| چکیده انگلیسی مقاله |
Background & Aims: Infertility is associated with violence, aggression, anger, divorce, isolation and hopelessness and for many couples, it is considered a major crisis and stressful. There is a direct link between infertility and domestic violence. Domestic violence is more common in infertile women than pregnant women. Since infertile couples face a number of problems in their marital relationship, problem-solving skills and coping skills are essential to avoid conflict and domestic violence. The use of problem-solving skills training intervention in reducing, controlling or combating domestic violence in pregnant women has been done in several studies. However, research on the effectiveness of problem-solving skills training in dealing with infertile women with domestic violence is necessary, and on the other hand, less intervention studies have been conducted on domestic violence against infertile women in the world and in Iran. Therefore, the current study conducted to evaluate the effect of problem-solving skills training on the rate of Iranian infertile women exposed to domestic violence. Materials & Methods: The present study was a quasi-experimental pre-test-post-test study with a control group conducted in the infertility clinic of Shahid Akbarabadi Hospital affiliated to the Iran University of Medical Sciences, Tehran, Iran. The study population was all Iranian infertile women with experience of domestic violence referred to the infertility clinic. The minimum sample size in each group was 38 people. A total of 80 infertile women were considered. Samples were randomly assigned to intervention (n=40) and control (n=40) groups by available random sampling using block randomization. The intervention was in the form of four two-hour sessions of problem solving skills training that was held every week in Akbarabadi Hospital and the samples were followed up again two months after the end of the training. To assess the outcomes, a three-part questionnaire including demographic characteristics (age, education, occupation, years live with spouse and household income status), midwifery characteristics (number of pregnancies, number of abortions, stillbirths, ovulation induction with medication, IUI, IVF and history of failed treatment) and a domestic violence questionnaire were used. The Domestic Violence Questionnaire has 36 questions and includes the areas of physical violence (12 questions), psychological violence (8 questions) and sexual violence (4 questions) along with t violence leading to injury and harm caused by physical violence (6 questions) and negotiation and agreement and disagreement scale of the couple in resolving conflicts (6 questions). Data analysis was performed using SPSS software version 16 using t-test, Chi-square, Fisher's exact test, Mann-Whitney and Wilcoxon tests. Results: 38 infertile women were in the control group and 34 in the intervention group. The mean and standard deviation of age of infertile women participating in the present study was 33.94±4 4.04 in the intervention group and 32.6± 6.13 in the control group. 23 (60.5%) women in the control group and 16 (47.1%) women in the intervention group had diploma degree. 29 (76.3%) women in the control group and 23 in the intervention group (67.6%) were housewives. 5-9 years lives with husband were 19 (50%) in control group and 13 (38.2%) in the intervention group. The medium household income status in both groups was the most frequent, so that 28 people (73.7%) and 19 people (55.9%) were in this income situation. The two groups of intervention and control were not statistically significant different in terms of demographic characteristics (age, education, occupation, life expectancy with spouse and household income status) and were homogeneous. There was no statistically significant difference between the two groups in terms of midwifery characteristics and they were homogeneous. Psychological violence before training was 60.5% of the control group and 55.9% in the intervention group and after training in 84.2% in the control group and 79.4% in the intervention group. Psychological violence based on Mann-Whitney test did not show a statistically significant difference between the intervention and control groups before (p = 0.774) and after problem-solving skills training (p = 0.973). The result of Wilcoxon test showed that in the control group (p = 0.001) and also the intervention group (p = 0.026) the mean of psychological violence after problem solving skills training was significantly higher than before training. Physical and sexual violence before training were 23.7% and 21.1% in the control group and 25.5% and 23.5% in the intervention group and after training in 23.7% and 15.8% of the control group and 17.6% and 14.7% in the intervention group, respectively. Physical and sexual violence based on Mann-Whitney test did not show a statistically significant difference between the intervention and control groups before and after problem-solving skills training (p>0.05). The results of Wilcoxon test showed that in the control group and also in the intervention group, the mean of physical and sexual violence after problem solving skills training was not statistically significant deferent in comparison with before training (p>0.05). Conclusion: The effectiveness of problem solving skills training in physical and sexual violence in the intervention and control groups did not show a significant difference. Results of the present study showed that the report of exposure to psychological violence has increased in the intervention and control groups. Lack of familiarity of infertile women referring to the clinic with the concepts and examples of domestic violence in the first course evaluation and inadequate equipment in the Quaid-19 pandemic condition made the problem-solving skills training intervention ineffective. Also, the increase in psychological violence, especially in the control group, can be due to the increase in violence due to COVID-19 quarantine or due to their increased awareness and sensitivity to the issue of violence and Howthrone effect. In some studies, problem-solving skills, along with other skills, have been taught to clients simultaneously and it should be noted that only problem-solving skills training without considering other educational provisions can show its effectiveness in different statistical communities or need other courses. On the other hand, it seems that despite the ineffectiveness of problem solving training in the present study, the repetition of research with psychological interventions, life and communication skills and their follow-up by considering the criteria of effective teaching in appropriate conditions and preferably training as well as with higher sample size is necessary. Of course, it should be borne in mind that various factors such as the current economic and social conditions of society can affect violence, the effect of which should be examined in future studies or eliminated through appropriate statistical tests. |
| نویسندگان مقاله |
محبوبه میراحمدیان | Mahboobeh Mirahmadian
School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی ایران، تهران، ایران.
مریم معادی | Maryam Maadi
School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
گروه مشاوره، دانشکده روانشناسی و علوم تربیتی، دانشگاه علامه طباطبایی، تهران، ایران
فهیمه رنجبر | Fahimeh Ranjbar
School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
مرکز تحقیقات مراقبتهای پرستاری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی ایران، تهران، ایران.
شیما حقانی | Shima Haghani
School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
مرکز تحقیقات مراقبت های پرستاری، دانشگاه علوم پزشکی و خدمات بهداشتی درمانی ایران، تهران، ایران.
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