correct use of contraceptives. Participants recommended improvements, including holding mixed-gender extracurricular workshops with a comprehensive approach to sexual health and relationships education.

CONCLUSIONS

There is a clear need and demand for provision of relevant and reliable sexual health and relationships education for young adults in Tehran. This should be addressed to empower young people to make informed choices and avoid risky sexual behavior.

The effect of a midwife-based counseling education program on sexual function in postmenopausal women: a randomized controlled clinical trial

OBJECTIVE

The present study was conducted to investigate the effect of a midwife-based counseling education program on sexual function in postmenopausal women.

METHODS

A randomized clinical trial was conducted on 52 eligible postmenopausal women. Participants' sexual function was assessed using the Female Sexual Function Index (FSFI). The women were randomly allocated into two groups: (1) the intervention group, in which the participants received a midwife-based counseling education program in 4 sessions held at 10-day intervals, with each session lasting for 70 minutes; (2) the control group, in which the participants only received routine care. Data were collected 1 week before the start of the sessions, 2 weeks after the end of the sessions, and 2 months after the last follow-up.

RESULTS

No statistically significant differences were reported between the groups in terms of personal and sociodemographic characteristics and sexual function before the intervention; the total FSFI score was 17.05 (±4.54) in the intervention group and 16.66 (±3.62) in the control group. After the program, in the first and second follow-ups, the scores reached 27.18 (±4.61) and 28.20 (±4.43) in the intervention group and 16.06 (±3.94) and 16.32 (±2.98) in the control group. Significant improvements were observed in the total score of sexual function and all the FSFI domains in the intervention group, but not in the control group (P < 0.001).

CONCLUSION

Midwife-based counseling education can be an appropriate approach to improving sexual function in postmenopausal women.

Evaluation of feasibility and safety of changing body position after transfemoral angiography: A randomized clinical trial

BACKGROUND

Considering the growing number of patients who suffer from cardiovascular and coronary artery disease and the significant importance of angiography in the diagnosis of coronary artery disease, this study investigated the effects of position change on the acute complications of coronary angiography.

METHODS

This study was a randomized clinical trial. Sixty patients undergoing coronary angiography, which was performed by a single operator were selected by convenience sampling method and were assigned to intervention or control groups by randomized block design (30 cases in each group). Intervention group patients' position was changed according to schedule, whereas patients in the control group remained in the supine position in complete bed rest. At the entrance hours, 3, 6, 8, and 24 hours after the angiography, patients in both groups were evaluated in terms of vascular complications, urinary retention, low back pain, groin pain, and comfort. Data were analyzed by repeated measures, Friedman, Mann-Whitney, chi-square, independent t-test, and Kolmogorov-Smirnov tests with SPSS-22.

RESULTS

The two groups did not show any significant difference in terms of demographic, clinical, and preinterventional catheterization characteristics (P > 0.05). There was no significant difference with regard to vascular complications including hematoma (P = 0.149), bleeding (P > 0.01), bruise (P = 0.081), and thrombosis in the two groups of patients during 5 consecutive reviews. However, there was a significant statistical difference regarding low back pain (P < 0.001), groin pain (P < 0.001), urinary retention (P = 0.02), and comfort (P < 0.001).

CONCLUSIONS

The results of this study showed that changing the positions of patients after angiography based on the provided program created no change in the incidence of vascular complications (hematoma, bleeding, thrombosis, and bruise) but resulted in reduced severity of back pain, groin pain, urinary retention, and increased patients' comfort.

Considerations and guidance in designing equity-relevant clinical trials

Health research has documented disparities in health and health outcomes within and between populations. When these disparities are unfair and avoidable they may be referred to as health inequities. Few trials attend to factors related to health inequities, and there is limited understanding about how to build consideration of health inequities into trials. Due consideration of health inequities is important to inform the design, conduct and reporting of trials so that research can build evidence to more effectively address health inequities and importantly, ensure that inequities are not aggravated. In this paper, we discuss approaches to integrating health equity-considerations in randomized trials by using the PROGRESS Plus framework (Place of residence, Race/ethnicity/culture/language, Occupation, Gender, Religion, Education, Socio-economic status, Social capital and "Plus" that includes other context specific factors) and cover: (i) formulation of research questions, (ii) two specific scenarios relevant to trials about health equity and (iii) describe how the PROGRESS Plus characteristics may influence trial design, conduct and analyses. This guidance is intended to support trialists designing equity-relevant trials and lead to better design, conduct, analyses and reporting, by addressing two main issues: how to avoid aggravating inequity among research participants and how to produce information that is useful to decision-makers who are concerned with health inequities.