Volume 37, Issue 148 (July 2024)                   IJN 2024, 37(148): 160-177 | Back to browse issues page

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Neisani Samani L, Arjmand S, Seyedfatemi N, Haghani S. Impact of Online Stress Management Training Program on the Sexual Function of Perimenopausal Women: A Clinical Trial. IJN 2024; 37 (148) :160-177
URL: http://ijn.iums.ac.ir/article-1-3683-en.html
Impact of Online Stress Management Training Program on the Sexual Function of Perimenopausal Women: A Clinical Trial
Leila Neisani Samani1 , Shima Arjmand 2, Naeimeh Seyedfatemi3 , Shima Haghani4
1- Department of Midwifery, Nursing and Midwifery Care Research Center, Iran University of Medical Sciences, Tehran, Iran.
2- Department of Midwifery, Nursing and Midwifery Care Research Center, Iran University of Medical Sciences, Tehran, Iran. , shimaarjmand406@gmail.com
3- Department of Psychiatric Nursing, Geriatric Mental Health Research Center, Nursing and Midwifery Care Research Center, Tehran, Iran.
4- Department of Biostatistics, Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Nursing and Midwifery, Tehran, Iran.
Keywords: Virtual education, Stress management, Sexual performance, Perimenopause
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Introduction
Perimenopause usually begins in women’s mid-40s. With the onset of menopause symptoms, most women feel a kind of anxiety, discomfort, and physical and mental complications, which may affect body image, sexual activity, psychological well-being, and health-related quality of life. One of the problems of transition to menopause is sexual dysfunction, which often begins at the age of 45. Therefore, stress management training can be helpful for these women in dealing with unhelpful thoughts and negative emotions. Recently, the non-face-to-face methods in the treatment of many psychological disorders have attracted the attention of many experts. In this regard, due to its accessibility and attractive ways of presenting content on many issues, especially sexual issues that may be difficult for people to talk about and seek treatment due to socio-cultural issues, virtual stress management training can be helpful for perimenopausal women. The present study aims to determine the effects of a virtual stress management training program on the sexual function of perimenopausal women in Shahriar, Tehran, Iran.

Methods
This is a randomized clinical trial with a pre-test/post-test design conducted in winter 2022. The study population includes all healthy perimenopausal women aged 40-50 referring to Sohrab Ali Bakhshi Comprehensive Health Center in Shahriar town with health records in the SIB system of the center. Inclusion criteria were literacy, ability to use a smartphone, living with their husbands, having sexual activity, not using any hormonal, or psychological drugs, experiencing menstruation at least once in the past three months, and having no any stressful experience during this period that can cause distress. Fifty eligible women were selected using a continuous sampling method. 
They were divided into five groups of 10 and received stress management training online using a 30-minute educational video sent to them on WhatsApp, at 8 sessions, two times per week, for four weeks. They completed a sociodemographic/obstetric form (surveying age, educational level, employment status, ethnicity, contraceptive status, number of pregnancies, number of childbirths, number of children, and history of infertility) and the female sexual function index (FSFI) with six domains of sexual desire, sexual arousal, lubrication, orgasm, satisfaction, and pain, before, immediately after, 4 weeks after, and 8 weeks after the intervention. They were completed using a self-report and online method.
The SPSS software, version 24 was used for data analysis. Descriptive and inferential statistics were employed to analyze the collected data. Descriptive statistics were frequency (for the qualitative variables), mean, and standard deviation (for the quantitative variables). Inferential statistics were the paired t-test (to compare the FSFI score before and after the intervention), and repeated measures analysis of variance (to examine the difference in the FSFI score between four assessment phases). The significance level was set at 0.05.

Results
The mean age of women was 44.77±3.07 years. Most of them had lower than high school education (56%), were housewives (64%), with Fars ethnicity (50%), and from urban areas (98%). The mean total FSFI score before the intervention was 22.91±3.35, which increased to 24.15±2.57 immediately after the intervention. Four and 8 weeks later, the scores were 24.9±2.33 and 25.22±2.46, respectively. There was a significant difference in all FSFI domains over time. The pairwise comparison showed a significant difference in weeks 4 and 8 compared to pretest values in all FSFI domains, but there were no statistically significant differences between 4 and 8 weeks after intervention except for the orgasm domain (P=0.016) and the total score (P=0.015).

Conclusion
The online stress management training program can improve the sexual function of perimenopausal women in the areas of sexual desire, sexual arousal, satisfaction, pain, orgasm, and lubrication. Due to the ease of use, accessibility, and cost-effectiveness, the online method of stress management training is useful, and can be used to improve the sexual performance of perimenopausal women in Iran. It is recommended to use the intervention for other age groups, such as newly married teenage girls or menopausal women.

Ethical Considerations
Compliance with ethical guidelines
This study was approved by the ethical committee of Iran University of Medical Sciences (Code: IR.IUMS.REC.1400.620) and was registered by the Iranian Registry of Clinical Trials (ID: IRCT20140823018903N).

Funding
This article was extracted from the master’s thesis of Shima Arjmand at Iran University of Medical Sciences.

Authors' contributions
The authors contributed equally to preparing this paper.

Conflict of interest
The authors declared no conflict of interest.

Acknowledgments
The authors would like to thank all participants for their cooperation in this study.
 
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Type of Study: Research | Subject: Midwifery
Received: 2023/04/13 | Accepted: 2024/06/21 | Published: 2024/07/1
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