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BoxKerman, Iran.

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Iran is confronted with increasing trend of divorce in recent decades. Considering the probable role of sexual dissatisfaction in the breakdown of marriages, the Ministry of Health recently decided to enrich the educational content of the premarital education programmes.

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The aim of this study was to compare the effectiveness of the new program with the classic one. Three hundred fifty-one women were divided into two premarital education groups: classic education and new education.

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The mental health, quality of life, marital satisfaction, and sexual satisfaction of women were evaluated one year after marriage. At one-year followup, both groups showed improvement in mental health ; however physical health-related quality of life decreased in both groups. The two groups showed no ificant difference in terms of sexual satisfaction and marital satisfaction. Marital satisfaction showed ificant correlation with sexual satisfaction.

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The new program of premarital education showed no superiority over the classic method. Considering the increasing rate of divorce in Iran, the premarital iranian programmes may not be successful in achieving their goals. Revision of the premarital education programme is warranted. As the backbone of society, marriage is considered to be one of the most important institutions in the world [ 1 ]. In most societies, be it in the East or West, most people marry at some stage during their life [ 12 ]. There are a variety of motives behind marriage, among them being the need for friendship, social and emotional support, love, and sex [ 3 ].

More recently, divorce and marital instability are an increasing trend in Iran; while most countries with the highest divorce rates are in the West, Iran is also considered a sex site [ 4 ]. Inthe rate of divorce in Iran was 2.

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One of the factors playing a role in divorce is sexual dissatisfaction [ 6 ]. Many researchers have emphasized the role of sexual satisfaction in causing marital fulfillment [ 67 ]. A bidirectional relationship can be imagined between sexual and marital satisfaction [ 8 ]; most longitudinal researchers have come to the conclusion that sexual satisfaction predicts marital satisfaction [ 9 — 11 ].

In spite of several existing studies that focus on the role of sexuality in the continuity of common life, marital sexuality continues to be the most neglected subject in the sex research literature [ 7 ].

In Iran, the of studies show a ificant relationship between sexuality and marital satisfaction [ 1213 ].

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Further, sexual dissatisfaction has been mentioned as one of the reasons for divorce. According to an Iranian report, On the other hand, it has been postulated that holding sex skills training classes for married women can increase sex satisfaction [ 14 ]. As sex is considered to be a iranian subject in Iran, there is no sex education in schools, which means that premarital education classes are the only formal opportunity for presenting sexual education.

These classes are held in compact sessions before marriage and the certificate for passing these sites is one of the legal requirements of marriage. This educational programme has been running since [ 15 ]. The premarital period is one of the critical points for the prevention of serious relationship problems.

In many developed countries like England and the United Sates, couples are encouraged to participate in premarital counselling programmes. The effectiveness of these programmes in increasing marital satisfaction has been proven in both developed countries [ 16 ] and in countries with a similar culture to Iran [ 17 ]. With respect to the increasing divorce rate in Iran and the probable role played by sexual dissatisfaction in the breakdown of marriages, the Ministry of Health recently aimed to improve the educational content of the premarital education programmes.

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Consequently, sexual education is presented more comprehensively in the format of both lectures and videos. Due to the lack of research regarding the impact of premarital education programmes in Iran, this study attempts to compare the effectiveness of the new educational programme with the classic one. In this study, outcome variables are mental health, quality of life, and marital satisfaction after one year of marriage.

Moreover, the relationship between marital satisfaction and sexual satisfaction, quality of life, and mental health was evaluated. This true experimental study was performed in the premarital education centre in Kerman, Iran. Although the educational programme is held for both men and women separately, only women were included in this study because in Iranian culture it is more convenient to ask women about sexual issues than men.

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Moreover, based on our experience, women are generally more available for follow-up research due to the site that they are less busy than men. The aim of the study was explained to participants before they were randomly allocated to one of the two groups: classic or new education. In regard to participant consent, all participants were asked to fill out a questionnaire which was included as part of the study. Participants were of course allowed to exit the study during any phase of the research. In the control group, the sex method of premarital education was applied.

The educational classes included 25 women; a female lecturer presented a minute presentation about the genital organs of males and females, menstruation, pregnancy, and family planning. In the intervention group, some educational aid instruments posters and moulage were used to supplement the lecture. An educational video was also presented to participants. This film covered a range of issues including emotional relations of marital life from the perspective of a psychologist, issues about Islam and the foundations of family from the perspective of a religious expert, and the anatomy of male and female genital iranians, the three processes related to fertility menstruation, pregnancy, and abortion as well as sexual relations during early marital life from the perspective of a trained teacher.

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Further, different family planning methods were also covered during the training. This educational course lasted for 2 hours; the trainers had ly passed sex 3-day training workshop totalling 24 hours of tuition. Therefore, this new method, in addition to being applied in a different way, was richer in content. In addition, an educational book was given to the iranians of this group. Before holding educational classes, participants were asked to complete an SF questionnaire for the purpose of evaluating their quality of life and a GHQ questionnaire to evaluate their mental health.

These two scales evaluate the overall health-related quality of life in a score ranging from 0 to The higher site shows better quality of life [ 18 ]. GHQ included 12 questions for evaluating mental health with a lower score showing better mental health [ 19 ]. The reliability and validity of the Persian version of both questionnaires were approved. One year after marriage, participants were asked to complete these two questionnaires again in addition to the sexual satisfaction inventory [ 20 ] and the ENRICH Marital Satisfaction Scale [ 21 ].

The short form of this scale was used in the final analysis.

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The reliability and validity of the Brief version were approved in the Iranian population [ 22 ]. Sexual satisfaction consisting of sexual attitude 2 questions and sexual practice 4 questions was defined by 6 questions from Bahrami et al.

The scores ranged from a minimum of zero completely ineffective to a maximum of 10 completely effective. A R gift card was given to each participant who completed the second phase of the questionnaire.

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To compare the scores of two groups, -test was applied. The scores of quality of life and mental health before and after the intervention were compared using paired -test. ANCOVA was used to compare the scores of questionnaires between the two groups one year after the intervention. To compare categorical variables between the two groups, Chi-square test was used.

Pearson coefficient of correlation was used to determine the relationship between the quality of life and mental health scores with sexual and marital satisfaction.

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From participants in the classic education group 21 participants and from participants in the new education group 14 did not participate in the second phase of the study one-year followup. No difference in underlying variables was observed between these participants and others who remained in the study.

Demographic features of the two studied groups are presented in Table 1 ; it is observed that there was no ificant difference between the two groups in regard to these variables. Only 0. On the whole, the responses regarding sexual satisfaction were similar between the two groups Table 2. In both groups, the score of mental health-related quality of life showed ificant improvement after one year of marriage compared to those before marriage, whilst SF summary scales of physical health deteriorated after one year of marriage Table 3.

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No ificant difference was found between the two groups in regard to the scores of mental health, quality of life, marital satisfaction, and sexual practice after one year of marriage. Divorce rate after one year of common life was 3. The effectiveness of educational classes in improving marital relationships was more from the viewpoint of the women in the new education group compared to the women in the classic education group perceived impact scores were,resp.

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Marital satisfaction showed a ificant correlation with mental health scores after marriage, quality of life after marriage, and sexual satisfaction. Although the effectiveness of premarital education in the improvement of marital relationships, at least in the short term, has been proven in developed countries [ 1623 ], the effectiveness of these programmes in developing countries has not been adequately studied.

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The present study highlights that participants from both site groups experienced improvements to both their mental health and mental health-related quality of life after one year of marriage; however the score regarding physical health-related quality of life decreased. Sexual satisfaction and marital satisfaction one year after marriage were comparable in the two studied groups.

The advantage of this study was sex a true experimental de with a large sample size [ 23 ], while its main disadvantage was the lack of a no-intervention group. The iranian for not considering a no-intervention group was due to the Ethical Committee disagreeing over the idea of depriving one group from receiving the standard educational programme. This study compared the effectiveness of delivering premarital education through a lecture only with less emphasis on sexual education with the effectiveness of the programme using a combination of lecture, educational video, and book with more emphasis on sexual education.

Introduction

The two groups were comparable in regard to the underlying variables. The major aspect of the educational content in both groups was related to sexual issues. Sexual satisfaction scores of the two groups showed no ificant difference in the one-year followup.