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
*Corresponding
Author’s Email: sivavimal.guru@gmail.com
ABSTRACT:
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.
KEYWORDS:
Alcohol dependence, marital satisfaction, burden, and wives
INTRODUCTION:
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.
RESULTS:
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
DISCUSSION:
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.
CONCLUSION:
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.
ACKNOWLEDGEMENT:
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
Int. J. Adv. Nur. Management. 2016; 4(4): 361-364.
DOI: 10.5958/2454-2652.2016.00080.9