Comparison Between the Effect of the Information–Motivation–Behavioral (IMB) Model and Psychoeducational Counseling on Sexual Satisfaction and Contraception Method Used Under the Coercion of the Spouse in Iranian Women: A Randomized, Clinical Trial

Zarbaf, Alieh; Ahmadi, Atefeh; Rafati, Elahe; Ghorbani, Faezeh; Pour, Masumeh Ghazanfar; Alidousti, Katayoun

doi:10.1055/s-0043-1772487

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Original Article, Contraception/Sexuality • Rev Bras Ginecol Obstet 45 (8) • 2023 • https://doi.org/10.1055/s-0043-1772487 copy

Comparison Between the Effect of the Information–Motivation–Behavioral (IMB) Model and Psychoeducational Counseling on Sexual Satisfaction and Contraception Method Used Under the Coercion of the Spouse in Iranian Women: A Randomized, Clinical Trial

Comparação entre o efeito do modelo Informação-Motivação-Comportamental (IMB) e o aconselhamento psicoeducacional sobre a satisfação sexual e o método contraceptivo usado sob coerção do cônjuge em mulheres iranianas: um ensaio clínico randomizado

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

Women play an essential role in maintaining the family's health, and family planning is part of women's and families' health. The couple's mutual understanding of family planning methods is essential in selecting contraception. Acceptance of and satisfaction with different contraception methods can impact sexual satisfaction. The present study aimed to compare the effect of the information-motivation-behavioral (IMB) model and psychoeducational counseling on sexual satisfaction and contraception methods of women referring to health centers in Kerman.

Methods

This trial was conducted on 81 women aged 18 to 45, in Kerman health centers, from 2021 to 2022. Participants were randomly divided into 3 groups of 27 people (control, psychoeducational counseling, and IMB method). Three online counseling sessions were held for the psychoeducational group, and four were held for the IMB group. The control group received routine care. The IBM SPSS Statistics for Windows, version 22 (IBM Corp. Armonk, NY, USA) was used for data analysis using nonparametric Friedman and Kruskal-Wallis tests.

Results

The mean age of participants was 32.59 ± 7.04, and the majority of them had university degrees and were homemakers. The mean sexual satisfaction score significantly increased immediately after the intervention and 1 month later in the 2 interventional groups (p < 0.0). Changes in contraception methods after intervention were significant in the psychoeducational group (p = 0.0)

Conclusion

The results indicate the positive impact of psychological counseling on women's sexual satisfaction and contraception method. The IMB method also impacted men's sexual satisfaction but did not lead to any changes in the contraceptive method.

Keywords
psychoeducational counseling; information–motivation–behavioral model; sexual satisfaction; contraception violence

Session	Objective	Content
Psychoeducational counseling package
First	Introduction and awareness	Informing people about violent behaviors, teaching contraception methods
Second	Identifying sexual misconceptions	Teaching to improve sexual relations, expressing the importance of sex, talking about sexual misconceptions, extensive training on contraception methods
Third	Effective communication and assertiveness	Assertiveness skill training, communication styles, effective communication skills training
Information–motivation–behavioral package
First	Identifying distorted dimensions in sex	Defining contraception methods and the benefits and harms of each method, defining spousal violence in contraception, defining sexual satisfaction and sexual satisfaction related to contraception.
Second	Motivational dialogue	Conducting a motivational interview to accept or change the contraception method to make it voluntary and increase sexual satisfaction
Third	Efficient sexual dialogue with the spouse	Improving perceived individual skills and self-efficacy
Fourth	Activate assertive behaviors	Activating avoidance behaviors and improving assertiveness skills by increasing motivation and behavioral skills

Variables		Group			P-value^* * Chi-square.
Variables		Psychoeducation N (%)	IMB N (%)	Control N (%)	P-value^* * Chi-square.
Women education	High school education	2 (7.4%)	2 (7.4%)	3 (10%)	0.9
	Diploma	13 (48.1%)	13 (48.1%)	11 (36.7%)
	University education	12 (44.4%)	12 (44.4%)	16 (53.3%)
Women job	Housekeeper	19 (70.4%)	15 (55.6%)	20 (66.7%)	0.34
	Employee	6 (22.2%)	7 (25.9%)	9 (30%)
	self-employment	2 (7.4%)	5 (18.5%)	1 (3.3%)
Spouse education	High school education	3 (11.1%)	7 (25.9%)	5 (18.5%)	0.22
	Diploma	12 (44.4%)	13 (48.1%)	9 (30%)
	University education	12 (44.4%)	7 (25.9%)	16 (53.3%)
Spouse job	permanent job	15 (55.6%)	13 (48.1%)	14 (46.7%)	0.83
	Temporary job	10 (37%)	13 (48.1%)	15 (55.6%)
	workless	2 (7.4%)	1 (3.3%)	1 (3.3%)
Variable		Mean ± SD	Mean ± SD	Mean ± SD	P-value^ Kruskal-Wallis test.
Age		7.255 ± 34.44	7.704 ± 32.04	31.30 ± 6.199	0.22
Age of onset of sexual activity		4.029 ± 23.19	3.652 ± 21.52	3.151 ± 22.27	0.24
Parity		1.368 ± 2.89	1.812 ± 2.85	1.654 ± 2.77	0.89

Sexual satisfaction	Mean ± SD			P-value^* * Kruskal-Wallis test.
Sexual satisfaction	Psychoeducation	IMB	Control	P-value^* * Kruskal-Wallis test.
Before intervention	22.73 ± 166.66	18.43 ± 167.62	18.08 ± 169.33	0.97
After intervention	16.85 ± 184.37	13.01 ± 190.29	15.38 ± 167.30	0.001<
One month after intervention	16.48 ± 189.25	11.05 ± 203.48	15.49 ± 166.13	0.001<
P-value^ >Friedman test.	0.001<	0.001<	0.71

Group	Contraceptive method	Before intervention	After intervention	One month after intervention	P-value^* * Kendall test.
Psychoeducation	Withdrawal	14 (51.85%)	8 (29.62%)	8 (29.62%)	0.02
	Condom	6 (22.22%)	11 (40.74%)	11 (40.74%)
	Combined oral pills	5 (18.51%)	4 (14.81%)	4 (14.81%)
	Medroxyprogesterone asetat	1 (3.7%)	2 (7.4%)	2 (7.4%)
	IUD	1 (3.7%)	2 (7.4%)	2 (7.4%)
IMB	Withdrawal	13 (48.14%)	10 (37.03%)	5 (18.51%)	0.07
	Condom	5 (18.51%)	8 (29.62%)	9 (33.33%)
	Combined oral pills	5 (18.51%)	5 (18.51%)	6 (22.22%)
	Medroxyprogesterone asetat	1 (3.7%)	1 (3.7%)	2 (7.4%)
	IUD	3 (11.11%)	3 (11.11%)	5 (18.51%)
Control	Withdrawal	14 (51.85%)	14 (51.85%)	15 (50%)	1
	Condom	9 (33.33%)	9 (33.33%)	8 (29.62%)
	Combined oral pills	5 (18.51%)	5 (18.51%)	5 (18.51%)
	Medroxyprogesterone asetat	1 (3.7%)	1 (3.7%)	2 (7.4%)
	IUD	1 (3.7%)	1 (3.7%)	1 (3.7%)

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[1] Address for correspondence Katayoun Alidousti Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences Kerman Iran (e-mail: kalidousti@gmail.com).