Evaluation of Sexual Health Counseling for Primiparous Pregnant Women Using PLISSIT Model and Motivational Interviewing

Evaluation of Structured Sexual Health Counseling for Primiparous Pregnant Women Based on PLISSIT Model Supported by Motivational Interviewing

This study is a simple randomized controlled intervention study to evaluate the effects of sexual counseling given to primiparous pregnant women using motivational interviewing on sexual self-efficacy, attitude towards sexuality and quality of sexual life.

HO: There is no difference between the mean Sexual Function Scale score in the last evaluation of pregnant women in the intervention and control groups.

H0a: There is no difference between the mean Sexual Self-Efficacy Scale score in the last evaluation of pregnant women in the intervention and control groups.

H0b: There is no difference between the mean Attitude Towards Sexuality During Pregnancy Scale score in the last evaluation of pregnant women in the intervention and control groups.

H0c: There is no difference between the mean Sexual Life Quality Scale score in the last evaluation of pregnant women in the intervention and control groups.

Pregnancy is a natural process that involves hormonal, physical, and social changes, affecting a woman's mood, relationships, and sexual life. The first pregnancy is a significant transition period, during which women may experience various fears related to sexuality, such as fear of miscarriage, premature birth, harming the baby, or increased risk of infection. These concerns often lead to a decrease in sexual activity during pregnancy.

The PLISSIT Model is suggested as an effective approach for assessing sexual health during pregnancy. This model consists of four stages: permission for expressing thoughts and concerns about sexuality, providing limited information, offering specific suggestions, and referring to intensive therapy when necessary. Additionally, the motivational interviewing method can help pregnant individuals recognize conflicting emotions and make positive behavioral changes.

Research indicates that sexual knowledge impacts sexual function, and participation in educational programs can improve sexual health during pregnancy. However, studies also show that healthcare professionals often lack sufficient support in this area. Nurses play a crucial role in educating and counseling pregnant women to enhance their awareness of sexual health. The absence of sexual health recommendations in the Ministry of Health's prenatal care guidelines highlights a gap in this area. Improving sexual quality of life during pregnancy is essential for strengthening women's self-confidence and sense of adequacy.

In the study, the data collection tools used were the **Inclusion Criteria Questionnaire (ICQ), Personal Information Form, Sexuality Diary, Female Sexual Function Index (FSFI), Sexual Self-Efficacy Scale (SSES), Attitudes Towards Sexuality During Pregnancy Scale (ATSPS), and Sexual Quality of Life Questionnaire-Female Version (SQOL-F).**

• **ICQ:** A ten-item form assessing the eligibility criteria for pregnant participants. Women who scored below 26.55 on the FSFI and answered all questions as "yes" were included in the study.
• **Personal Information Form:** A 15-item form assessing the socio-demographic and obstetric characteristics of pregnant individuals.
• **FSFI:** A scale evaluating female sexual function. A score below 26.55 indicates female sexual dysfunction.
• **SSES:** A scale measuring individuals' sexual self-efficacy, ranging from 0 to 40. Higher scores indicate higher sexual self-efficacy.
• **ATSPS:** A 34-item Likert-type scale assessing attitudes toward sexuality during pregnancy. Higher scores indicate a more positive attitude. The cutoff point is set at 111.5.

Inclusion Criteria:

• Those over 19 years of age
• Those in their first pregnancy
• Those in their 8th-16th weeks of pregnancy
• Those who are sexually active
• Those who have a score of less than 26.55 on the Female Sexual Function Scale (FSFI)

Exclusion Criteria:

• Those who have given birth prematurely
• Those who have developed a pregnancy complication that prevents coitus at any stage of the study (placenta previa, preterm premature rupture of membranes)
• Those who do not comply with the study plan
• Those who have received any sexual counseling
• Those who have experienced a life crisis (death of partner, divorce, moving, etc.)
• Those who want to withdraw from the study at any stage of the study