Marital Satisfaction and Burden among Wives of men with Alcohol Dependence Attending at Psychiatric OPD of Pravara Rural Hospital
Mrs. G. Vimala
Asst. Professor, Pravara Institute of Medical Sciences (DU), College of Nursing, Loni (Bk), Tal. Rahata, Dist. Ahmednagar, MS – 413736
Introduction: Alcohol dependence is a multifaceted disorder with complex etiology and contributing factors. Alcohol related problem primarily occurs within the family as well in society; however the maximum impact felt on spouse due to the nature of intimate relationship and togetherness. Spouse play significant role in prevention and management of substance abuse disorders including alcohol related disorders. Hence the present communication was carried out to assess marital satisfaction and burden in wives of men with alcohol dependence. Materials and Methods: It’s a case control study; out of 140 participants 70 wives of men with alcohol dependence and 70 wives of men without alcohol dependence was selected through simple random sampling technique as a case and control. Wives of 21 years of age, attending the OPD and willing to participate were enrolled in the study. The Short Alcohol Dependence Data, Kansas Marital Satisfaction Scale and Zarit Burden Interview were used to assess study variables. The data were analyzed with descriptive and inferential statistics wherever required. Results: The results highlight that the men having drinking habit had mean score of (18.94±6.8) indicates the men had ‘medium alcohol dependence’. In relation to marital satisfaction, the mean score for wives in case is (11.47±4.4) indicates wives had ‘some degree’ of marital distress, and they had ‘moderate level’ of burden with the mean score of (47.87±18.1). However, the wives in control had comparatively less scores than the wives in case. Marital satisfaction was negatively correlated (r= - 0.35) with severity of alcohol dependence. Socio demographic variable such as education (x2=3.96) had significant association with marital satisfaction at p<0.05 level. Conclusion: The men with alcohol dependent had ‘medium’ alcohol dependence, and their wives had ‘low’ marital dissatisfaction and had ‘moderate’ level burden. Addressing these issues will be helpful as spouses are known to play a significant role in the prevention, treatment and rehabilitation of alcohol dependence syndrome.
Alcoholism is a major public health problem around the world, and in India around 33% of its population consumes alcohol1.
Alcoholism is considered to be a prime stressor, not only for the individual who consume alcohol but also for wife, family members and relatives as well. Approximately up to 15% men and 5% women have risk for developing alcohol dependence in a life time. Alcoholism spreads all over the world, from state to state, from entire country affecting every civilized society irrespective of caste, creed, religion, culture and geographical location2,3.
World Health Organization (WHO) reported that around 44 million people in middle income countries had alcohol dependence. Alongside the prevalence of alcohol dependence in India is 21% and among the total alcohol users, 17% were classified as dependent users based on ICD – 10 criteria. Alcohol dependence has adverse effect on various dimensions of health including the physical, mental health and social wellbeing as well4. The presence of individual with alcohol dependence in the family affects various aspects of family like leisure time activities, relationship, and finances. In alcoholism spouses are mainly affected because of the intimate nature of the relationship with husband and constant exposure to the behavior of alcoholics5,6. Alongside the spouse plays a very significant contribution in management and restorative functions of alcohol related disorders. Though the spouses are innate in management of alcoholism, they are exposed to high rates of domestic violence, physical abuse, low martial satisfaction, maladaptive coping skills, poor social support and financial and caring burden etc7,8. These facts were supported with scientific literatures, further to explore the marital satisfaction and burden among wives, and to assess the association the present communication was carried out.
MATERIALS AND METHODS:
A case control study was carried out to assess the marital satisfaction and burden among wives of men with alcohol dependence. The study was conducted at Psychiatric Out Patient Department of Pravara Rural Hospital, Loni (Bk). The protocol of study was explained to the participants and written informed consent was obtained. The sample size was calculated by Fleiss with CC and sample size was 140, out of which 70 were enrolled as case and 70 as control respectively. The wives of alcoholics above 21 years of age, attending the OPD, and willing to participate were selected through simple random sampling technique. The structured interview method was used to collect data, it consist of a) Short Alcohol Dependence Data (SADD), it has 15 items each with four responses scored as 0, 1, 2 and 3; based on score the dependence was categorized as low, moderate and high b) Marital Satisfaction Scale (MSS) was used for assessing the marital satisfaction, which has three items with seven possible responses scored as 1 (extremely dissatisfied), to 7 (extremely satisfied) and the score above 17 indicate no distress and score 16 and less indicate some degree of distress and c) Zarit Burden Interview was used to assess the burden which comprised of 22 items with five response scored as 0 (never) to 4 (always), and categorized as no burden to high level burden. The collected data were complied, tabulated and analyzed based on objectives with help of descriptive (arithmetic mean, SD and mean percentage) and inferential (chi square test) statistical methods wherever required.
Socio demographic profile of alcoholic dependent:
A higher percentage (41%) of alcohol dependent was in 39 – 48 years of age; one third of participants had primary (36%) and secondary education (33%) respectively. Nearly half (49%) of alcoholics were daily wagers followed by (35%) performing agriculture work, higher percent (44%) had monthly income of Rs. 3001 to 6000, majority 71% were belong to nuclear family, and most 89% of them were belong to Hindu religion.
Socio demographic profile of wives of alcoholics: Higher percent (47%) of wives were in 39 – 48 years of age, 40% had secondary education and significant percent (36%) did not had any formal education, and 68% of them were house wives, and the remaining 32% were performing agriculture related work.
Level of alcohol dependence:
overall (93%) of participants had ‘medium to high level’ of alcohol dependence (medium – 46% and high – 47%) while only mere (7%) had low alcohol dependence. The total score varied from 8 – 34 with the mean score of (18.94±6.84) indicates the participants had medium level of alcohol dependence.
Level of marital satisfaction:
The wives of alcoholics had overall mean score of (11.47±4.39) indicate ‘some degree’ of distress whereas the wives of non alcoholics had mean score of (17.21±3.26) indicate they are ‘not distressed’. The total score varied from 3 – 18 and 76% of wives of alcoholics had ‘some degree’ of distress whereas 89% of wives of non alcoholics were ‘not distressed’ (figure no.1). The marital distress among wives was statistically significant (t value is 4.199) at p<0.05 level.
Level of burden:
The wives of alcoholics had overall mean score of (47.87±18.04) indicates ‘moderate level’ of burden whereas the wives of non alcoholics had mean score of (38.97±17.48) indicate they had ‘low level’ of burden (figure no. 2). The level of burden among wives was statistically significant (t value is 4.19) at p<0.05 level. There was a negative relationship found between marital satisfaction and burden (r= -3.88) of wives of alcoholics. A statistically significant association was found between marital satisfaction and demographic characteristics like educational status (x2 = 3.96) at p< 0.05 level.
Figure no.1: Level of distress experienced by wives of alcoholics and non alcoholics
Figure no.2: Level of burden experienced by wives of alcoholics and non alcoholics
Alcoholics are regarded as villain and families as a victim. Individuals drinking alcohol more than the recommended limits, experiencing harm and symptoms of dependence are considered as alcohol dependence. In the present study it was found that most of alcoholics under study had moderate to high dependence. It co insides the World Health Organization (WHO) fact that worldwide around 6% of population had alcohol dependence9. Consumption of alcohol has significant negative impact on marital life. It was noted that the marital satisfaction of wives of alcoholics in this study is significantly lower when compared to wives of non alcoholics. The findings was consistent with the study by Maheswari K and Nallangal M that half (50%) of wives of alcoholics had low level of marital satisfaction10. Moderate level of burden was noticed among the wives of alcoholics than the counterpart (experienced low burden). This is in congruence of findings noted by Bhowmick P, Tripathi BM, Jhingan HP, Pandey RM that (55%) of the wives of alcoholics had mild to moderate level and 45% of them had significant burden which needs immediate attention by family members and health care professional11. Marital satisfaction was negatively correlated with burden experienced by the wives of alcoholics. It was noticed that the marital satisfaction had significant association with demographic characteristics such as educational status. Farid B, Elsherbins M, Odgen M, Luckas M and William R revealed a strong relation between marital satisfaction and span and severity of alcoholism12.
Consumption of alcohol is not only affecting the addicted individuals but it also has negative impact on their marital and family life. It was noted in the study that alcohol dependent person had medium alcohol dependence, alongside their wives had some degree of marital distress and had moderate level of burden. Alcoholism is a life time risk factor for the wives psychological distress. Addressing these issues will be helpful as wives are known to play significant role in the treatment and rehabilitation of alcohol dependence syndrome. The interventions comprised of education, pharmacological, psychological, and social and rehabilitation helps the alcoholics to overcome the dependence and also enable the wives to deal with the stress of living with an addicted spouse. The psychiatric nurse contributes the treatment of alcoholics, improve family relations and reduce behavioral and emotional problems of wives and children living in the family.
The author expresses sincere thanks to Pravara Institute of Medical Sciences (Deemed University), Institutional Ethics/Research Committee, Medical Superintendent, Head of Department of Department of Psychiatry of Pravara Rural Hospital, Loni (Bk) and the participants for their kind cooperation and support.
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Received on 25.07.2016 Modified on 21.08.2016
Accepted on 29.08.2016 © A&V Publications all right reserved