✅ بنابراین میتوان نتیجه گرفت با وجود تفاوت بین دو رویکرد شناختی-رفتاری و مدل EIS هردو در زمینه عملکرد جنسی و خرده مقیاسهای آن مؤثر هستند اما با توجه به اثربخشی بیشتر مدلEIS میتوان از آن در دوران بارداری به عنوان روش کارآمدتر در کنار سایر مراقبتها استفاد کرد.
Pregnancy causes many physical and psychological changes. Therefore, pregnant women may face many issues and problems, including a lack of reduced sexual function. This study was prepared to compare the effectiveness of cognitive-behavioral couple therapy training and the EIS (empathy, intimacy, and sexual satisfaction) model on sexual function in pregnant women.
This was a semi-experimental study with pre- and post-test design. A total of 60 people among the statistical population who met the inclusion criteria were chosen and randomly divided into three groups of 20 (two intervention groups and one control group). The intervention participants were trained using cognitive-behavioral and EIS models in 8 sessions of 90 minutes, while the control group did not receive any training during this time. The tool used to collect data in pre- and post-test was the Women's Sexual Performance Index (FSFI). Data were analyzed using SPSS 23 (SPSS Inc., Chicago, Ill. USA) at a significance level of 0.05.
Findings showed that both cognitive-behavioral approaches and the EIS model are practical on sexual function and its subscales (sexual desire, sexual arousal, vaginal moisture, orgasm, sexual satisfaction, painful intercourse) (P value<0.05). There is a difference in their effectiveness in this regard. The EIS model with a mean and standard deviation of 24.08 ± 1.85 had a more significant effect on sexual function than the cognitive-behavioral approach with a mean and variation of 17.58 ±1.1.
The aim of this study was to compare the effectiveness of cognitive-behavioral couple therapy training and EIS model on sexual function in pregnant women. The findings of the present study indicate that there is a difference between the two methods of cognitive-behavioral couple therapy and the EIS model in terms of effectiveness on sexual function and its subscales (sexual desire, sexual arousal, vaginal moisture, orgasm, sexual satisfaction, painful intercourse) in pregnant women. The data also show that both cognitive-behavioral approaches and the EIS model are effective on sexual function and its subscales (libido, sexual arousal, vaginal moisture, orgasm, sexual satisfaction, painful intercourse) in pregnant women. However, in the post-test, the EIS model is more effective than the cognitive-behavioral approach in improving sexual function and each subscale of sexual desire, sexual arousal, vaginal moisture, orgasm, sexual satisfaction, painful intercourse.
Nezamnia et al., in a study, concluded that cognitive-behavioral therapy improves sexual function and sexual self-efficacy in pregnant women compared to conventional care during pregnancy [22]; this result is consistent with the results of the present study.
The Konzen model is based on Satir's "human credentialing process" model, which emphasizes intrapersonal change and growth and increases self-esteem and self-worth [14]. Ebrahimi, in a study, concluded that marital counseling based on the human credit model reduces conflict and increases marital satisfaction [28], which is indirectly in line with the result of the present study.
It can be said that the cognitive-behavioral approach and the EIS model are effective on sexual function and its subscales in pregnant women, given that the cultural context of the study population is traditional and religious, and there are negative social beliefs about sexuality. The issue of sexuality is taboo in most people's minds, also due to the lack of necessary and sufficient education about sexuality before and after marriage and the lack of necessary sexual knowledge during pregnancy [6] and finally considering that most pregnant women in this study (0.70 to 0.80) were housewives and had less opportunity to interact with other women and thus less opportunity to learn about pregnancy and sexual function at the time. It is natural that cognitive-behavioral approaches and the EIS model improve sexual function in pregnant women through education and sexual knowledge and skills through their own principles and techniques.
However, there is a difference between the two methods of cognitive-behavioral couple therapy and the EIS model in terms of effectiveness on sexual function and its subscales (sexual desire, sexual arousal, vaginal moisture, orgasm, sexual satisfaction, painful intercourse) in pregnant women.
It can be argued that the basics of cognitive-behavioral approach to the interaction and behavioral relationship of couples are problematic behaviors and awareness of them, explaining the relationship between thoughts and feelings and behavior of individuals, changing expectations, beliefs and cognitive errors and unrealistic cognitions of couples, reconstruction and correction emphasizing incorrect cognitions and attributions in relational interactions [13]. While the EIS model is based on human, empirical and systemic approaches and focuses less on cognitive dimension and problem solving and instead focuses on experience, discovery and awareness of emotions and communication and emotional reactions of couples and ultimately correction and reconstruction and growth of reactions [14]. Therefore, considering the differences in the theoretical foundations of the two approaches (cognitive-behavioral, EIS model), the difference in their effectiveness on sexual function and its subscales seems logical. Also, because the EIS model relies more on experience and the human and spiritual dimension, and its techniques are more sexual in nature, and also given the cultural context of our society, which places great emphasis on religion and following its precepts and human issues, it can be concluded that it has a greater impact on sexual function and its subscales than the cognitive-behavioral approach in pregnant women.
Therefore, it can be concluded that despite the differences between these two approaches (cognitive-behavioral approaches and EIS model), both are useful in terms of sexual function and its subscales. However, due to the greater effectiveness of the EIS model, it can be used during pregnancy besides the other care.
The present article is taken from the first author's doctoral dissertation in the field of counseling and guidance, Faculty of Literature, Islamic Azad University, Sanandaj Branch, with registration code 5936, which was approved in 2019. Also, this research has been approved by the ethics committee of Kurdistan University of Medical Sciences with the code of ethics (IR.MUK.REC.1398.279). Finally, we would like to thank all those who participated in this study, especially the pregnant women who cooperated fully despite all the problems during the pregnancy, and we also need to thank Dr. Jennifer Kans, the model presenter (EIS), who accompanied us throughout the research process.
The authors declared no conflict of interest.
Pregnancy causes many physical and psychological changes. Therefore, pregnant women may face many issues and problems, including a lack of reduced sexual function. This study was prepared to compare the effectiveness of cognitive-behavioral couple therapy training and the EIS (empathy, intimacy, and sexual satisfaction) model on sexual function in pregnant women.
This was a semi-experimental study with pre- and post-test design. A total of 60 people among the statistical population who met the inclusion criteria were chosen and randomly divided into three groups of 20 (two intervention groups and one control group). The intervention participants were trained using cognitive-behavioral and EIS models in 8 sessions of 90 minutes, while the control group did not receive any training during this time. The tool used to collect data in pre- and post-test was the Women's Sexual Performance Index (FSFI). Data were analyzed using SPSS 23 (SPSS Inc., Chicago, Ill. USA) at a significance level of 0.05.
Findings showed that both cognitive-behavioral approaches and the EIS model are practical on sexual function and its subscales (sexual desire, sexual arousal, vaginal moisture, orgasm, sexual satisfaction, painful intercourse) (P value<0.05). There is a difference in their effectiveness in this regard. The EIS model with a mean and standard deviation of 24.08 ± 1.85 had a more significant effect on sexual function than the cognitive-behavioral approach with a mean and variation of 17.58 ±1.1.
The aim of this study was to compare the effectiveness of cognitive-behavioral couple therapy training and EIS model on sexual function in pregnant women. The findings of the present study indicate that there is a difference between the two methods of cognitive-behavioral couple therapy and the EIS model in terms of effectiveness on sexual function and its subscales (sexual desire, sexual arousal, vaginal moisture, orgasm, sexual satisfaction, painful intercourse) in pregnant women. The data also show that both cognitive-behavioral approaches and the EIS model are effective on sexual function and its subscales (libido, sexual arousal, vaginal moisture, orgasm, sexual satisfaction, painful intercourse) in pregnant women. However, in the post-test, the EIS model is more effective than the cognitive-behavioral approach in improving sexual function and each subscale of sexual desire, sexual arousal, vaginal moisture, orgasm, sexual satisfaction, painful intercourse.
Nezamnia et al., in a study, concluded that cognitive-behavioral therapy improves sexual function and sexual self-efficacy in pregnant women compared to conventional care during pregnancy [22]; this result is consistent with the results of the present study.
The Konzen model is based on Satir's "human credentialing process" model, which emphasizes intrapersonal change and growth and increases self-esteem and self-worth [14]. Ebrahimi, in a study, concluded that marital counseling based on the human credit model reduces conflict and increases marital satisfaction [28], which is indirectly in line with the result of the present study.
It can be said that the cognitive-behavioral approach and the EIS model are effective on sexual function and its subscales in pregnant women, given that the cultural context of the study population is traditional and religious, and there are negative social beliefs about sexuality. The issue of sexuality is taboo in most people's minds, also due to the lack of necessary and sufficient education about sexuality before and after marriage and the lack of necessary sexual knowledge during pregnancy [6] and finally considering that most pregnant women in this study (0.70 to 0.80) were housewives and had less opportunity to interact with other women and thus less opportunity to learn about pregnancy and sexual function at the time. It is natural that cognitive-behavioral approaches and the EIS model improve sexual function in pregnant women through education and sexual knowledge and skills through their own principles and techniques.
However, there is a difference between the two methods of cognitive-behavioral couple therapy and the EIS model in terms of effectiveness on sexual function and its subscales (sexual desire, sexual arousal, vaginal moisture, orgasm, sexual satisfaction, painful intercourse) in pregnant women.
It can be argued that the basics of cognitive-behavioral approach to the interaction and behavioral relationship of couples are problematic behaviors and awareness of them, explaining the relationship between thoughts and feelings and behavior of individuals, changing expectations, beliefs and cognitive errors and unrealistic cognitions of couples, reconstruction and correction emphasizing incorrect cognitions and attributions in relational interactions [13]. While the EIS model is based on human, empirical and systemic approaches and focuses less on cognitive dimension and problem solving and instead focuses on experience, discovery and awareness of emotions and communication and emotional reactions of couples and ultimately correction and reconstruction and growth of reactions [14]. Therefore, considering the differences in the theoretical foundations of the two approaches (cognitive-behavioral, EIS model), the difference in their effectiveness on sexual function and its subscales seems logical. Also, because the EIS model relies more on experience and the human and spiritual dimension, and its techniques are more sexual in nature, and also given the cultural context of our society, which places great emphasis on religion and following its precepts and human issues, it can be concluded that it has a greater impact on sexual function and its subscales than the cognitive-behavioral approach in pregnant women.
Therefore, it can be concluded that despite the differences between these two approaches (cognitive-behavioral approaches and EIS model), both are useful in terms of sexual function and its subscales. However, due to the greater effectiveness of the EIS model, it can be used during pregnancy besides the other care.
The present article is taken from the first author's doctoral dissertation in the field of counseling and guidance, Faculty of Literature, Islamic Azad University, Sanandaj Branch, with registration code 5936, which was approved in 2019. Also, this research has been approved by the ethics committee of Kurdistan University of Medical Sciences with the code of ethics (IR.MUK.REC.1398.279). Finally, we would like to thank all those who participated in this study, especially the pregnant women who cooperated fully despite all the problems during the pregnancy, and we also need to thank Dr. Jennifer Kans, the model presenter (EIS), who accompanied us throughout the research process.
The authors declared no conflict of interest.
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