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.

Validity and Reliability of the Turkish Version of Screening Tool on Distress in Fertility Treatment (SCREENIVF).

BACKGROUND: Women diagnosed with infertility and receiving infertility treatment reported high levels of depressive symptoms, anxiety and distress. Infertile women should first be screened for psychosocial risks. Psychosocial care interventions should be planned according to their needs. The aim of this methodologically designed study was to test the validity and reliability of the Screening Tool on Distress in Fertility Treatment's (SCREENIVF) Turkish version in infertile women. SUBJECTS AND METHODS: The present study included 323 women diagnosed with nulliparous and undergoing fertility treatment. Women filled in the descriptive characteristics questionnaire, The Copenhagen Multi-Centre Psychosocial Infertility-Fertility Problem Stress Scale (COMPI-FPSS) and the SCREENIVF. RESULTS: To examine the contribution of the items to the scale, six items with an insufficient contribution to the scale were removed from the scale as a result of the item-total score correlation values (Corrected item-total correlation <0.25). The item-total score correlation coefficients and subscale-total score correlation coefficients obtained for each subscale ranged from 0.31 to 0.98. According to the regression equation formed in line with the multivariate linear regression model that will model the linear relationship between COMPI-FPSS, which is a scale equivalent to the subscale of the SCREENIVF, the total scores of the subscale were statistically significant predictors of the scores obtained from COMPI-FPSS, and (F=161.281, p<0.001) multiple explanatory coefficients were 77.2%. Cronbach's alpha coefficient was 0.77 and accepted to be reliable. 16% of the women participating in this study were above the cut-off scores concerning anxiety and depression, 13.9% acceptance, 8.2% hopelessness and 2% social support. The scale consisted of five subscales and 28 items. CONCLUSION: The findings indicate that the Turkish version of SCREENIVF is a valid and reliable measurement tool that can be used in the routine assessment regarding psychosocial aspects in the infertility treatment process.

Efficacy of Nursing Support in the Pre- and Postmedical Termination of Pregnancy Phases: A Randomized Study.

This study was conducted to evaluate the efficiency of a nursing support program developed in accordance with the Roy adaptation model that was applied in addition to routine nursing care during the treatment process of pregnant women for whom the medical termination decision. This study, which was conducted using a pretest-posttest design, was a prospective, single-blind, and randomized-controlled empirical study. In the experimental group, although the first and last assessment State Anxiety Inventory scores were higher than those in the control group after the medical termination nursing support program, there was no significant difference. Compared with the control group, there were positive differences in the Scale of Ways of Coping with Stress, Adaptation Assessment Form for Role Function Area, and physical complaints in the experimental group. At the follow-up assessment, the total Perinatal Grief Scale score was significantly higher than that in the control group.

Sexual Counseling in Women With Primary Infertility and Sexual Dysfunction: Use of the BETTER Model.

The aim of the study was to determine the effect of sexual counseling based on the BETTER model of female sexual health in infertile women with sexual dysfunction. This is an experimental, prospective study carried out in an infertility clinic. The study included 70 women with primary infertility, of whom 35 were in the experimental group and 35 were in the control group. The Female Sexual Function Scale and the Golombok-Rust Sexual Satisfaction Scale were administered at the initial assessment and the final assessment. Two sessions of sexual counseling were given to the experimental group based on the BETTER model. A routine follow-up of the control group was performed. After the counseling, there was a statistically significant improvement in the mean scores for Female Sexual Function Scale and the total scores for the Golombok-Rust Sexual Satisfaction Scale and its subscales in the experimental group compared to the control group. The women who had been infertile for six years and more had less improvement in sexual dysfunction and sexual dissatisfaction. The sexual counseling given in accordance with the BETTER model was found to be effective in improvement of sexual function and sexual satisfaction in the women with one to two years of infertility.

Effects of Transobturator Midurethral Sling Surgery on Sexual Functions: One-Year Follow-Up.

AIM: To evaluate sexual functions of women having stress urinary incontinence (SUI) preoperatively and 6 months and 12 months after undergoing a transobturator tape (TOT) ± pelvic organ prolapse (POP) surgery. METHODS: One hundred-ninety-five women with SUI ± POP were recruited and 150 sexually active women who had clinical ± urodynamic SUI and underwent TOT ± POP surgery were included in this prospective study. Urogynecologic symptoms were evaluated preoperatively, at 6 months, and 12 months by Female Sexual Function Index (FSFI). RESULTS: One hundred fifty women completed the study. Seventy-four underwent TOT-only and 76 underwent TOT + concomitant surgery. Mean total scores of FSFI were 21.7 ± 7.8, 22 ± 8.7, and 22.1 ± 8 in the preoperative period, postoperative 6, and 12 months, respectively. There was significant improvement in desire and total scores in the TOT-only group, whereas there was no significant difference in the TOT + concomitant surgery group except for significant worsening in the lubrication domain. The frequency of sexual intercourse increased while that of coital incontinence decreased after surgery. CONCLUSIONS: In our study, TOT was associated with decrease in coital incontinence and significant improvement in desire. In addition, there was significant improvement in FSFI desire and total scores in the TOT-only group, whereas no significant difference was observed in the TOT + concomitant surgery group except for the worsening of lubrication.

Sexual life of women in the climacterium: A community-based study.

Our purpose of conducting this community-based study was to determine sexual functions of women in climacterium and effects of menopausal symptoms on sexual functions. It was descriptive, cross-sectional, and community-based. The study sample consisted of 282 climacteric women. Menopause Rating Scale (MRS), Female Sexual Function Index (FSFI), and Sexual Satisfaction Scale for Women (SSS-W) were used for data collection. The total score was 13.42 ± 8.82 for MRS, 18.73 ± 9.79 for FSFI, and 82.56 ± 18.07 for SSS-W. Seventy-nine-point four percent of the women had sexual dysfunction. While complaints typical of the climacteric period increased, sexual functions and satisfaction decreased.

Effect of Reflexology to Depressive Symptoms in Women With Overactive Bladder.

This study is to determine the effect of foot reflexology on the level of depression in women with OAB. Study findings included in the study showed foot reflexology as a part of OAB treatment relieved urinary and depressive symptoms and had a positive effect on quality of life.

Effect of Lactation Management Model on Breastfeeding Process After Cesarean: A Prospective Randomized Controlled Study.

It is important to implement supportive programs to ensure mothers breast feed for the desired period, and infants are fed by only mother's milk. In the research, it was aimed at evaluating the effects of lactation management model on mothers' breastfeeding process following a caesarean section. Women who gave birth by planned cesarean delivery were divided into two groups, randomized control and experimental. Data collection was performed during gestation, first day after postpartum, pre-discharge, on the 9th day in a face to face interview, and in the form of monthly phone interviews up to 6 months. While the experimental group exercised the lactation management model, the control group received routine lactation practices in clinic. In the scores of Breastfeeding Charting System and Documentation Tool, a significant difference was found between the groups (p<0.001). 87.9% of the experimental group and 48.5% of the control group were determined to apply successful breast-feeding techniques. In addition, it was found that all of the experimental group breast fed 1 month longer than the control group, and for the first month, 90.9% of the experimental group and 78.8% of the control group breast fed with mother's milk only and a higher breastfeeding. Among in the experimental group, it was found that breastfeeding self-efficacy was higher, and breastfeeding techniques were accurate and successful and breastfeeding only and continuity rates were higher while breastfeeding related breast problems developed less frequently. Clinical Trials.gov Protocol Registration Number: NCT04593719.

Comparison of the effects of electrical stimulation and posterior tibial nerve stimulation in the treatment of overactive bladder syndrome.

AIM: To compare the effects of transvaginal electrical stimulation (ES) and posterior tibial nerve stimulation (PTNS) in the treatment of overactive bladder syndrome (OAB). METHODS: Women applying with symptoms of urgency, frequency, and nocturia with or without incontinence and diagnosed with OAB were divided into an ES or PTNS group. Bladder diary, urodynamics, 1-hour pad test, and King's Health Questionnaire were performed before and after treatment. ES was applied for 20 min, 6-8 weeks with pulses of 10-50 Hz square waves at a 300-µs or 1-ms pulse duration and a maximal output current of 24-60 mA with 5-10 Hz frequency, three times per week. PTNS was applied for 30 min once a week for 12 weeks. RESULTS: Thirty-five patients received ES, 17 patients received PTNS. Pad test, urinary diary, and quality of life parameters after both treatments decreased significantly; the decrease in the ES group was greater. The number of patients who describe themselves as cured was higher in the ES group. CONCLUSION: PTNS and ES are both effective in the treatment of OAB with significant improvement in objective and subjective parameters. Objective results show no significant difference between the two groups; however, the number of patients who describe themselves as cured in the ES group was significantly higher.

Adaptation of the Prenatal Comfort Scale into Turkish: A Validity and Reliability Study.

AIM: This study aims to test the validity and the reliability of the Turkish version of the Prenatal Comfort Scale. METHOD: The sample of this methodological study included 260 pregnant women presenting to a prenatal screening outpatient clinic. The Prenatal Comfort Scale included 15 items and 5 subscales. Internal consistency analysis, item-total score correlations, and confirmatory factor analysis with Lisrel (8.51) were used to test the reliability of the scale. RESULTS: The internal consistency Cronbach's alpha value was .86 for the Prenatal Comfort Scale and .78, .79, .82, .69, and .60 for the subscales. The item-total score correlation coefficients ranged from .32 to .66 (r = .32-.66). A factor analysis was made to evaluate consistency between the Turkish version of the scale and the original scale. The second item loaded on interacting with fetal movements in the original scale was found to load on recognizing changes during pregnancy in the Turkish version of the scale. CONCLUSION: The Turkish version of the Prenatal Comfort Scale was found to have sufficient compatibility. It is also a valid and reliable scale.

Reproductive and Sexual Health in Males with Physical, Hearing, and Vision Disabilities.

Objective This study aimed to determine reproductive health, sexual functions, and sexual satisfaction levels of males with disabilities. Methods: The study had a cross-sectional, descriptive, and correlational design and was conducted on 136 males with disabilities. Data was collected using an introduction form, International Index of Erectile Function, the Erectile Performance Anxiety Index (EPAI), the Premature Ejaculation Profile (PEP), and the Sexual Satisfaction Scale (SSS). Results: The total EPAI score was 19.86 ± 8.98(10-50), the total PEP score was 9.91 ± 4.20(0-16) and the total SSS score was 86.79 ± 18.20(44-119). Conclusions: Education and counseling on reproductive and sexual health should be given based on their individual needs.

Reflection of Learning Styles on Students' Anxiety and Learning Levels in Simulation Education: An Obstetrics and Neonatology Nursing Experience.

AIM: This study aimed to investigate whether the learning styles of nursing students affected their anxiety and learning levels during simulation education. METHOD: This was a cross-sectional and quasi-experimental study, which included a total of 60 nursing students. The students received simulation education about labor management and first care of newborns. The Learning Styles Inventory III, the Trait Anxiety Scale, and a pretest were used before the simulation education, and the Perceived Learning Scale and a posttest were used after the simulation education to collect data. RESULTS: According to data from the learning styles inventory, 81.6% of the students had a diverging learning style, 11.7% had an assimilating learning style, and 6.7% had an accommodating learning style. The mean state anxiety score was 49.83 ± 10.59 just before the simulation. The mean pretest score was 51.50 ± 16.96 and the mean posttest score was 54.17 ± 15.22. The perceived learning score was 35.45 ± 5.12. There was a significant difference in anxiety levels in terms of learning styles (p < .005). CONCLUSION: Most of the students in this study had a diverging learning style. Their anxiety levels did not change depending on their learning styles. The pretest/posttest results and perceived learning levels showed that simulation helped to achieve learning in all types of learners.

Overview of the social impact of urinary incontinence with a focus on Turkish women.

Although urinary incontinence is a common problem among women and can seriously affect their quality of life, more than half of women report no discomfort with the disorder, and most do not seek medical help. In Turkey, women traditionally prefer not to seek medical advice for a urinary incontinence problem. Except for treatment-seeking behaviors, women practice coping methods for the management of urinary incontinence. The problem of urinary incontinence has been gaining more importance in recent years, and nurses' roles and responsibilities have been increased in this area. Consequently, there have been developments in Turkey related to the education of nurses.

The prevalence of and the related factors for urinary and fecal incontinence among older residing in nursing homes.

AIMS AND OBJECTIVES: To determine the prevalence of urinary incontinence and fecal incontinence among older people residing in nursing homes in Istanbul. BACKGROUND: Urinary incontinence (UI) is a multifactorial condition associated with age-related changes and disorders of the genitourinary system and systemic problems affecting normal micturition. The impact of UI and fecal incontinence (FI) on older people living in nursing homes is more significant than those living in the community. DESIGN: Cross-sectional study. METHODS: This study was performed with 1110 older people who were 60 years and older residing in five government rest homes on the European side of Istanbul in Turkey. An interview was conducted with the residents that had sufficient cognitive function and agreed to participate. Demographic findings and complaints about incontinence were analyzed using a special questionnaire. RESULTS: The total number of older people who participated was 694; 56.5% females and 43.5% males; 43.4% of females and 20.9% of males. Urge incontinence was common in both groups. FI was more common among females (14%, males 6%) and the mean duration of symptoms was longer. The related factors for UI among older females revealed that history of an episiotomy, frequency, urgency, fecal incontinence and functional incapacity among males; whereas history of stroke and pulmonary disorders were independent variables that increased the incidence of frequency, recurrent urinary tract infections and fecal incontinence. The related factors for fecal incontinence among older females included history of stroke and functional status. Diabetes mellitus requiring medical treatment, frequency, functional incapacity and urinary incontinence were significant related factors for fecal incontinence among males. CONCLUSIONS: According to similar studies, the urinary and fecal incontinence rates in nursing home residents were lower compared to the other countries. Incontinence was more common among females according to males. Understanding related factors of incontinence are important for providing care and counseling in nursing homes. RELEVANCE TO CLINICAL PRACTICE: Nurses can provide appropriate information and support at each step in the protecting, screening, diagnosis and treatment process so that elders' incontinence is minimized.

Emotional freedom techniques and breathing awareness to reduce childbirth fear: A randomized controlled study.

BACKGROUND: Emotional freedom techniques (EFT) and breathing awareness (BA) are applicable during labour. The present study aimed to determine the effectiveness of EFT and BA in the reduction of childbirth fear. MATERIALS AND METHODS: This randomized controlled study included 120 pregnant women, of whom the EFT, BA and control groups. The women in the EFT and BA groups were offered their intervention in the latent, active and transition phases of labour. RESULTS: There was no significant difference in the sociodemographic and obstetric factors between the groups (p > 0.05). The Subjective Units of Distress Scale in active and transition phases were significantly lower in the EFT group. The difference in the scores for the Wijma Delivery Expectancy/Experience Questionnaire (version B) between the groups was significant (p < 0.001). CONCLUSION: Both EFT and BA were observed to be beneficial in clinical practice; the EFT was found to be more effective and permanent.

Exposure to domestic violence in women living in Istanbul and Aegean regions: a Turkish sample.

Domestic violence (DV) is a serious public health problem in the world. DV against women is also a global problem without cultural, geographic, religious, social, economic or national boundaries. This descriptive cross-sectional study was carried out to determine the situations of DV in women living in Istanbul and the Aegean Region in Turkey. The study population included outpatient clinics of state hospitals both regions. A stratified sampling by age was performed and 1100 women were included into the sample. Data were collected at face-to-face interviews with Domestic Violence Against Women Determination Scale. The mean age of the women living in Istanbul was 41.81 ± 9.75 years and Aegean Region was 33.72 ± 11.38 years. The prevalence of emotional and financial violence were higher in Istanbul and the Aegean Region. The women living in Istanbul got higher scores for Domestic Violence Against Women Determination Scale. The prevalence of the women reporting to suffer from violence from their spouses was 15.4% in Istanbul and 14% in the Aegean Region. While the prevalence of the women suffering from violence was higher in Istanbul, the women in Aegean Region suffered from more severe violence. The violence prevalence was lower among the wives and the husbands with high education levels, employed women and high-income families.

Prevalence and risk factors for low sexual function in women: a study of 1,009 women in an outpatient clinic of a university hospital in Istanbul.

INTRODUCTION: Sexual functioning is a common and multidimensional problem, associated with multiple biological, medical, psychological, sociocultural, political, economic, and interpersonal factors. AIM: The study was planned to determine the prevalence and risk factors for low sexual function in women in an outpatient clinic of a university hospital in Istanbul. METHODS: Totally, 1,009 women over 20 years of age or their healthy female companions were interviewed in the outpatient clinics of the Department of Internal Medicine in a university hospital in Istanbul. MAIN OUTCOME MEASURES: Female Sexual Function Index (FSFI) was used to evaluate sexual function. RESULTS: The mean age of women was 38.62 +/- 12.82 and 22.2% of women were postmenopausal. The mean FSFI score was found to be 24.25 +/- 9.50 out of a maximum total score of 36. Based on the total FSFI score, 43.4% of the women had scores less then 26. The mean domain scores were: desire 3.14 +/- 1.47, arousal 3.60 +/- 1.85, lubrication 4.53 +/- 2.01, orgasm 4.02 +/- 1.97, satisfaction 4.27 +/- 1.64, and pain 4.69 +/- 1.96 out of a maximum domain score of six. The rate of low sexual function by the age groups were 22% for those 20-29 years, 39.7% for those 30-39 years, 50.2% for those 40-49 years, 71.3% for those 50-59 years, 82.9% for those 60-64 years, and 87.8% for those 65 and over. Lower educational level, menopause, depression, presence of sexual dysfunction in their partner, and contraceptive use were found to be significantly associated with low sexual function in women. CONCLUSIONS: The prevalence of low sexual function in women was found to significantly increase with age. The most significantly affected domains were desire and arousal followed by orgasmic problems, satisfaction, and pain, respectively.

Bladder training and Kegel exercises for women with urinary complaints living in a rest home.

BACKGROUND: Urinary incontinence is an annoying, uncomfortable and unpleasant condition affecting the elderly. The problem of bedwetting and other urinary complaints are common in rest homes. OBJECTIVE: Our study aimed to determine the efficiency of bladder training and Kegel exercises for older women living in a rest home. METHODS: This is an experimental prospective research study. Through a randomization process, 25 women were included in the treatment group, and another 25 were included in the control group. Participants were living in a rest home for women aged older than 65 years with urinary complaints. The pretreatment interview form, Quality of Life Scale, Mini-Mental Test, Rankin Scale, daily urinary forms and pad tests were administered to the treatment and control groups. Bladder training and Kegel exercises were given to the treatment group for 6-8 weeks. The second evaluation was performed 8 weeks after treatment, and the last evaluation was carried out 6 months after treatment. RESULTS: The average age of the treatment group was 78.88 +/- 4.80 years, and the average age of the control group 79.44 +/- 5.32 years. Urgency, frequency and nocturia were common complaints. Pretreatment, 8-week and 6-month evaluations revealed that the amount of urinary incontinence with urgency, frequency and nocturia complaints statistically and significantly decreased in the treatment group compared to the control group. In the pad test results, a statistically significant decrease was observed in the treatment group compared to the control group. A significant increase in pelvic floor strength was observed in the treatment group compared to the control group upon all evaluations. CONCLUSION: Behavioral therapy can be used easily as an effective treatment for urinary incontinence in elderly women living at a rest home.

The Prevalence of Diurnal Urinary Incontinence and Enuresis and Quality of Life: Sample of School.

PURPOSE: Enuresis can cause loss of self-esteem in children, change relations with family and friends, and decrease the school success. This study was conducted to determine the prevalence of urinary incontinence (UI) in school children aged between 11-14 years and identify the emotions and social problems of enuretic children. MATERIALS AND METHODS: A mixed methods approach was used on a group of students who reported UI by combining quantitative data from school population-based cross-sectional design with qualitative data using in-depth interview techniques. The data of this descriptive and cross-sectional study were collected from 2750 primary school students aged between 11-14 years in Istanbul. RESULTS: The overall prevalence of UI was 8.6% and decreased with age. Prevalence of the diurnal enuresis in children was 67.9% and all of them had non-monosymptomatic enuresis. 83.3% of the children were identifiedwith secondary enuresis for 1-3 years. UI was significantly more common in boys and those who had frequent urinary infections, whose first degree relatives had urinary incontinence problem in childhood, and who reportedlow socioeconomic level in the family. The emotional and social effects of urinary incontinence were given in the context of children's own expressions. CONCLUSION: Urinary incontinence is an important problem of school-age children. In this study the prevalence of UI was found to be 8.6%, diurnal UI and secondary enuresis were very common, and all of the children werenon-monosymptomatic. Enuresis has negative emotional and social effects on children.

The Effects of Cold Application to the Perineum on Pain Relief After Vaginal Birth.

PURPOSE: Perineal pain developing during the postpartum period affects women's relationships with their families and infants. The aim of this study was to determine the efficacy of cold gel pad application for relieving perineal pain and possibly increasing mothers' comfort after vaginal delivery. METHODS: This experimental randomized controlled study was conducted in the postpartum department of obstetrics and gynecology hospital. A total of 200 mothers were included in the study. Cold gel pads were applied to the perineum of mothers in the experimental group for 20 minutes in the postpartum first 2 hours and 4 hours after the first application. All the data were collected by using an information form, the visual analog scale, and the postpartum comfort questionnaire. RESULTS: In the experimental group, the first visual analog scale score was 6.73 ± 1.68; after cold gel pad application, the pain levels decreased to 2.59 ± 1.20 in both primiparous and multiparous mothers. In addition, the postpartum comfort questionnaire score increased from 2.58 ± 0.14 to 2.69 ± 0.14 in the second assessment after the cold gel pad application and the difference was statistically significant (p < .001). CONCLUSION: The application of the cold gel pad to the perineum relieved perineal pain and increased postpartum comfort in all the women. The pain felt by the women during the recovery and the daily activities decreased. Postpartum perineal pain adversely affected daily activities such as lying down, sitting, and walking; infant care, breastfeeding, and urination; and comfort levels of the postpartum women.