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Table of Contents
ORIGINAL ARTICLE
Year : 2018  |  Volume : 15  |  Issue : 1  |  Page : 43-47

“Marital Satisfaction And Burnout In Spouses Of Patient With Schizophrenia”


1 
2 Assistant. Professor, Dept. of Psychiatric Nursing, LGBRIMH, Tezpur, Assam, India

Date of Web Publication10-Jul-2019

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2231-1505.262505

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  Abstract 


Schizophrenia is a severe mental disorder, characterized by profound disruptions in thinking, affecting language, perception, and the sense of self. The partner diagnosed with schizophrenia, weaves a web of doubt, confusion and chaos in the caregiving spouse. Information from the World Health Organization states that schizophrenia affects about 24 million people across the world, with a worldwide prevalence of about 0.7%.The study aimed to find out marital satisfaction and burnout in spouses of patient with schizophrenia. Materials And Method: A non experimental quantitative approach and descriptive research design was adopted for the present study. Seventy spouses of patients with schizophrenia were selected through purposive sampling technique. The data was collected by using socio demographic data sheet, Locke & Wallace Marital Adjustment Test (MAT) and Oldenburg Burnout Inventory (OLBI). The collected data were systematically coded, computed and analyzed using descriptive and inferential statistics with SPSS 20. Analyses of the data were done in accordance with the specified objectives. Result: The majority respondents had marital satisfaction and lower scores of burnout. The marital satisfaction of spouses of patient with schizophrenia had significant negative correlation with the domains of burnout i.e. exhaustion (r=-0.534, P=0.000) disengagement (r= -0.366, P=0.002).

Keywords: Marital Satisfaction, Burnout, Schizophrenia, Spouse


How to cite this article:
Jacob I, Ahmed N. “Marital Satisfaction And Burnout In Spouses Of Patient With Schizophrenia”. Indian J Psy Nsg 2018;15:43-7

How to cite this URL:
Jacob I, Ahmed N. “Marital Satisfaction And Burnout In Spouses Of Patient With Schizophrenia”. Indian J Psy Nsg [serial online] 2018 [cited 2023 Jun 3];15:43-7. Available from: https://www.ijpn.in/text.asp?2018/15/1/43/262505




  Introduction Top


Marital satisfaction is a mental state that reflects the perceived benefits and costs of marriage to a particular person. Marital satisfaction not only makes people happier, healthier, and more joyful life but also contributes in the health of partners, life durability and rearing the next generation. Moreover, a spouse may provide emotional intimacy and support, fulfilling an essential human need for connection[1].The marriage often brings a mixed bag of stressors and rewards to all those who embark on the journey but for spouses of persons with mental illness, these stressors are even greater.

Mental health problems in one spouse impact on the mental health of their partner, due to difficulties in their relationship, through any consequences on their economic or living conditions, or as a direct consequence of one spouse having to care for the other. Hence the relationship satisfaction is related to a person’s own mental health as well as the mental health of their partner[2].

The marital life dwindles when the spouse’s actions are unpredictable and sometimes embarrassing. For instance, ill person may suspect infidelity or feel like their partner takes advantage of them. Gradually, the spouses of persons with schizophrenia deal with insecurity, fear, shame and blame. But as exhaustion and frustration increase, the feelings of the unaffected partner may turn to anger or resentment.

If romantic expectations are not met, frustration is attributed to spouse directly leading to reduced love and commitments; in this case, burnout will be substituent of love. Marital burnout is one of fundamental reasons for marital disorders and reduced intimacy. Noosrom & Wongwat consider burnout as a multistage process that gradually emerges. These stages consist of physical exhaustion, emotional exhaustion, mental exhaustion, depersonalization, and loss of personal performance[3].

The spouse often evaluates living with a partner who is diagnosed as schizophrenia as a decisive point in life that seriously affects the couple’s relationship, the family, and the spouse’s own life. The chronic burdens of everyday living can profoundly reduce the quality of life and the subject’s satisfaction with the partnership[4]. Studies in India have revealed that a number of clinical and socio-demographic factors including symptoms of schizophrenia influence the outcome of marriage in schizophrenia[5].

Many couples though experience difficulties in their relationship related to schizophrenia, some also say they feel closer as a result of going through hard times together. Also, some couples report retaining the emotional and sexual intimacy they had shared before schizophrenia is challenging[6].

Too often it happens that the health care professionals focuses more on the needs of the mentally ill spouse and forgets that the partner supporting the ill partner needs love and support as well. Due to deficient or lack of needed support, caregivers can experience burnout. Not only can their health be compromised if they experience caregiver burnout, but they will also be unable to support their mentally ill spouse[7].

The research studies regarding marriage, marital outcome, and factors influencing the schizophrenia in India is sparse[8].

The research studies solely based on the marital life of spouses of schizophrenia are rare but numerous studies are available on marital life of spouses of patient with alcohol dependence or depression or dementia. Hence, the investigator wanted to elucidate the marital satisfaction and burnout in spouses of patient with schizophrenia.


  Material And Methods Top


A non experimental quantitative approach and descriptive research design was adopted for the present study. Seventy spouses of patients with schizophrenia were selected through purposive sampling technique. Tools: A socio demographic data sheet to assess the sample characteristics, the socio demographic and clinical variables of the patient with schizophrenia was used and a standardized tool Locke & Wallace Marital Adjustment Test (MAT) was used to assess the marital satisfaction and Oldenburg Burnout Inventory (OLBI) to find out burnout in the spouses of patient with schizophrenia. The tools were translated into Assamese. Reliability and validity of the tools were established prior to their use. Pilot study was done before actual data collection.The collected data was systematically coded, computed and analyzed using descriptive and inferential statistics with SPSS 20 version. Analyses of the data were done in accordance with the study objectives. The investigator obtained permission from the concerned authority to conduct the research and written consent was obtained from individual respondents.


  Results Top


Socio-demographic profile of spouses of patients with schizophrenia

The mean age of respondents was 41.70 years (SD ±7.45) and 62.9% were male while 37.1% were female. Majority 90 % were Hindu. The educational status of 38.6% of respondents was up to high school and 80% were working. Majority 77.1% had arranged marriage. Most (65.7%) of the respondents belonged to nuclear family and 44.3% respondents duration of care giving to their spouse was for the period of two to five years. The mean score of monthly family income was Rs. 16714.28(SD± 16395).

Socio demographic and clinical variables of the patient with schizophrenia

The mean age of the patient with schizophrenia was 40.04years (SD±8.24) and the mean duration of illness was 9.14years (SD ±7.17). The mean score of duration of treatment was 8.16years (SD±6.92). Majority 87.1% of patients with schizophrenia were having no active psychopathological symptoms during the study period.

Assessment of marital satisfaction and burnout in spouses of patient with schizophrenia

The mean score of marital satisfaction of the subjects was 111.15 (SD±30.11) with minimum score of 47 and maximum score of 156. The majority 68.6% had above, while 31.4% had below the cut off score of 100 of marital satisfaction as per the MAT scale.

The mean scores of burnout on the domains of exhaustion and disengagement were 14.42 (SD±5.51) and 15.17 (SD±3.95) respectively. The mean score of burnout domains on exhaustion and disengagement as per OLBI tool the scores are 16 for both the domains of burnout. Hence, the result indicated that the majority respondents had the burnout scores towards the lower side.

Association between selected socio demographic variable with marital satisfaction and burnout among spouses of patient with schizophrenia

The data presented in [Table 1], [Table 2] and [Table 3] showed that the chi square value of selected socio demographic variable i.e. gender, educational status, occupation, type of marriage, type of family and duration of care giving depicted no significant association with marital satisfaction, exhaustion and disengagement domains of burnout.
Table 1: Chi square (X2) values showing association between marital satisfaction and selected demographic variables of spouses of patients with schizophrenia n=70

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Table 2: Chi square (X2) values showing association between exhaustion and selected demographic variables of spouses of patients with schizophrenia n=70

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Table 3: Chi-square (X2) values showing association between disengagement and selected socio demographic variable among spouses of patient with schizophrenia n=70

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Correlation between marital satisfaction and burnout in spouses of patient with schizophrenia

The data presented in [Table 4] shows that the correlation between marital satisfaction and burnout in spouses of patient with schizophrenia. On analysis it was found that the marital satisfaction of spouses of patient with schizophrenia had significant negative correlation with the domains of burnout i.e. exhaustion (r=-0.534, p=0.000) disengagement (r= -0.366, p=0.002). Hence, the marital satisfaction is inversely correlated with the burnout.
Table 4: Correlation between marital satisfaction and burnout in spouses of patient with schizophrenia n=70

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  Discussion Top


Present study depicted the mean age of the respondents as 41.70±7.45 years and most of the respondents, 62% were male. In a study conducted by Kaushik et al9 showed the mean age of spouse of patient with schizophrenia was 42.16 years. The study by Jacob et al1 showed majority 36(60%) of 60 respondents were males. Hence the present study is supported by the compared studies.

Present study showed 53(75.7%) respondents belonged to the rural region and showed majority 54(77.1%) had arranged marriage. The possible reason might be that in the rural region as per Indian culture the arranged marriage is more socially acceptable and prevalent than the love marriage. The present study finding is at par with the study by Jacob et al1 wherein majority (81.7%) of the marriages were arranged marriage.

In the present study 65.7% respondents belonged to nuclear family. The possible reasons might be the emerging nuclear families, to meet the need for autonomy, personal space and provision of better care and nurture to children. The findings are similar to the study conducted by Kaushik et al9 and Jacob et al1 which showed the majority of respondents were from nuclear family.

The result showed mean score of the duration of treatment was 8.16±6.92 and the majority 61(87.1%) patients with schizophrenia were having no active psychopathological symptoms. The results are at par with a study conducted by Rammohan et al10 which showed the mean age of patient was 43.04±7.71 years, mean duration of illness and mean duration of treatment was 12.25±6.76 and 11.17±5.94 respectively.

Majority 68.6% of spouses of patient with schizophrenia were having above and 31.4% were having below the cut off score of marital satisfaction i.e. 100 as per the MAT. The present study finding is at par with the study of Jacob et al1 which depicted marital satisfaction among spouses of patients with severe mental illness as 41(68.3%) have satisfaction and 19(31.7%) have dissatisfaction in their marital relationship.

The data indicated that the respondents had mean scores of burnout domains on disengagement and exhaustion towards the lower side. The possible reasons might be majority subjects were male and belonged to middle age group. A study by Cherkil11 has revealed that women experience and respond to stress in distinctive ways as compared to men as women’s stress response process is both qualitatively and quantitatively different in terms of hormonal profile, activation of the sympathetic, adrenal, medullary and hypothalamic- pituitary-adrenal-cortical response pathways, and in emotional quality. The male spouses who are the caregivers has more adjustment, good coping skills etc. than that of female caregiver spouses who may have fear, hopelessness, helplessness, dependent, uncertainty, poor coping skills compared to that of the male spouses. Also adequate financial support, availability of health care facility and treatment is available free of cost would lead to less financial burden.

On analysis it was found that the chi square value of selected socio demographic variable i.e. gender, educational status, occupation, type of marriage, type of family, and duration of care giving depicted no significant association with marital satisfaction and burnout. In a study by Jacob et al1 marital satisfaction of the spouses and their selected demographic variables such as age (χ2 (1)= 5.398, p<0.05),gender (χ2 (1)= 6.213, p<0.05), occupation (p<0.01), intercaste marriage (p<0.05) had statistically significant association. Hence present study is in contrast with the compared study.

On analysis it was found that the marital satisfaction of spouses of patient with schizophrenia had significant negative correlation with the domains of burnout i.e. exhaustion (r=- 0.534, P=0.000) disengagement (r= -0.366, P=0.002).

The possible reason might be that the majority spouses of patient with schizophrenia would shared togetherness, committed to their ill spouses, also able to cope with the catastrophic situations, so they would had emotional well-being. Also majority of the study respondent’s spouses had no active psycho-pathological symptoms during the study period which would have lead to less stressor and availability of free of cost treatment which would have lead to less financial burden. As per the literature, caregivers report difficulty in coping with the negative symptoms or aggressive behavior of the ill partner, burden is exacerbated by limited financial and healthcare resources and reduced intimacy leads to marital burnout[5],[12].


  Conclusion Top


The investigator conducted the present study with the aim to assess marital satisfaction and burnout in spouses of patients with schizophrenia and findings can be concluded as the majority of spouses of the patient with schizophrenia had higher scores of marital satisfaction and scores of burnout was towards lower side. The marital satisfaction of spouses of patient with schizophrenia had significant negative correlation with the domains of burnout i.e. exhaustion and disengagement.

Marital satisfaction is an important factor in life that brings calmness between couples in life and family which can have positive implications for society. But marital dissatisfaction causes many problems and conflicts between couples leading to divorce; hence, negative implication of this factor is obvious. It implies that marital satisfaction is not simply achievable, but marital satisfaction is a process formed during marital life. When intimate relationship is stopped then love changes to anger and discomfort; therefore, conflicts, repetitive criticisms, silence, lack of emotional involvement, and unsolved problems will increase. Hence, it’s important to that the psychiatric nurses assess the issues been faced by such

spouses and provide intervention like psychoeducation, teach about effective communication, problem solving techniques, and referral services so that vulnerable spouses can cope, deal and love their spouses with mental illness which ultimately will lead them to fulfill their marriage vows and live healthy marital relationship.



 
  References Top

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Kebritchi A, Mohammadkhani S. The Role of Marital Burnout and Early Maladaptive Schemas in Marital Satisfaction between Young Couples. International Journal of Medical Research [Online] 2016 [cited on 2017 Dec 11]; 12(5):239- 246. Available from: www.ijmrhs.com.  Back to cited text no. 3
    
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5.
Cowen P, Harrison P, Burns T. Shorter oxford textbook of psychiatry. 6thedition. UK: Oxford University Press; 2012.  Back to cited text no. 5
    
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Deshmukh V, Bhagat A, Shah N, Sonavane S, Desousa AA. Factors affecting marriage in schizophrenia: A cross- sectional study. [Online] 2016 [cited on 2017 Oct 11]; 21(2): 122-124. DOI: 10.4103/0971-8990.193432. Available from: http://www.jmhhb.org/article.asp?issn=0971-  Back to cited text no. 8
    
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Kaushik P, Bhatia MS. Burden and quality of life in spouses of patient with schizophrenia and bipolar disorder. Delhi psychiatry journal. [online] 2013 [cited 2017 Dec20]; 16(1): 83-89. Available from medind.nic.in/daa/t13/i1/daat13i1p83.pdf  Back to cited text no. 9
    
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Rammohan A, Rao K, Subba DK. Burden and coping in caregivers of persons with Schizophrenia. Indian Journal of Psychiatry [online] 2002 [cited 2017 Dec20]; 44(3)220-227. Available from: https://www.ncbi.nlm.nih.gov/pubmed/21206576  Back to cited text no. 10
    
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Cherkil S. Coping styles, stress tolerance and wellbeing and their correlations in the women spouses of the mentally ill. Indian J Psychol Med. [Online] 2010 [cited 2017 Oct 22]; 32(2): 99-103. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3122552/  Back to cited text no. 11
    
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    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]


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