Infertility interferes with sexual and emotional relationships, fears of separation, feelings of isolation and depression in infertile people, and as a result has adverse effects on marital satisfaction and Quality of life. The aim of this study was to determine the effect of cognitive-behavioral counseling on marital satisfaction and Quality of life of infertile women through virtual education in Isfahan.

 

The present study is a Clinical trial study with the approach of an intervention group and a control that was conducted in 2018 with the participation of 60 infertile women in Isfahan. Samples were selected by available method. The intervention group received training and cognitive-behavioral counseling via WhatsApp. In this way, the samples received 30 minutes of training and counseling in 5 weeks, and their questions were answered via text message or call. The two variables of marital satisfaction and quality of life were assessed before and after the intervention. Data were analyzed by paired t-test and Covariance using SPSS 20.

According to the results of the study, although the mean score of marital satisfaction after the intervention increased compared to before the intervention in the control group and in the intervention group, the mean score of marital satisfaction of the control group in the post-test did not differ significantly compared to the pre-test. Also, no significant difference was observed in the intervention group of marital satisfaction score in post-test and pre-test. Coinciding with this study, in their study, Sexton et al. concluded that infertility stress management intervention virtually reduced the symptoms of generalized stress in infertile women, but there was no statistical difference between the two groups in terms of perceived infertility stress. [21]. Cousineau et al. also showed in their research that the intervention of psychological education in a virtual way improved the score of the social subjects subtest test of the Newton Infertility Stress Questionnaire in comparison with the control group [15]. Although counseling and e-learning have a positive effect on promoting couples' mental health, they are not as effective as face-to-face counseling. In fact, due to the virtual nature of the intervention, there may be intervening variables that are beyond the control of researchers and affect the outcome.
Hämmerli, Znoj, and Barth stated in their study that psychological interventions in infertile women have no effect on improving mental health, including depression, anxiety, and psychological distress [22]. The results of the present study are consistent with the study of Mazaheri et al. who concluded that there is not much difference in the study of problem solving methods and marital adjustment in infertile and fertile couples [23]. The study of Leiblum, Aviv and Hamer also showed that marital adjustment was not significantly different in the three groups (successful IVF, unsuccessful IVF without adopted child, unsuccessful IVF with adopted child) [24]. In contrast, the study by Noorbala et al. determined that cognitive-behavioral therapies play an important role in increasing marital satisfaction [25]. Farrokh Eslamlou also showed that one month after counseling in the intervention group, women's sexual satisfaction was higher than the control group [26]. According to a study by Vizheh and Pak Gohar, counseling also improves sexual satisfaction in infertile women [27].
Based on the results of paired t-test, the mean quality of life score of the subjects in the control group in the post-test was not significantly different from the pre-test, but in the intervention group in the post-test compared to the pre-test increased significantly. The study by Monga et al. noted that having children is often an important expectation of marriage, and for most couples having children is an expected sexual consequence. Meanwhile, social pressures and those around to continue the generation can cause psychological stress and thus reduce marital satisfaction and on the other hand the quality of life of infertile couples [28]. The results of Goli and Ahmadi study showed that the quality of life in infertile women is low and infertility has a negative effect on their quality of life [29]. Also, the study of Hamzeh Pourhaghighi, Ghorban Shiroodi and Tizdast showed that group counseling with a participatory approach reduces the specific stress of infertility in various aspects of life, including reducing sexual worries in infertile women and increases their quality of life [30]. In this study, it was found that counseling and education improve couples' relationships and as a result, their quality of life increases. In order to observe the research ethics, after the intervention, two group counseling sessions were held for both groups.

 

Although virtual education did not significantly change the marital satisfaction of infertile women compared with the control group, the average score of marital satisfaction after the intervention increased compared to the previous intervention in the subjects of the intervention group. Also, intervention through virtual education has caused a significant change in the quality of life of infertile women compared with the control group, so it seems that virtual education and counseling is useful in promoting the health of infertile women.

 

The research vice chancellor of Falavarjan Azad University of Nursing and Midwifery is thanked for the approval and financial support our article with the registration number 28412/301. The researchers also thank all the subjecys who participated in this study, the esteemed authorities of Isfahan Infertility Centers, and all the loved ones whose articles were used in this study.

 

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.