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Background The present study aimed at investigating the effect of sexual health education and cognitive-behavioral therapy (CBT) on sexual assertiveness (primary outcome) and sexual satisfaction (secondary outcome) of newly married women. Method This RCT was conducted on 66 newly married women with cases in pre-marriage counseling centers in Tabriz, Iran. Participants were assigned into three groups using block randomization. Eight group sessions of CBT were held for one of the intervention groups (n = 22) and 5–7 sessions of sexual health education for other intervention group (n = 22). The control group (n = 22) received neither education nor counseling during the research. The data were collected using the demographic and obstetric characteristics, Hulbert sexual assertiveness index, and Larson sexual satisfaction questionnaires, and analyzed using ANOVA and ANCOVA tests. Results The mean (standard deviation: SD) score of the sexual assertiveness and sexual satisfaction in the CBT group enhanced from 48.77 (13.94) and 73.13 (13.53) before the intervention to 69.37 (7.28) and 86.57 (7.5) after the intervention, respectively. The mean (SD) score of the sexual assertiveness and sexual satisfaction in the sexual health education group increased from 48.9(11.39) and 74.95 (8.30) before the intervention to 66. 94 (7.42) and 84.93 (6.34) after the intervention, respectively. The mean (SD) score of the sexual assertiveness and sexual satisfaction in the control group changed from 45.04 (15.87) and 69.04 (10.75) before the intervention to 42.74 (14.11) and 66.44 (10.11) after the intervention, respectively. Eight weeks after the intervention, the mean scores of sexual assertiveness and sexual satisfaction in two intervention groups were more than that in the control group (P < 0.001), However, there was no significant difference between the two intervention groups (P > 0.05). Conclusion The results of this research indicated that CBT and sexual health education are effective in improving women’s sexual assertiveness and sexual satisfaction. Considering that sexual health education, does not require complex counseling skills compared to CBT, it can be used as a preferred intervention in promoting sexual assertiveness and satisfaction of newly married women. Trial registration Iranian Registry of Clinical Trials: IRCT20170506033834N8. Date of registration: 11.09.2021. URL: http://en.irct.ir.
Letter to the Editor Dear Editor, Midwifery students have an essential role in improving the sexual health of individuals, families, and communities 1 . Studies conducted with midwifery students show that students are inadequate in sexual education and counseling 2,3 . However, sexual health counseling given by midwives increased women's sexual satisfaction during pregnancy and postpartum, decreased their inefficient sexual beliefs, and increased the sexual function of postmenopausal women [4][5][6] . Midwifery students need to have positive attitudes towards sexuality to be able to provide sexual health counseling in their professional life as midwives. Therefore, this cross-sectional study aimed to determine midwifery students' attitudes toward sexual education.This study was conducted during the 2018-2019 academic year. The study sample consisted of 235 midwifery students in the Faculty of Health Sciences at a state university in northeastern Turkey. Students completed two questionnaires: the Student Information Form and the Inventory of the Attitude toward Sexual Education 7 . Written permission was obtained from the university ethics committee (Date of Decision: 25/03/2019 Decision No: 2019/24) and by the Faculty of Health Sciences. The study was performed following the Declaration of Helsinki. Data were analyzed using the SPSS 24 package program. Descriptive statistics, Kolmogorov-Smirnov test, Mann Whitney U test, and Kruskal Wallis test, were used in data analysis.The mean age of the students participating in the study was 20.65 ± 2.04 years (range: 18-38). The majority of the respondents were single, 72.3% had a nuclear family structure, 48.9% lived in a city, 87.7% had moderate socioeconomic status, and the incomes of 76.2% were equal to their expenses. Of the students, 20.4% received sex education from their families; 34.9% received sex education before college; 40.4% received sex education at university; 79.6% wanted to learn more about sexuality; and 36.2% evaluated the patients' sexual life in the clinic. There was no significant difference between the scale scores according to classes, sex education status, and evaluation of the patients' sexual life in the clinic (p>0.05). However, perceived socioeconomic status, mother's education level, and desire to receive education about sexuality affected students' attitudes (p<0.05).In conclusion, we can say that there is a gap in the midwifery curriculum related to sex education in this study, because the number of students who do not receive sex education is high, and there is no difference between the attitudes toward sex education of students who do and do not receive sex education. The most critical barriers for midwifery students were lack of experience with sex medicine, fear of failing to respond to patients' sexual health issues, and lack of knowledge 8 . Midwifery care includes counseling on sexual health, and it is a fundamental human right and an important step in enabling women to control their health outcomes 9 . Interactive workshops with sta...
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