Providing sexual health services by midwives in comprehensive health centers: A qualitative study from Iran - Payesh (Health Monitor)
Volume 22, Issue 1 (January-February 2023)                   Payesh 2023, 22(1): 61-72 | Back to browse issues page

Ethics code: IR.SBMU.RETECH.REC.1397.055


XML Persian Abstract Print


1- Department of Midwifery, School of Nursing and Midwifery, Geriatric Care Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
2- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran
4- Department of Biostatics, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Abstract:   (1119 Views)
Objective (s): Sexual health is one of the most important aspects of health However, few healthcare providers are capable of sexual counseling skill in clinical environments. Considering that in Iran most of the reproductive and sexual health services are provided in comprehensive health centers by midwives, the present study was conducted to explain the factors related to the provision of sexual health services by midwives in these centers.
Methods: This qualitative study was conducted in Rafsanjan, Iran in 2018-2019. Participants were 16 midwives, 7 key informants, and 6 women who referred to comprehensive health centers. Data were collected through 3 sessions of focus group discussion and 8 semi-structured interviews and analyzed via the conventional content analysis method. MAXQDA 10 software was used to perform analysis.
Results: In all 87 codes, 27 sub-categories, and 9 categories were extracted. Further examination of the categories led to emergent of three main themes: ‘professional competence of midwives in providing sexual health services’, ‘educational gap in sexual health’, and restrictions to providing sexual health services’.
Conclusion: The results showed that due to the lack of adequate education in sexual health and obstacles such as attitudes of policymakers, limited time and resources, and cultural issues, sexual health services are not provided proficiently. Indeed, considering the professional capacity of midwives, revising the midwifery educational curriculum in sexual health, is recommended.
Full-Text [PDF 1171 kb]   (788 Downloads)    
type of study: Descriptive | Subject: Reproductive Health
Received: 2022/12/28 | Accepted: 2023/01/18 | ePublished ahead of print: 2023/01/22 | Published: 2023/02/7

References
1. Evangelista ADR, Moreira ACA, Freitas C, Val DRD, Diniz JL, Azevedo SGV. Sexuality in old age: knowledge/attitude of nurses of family health strategy. Revista da Escola de Enfermagem da U S P 2019; 53:e03482 [DOI:10.1590/s1980-220x2018018103482]
2. Maroufizadeh S, Riazi H, Lotfollahi H, Omani-Samani R, Amini P. The 6-item Female Sexual Function Index (FSFI-6): factor structure, reliability, and demographic correlates among infertile women in Iran. Middle East Fertility Society Journal 2019; 24:7 [DOI:10.1186/s43043-019-0008-8]
3. Ören B, Zengin N, Yazıcı S, Akıncı A. Attitudes, beliefs and comfort levels of midwifery students regarding sexual counselling in Turkey. Midwifery 2018;56:152-7 [DOI:10.1016/j.midw.2017.10.014]
4. Wang P, Ai J, Davidson PM, Slater T, Du R, Chen C. Nurses' attitudes, beliefs and practices on sexuality for cardiovascular care: A cross-sectional study. Journal of Clinical Nursing 2019; 28: 980-986 [DOI:10.1111/jocn.14692]
5. Dyer K, das Nair R. Why don't healthcare professionals talk about sex? A systematic review of recent qualitative studies conducted in the United Kingdom. The Journal of Sexual Medicine 2013; 10:2658-70 [DOI:10.1111/j.1743-6109.2012.02856.x]
6. Halle-Ekane GE, Timti LF, Tanue EA, Ekukole CM, Yenshu EV. Prevalence and associated factors of female sexual dysfunction among sexually active students of the University of Buea. Sexual Medicine 2021; 9: 100402 [DOI:10.1016/j.esxm.2021.100402]
7. Alselaiti M, Saleh MA, Muhammed H, Attallah E, Dayoub N. Prevalence of female sexual dysfunction and barriers to seeking primary health care treatment in an Arab male-centered regime. Open Access Macedonian Journal of Medical Sciences 2022; 20:493-7 [DOI:10.3889/oamjms.2022.8771]
8. Zhu Y, Yang X, Fan X, et al. Decreased sexual desire among middle-aged and old women in China and factors influencing it: A questionnaire-based study. Evidence-based complementary and alternative medicine 2021; 6649242 [DOI:10.1155/2021/6649242]
9. Ranjbaran M, Chizari M, Maturi P. The prevalence of female sexual dysfunction in Iran: systematic review and meta-analysis. Journal of Sabzevar University of Medical Sciences 2015; 22:1117-25 [Persian]
10. Ghiasi A, Keramat A. Prevalence of sexual dysfunction among reproductive-age women in Iran: a systematic review and meta-analysis. Journal of Midwifery and Reproductive Health 2018; 6:1296-304 [Persian]
11. Alizadeh S, Riazi H, Majd HA, Ozgoli G. The effect of sexual health education on sexual activity, sexual quality of life, and sexual violence in pregnancy: a prospective randomized controlled trial. BMC Pregnancy Childbirth 2021; 21:334 [DOI:10.1186/s12884-021-03803-8]
12. Baker-Green R. Nurses experiences discussing sexuality with urinary catheter patients: Nurses experiences discussing sexuality. International Journal of Urological Nursing 2016; 11 [DOI:10.1111/ijun.12114]
13. Çuhadaroğlu A. The effects of sex education on psychological counseling students in Turkey. Sex Education 2017; 17:209-19 [DOI:10.1080/14681811.2016.1164132]
14. Khandan S, Riazi H, Amir Ali Akbari S, Nasiri M, Montazeri A. Adaptation to maternal role and infant development: a cross sectional study. Journal of Reproductive and Infant Psychology 2018; 36:289-301 [DOI:10.1080/02646838.2018.1437895]
15. Ford JV, Barnes R, Rompalo A, Hook EW, 3rd. Sexual health training and education in the U.S. Public Health Reports 2013; 128 Suppl 1:96-101 [DOI:10.1177/00333549131282S111]
16. Khadivzadeh T, Ghazanfarpour M, Latifnejad Roudsari R. Cultural barriers influencing midwives' sexual conversation with menopausal women. Journal of Menopausal Medicine 2018; 24:210-216 [DOI:10.6118/jmm.2018.24.3.210]
17. McPhillips H, Wood AF. Consultation and clinical assessment for advanced clinical practitioners in sexual health. British Journal of Nursing 2022; 31:478-481 [DOI:10.12968/bjon.2022.31.9.478]
18. Chokka PR, Hankey JR. Assessment and management of sexual dysfunction in the context of depression. Therapeutic Advances in Psychopharmacology 2018; 8:13-23 [DOI:10.1177/2045125317720642]
19. Gambrah HA, Hagedorn JC, Dmochowski RR, Johnsen NV. Understanding sexual health concerns in women after traumatic pelvic fracture. Neurourology and Urodynamics 2022; 41:1364-1372. [DOI:10.1002/nau.24942]
20. Eissa MF, Missiry MA, Kamel KFW, Mahmoud DAM. Sexual dysfunction and quality of life in female patients with major depression disorder. Middle East Current Psychiatry 2022; 29: 43 [DOI:10.1186/s43045-022-00206-z]
21. Coleman E, Elders J, Satcher D, Shindel A, Parish S, Kenagy G, Bayer CR, Knudson G, Kingsberg S, Clayton A, Lunn MR, Goldsmith E, Tsai P, Light A. Summit on medical school education in sexual health: report of an expert consultation. The Journal of Sexual Medicine 2013;10:924-38 [DOI:10.1111/jsm.12142]
22. ICM. ICM International definition of the midwife; The Netherlands: International Confederation of Midwive; 2011. https://www.internationalmidwives.org
23. Elmerstig E, Thomtén J. Vulvar pain-associations between first-time vaginal intercourse, tampon insertion, and later experiences of pain. Journal of Sex & Marital Therapy 2016; 42:707-20 [DOI:10.1080/0092623X.2015.1113589]
24. Khadivzadeh T, Ardaghi M, Mirzaii K, Mazloum SR. The effect of interactive educational workshops with or without standardized patients on the self-efficacy of midwifery students in sexual health counseling. Journal of Midwifery and Reproductive Health 2016; 4:562-70
25. Walker SH, Davis G. Knowledge and reported confidence of final year midwifery students regarding giving advice on contraception and sexual health. Midwifery 2014; 30:e169-e76 [DOI:10.1016/j.midw.2014.02.002]
26. Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Education Today 2004; 24:105-12 [DOI:10.1016/j.nedt.2003.10.001]
27. Guba EG. Lincoln YS. Competing paradigms in qualitative research. In: Denzin NK and Lincoln YS. Eds. Handbook of Qualitative Research, 1st Edition, Sage Publications: Oaks,1994
28. Karimian z. Designing and evaluation of the community-based modules in sexual health assessment and counceling to promote midviews' professional practices.PhD thesis. Shahrud: shahrud University of Medical Sciences; 2016 [Persian]
29. Viveiros CJ, Viveiros CJ, Darling EK. Barriers and facilitators of accessing perinatal mental health services: The perspectives of women receiving continuity of care midwifery. Midwifery 2018; 65:8-15 [DOI:10.1016/j.midw.2018.06.018]
30. Mansour SE, Mohamed HE. Handling sexuality concerns in women with gynecological cancer: Egyptian nurs's knowledge and attitudes. Gynecology & Obstetrics 2015; 6:146-59
31. Percat A, Elmerstig E. "We should be experts, but we're not": Sexual counselling at the antenatal care clinic. Sexual & Reproductive Health Care 2017; 14:85-90 [DOI:10.1016/j.srhc.2017.10.001]
32. Lamyian M, Maasoumi R. How Iranian practitioners in primary health care setting can provide client's sexual problems? A case report study. Health Education and Health Promotion 2014; 2:57-65
33. Motamedi M. Sexual health program assessment in health system. MSc. dissertation. Esfahan: Esfahan university of medical sceince; 2016 [Persian]
34. Quinn C, Happell B, Browne G. Talking or avoiding? Mental health nurses' views about discussing sexual health with consumers. International Journal of Mental Health Nursing 2011; 20:21-8 [DOI:10.1111/j.1447-0349.2010.00705.x]
35. Zeng YC, Liu X, Loke AY. Addressing sexuality issues of women with gynaecological cancer: Chinese nurses' attitudes and practice. Journal of Advanced Nursing 2012; 68:280-92 [DOI:10.1111/j.1365-2648.2011.05732.x]
36. Tabatabaie A. Constructing the ideal Muslim sexual subject: problematics of school-based sex education in Iran. Sex Education 2015; 15:204-16 [DOI:10.1080/14681811.2014.992066]

Rights and Permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.