بررسی تأثیر آموزش غنی‌سازی روابط بر صمیمیت زناشویی زوجین نابارور دارای خشونت خانگی

نوع مقاله : مقاله های پژوهشی

نویسندگان

1 عضو هیأت علمی، گروه مامایی، دانشکده‌ی پرستاری و مامایی، دانشگاه علوم پزشکی شاهرود، شاهرود، ایران

2 دانشجوی کارشناسی ارشد، گروه مشاوره در مامایی، دانشکده‌ی پرستاری و مامایی، دانشگاه علوم پزشکی شاهرود، شاهرود، ایران

3 استادیار، گروه روان‌پزشکی، دانشکده‌ی پزشکی و بیمارستان امام حسین (ع) شاهرود، دانشگاه علوم پزشکی شاهرود، شاهرود، ایران

4 دانشیار، گروه بهداشت باروری، دانشکده‌ی پرستاری و مامایی و مرکز تحقیقات علوم رفتاری و اجتماعی در سلامت، دانشگاه علوم پزشکی شاهرود، شاهرود، ایران

5 استادیار، مرکز تحقیقات مراقبت‌های مادر و کودک و گروه مامایی، دانشکده‌ی پرستاری و مامایی، دانشگاه علوم پزشکی همدان، همدان، ایران

6 دانشجوی دکتری روان‌شناسی تربیتی، گروه روان‌شناسی، دانشکده علوم انسانی، دانشگاه آزاد اسلامی، واحد بابل، بابل، ایران

چکیده

مقدمه: حمایت زوجین نابارور و ارایه‌ی‌ آموزش به آنان جزء برنامه‌های حمایتی طرح تحول سلامت می‌باشد. با توجه به این که ناباروری موجب مشکلاتی در روابط زناشویی زوجین نابارور می‌شود، پژوهش حاضر با هدف تأثیر آموزش غنی‌سازی روابط بر صمیمیت زناشویی زوجین نابارور دارای خشونت خانگی انجام شد.روش‌ها: مطالعه‌ی کارآزمایی بالینی حاضر، به صورت پیش و پس آزمون بر روی 36 زوج نابارور دارای خشونت خانگی مراجعه کننده به مرکز ناباروری ساری در سال 1394 که به طور تصادفی به دو گروه مورد و شاهد تقسیم شده بودند، انجام شد. غربالگری خشونت با پرسش‌نامه‌ی استاندارد خشونت خانگی (Conflict tactics scale2 یا CTS2) از بین زوجین نابارور داوطلب شرکت کننده انجام گرفت. ابزار گردآوری داده‌ها، پرسش‌نامه‌ی صمیمیت زناشویی بود که توسط هر دو گروه در مراحل قبل، بلافاصله و بعد از دو ماه از اتمام جلسات آموزشی تکمیل شد. روایی و پایایی هر دو پرسش‌نامه، پیش‌تر در سایر مطالعات داخلی تأیید شده بود. آموزش غنی‌سازی روابط زوجین در هفت جلسه‌ی 90 دقیقه‌ای توسط دانشجوی کارشناسی ارشد مشاوره‌ی مامایی با همکاری دانشجوی دکتری روان‌شناسی برای زوجین در گروه مورد برگزار شد. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار SPSS انجام شد.یافته‌ها: غنی‌سازی روابط بر بهبود نمره‌ی صمیمیت زناشویی (001/0 > P) و ابعاد آن شامل عاطفی (001/0 > P)، عقلانی (001/0 > P)، فیزیکی (001/0 > P)، اجتماعی (001/0 > P)، ارتباطی (001/0 > P)، مذهبی (001/0 > P)، جنسی (001/0 > P) و کلی (001/0 > P) به طور معنی‌داری مؤثر بود. هر چند، اثر مداخله در بعد روان‌شناختی به لحاظ آماری بی‌تأثیر بوده است (180/0 > P).نتیجه‌گیری: آموزش غنی‌سازی روابط، موجب افزایش صمیمیت زوجین می‌گردد. هر چند اختلاف نمره‌ی بعد روان‌شناختی صمیمیت به لحاظ آماری معنی‌دار نبود، اما تأثیر آموزش بر سایر ابعاد صمیمت زناشویی در گروه مورد مشاهده گردید. بنابراین، برگزاری کارگاه‌های آموزش غنی‌‌سازی روابط با هدف ارتقای روابط بین فردی زوجین نابارور در مراکز ناباروری توصیه می‌گردد.

کلیدواژه‌ها


عنوان مقاله [English]

The Effect of Relationship Enrichment Training on Marital Intimacy among Infertile Couples with Domestic Violence

نویسندگان [English]

  • Mahbobeh Poorheidari 1
  • Fatemeh Alijani 2
  • Seyed Shahrokh Aghayan 3
  • Afsaneh Keramat 4
  • Seyedeh Zahra Masoumi 5
  • Zohreh Asadi 6
1 Faculty Member, Department of Midwifery, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
2 MA Student in Counseling in Midwifery, Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Sharoud,Iran
3 Assistant Professor, Department of Psychiatry, School of Medicine AND Imam Hossien Hospital, Shahroud University of Medical Sciences, Shahroud, Iran
4 Associate Professor, Department of Reproductive Health, School of Nursing and Midwifery AND Center for Health-Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
5 Assistant Professor, Reasearch Center for child and Maternity Care AND Department of Midwifery, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
6 PhD Student in Clinical Psychology, Department of Psychology, School of Hunamnities, Babol Branch, Islamic Azad University, Babol, Iran
چکیده [English]

Background: Support for infertile couples and offering them training programs are part of the health reform plan. Considering that infertility causes problems in the marital relationships of infertile couples, the current study was conducted to determine the effect of relationship enrichment training on marital intimacy amomg infertile couples with domestic violence.Methods: This was a semi-experimental study with pre- and post-test on 36 infertile couples with domestic violence referred to the infertility center of Sari City, Iran, in 2015. The couples were randomly divided to control and experimental groups. Domestic violence screening among infertile couples was performed with the Conflict Tactic Scales (CTS) standard questionnaire. Data were collected using marital intimacy questionnaire, which was completed by both groups before and immediately and two months after the intervention. The validity and reliability of both questionnaires were approved before in other Iranian studies. The intervention consisted of seven 90-minute training sessions and was conducted by a graduate student of midwifery counselling. Data were analyzed using SPSS20 software.Findings: Intervention improved the mean score of marital intimacy (P < 0.001) and emotional (P < 0.001), intellectuality (P < 0.001), physical (P < 0.001), social (P < 0.001), communication (P < 0.001), spiritual (P < 0.001), sexual (P < 0.001) and general (P < 0.001) dimensions significantly. However, there was no statistically significant improvement in psychological dimension (P < 0.180).Conclusion: Relationship enrichment increased the marital intimacy; therefore, using the relationship enrichment training workshops is recommended. Although mean score of psychological dimension was not statistically significant, it increased after intervention. Furthermore, other dimensions showed significant improvement in post-test.

کلیدواژه‌ها [English]

  • Enrich relationships
  • Marital intimacy
  • Infertility
  • Domestic vio
  1. Monga M, Alexandrescu B, Katz SE, Stein M, Ganiats T. Impact of infertility on quality of life, marital adjustment, and sexual function. Urology 2004; 63(1): 126-30.
  2. van der Poel SZ. Historical walk: the HRP Special Programme and infertility. Gynecol Obstet Invest 2012; 74(3): 218-27.
  3. Mascarenhas MN, Flaxman SR, Boerma T, Vanderpoel S, Stevens GA. National, regional, and global trends in infertility prevalence since 1990: a systematic analysis of 277 health surveys. PLoS Med 2012; 9(12): e1001356.
  4. Vahidi S, Ardalan A, Mohammad K. Prevalence of primary infertility in the Islamic Republic of Iran in 2004-2005. Asia Pac J Public Health 2009; 21(3): 287-93.
  5. Sheikhan Z, Ozgoli G, Azar M, Alavimajd H. Domestic violence in Iranian infertile women. Med J Islam Repub Iran 2014; 28: 152.
  6. Avila Espada A, Moreno Rosset C. Psychological intervention in infertility: guidelines for a clinical intervention protocol. Papeles del Psicologo 2008; 29(2): 186-96. [In Spanish].
  7. Sbaragli C, Morgante G, Goracci A, Hofkens T, De Leo V, Castrogiovanni P. Infertility and psychiatric morbidity. Fertil Steril 2008; 90(6): 2107-11.
  8. Parveen B, Ahmed ID, Kousar S, Musharaf S, Masood A, Afzal S. Psychosocial adjustment of educated and uneducated infertile females of Pakistan. Annals of Punjab Medical College 2008; 2(2): 108-12.
  9. Moura-Ramos M, Gameiro S, Soares I, Santos TA, Canavarro MC. Psychosocial adjustment in infertility: a comparison study of infertile couples, couples undergoing assisted reproductive technologies and presumed fertile couples. Psicologia: Saude e Doencas 2010; 11(2): 299-319.
  10. Fooladi E, Danesh M, Kashfi F, Khani S, Mohammadpor R. Study of infertile husbands' and wives' point of view to infertility and marital adjustment in patients reffering to Royan infertility center of Tehran in 2005. J Mazandaran Univ Med Sci 2006; 16 (55):131-7. [In Perssian].
  11. Garcia-Moreno C, Jansen HA, Ellsberg M, Heise L, Watts C. WHO multi-country study on women's health and domestic violence against women. Initial results on prevalence, health outcomes and women's responses. Geneva, Switzerland: World Health Organization; 2005.
  12. Bodaghabadi M. Prevalence of violence and related factors in pregnant women referring to Shahid Mobini Hospital, Sabzevar. Hormozgan Med J 2007; 11(1): 71-6. [In Persian].
  13. Logan TK, Shannon L, Cole J, Walker R. The impact of differential patterns of physical violence and stalking on mental health and help-seeking among women with protective orders. Violence Against Women 2006; 12(9): 866-86.
  14. Porreza A. Violence against women and social its consequences. Family Health 2003; 8(25): 66-7. [In Persian].
  15. Shackelford TK, Buss DM, Peters J. Wife killing: risk to women as a function of age. Violence Vict 2000; 15(3): 273-82.
  16. Richardson JR, Feder G, Coid J. Domestic violence affects women more than men. BMJ 2002; 325(7367): 779.
  17. Campbell JC. Health consequences of intimate partner violence. Lancet 2002; 359(9314): 1331-6.
  18. Zorrilla B, Pires M, Lasheras L, Morant C, Seoane L, Sanchez LM, et al. Intimate partner violence: last year prevalence and association with socio-economic factors among women in Madrid, Spain. Eur J Public Health 2010; 20(2): 169-75.
  19. Ardabily HE, Moghadam ZB, Salsali M, Ramezanzadeh F, Nedjat S. Prevalence and risk factors for domestic violence against infertile women in an Iranian setting. Int J Gynaecol Obstet 2011; 112(1): 15-7.
  20. Ameh N, Kene TS, Onuh SO, Okohue JE, Umeora OU, Anozie OB. Burden of domestic violence amongst infertile women attending infertility clinics in Nigeria. Niger J Med 2007; 16(4): 375-7.
  21. Yildizhan R, Adali E, Kolusari A, Kurdoglu M, Yildizhan B, Sahin G. Domestic violence against infertile women in a Turkish setting. Int J Gynaecol Obstet 2009; 104(2): 110-2.
  22. Bahrami F, Oulia N, Fatehizadeh M. Marital enrichment training. Tehran, Iran: Danjeh Publications; 2013. [In Persian].
  23. Bowling TK, Hill CM, Jencius M. An overview of marriage enrichment. The Family Journal 2005; 13(1): 87-94.
  24. Tompkins SA, Roeder JA, Thomas JJ, Koch KK. Effectiveness of a relationship enrichment program for couples living with multiple sclerosis. Int J MS Care 2013; 15(1): 27-34.
  25. Wilde JL, Doherty WJ. Outcomes of an intensive couple relationship education program with fragile families. Fam Process 2013; 52(3): 455-64.
  26. Oulia N, Fatehizadeh MA, Bahrami F. The study of effectiveness of instruction marital enrichment on increasing of marital intimacy. Journal of Family Research 2006; 2(6): 119-35. [In Persian].
  27. Ahmadi Z, Ahmadi SA, Fatehizadeh M. Evaluation of effectiveness of brief object-relation couple therapy on couples' communication patterns. Journal of Family Research 2006; 2(6): 105-17. [In Persian].
  28. Behboodi-Moghadam Z, Salsali M, Eftekhar Ardebily H, Vaismoradi M, Ramezanzadeh F. Experiences of infertility through the lens of Iranian infertile women: A qualitative study. Jpn J Nurs Sci 2013; 10(1): 41-6.
  29. Amini L, Heydari M, Daneshparvar H, Gharaee B, Mehran A. The relationship between dimensions of domestic violence and social structural determinants of health in women. J Mazandaran Univ Med Sci 2014; 24 (114):131-4. [In Persian].
  30. Dolatian M, Gharache M, Ahmadi M, Shams J, Alavi Majd H. Relationship between partner abuse during pregnancy and pregnancy outcomes. Hormozgan Med J 2010; 13 (4): 261-9. [In Persian].
  31. Panaghi L, Dehghani M, Abbasi M, Mohammadi S, Maleki G. Investigating reliability, validity and factor structure of the revised conflict tactics scale. Journal of Family Research 2011; 7(1): 103-17. . [In Persian].
  32. Braithwaite SR, Fincham FD. ePREP: Computer based prevention of relationship dysfunction, depression and anxiety. Journal of Social and Clinical Psychology 2007; 26(5): 609-22.
  33. Ledermann T, Bodenmann G, Cina A. The efficacy of the couples coping enhancement training (CCET) in improving relationship quality. J Soc Clin Psychol 2007; 26(8): 940-59.
  34. Bahrami F, Oulia N, Fatehizadeh M. Marital enrichment training. Tehran, Iran: Danjeh Publications; 2009. [In Persian].
  35. Heydarnia A, Nazari AM, Soleimanian AA. The effectiveness of prevention and relationship enhancement program (PREP) on marital intimacy. Clinical Psychology Study 2015; 5(15): 61-78. [In Persian].
  36. Kazemian S, Esmaeily M, Fooladipoor E. Evaluation of the effectiveness of stress coping skills training based on therapeutic common factors on marital adjustment and conflict resolution styles in infertile women. Life Science Journal 2012; 9(4): 3225-9.
  37. Alqashan H. Enrichment training program and successful marriage in Kuwait: a field study on Kuwaiti couples. Digest of Middle East Studies 2008; 17(2): 1-16.
  38. Markman HJ, Renick MJ, Floyd FJ, Stanley SM, Clements M. Preventing marital distress through communication and conflict management training: a 4- and 5-year follow-up. J Consult Clin Psychol 1993; 61(1): 70-7.
  39. Isanejad O, Ahmadi SA, Etemadi O. Effectiveness of relationship enhancement on marital quality of couples. J Behav Sci 2010; 4(1): 9-16. [In Persian].
  40. Scuka RF. Relationship enhancement therapy: healing through deep empathy and intimate dialogue. New York, NY: Routledge; 2013.
  41. Isanezhad O, Ahmadi SA, Etemadi O. Effectiveness of relationship enhancement on marital quality of couples. International Journal of Behavioral Sciences 2010; 4(1): 9-16.
  42. Miri M, Aizadeh M, Moasheri N, Ataee M, Moodi M. The effects of relationship enrichment program on compatibility and marital satisfaction of infertile couples. Journal of Health Literacy 2016; 1 (1): 53-60.