International Research Journal of Applied and Basic Sciences
© 2013 Available online at www.irjabs.com
ISSN 2251-838X / Vol, 5 (9): 1175-1179
Science Explorer Publications
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1. Associate Professor of Psychiatric, Behavioral Science Research Center, Baqiyatallah University of Medical
Science, Tehran, Iran.
2. Associate Professor of Psychology, Behavioral Sciences Research Center, Baqiyatallah University of Medical
Sciences, Tehran, Iran.
3. Medical student, Baqiyatallah University of Medical Science, Tehran. Iran
4. Corresponding author: M. A. in clinical psychology. Number 216, Borhani Street, 17 Shahrivar Boulevard, Yazd,
I.R. Iran.
Corresponding Author email: Anikazin@yahoo.com
ABSTRACT : Present research through correlation study examines relationship between general health and marital satisfaction in three groups of Iranian veterans with physical, chemical and psychiatric disability. Using purposive sampling method 150 physical, chemical and psychiatric veterans visiting
Baqiyatallah Hospital were selected as the examinees and answered the General Health Questionnaire
(GHQ-28) and the ENRICH marital satisfaction questionnaire. chemical veterans had the greatest number of hospitalization. The results indicated there is not significant relationship between general heath and marital satisfaction. However there were significant correlations between general health with some dimensions of marital satisfaction. Financial management has highest correlation with general health and its dimensions included Physical symptoms, Anxiety and sleep disturbance, Social function, and depression. this results revealed financial issues have big impact on veterans general health and one of veterans worry is financial problems in family. Also depression had a significant correlation between all dimensions of marital satisfaction. In other words depression is one of most important predictor of marital satisfaction.
Key words: mental health, physical veteran, chemical veteran, psychiatric veteran, marital conflict
INTRODUCTION
Mental health of war participants is an interventional research line in the world to which annually part of researches is dedicated, since spreading of psychological disorders among the war veterans has been always alarming. For example, studies have shown nearly 40 percent of the US military forces in Afganistan and Iraq suffer
from serious psychiatric and psychological problems(Seal et al. 2009; Jacobson et al. 2008; Wilk et al. 2010). Many
of these soldiers have reported they haven’t been provided with adequate hygienic and health care services during
and after the military service(Calhoun et al. 2008; Milliken et al. 2007). Studies demonstrate poor living quality of
the chemical veterans who have been exposed to mustard sulfur and suffer from acute pruritus in the areas of
symptoms and feelings, personal relationship, and daily activities(Panahi et al. 2008).After post traumatic stress disorder (PTSD), alcohol abuse, depression, and anxiety are widely common disorders in veterans(Romano Jr et al. 2007; Page 2003; Dougherty 1999). In addition, the high degree of deployment in battle front is accompanied with certain psychological symptoms (Toomey et al. 2007).
Family is the oldest social unit and nucleus of broader social organizations with diverse functions(MacNeil and Byers 2009). Marital satisfaction is defined as feeling of happiness, gratification and the pleasure experienced
by the spouse, taking all aspects of marital life into account. The role of marital satisfaction in promotion of psychological wellbeing has been the subject of various studies. A review study indicates association of sexual
activity and satisfaction with emotional wellbeing, spouse satisfaction and general quality of life(Rosen et al. 2000).
Also, there is a significant relationship between the experienced intimacies (emotional, social, sexual, subjective
and recreational intimacy) and marital satisfaction in both sexes(P. Greeff 2001). In general, numerous factors
contribute to marital satisfaction among which it can be referred to quality of relationships before marriage, fashion

Intl. Res. J. Appl. Basic. Sci. Vol., 5 (9), 1175-1179, 2013
of marriage, manner of relationship, personality of couples, and way of dealing with marital issues(Patrick et al.
2007).
Marital satisfaction affects many aspects of individual and social life of humans. Satisfactory matrimonial relation is the foundation of a proper family functioning. Results of studies suggest people with enduring and strong married life generally live longer, are more sympathetic, physically healthier, feel happy and stand a greater chance
of recovery from cancer (Coombs 1991).Soldiers with PTSD disorder suffer from more psychological disorders and
matrimonial problems. In families of these patients, verbal abuses and physical violence are more frequent and most of these aggressions are directed toward the spouse. In contrast, partners of PTSD patients are more apt to
anger which in turn adds more fuel to marital conflict(Beckham et al. 1996; Gruden and Gruden Jr 2000). In the
meantime, research results report that nearly half of the chemical Iranian veterans are dissatisfied with their marriage and married life and in 11 percent of them the marital dissatisfaction level is extraordinarily high.
Moreover, 65.4 percent of these veterans suffer from some type of sexual disorder(Ahmadi et al. 2007).
At any rate, functional condition of the physical veterans appears to be better in comparison with chemical and psychiatric veterans. A research on 200 veterans with physical impairment reports this group of veterans has a satisfactory social and familial functioning and they all are married of whom 96 percent have child. Yet, clinical symptoms of phantom sensation, phantom pain, phantom movement, and stump pain prevailed in 64, 32, 20, and
24% of the veterans, respectively, meanwhile 36 percent of the examinees had a history of psychiatric disorder
ranging from minor depression to PTSD (Ebrahimzadeh et al. 2006).
Not only marital satisfaction of veterans, but also marital satisfaction of their spouses is vulnerable.
Although partners of chemical veterans did not show any significant difference in terms of marital satisfaction and psychological health from partners of psychiatric veterans, yet there was a significant association between intensity
of psychological symptoms and marital satisfaction in both groups (Salimi et al. 2006).
In sum, research background indicates a greater share of psychiatric veterans with PTSD symptoms in the so far conducted researches in this line. However, general health and marital satisfaction of the three groups of veterans have not yet been subject to a comparative study. Hence, current study contributes to this field by comparative analysis of general health and marital satisfaction in three groups of physical, chemical, and psychiatric veterans.
MATERIALS AND METHOD
Statistical population and sample
Statistical population of the present research includes all the disabled Iranian veterans who had participated in the 8-year war of Iran and Iraq during 1981 through to 1989 or after this period in the battle fronts incurred injuries and from September 2012 to March 2013 has been visiting Baghiyatollah Hospital. Of this population using Cohen’s formula and the Effect Size 0.65 a sample consisting of 150 patients (50 patients for each group) was calculated. Considering the large size of the population members and difficulty of data collection, purposive sampling method was employed based on which the sample was selected from among the physical, chemical and psychiatric who have been visiting Baqiyatallah hospital within the above mentioned time interval.
Measures
Evaluation and Nurturing Relationship Issues, Communication and Happiness (ENRICH)
questionnaire(Olson et al. 1982)
: the questionnaire original form comprises 115 closed questions and 12 subscales of which except the first sub-scale which has 5 questions, other sub-scales contain 10 questions. In this questionnaire, respondent answers the 5-choice questions (strongly agree with, agree with, neutral, disagree with,
and strongly disagree with). Olson et al (Olson et al. 1982)used this questionnaire to investigate marital
satisfaction. They believe each topic in this questionnaire concerns an important dimension of marital satisfaction.
The questionnaire reliability outside of Iran has been many times examined and confirmed. Test of the questionnaire discriminate validity showed this instrument by 85 to 95 percent confidence was able to tell the
difference between satisfied and dissatisfied couples(Fowers and Olson 2007). Given the large number of the
queries in the questionnaire (115 in total) which caused excessive fatigue of the examinees, a concise version of it with 47 questions is constructed for the Iranian populations comprising 9 domains of personality issues, marital relationship, conflict resolution, financial management, leisure activities, sexual relation, marriage and children, relatives and friends, and religious orientation.
The General Health Questionnaire (GHQ-28)(Goldberg and Hillier 1979): GHQ-28 is a multidimensional
self-report measure which has been designed for assessment of non-psychotic psychiatric disorders. This questionnaire can be used for adolescents and adults at any age for detection of inability for normal functioning and
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Intl. Res. J. Appl. Basic. Sci. Vol., 5 (9), 1175-1179, 2013 presence of disturbing events in life. This test is not for diagnostic purposes and is only used for screening the individuals in acute condition. Present study utilizes the 28-question version of the GHQ consisting of 4 sub-scales of Somatic symptoms, Anxiety and sleep disturbance, Depression, and social dysfunction each of which contain 7 questions. For evaluation and scoring, Likert Scale is used based on which each 4-choice question of the test is assigned a point in ascending order (as 0, 1, 2 and 4).
RESULTS
Descriptive statistics
All the participants in the present research were men and married. In table 1 and 2,distribution of age and hospitalization frequency in three groups of veterans are presented.
Table 1. Age frequency (percentage) of the examinees per type of veteran
Age
35 to 45
46 to 55
56 to 65
66 to 75 total
Type of veteran chemical
15 (10)
23 (15.3)
7 (4.7)
5 (3.3)
50 (33.3) psychiatric
19 (12.7)
20 (13.3)
8 (5.3)
3 (2)
50 (33.3) physical
8 (5.3)
28 (18.7)
14 (9.3)
0
50 (33.3) total
42 (28)
71 (47.3)
29 (19.3)
8 (5.3)
150 (100)
AwAZAaaaaS S
Chemical
Psychiatric
Physical total
Table 2. Mean and standard deviation of hospitalization in three groups of veterans mean
7.84
5.76
4.05
5.80
SD
6.16
8.87
6.61
6.61 minimum
1
1
1
1 maximum
20
50
20
50
In table 1, the results indicate that in all three groups of veterans and in aggregate the age group of 46-55 years old has the greatest frequency and the age group of 66-75 years old has the least frequency. According to the results provided in table 2, chemical veterans with 7.84 times hospitalization has the highest frequency and physical veterans with 4.05 times hospitalization has the lowest frequency.
Inferential statistics
In table 3, the obtained results from correlation between general health and marital satisfaction are presented.
The results presented in table 3 revealed that there is no significant correlation between marital satisfaction and general health and its dimensions. Unlike total marital satisfaction, there is significant correlation between general health and dimensions of marital relationship, conflict resolution, financial management, leisure activities, marriage and children, relatives and friends, and religious orientation (P<0.01, P<0.05). Financial management has highest relationship with general health and its dimensions.
Data analyze
Having made arrangements with management of Baqiyatallah Hospital, the questionnaires were performed on the hospitalized veterans in different units of the hospital. The veterans were provided with the necessary information and in the meantime the research objectives were explained to them. Next, the written informed consent for participation in the research was completed by the veterans. Physical, chemical or psychiatric disability wasthe main qualification criterion for participation in the research and this was verified by checking their disability card. Other criteria for entering the study were marriage and having at least primary education. In addition, the criteria for exclusion from the study were psychotic disorders, illiteracy, and having several types of disability.
Pearson correlation coefficient was used for data analyze.
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Intl. Res. J. Appl. Basic. Sci. Vol., 5 (9), 1175-1179, 2013 variable
Table 3. correlation between general health and marital satisfaction in tree group of veterans
Mean SD 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1 Physical symptoms 18.21
2 Anxiety and sleep disturbance 18.03
3 Social function
4 Depression
16.59
12.33
5
6
7
8
9
10
11
12
13
14
15
General health personality issues marital relationship conflict resolution financial management leisure activities sexual relation marriage and children relatives and friends religious orientation
Total marital satisfaction
4.11
4.65
3.56
5.37
1
0.70
0.47
0.50
1
0.55
0.66
1
0.53 1
65.16
22.07
20.92
16.92
14.65 0.80
4.79 0.02
4.89 -0.10
ns
-0.10
ns
4.09 -0.06
ns
0.89
-0.24
-0.29
ns
0.75
ns
-0.02
-0.09
ns
0.85
-0.24
-0.07
ns
-0.32
-0.30
3.77 -0.27 -0.39 -0.42 -0.50
1
-0.12
-0.24
-0.24
ns
1
0.82
0.80
1
0.87 1
16.29 -0.48 0.59 0.61 0.62 1
16.22
16.58
17.48
18.27
18.61
2.14 -0.24
3.65 -0.06
ns
3.98 -0.15
ns
2.97 -0.08
ns
3.71 -0.10
ns
149.12 38.02 -0.04
ns
-0.28
-0.20
-0.30
-0.19
-0.21
ns
-0.15
-0.22
-0.13
ns
-0.25
-0.10
ns
-0.19
-0.15
-0.07
ns
ns
-0.43
-0.20
0.04
ns
-0.29
-0.14
ns
-0.30
-0.18
-0.31
-0.19
ns
0.36 0.44 0.37 0.34 1
0.51 0.63 0.66 0.38 0.37 1
0.66
0.59
0.67
0.63
0.70
0.59
0.65
0.51
0.43
0.47
0.56
0.54
1
0.61 1
-0.22
-0.10
ns
0.56 0.74 0.76 0.59 0.40 0.49 0.65 0.75 1
0.79 0.87 0.83 0.68 0.53 0.72 0.74 0.80 0.85 1 ns: the correlation is not significant statistically
DISCUSSION
Current study was conducted for correlation analysis of general health and marital satisfaction in three groups of physical, chemical and psychiatric veterans. Descriptive results showed that majority of veterans are within the age range of 46 to 55 years, implying middle age of the disabled Iranian veterans who are expected to get improved by developmental factors at this stage. In descriptive study regarding hospitalization frequency, chemical veterans were found with the greatest frequency, implying lower general health condition in this group relative to other two groups. On the contrary, the group of physical veterans had the least hospitalization frequency, suggesting a generally better health condition in this group.
The results indicated there is not significant relationship between general heath and marital satisfaction. However there were significant correlations between general healthwith some dimensions of marital satisfaction. Financial management has highest correlation with general health and its dimensionsincluded Physical symptoms, Anxiety and sleep disturbance, Social function, and depression. this results revealed financial issues have big impact on veterans general health and one of veterans worry is financial problems in family. Also depression had a significant correlation between all dimensions of marital satisfaction. In other words depression is one of most important predictor of marital satisfaction.
In explanation of this finding, in the first place, by looking at the number of hospitalization, we find that chemical veterans compared to the other two groups have the greatest hospitalization frequency which implies more serious health issues in the former group. On the other hand,
pulmonary diseases and respiratory problems which are often irreparable are the case in over 50 percent of the chemical veterans,(Bagheri et al.
2003) and impose restrictions on their physical role. These people are not able to go to the cities and urban areas with air pollution and usually stay
at home and occupy themselves with watching TV, going to mosque and strolling.Such low social functioning should be attributed to their physical
condition. These veterans in addition to physical problems suffer from psychological problems such as anxiety and depression (Romano Jr et al.
2007; Page 2003). These results in concert with other findings revealsserious role of chemical factors in disrupting living quality of the chemical veterans(Panahi et al. 2008).
As concerns the physical veterans, physical and general health condition and social functioning in this group is affected by a wide range of bodily injuries and impairments including body parts hit by shrapnel and bullet, hearing and vision impairment, spinal cord injury, and dismembering. However, except in cases ofdismembering in lower parts, spinal cord injury and blindness in both eyes, other patients keep
functioning normally in many areas (Dougherty 1999).
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In overall the results suggested general health and depression have important roles in marital satisfaction and improvement of Iranian veterans’ general health can lead to better marital satisfaction. Also following financial problem in veterans has important role in their economic status and quality of life.
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