Investigating effective psychological interventions in pregnant women's sexual satisfaction: A systematic review.

Sexual satisfaction is an important factor in people's lives, which is effective in all aspects of a couple's life. During pregnancy, due to existing changes, sexual performance is affected, which will also change sexual satisfaction. By performing effective interventions, changes can be made in the level of sexual satisfaction. The aim of this study is to investigate effective psychological interventions in the sexual satisfaction of pregnant women, which has been conducted in the form of a systematic review. This study is performed in 2022 with the steps of design of study question, search in SID, PubMed, Magiran, Iran doc, Science Direct, Scopus, and Google Scholar search engine with keywords such as "interventions", "sexual satisfaction", "Sexual function", "couples", "pregnant women" and their English equivalents, and after that, related studies were identified from the period of 2012 to 2022 (the last 10 years), the selection of studies, which after screening the title, abstract, and full text. Among 821 studies, finally 13 studies were left to announce the results. Researches that had unclear sample size and method of implementation and whose full text was not available were initially excluded from the study process. Screening of the quality of the studies was done by the risk assessment checklist and the Jadad Scale of the intervention studies. Then the findings were classified. The results of the present study were taken from 13 articles, which included mindfulness, cognitive-behavioral therapy, therapy based on acceptance and commitment and group counseling, PLISSIT model intervention, and education and support package. As per the results of interventions, all interventions during pregnancy can increase sexual satisfaction in pregnant women. Therefore, such interventions are recommended but it is necessary to do more interventions with minimal bias and long-term follow-up and comprehensive examination of variables to reach stronger evidence.

Comparing the effect of sexual counseling based on BETTER and PLISSIT models on sexual assertiveness in women with breast cancer after mastectomy.

BACKGROUND: Sexual changes in breast cancer occur after diagnosis and treatment, including a mastectomy. Sexual assertiveness is an effective factor in sexual satisfaction, which means the ability to convey sexual feelings, beliefs, and thoughts. Given the limited studies on sexual assertiveness in breast cancer and different client participation, this study was conducted to compare the effect of sexual counseling based on two models of PLISSIT (Permission, Limited Information, Specific Suggestion, Intensive Therapy) and BETTER (Bring Up, Explain, Tell, Time, Education, Record) on sexual assertiveness in women after mastectomy. MATERIALS AND METHODS: This quasi-experimental intervention was conducted in 2021 in Mashhad, Iran. Seventy-eight mastectomized women with breast cancer were assigned to the BETTER (n = 39) and PLISSIT (n = 39) groups using permuted block randomization with a block size of 4 and an allocation ratio of 1:1. Both groups received four individual counseling sessions, one week apart. The research tools included a demographic information form and the Hulbert index of sexual assertiveness. Changes in the mean scores of sexual assertiveness between the two groups were evaluated before and four weeks after the intervention, and the mean changes were compared between the groups. Data analysis was conducted using the Kolmogorov-Smirnov test, independent t-test, paired t-test, and Chi-square tests using Statistical Package for the Social Sciences (SPSS) version 25 (P < 0.05). RESULTS: The results of the study showed that before the intervention, there was no significant difference in the score of sexual assertiveness in both groups (P = 0.253). The mean score of sexual assertiveness changes before and after the intervention in the BETTER group (8.07 ± 4.9) was significantly higher than in the PLISSIT group (5.58 ± 4.7) (P < 0.001). CONCLUSION: The results indicated that BETTER sexual counseling was more effective in increasing the sexual assertiveness of mastectomized women than PLISSIT counseling. Due to its simplicity and client-centeredness, this model can be used in breast cancer care programs.

Comparing the Effectiveness of Sexual Counseling Based on PLISSITand BETTER Models on Sexual Selfdisclosure in Women with Sexual Problems after Childbirth: A Randomized Trial.

BACKGROUND: Sexual self-disclosure is one of the factors that affect sexual satisfaction. The aim of this study was to assess the efficacy of individual therapy using the Bring up, Explain, Tell, Timing, Educate, and Record (BETTER model) in comparison to individual therapy using the Permission, Limited Information, Specific Suggestions, and Intensive Therapy (PLISSIT model) in terms of increasing sexual self-disclosure in women with sexual problems after childbirth. MATERIALS AND METHODS: This randomized trial was conducted in 2017 in Mashhad, Iran. 80 women with sexual problems within 4 weeks to 6 months after childbirth were randomized into two equal groups and received the interventions in 2 sessions of 60-90 minutes. The research instruments included a demographic questionnaire, the Female Sexual Function Index (FSFI) and Hulbert sexual self-disclosure index. Changes in mean (SD) scores of sexual self-disclosures between groups were assessed before and 4 weeks after the intervention and the results (mean changes) were compared between groups. The data analysis was conducted using independent t-test, paired t-test, Chi-square, analysis of covariance (ANOVA), and Mann-Whitney U test in SPSS (p < 0.05). RESULTS: In the PLISSIT group, the mean (SD) sexual self-disclosure score at baseline was 43.80 (9.50) and after 4 weeks was 51.60 (8.30). In the BETTER group, at baseline and after 4 weeks the mean (SD) sexual self-disclosure score was, respectively, 44.10 (10.30) and 55.60 (8.20) (Z = -2.5, p = 0.013). CONCLUSIONS: The findings confirm the effectiveness of the BETTER counseling model in increasing sexual self-disclosure after childbirth.

Effect of Positive Psychology Interventions on the Quality of Prenatal Care Offered by Midwives: A Field Trial.

BACKGROUND: The quality of prenatal care has been recognized as critical to the effectiveness of care in optimizing maternal and child health outcomes. This study examined the effect of positive psychology interventions on the quality of prenatal care offered by midwives. MATERIALS AND METHODS: This field trial was conducted on 60 midwives working in community health centers in Mashhad, Iran, from September 23, 2015 to March 20, 2016. Initially, centers No. 1 and No. 3 were selected via cluster sampling from among the five healthcare centers of Mashhad. Then, all subsidiaries of these centers were listed and assigned to intervention and control groups through simple random sampling. Thus, 60 midwives were randomly assigned to two equal intervention and control groups. The intervention, based on Seligman's Well-Being Theory, was presented weekly with homework in eight 2-h sessions. Before the interventions and immediately after the intervention, the Oxford Happiness Questionnaire (OHQ) and Ryff's Scales of Psychological Well-Being (SPWB) were completed by the midwives, and the Quality of Prenatal Care Questionnaire (QPCQ) was completed by two pregnant women for each midwife. RESULTS: After the intervention, the mean [Standard Deviation (SD)] score of the overall quality of prenatal care in the intervention group was significantly higher than that of the control group [mean (SD) = 1.51 (0.49) vs. 0.05 (0.21); t43,12= 18.7, p < 0.001]. CONCLUSIONS: It seems that improving the well-being of midwives through positive psychology interventions is effective on the quality of prenatal care provided by them.

Effect of maternal role training program based on Mercer theory on maternal self-confidence of primiparous women with unplanned pregnancy.

INTRODUCTION: Maternal confidence is an extremely important factor in playing the mother's role and her identity formation. Loss of self-confidence occurs in primiparous women due to the lack of maternal skills. Obtaining the behaviors of maternal role and self-confidence, the mother provides better care for her child. Hence, the aim of this study was to examine the effect of maternal role training program based on Mercer theory on maternal self-confidence of primiparous women with unplanned pregnancy. METHODOLOGY OF THE RESEARCH: This clinical trial was performed on 67 primiparous women referring to Mashhad health centers. Individuals were randomly divided into intervention and control groups. A maternal role training program based on Mercer theory was carried out for intervention group (three sessions of group training in the 34th, 35th, and 36th weeks of pregnancy and one individual training session before discharge from the hospital and then, weekly follow-up over the phone for 4 weeks). The control group received the normal pregnancy care. The research tools were questionnaires of demographic characteristics, London, DASS 21, Edinburgh Postnatal Depression Scale, Parenting Sense of Competence, General Impressions on Infant Temperament Questionnaire, and Six Simple Questions. Maternal self-confidence was measured before training, 4 weeks after delivery, and 4 months after delivery. Data analysis was carried out using independent t-test, Chi-square test, paired t- test, Mann-Whitney test, one-way ANOVA, and Wilcoxon test. P < 0.05 was considered statistically significant. RESULTS: There was a significant difference between mean maternal self-confidence changes (before training and 4 weeks after delivery (P = 0.003) and before training and 4 months after delivery (P = 0.001) in both groups. After eliminating the effect of interventional variables, the mean scores of maternal self-confidence after training in the intervention group had a statistically significant difference with that in the control group (P = 0.001). CONCLUSIONS: Maternal role training program based on Mercer theory increases maternal self-confidence in primiparous women with unplanned pregnancy. Teaching maternal role is recommended to all health-care providers.

Effect of a maternal role training program on maternal identity in primiparous women with unplanned pregnancies.

AIM: Primiparous women with unplanned pregnancies experience greater levels of anxiety that reduce their ability to perform their maternal role. METHODS: This clinical trial was conducted in 2014 on 67 primiparous women with unplanned pregnancies visiting the health centers of Mashhad, Iran, who were randomly divided into an intervention and a control group. The intervention group received maternal role training based on Mercer's Maternal Role Attainment Theory, and the control group received the routine pregnancy care. Maternal identity was measured before training and 4 weeks and 4 months after delivery. RESULTS: Four months after delivery, 28 women (80%) in the intervention group and 18 women (56%) in the control group successfully formed a maternal identity (P = 0.036). CONCLUSION: A maternal role training program given based on Mercer's theory facilitates the formation of maternal identity in primiparous women with unplanned pregnancies.

Comparison of The Effects of A Positive Reappraisal Coping Intervention and Problem-Solving Skills Training on Depression during The Waiting Period of The Result of Intrauterine Insemination Treatment: A Randomized Control Trial.

BACKGROUND: The outcomes of fertility treatments are unpredictable, and levels of depressive symptoms increase in patients during the waiting period of the result of intrauterine insemination (IUI) treatment. The aim of this study was to compare the effects of a positive reappraisal coping intervention (PRCI) and problem-solving skills training (PSS) on depression during the waiting period of the result of IUI Treatment. MATERIALS AND METHODS: This randomized control clinical trial was done among 108 women undergoing IUI treatment. In the control group, the women received routine care. In the PRCI group, women attended two training sessions and were asked to complete coping thoughts cards and fill out daily monitoring forms during the waiting period. In the PSS group, PSS were taught over three sessions. The depression was measured by the beck depression inventory. RESULTS: On the 10thth day of the IUI waiting period, there were significant differences between the control group (21.42 ± 11.42) and the PSS group (12.52 ± 8.05) and PRCI groups (13.14 ± 9.7) (P<0.001), but no significant difference between the PRCI group and the PSS group. CONCLUSION: According to the results of this randomized control trial there is no difference between a PRCI and PSS on depression during the waiting period of the result of IUI treatment. This suggests that both interventions can be used to help infertile women combat depression during the waiting period of the result of fertility treatments (Registration number: IRCT2016020926490N1).

The effect of maternal role training program on role attainment and maternal role satisfaction in nulliparous women with unplanned pregnancy.

INTRODUCTION: The maternal role is one of the most basic and important roles played by women during their lifetime. The process of the maternal role starts during pregnancy and to continue and develop after postpartum with the growth of suckling. However, unplanned pregnancy may jeopardize achieving the maternal role and reduce maternal role satisfaction. Therefore, the researcher conducted the present study to determine the impact of maternal role training program on attainment of role and role satisfaction in nulliparous women with unplanned pregnancy. METHODOLOGY OF THE RESEARCH: In this clinical trial, the researcher divided 67 nulliparous women with unplanned pregnancies into two groups at random by drawing lots. For the intervention group, in addition to the usual pregnancy care, the researcher conducted 3 group training sessions at weeks 34, 35, and 36 of pregnancy and an individual training session in the 1st day after delivery before release; then, during the next 4 weeks, the researcher made follow-up phone calls each week. The control group received the usual pregnancy care. The research tools included London questionnaire to measure unplanned pregnancy, Myself-As-Mother Scale (SD-Self), My-Baby Scale (SD-Baby), Perceived Competence Scale to measure maternal role attainment, and Parenting Sense of Competence Scale to measure maternal role satisfaction. The researcher measured the maternal role attainment and maternal role satisfaction before training and 4 weeks after delivery. The researcher analyzed the data using SPSS software version 21 and statistical tests such as independent t-test, Chi-square, paired sample t-test, Mann-Whitney, one-way analysis of variance, and Wilcoxon. The amount of P was supposed to be <0.05. RESULTS: The mean age of research units was 24.10 ± 4.3. Twenty-one persons (60%) in the intervention group and ten persons (31.3%) in the control group attained the maternal role (P = 0.019) and changes to achieve the maternal role in intervention group were significantly more than the control group (P = 0.002). Changes in the mean scores of maternal role satisfaction in the intervention group were significantly more than the control group (P = 0.023). CONCLUSION: Maternal role training for nulliparous women with unplanned pregnancy during pregnancy and postpartum period can help them in maternal role attainment and maternal role satisfaction.

Does maternal and fetal health locus of control predict self-care behaviors among women with gestational diabetes?

INTRODUCTION: Gestational diabetes is the most common metabolic disorder in pregnancy, and lack of self-care is the most important reason for mortality in diabetic patients. Since the glycemic control is associated with physiological and psychological mechanisms, variables such as health locus of control can play a role in health behaviors of diabetic patients. Therefore, this study was aimed to predict self-care behaviors among women with gestational diabetes based on maternal health locus of control (MHLC) and fetal health locus of control (FHLC). METHODS: This study is a descriptive, predictive correlational study that it is conducted on over 400 women with gestational diabetes attending the health centers and clinic of hospitals affiliated to Mashhad University of Medical Sciences in 2015. Data were collected using individual questionnaire, self-care derived from the summary of diabetes self-care activities, MHLC, and FHLC scale. The data were analyzed using Spearman's correlation coefficient test, linear regressions model, and multiple regression in SPSS software version 16. P < 0.05 was considered statistically significant. RESULTS: Results of Spearman's correlation coefficient test showed a significant direct linear relationship between self-care and internal MHLC (P = 0.027) and internal dimensions (P < 0.0001) and powerful others (P = 0.012) of FHLC. According to linear regressions model, internal MHLC (P = 0.027), internal dimensions (P < 0.0001), and powerful others (P = 0.012) of FHLC are considered as predictor variables of self-care. CONCLUSION: Midwives should perform interventions to increase internal locus of control and encourage more responsibility among women with gestational diabetes to achieve better self-care.

Effectiveness of Psychoeducational Group Training on Quality of Life and Recurrence of Patients with Bipolar Disorder.

Objective: Bipolar disorder (BD) is a disabling psychiatric disorder with frequent recurrences. Besides pharmacotherapy, psychoeducation could be helpful in reducing symptoms as well as recurrence of this disorder, leading to improvement of patients' quality of life. This study aimed at investigating the effectiveness of a culturally adjusted structured program for training Iranian BD patients. Method: In a 6-month course (spring and summer 2014), 24 BD patients, visiting the outpatient clinic of Ibn-Sina Hospital in Mashhad and experiencing euthymic phase, were allocated in to 2 groups of intervention and control. The intervention group received 8 sessions of psychoeducation in four weeks. Patients in the control group received the usual treatment. The patients were evaluated with Hamilton Depression Rating Scale, Young Mania Rating Scale, and Short Form 36 before the intervention and 4 weeks later, and the results were compared using independent t test. The patients were reexamined after 6 months for recurrence, hospitalization, treatment adherence, and visiting a psychiatrist, and were compared with patients in the control groups. Results: There was a significant difference in the intervention group in improvement in quality of life before and after treatment (p<0.003). In addition, the difference was significant between the 2 groups in the number of recurrence (p<0.001) and hospitalization (p<0.000) in 6 months. Conclusion: In addition to pharmacotherapy, psychoeducation of patients with BD can improve their quality of life and decrease the risk of disorder recurrence.

The effect of problem-solving skill training on mental health and the success of treatment of infertile women under intrauterine insemination treatment.

INTRODUCTION: Using fertility treatment will cause high levels of anxiety and depression. The study was carried out with the objective of determining the effect of problem-solving skills (PSS) training on mental health and the success of treatment of infertile women under intrauterine insemination (IUI) treatment. MATERIALS AND METHODS: this randomized clinical trial was carried out on 72 women referring to Milad Infertility Center in Mashhad. Individuals were randomly assigned into control and intervention groups. PSS were taught in three sessions in the intervention group, and the control group received usual care. The success rate of therapy and the mean of anxiety and depression on the day of IUI operation were compared using the Beck Depression Inventory and Spielberger Anxiety Inventory in both groups. t-test, Mann-Whitney, paired t-test, Wilcoxon, and Chi-square tests were used to analyze the data. RESULTS: on the day of IUI operation, the mean score of state anxiety in the control group(5 0. 11 ± 8.51) and PSS (68.12 ± 11.49) was significant (P < 0.001), trait anxiety in the control group (46.41 ± 8.70) and PSS (44.00 ± 9.92) was significant (P < 0.001), and depression in the control group (17.44 ± 11.70) and PSS (12.99 ± 8.99) was significant (P < 0.001); however, the success of treatment in both groups (14.7% and PSS (26.5%) was not significantly different (P = 0.230). CONCLUSION: Considering the effect of problem-solving on reducing anxiety and depression, it is suggested that infertility center of this intervention should be used.

The effect of a positive reappraisal coping intervention and problem-solving skills training on coping strategies during waiting period of IUI treatment: An RCT.

BACKGROUND: Waiting period of fertility treatment is stressful, therefore it is necessary to use effective coping strategies to cope with waiting period of intrauterine insemination (IUI) treatment. OBJECTIVE: The aim of this study was comparing the effect of the positive reappraisal coping intervention (PRCI) with the problem-solving skills training (PSS) on the coping strategies of IUI waiting period, in infertile women referred to Milad Infertility Center in Mashhad. MATERIALS AND METHODS: In this randomized clinical trial, 108 women were evaluated into three groups. The control group received the routine care, but in PRCI group, two training sessions were held and they were asked to review the coping thoughts cards and fill out the daily monitoring forms during the waiting period, and in PSS group problem-solving skill were taught during 3 sessions. The coping strategies were compared between three groups on the 10th day of IUI waiting period. RESULTS: Results showed that the mean score for problem-focused were significantly different between the control (28.54±9.70), PSS (33.71±9.31), and PRCI (30.74±10.96) (p=0.025) groups. There were significant differences between the PSS group and others groups, and mean emotion-focused were significantly different between the control (32.09±11.65), PSS (29.20±9.88), and PRCI (28.74±7.96) (p=0.036) groups. There were significant differences between the PRCI and the control group (p=0.047). CONCLUSION: PSS was more effective to increase problem-focused coping strategies than PRCI, therefore it is recommended that this intervention should be used in infertility treatment centers.

A systematic review and meta-analysis on controlled treatment trials of metacognitive therapy for anxiety disorders.

BACKGROUND: To conduct a systematic review and meta-analysis on controlled treatment trials of meta-cognitive therapy for anxiety disorders. MATERIALS AND METHODS: Studies were included if they employed controlled methodology and treated people above 18 years with anxiety disorders. Case studies (with less than 4 cases) and single case designed studies were excluded. A comprehensive literature search identified 15 trials for systematic review. RESULTS: All included studies showed better treatment results in the MCT arms compared to the control groups. We also statistically pooled the results across studies (when possible). The meta-analyses also showed that MCT had statistically significant better results compared to the control groups in GAD (both immediately post-treatment and 12 months post-therapy results), OCD, and PTSD (p-values ranged <0.0001-0.025). CONCLUSION: Based on the results of our systematic review, MCT seems to be an effective treatment for anxiety disorders and can effectively control their psychological problems.

Frequency of harmful behaviors in patients who are suffering from substances abuse.

BACKGROUND: Drug abuse is a disorder associated with unhealthy pattern of drug consumption and is a widespread social delinquent both in society and at home. There have only been a few studies conducted on the frequency and types of harmful behaviors among drug abusers. OBJECTIVES: The objective of this study is to investigate the frequency of harmful behaviors in people who are suffering from drug abuse. PATIENTS AND METHODS: The population was comprised of all the patients with drug abuse disorders hospitalized during 6 month from 1389 - 1390 in adult wards of Ibn - Sina Psychiatric Hospital in Mashhad. Of those patients who had been identified as having drug abuse disorder, based on the initial interview by a psychiatrist and a urine drug screening test, 99 subjects were selected as the available sample and were informed of the study and its objectives. In this descriptive study patient's consent had been taken. In psychotic cases, legitimate guardian consent has been obtained. Furthermore, demographic questionnaire in order to determine the harmful behaviors has been completed. Comorbid psychiatric diagnosis was recorded by a psychiatrist, according to the patients' records. SPSS software was used to analyze the results and, descriptive statistics such as frequency tables and inferential statistics including the chi-square test were used. RESULTS: 85 drug abusers (58.5%) have a history of harmful behaviors and 14 persons (14.1%) have not acted out in this manner. Seventy individuals had participated in more than one harmful behavior. The most common harmful behavior has been reported as aggression by force and attack (65.5 %.). CONCLUSIONS: The most common type of harmful behaviors was "aggression by force and attack". The next most harmful behavior was defined as the threat of suicide. Clearly, drug abuse was a disorder strongly associated with harmful behaviors.