A R T I C L E   I N F O		A B S T R A C T
ORIGINAL ARTICLE		Background: Marital satisfaction refers to the positive self-assessment of individuals about their marital relations and marriage quality. Also, it is the most crucial issue in marital life and can either lead to stability or failure of the relationship. This study, therefore, was designed to determine marital satisfaction rate and factors effecting women referring to health care centers in suburbs of Yazd. Methods: This is a cross-sectional research with a sample of 246 women who visited health care centers in suburb of Yazd. Data collection instrument used in this study was the standard questionnaire of Index of Marital Satisfaction (IMS). Questionnaire was completed as a self-report, after data collection, information was analyzed using SPSS18 software and Chi-Square test. Results: Frequency distribution of marital satisfaction rate showed that 59.8% and 40.2% of women were respectively unsatisfied and satisfied. Chi-Square test conducted to determine marital satisfaction rate in terms of demographic variables, showed no significant results in terms of age, marriage duration, number of children, education level of women and their husbands, as well as employment status of women (P-value > 0/05). However, significant differences were observed in terms of husband employment (P-value = 0/023) and economical status (P-value = 0/025).    Conclusion: Considering significant association of economic status and husband employment with marital satisfaction of participants, appropriate planning in this regard and providing grounds for employment of these women's husbands is crucial.   Keywords: Marital Satisfaction, Women, Suburb
Article History: Received: 14 Jan 2017 Revised: 18 Feb 2017 Accepted: 8 May 2017
*Corresponding Author: Zohreh Karimian Kakolaki Email: zohrehkarimian68@yahoo.com Tel: +98 9132366910
Citation: Mazloomy Mahmoodabad SS, Karimian Kakolaki Z, Gerayllo S, Fallahzadeh H, Khabiri F. Marital Satisfaction Rate of Women Referring to Health Care Centers of Yazd Suburbs and the Related Factors. Social Behavior Research & Health (SBRH). 2017; 1(1): 3-8.

Introduction

Marriage is marital pact that has been encouraged by all religions and laws1, 2 and provides the means of individual and social development, satisfies sexual needs, guarantees generation continuance and survival, and satisfies mental needs. Thereby, it leads to individual and social health and wellbeing.3 Marriage and marital relationship are sources of support, intimacy, and human pleasure that lead to cooperation, sympathy, unity, tolerance, and responsibility in the form of family.4 One of the important objectives of marriage, being more important than the marriage itself, is achieving marital satisfaction. Marital satisfaction is the most crucial issue which has the highest influence on stability or failure of woman and man.2, 5, 6 Investigations on marital satisfaction from 1990s up to now have been of great interest to many researchers in different fields with
various aims.7 Marital status refers to positive
self-assessment of spouses about their marital relationship and marriage quality.8, 9 Marital satisfaction is defined as a concrete and objective feeling of happiness, joy, satisfaction, and pleasure experienced by woman and man in all dimensions of their lives including partner relationships, economic status, kids, etc.3, 4, 9-11 Marital status in family is the fundamental factor of family members' mental health which affects welfare and career satisfaction.8, 12, 13 It seems that personal compatibility, sexual skills education, income level, education, and marriage age are indices related to marital satisfaction.8 There remains still the question of how people maintain their lives.14 Marital satisfaction is the basis for family performance and allows parents to play their roles with more ease, which consequently leads to increased health, economic development, and more satisfaction from life. On the other hand, marital conflict not only leads to social relation problems, but also increases tendency towards social deviance, ethical deviance, and decay of society values among partners. Achievement of compatibility needs a set of information and awareness related to marriage success.2 Inability to have good relationship is an issue admitted by more than 90% of partners, suggesting high importance of marital compatibility.10 The harmony and consistency of partners cannot be a good sign of marital satisfaction, but rather being able to deal with inconsistency is more important.3 Partners under economic-mental pressures are more likely to be affected and this can lead to isolation, emotional pressure, and depression.15 The study carried out by Jose et al. (2002), entitled "Can demographic variables affect marital satisfaction?" showed that there is a significant association between marital satisfaction and demographic variables of age, education, number of children, employment, and marriage duration.16 Improvement of satisfactory relations can bring many advantages to both man and woman including increased mental and physical health and increased flexibility in facing with life pressures.15 Considering role of women as the main basis of family and importance of their marital satisfaction in maintaining family, nurturing future generation, and considering that no study has been previously conducted in suburbs of Iranian cities, this study was designed to determine marital satisfaction of women referring to health care centers of Yazd suburbs.
Methods
This study is a cross-sectional research with a sample of 246 members. These individuals were selected from women referring to health care centers in suburbs of Yazd (Azadshahr and Emamshahr health care centers); in categorizing health care centers, five centers were placed in suburban areas. Sampling was done through accepting candidates randomly based on their households' file numbers in an odd and even style. Questionnaires were filled out by women through self-reporting. The criteria for sampling included individuals within age range of 15 – 49 years, married, and residing in suburban areas of Yazd. Qualified individuals completed the questionnaires after declaring their consent.
The instrument applied in this study for data collection was Index of Marital Satisfaction (IMS) questionnaire. This questionnaire included 25 items designed by Hudson to measure rate, intensity, or importance of marital problems between partners. Validity of this questionnaire was reported as 82%. On the other hand, Cronbach's alpha scale of marital satisfaction was 0.96%, indicating its high internal consistency. Marital satisfaction index with correlation coefficient of 0.96% in retrial method had appropriate reliability. The marital satisfaction questionnaire's scores were within a range of 0-100 and the cut point of questionnaire was 30±5; scores lower than this showed higher marital satisfaction, while scores higher than 30 show lower marital satisfaction.17 The other part of questionnaire includes demographic characteristics such as age, education, employment, marriage duration, number of children, husband's education, husband's job, type of residence, and economic status (low, medium, good, and excellent). Collected information was analyzed after coding using SPSS18 software and Chi-Square test. Regarding ethical considerations, participants were ensured


about confidentiality of their information. For this purpose, participants remained anonymous and their names were not included in collection instruments. The participants were provided with the results on their consent.
Results
This study was performed on 246 women referring to health care centers located in suburban areas of Yazd, they were aged from 17 to 42 years with an average of  30.92 (6.18) years. The average of marriage duration was 9.86 (6.77) years and the number of children varied from zero to 6, 131 participants (53.1%) had academic education and 78 of them (31.7%) were employed, husbands of 106 women (43.1%) had academic degree and 138 of them (56.1%) were self-employed, 175 women (71.1%) reported average economic status and 133 of them (54.1%) had house with backyards (Table 1); 59.8% of women were not satisfied.
Chi-Square test results showed that marital satisfaction did not have any significant difference in terms of age, education, marriage duration, and number of children (P-value > 0.05). However, regarding employment variables of husband and economic status there was a significant difference (P-value < 0.05) (Table2).2

Table 1. Frequency distribution of marital satisfaction related to women referring to health care centers in Yazd suburbs
Marital satisfaction	Number	(%)
Satisfied	99	(40.2)
Unsatisfied	147	(59.8)

Table 2. Results of marital satisfaction Chi-Square test in terms of employment variables of husbands and economic status of participants
Variable		Satisfied		Unsatisfied		P-value  Chi-Square
		Number	(%)	Number	(%)
Husband Employment	Office worker	48	(48.5)	53	( 36.1)	0.023
	Self-Employed	51	(51.5)	87	(59.2)
	Unemployed	0	(0)	7	(4.8)
Economic Status	Weak and Medium	64	(64.6)	116	(78.9)	0.010
	Good and Excellent	35	(35.4)	31	(21.1)

Discussion
This study was conducted with the aim of determining marital satisfaction rate and related factors in women referring to health care centers in suburban areas of Yazd. Results of frequency distribution of marital satisfaction in women under study showed that 59.8% of women were affected by marital satisfaction. Morowati Sharifabad et al. (2014) also reported 56.7% of satisfaction among women.6 Since the number of unsatisfied women is more than satisfied ones, it seems necessary to take some actions after understanding the effective factors because human satisfaction in life is affected by multiple factors and it is not logical to emphasize on improving one aspect or variable to increase marital satisfaction.18
There was no significant association between dissatisfaction of women and their age. Results of the present study are in parallel to the studies conducted by Morowati Sharifabad et al. (2013), Ferasat et al. (2003), and Norouzian (2006).6, 19, 20 Fathi et al. (2003) also showed that there is no significant relation between age and successful marriage.2 According to Rostami et al. (2012) and Balsamo et al. (2013), however, there is an adverse effect of age on marital satisfaction.9, 21 In interpreting these results it can be justified that increase in age is not solely an influencing factor on marital satisfaction and should be considered besides other factors. There was no significant relation between women dissatisfaction and their or their husband's education. This result resembles results of other studies.2, 6, 13, 6, 2 It seems that education brings more understanding about life and increases marital satisfaction, but the results of this study did not show such a relationship. Marital satisfaction is a multi-dimensional concept. Higher levels of education cannot necessarily lead to marital compatibility, as educated people also are faced with problems, affecting their marital life.
Though women dissatisfaction was not significant in terms their employment, employment of their husbands influenced their marital satisfaction and women with unemployed husbands were more unsatisfied than those with employed husbands. Norouzian (2006) showed that there was no significant association between employment and marital satisfaction,20 also Morowati Sharifabad et al. (2013) in his study suggested lack of relation between employment and women satisfaction,6 which is consistent with results of the present study. Regarding the employment of men, it is evident that unemployment will lead to dissatisfaction of both man and woman. Unemployment causes reduction of self-confidence in men and affects the relationship between man and woman, thereby creating marital incompatibility.
Study results showed no significant relationship between marriage and dissatisfaction of women. Also, according to Aqapour et al. (2010) and Ferasat et al. (2004) there was no significant relation between these two factors22, 19 which are consistent with our results. In explaining these results, it can be said that at first stages of marriage, compatibility occurs with self-sacrifice and subsequently satisfaction can take place with responsibility and both of these can be reached through pass of time.  Regarding the number of children and marital dissatisfaction, no significant relation was reported. The study carried out by Ferasat et al. (2004) and also the one conducted by Aqapour et al. (2010) showed no significant relation between these two factors.19, 22 For justification, it can be said that women are essentially under pressure of taking the role of a mother and a wife, but, compatibility will be achieved by pass of time.
Economic status of women was associated with dissatisfaction; the study of Honarian et al. (2010) noted that husband and wife's relationship is affected during the time of financial pressure.15 Economic status added to low income of family and unemployment of husband disturbs marital life. Couples attempt to control each other due to financial problems. Poverty also leads to low self-esteem and makes man opinionated, as a result others, including his wife become disappointed with him and this exacerbates the marital tensions.
Conclusion
The results of this study showed that there is a need to understand about and improve the factors influencing women's dissatisfaction. Due to the impact of economic and employment situation of men on women's marital satisfaction a solution must be considered. Proper planning is required to improve men's employment. Living in a suburb does not necessarily mean being poor, because due to the current divisions, some affluent areas have also been marginalized. Some differences in the present study and previous researches may be due to differences of living in the suburban areas of Yazd city. In this study, the relationship between factors and their effects were investigated and researchers were faced with some limitations making generalization difficult. These limitations included the fact that this study was descriptive and cross-sectional, the community under study was at the suburb of Yazd, so it is not possible to generalize the results for the whole population. Furthermore, marital satisfaction is a self-report and multi-dimensional concept which can be affected by many different factors that make it difficult to consider all aspects. Failure to cooperate in some cases and lack of control of confounding variables also had an impact. It is therefore suggested that future studies consider the above limitations to achieve better results.
Conflicts of Interest
The authors declare that there is no conflict of interest in this work.
Acknowledgments
This study is a research proposal (code: IR.SSU.SPH.REC.1395.79) approved by The Research Center for Social Factors of Medical Sciences University of Shahid Sadoughi in Yazd. We would like to appreciate research vice chancellor of this university for undertaking the costs of this proposal. Also, we would like to offer our warm gratitude to the respectful personnel of health care centers in suburbs of Yazd and women who participated in this research.
Authors' Contribution
Conceptualization, S.S.M.M. and Z.K.K.; Methodology, Z.K.K.; Software, S.S.M.M. and Z.K.K.; Formal Analysis, Z.K.K., S.G., and H.F.; Investigation, Z.K.K.; Project Administration, S.S.M.M.; Data Curation, Z.K.K., S.G., and F.K.; Writing – Original Draft, Z.K.K.; Writing – Review & Editing, S.S.M.M.; Visualization, Z.K.K.; Funding Acquisition, S.S.M.M.

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