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ORIGINAL ARTICLE
Year : 2013  |  Volume : 4  |  Issue : 1  |  Page : 8-11

A study to assess the stress and coping behavior of childless couples living in selected communities of Mangalore


Department of Community Health Nursing, Father Muller College of Nursing, Principal of Father Muller School of Nursing, Mangalore, Karnataka, India

Date of Web Publication20-May-2013

Correspondence Address:
Jasmine Sarita Vas
Department of Community Health Nursing, Father Muller College of Nursing, Principal of Father Muller School of Nursing, Mangalore, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0975-9727.112262

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  Abstract 

Objectives: To assess the stress level of childless couples as measured by the stress scale and to determine the coping behavior of childless couples as measured by the coping behavior scale and also to find and study the relationship between the stress levels and the coping behavior of childless couples. Materials and Methods: A descriptive correlational design was used for this study and the study was carried out in a selected community of Mangalore, i.e. at Mullerkad at the home setting of the samples. The sample comprised of 50 couples (50 husbands and 50 wives) selected by snowball sampling technique. Results: Though both husbands and wives had moderate stress toward childlessness, wives had higher stress (mean: 105.26) than husbands (mean: 103.9). There was no significant difference between the stress of husbands and wives (t 98 = 0.435, P > 0.05). Their coping behavior was average. However, wives had better coping behavior (mean: 238.46) than husbands (mean: 221.5). There was significant difference between the coping behavior of husbands and wives toward childlessness (t 98 = 2.938, P < 0.05). There was no correlation between the stress and coping behavior of husbands toward childlessness (r = 0.113, P > 0.05). However, there was significant correlation between the stress and coping behavior of wives toward childlessness (r = 0.515, P < 0.05). There was no association between stress of the couples and selected demographic variables. Similarly there was no association between the coping behavior of the couples and selected demographic variables except education of wives (χ12 = 5.715, P < 0.05). Conclusion: Both husbands and wives had moderate stress and average coping behavior toward childlessness. However, wives exhibited better coping behavior than husbands.

Keywords: Childless couples, coping behavior, stress


How to cite this article:
Vas JS. A study to assess the stress and coping behavior of childless couples living in selected communities of Mangalore. Muller J Med Sci Res 2013;4:8-11

How to cite this URL:
Vas JS. A study to assess the stress and coping behavior of childless couples living in selected communities of Mangalore. Muller J Med Sci Res [serial online] 2013 [cited 2022 Jun 25];4:8-11. Available from: https://www.mjmsr.net/text.asp?2013/4/1/8/112262


  Introduction Top


Since the beginning of history, the phenomenon of reproduction has been the essence in the continuity of human race. In planning a life together most of the couples have a vision about, how their life should be and most of them wish to have children of their own for the future life.

In most cultures, pregnancy and parenthood represent critical and desirable developmental phases. Achievement of the parenthood role is one of the major life goals for most men and women and the attainment of this goal has been reinforced over the centuries. Parenthood is viewed as a necessary criterion for personal fulfillments, social acceptance, achievements of full adult status, religious membership, renewal identity, and psychological adjustment. Fertility is assumed to be a basic human right and parenthood is a necessary development milestone. People with fertility problems can experience a wide range of emotions from mild disappointment to emotional devastation. Infertility is not a personal failure or punishment. However, people sometimes from themselves or from others or may be from one or the other member of the couple get into trouble. [1]

Infertility is defined as the inability to conceive after 1 year of unprotected intercourse or the inability to carry a pregnancy to a live birth. Interest in and research devoted to infertility are evidenced by the fact that listings on the Medline database for biomedical research numbered more than 1166 articles published during 2004 in professional journals alone and in an international survey. [2]

It is estimated that 10-15% of couples of child-bearing age are infertile, and this number is increasing, especially, among younger women. Overall, approximately one in four couples will experience infertility, and it is estimated that one-third of women experience at least one episode of infertility during their reproductive years. [3]

During the community home visits, the investigator came across several childless couples, who shared their stressors related to childlessness, which included personal, social, sexual, relationship, need for parenthood, and others. This motivated the investigator to take up the study.

Objectives

  1. To assess the stress level of childless couples as measured by stress scale.
  2. To determine the coping behavior of childless couples as measured by coping behavior scale.
  3. To find the relationship between the stress level and the coping behavior of childless couples in selected communities of Mangalore.
  4. To find the association of selected demographic variables with stress and coping behavior.

  Materials and Methods Top


A correlative study approach, with a descriptive correlational design was used for this study. The study was conducted in the homes of the residents of Mullerkad Urban Health Centre, Mangalore, which is governed by Father Muller Charitable Institute, where nursing students are posted for their clinical practice in order to provide door-to-door health-care. Sample was selected using snow ball technique. Data was collected from 1 st to 24 th August 2008 from 50 childless couples. Data was collected using stress scale and coping behavior scale developed by the researcher.


  Results Top


The stress of the couples was classified as "mild" (score range: <40), "moderate" (score range: 40-60), and "severe" (score range: >60). The results showed that 80% of the wives and 78% of the husbands had moderate stress and 14% of the husbands and 12% of the wives had severe stress [Figure 1].
Figure 1: Bar diagram representing stress level of couples

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As evident from the data in [Figure 2] and 78% of husbands and 66% of wives have used average coping behavior, 24% of wives and 6% of husbands have adaptive coping behavior in response to childlessness.
Figure 2: Cylindrical diagram representing coping level of couples

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Significant Difference Between Stress and Coping Behavior of Childless Couples

Data in [Table 1] shows that there was no significant difference between the stress of husband and wife (t98 = 0.435, P > 0.05). However, coping behaviors of husbands and wives showed significant difference (t98 = 2.938, P < 0.05).
Table 1: Significant difference between stress and coping of couples

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Relationship Between Stress and Coping Behavior of Childless Couples

In order to test the relationship between stress and coping behavior of childless couples, the null hypothesis has been formulated. The hypothesis was tested using Karl Pearson Co-efficient of Correlation.

Data in [Table 2] shows that there was correlation between stress and coping behavior of wives (r = 0.515, P < 0.05). Hence, the null hypothesis is rejected and the research hypothesis is accepted.
Table 2: Correlation between stress and coping of couples

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There was no significant association between stress and coping behavior and selected demographic variables except education of wives and coping behavior (χ2 = 5.715).


  Discussion Top


The findings of the study show that there was a positive correlation between the stress and coping behavior of the husbands and wives (r = 0.113, P < 0.05; r = 0.515, P < 0.05).

A similar study was conducted among infertile couples in Kimberly, USA, which revealed that both men and women scored high scores on stress related to infertility. Another study was conducted among married couple in New York, which showed that women reported higher mean infertility stress than men. [4] The findings of the present study are similar to a study conducted in Orange USA on 1026 among infertile men and women. The result revealed a negative correlation with relationship stress and social stress for men and women, other areas strong positive correlation with each type of infertility stress for both men and women.(r = 0.34, P < 0.01). [5]

Another study conducted at the Netherlands on the people under treatment for infertility suggested that the relation between coping styles and distress was moderated by the social support these people's experience. [6]

There was no association between stress of the couples and selected demographic variables.

The findings of a study conducted at Canada revealed that a number of factors determine the emotional and other responses to infertility such as age, duration of marital life, income, clinical factors like tests and treatment received also has its own significance with stress factor. [7]

There was no association between the coping behavior of the couples and selected demographic variables except education of wives (χ1 2 = 5.715, P < 0.05).

Limitations of the Study

  1. Some of the samples were not willing to participate in the study
  2. As many of the samples were employed they could not devote sufficient time for data collection after their working hours.
Nursing Implications

Nursing implications of the study could be discussed under nursing education, nursing practice, administration, and nursing research.

Nursing Education

One of the greatest frustrations for infertile couples is health-care professionals, including nurses', lack of knowledge and understanding regarding the significant emotional effects of the infertility experience. Health-care providers need to be aware of each infertile emotional effects of infertility. Prior researches as shown that people with infertility felt that many providers focused only on the physical aspects of their care and the emotional effects of infertility were often not addressed. The current study showed that infertility caused moderate stress in both male and females. The result of this study relating to emotional effects of infertility in men is important for practitioners. The emotional needs of men also need to be taken into consideration.

Nursing Practice

Health education is an important aspect of nursing practice. The expanded role of the professional nurse emphasizes those activities, which promote health and strengthening of the infertile couples in the family and society. Community nurse should participate in assessing the community needs and they should be involved in planning, organizing, administering, and monitoring these problems. They must plan programs to improve emotional and psychological state of infertile couples by providing counseling. Nurses working in the hospital and community health settings can provide information to the public to have better awareness regarding the specific needs of infertile couples in order to bring out a healthy family leading to healthy society and nation.

Nursing Administration

Nurse administrators are the backbone for providing facilities to improve the stress and coping of the childless couples. There should be a provision for the nurses to devote time for giving health education regarding "awareness/advice, blame/balance, and competence/compassion." They should plan and organize program that is cost-effective. A hospital policy should be adopted to provide health education or written information to all in-patients and out-patients. Health education material such as leaflet and pamphlets should be made available to the public.

Nursing Research

Nurses being the largest group in the health-care delivery system and being more close to the patients should take initiative to conduct further research regarding the stress and coping behavior of the infertile couples. The present study reveals that majority of the wives as compared to husbands had excellent coping in social area. So the nurses, especially, those working in the community, should take initiative in conducting research studies regarding this aspect in the community. A planned awareness program can be organized in the community to educate the people.

Suggestions

  1. Nurses can organize programs to educate the couples regarding the infertility
  2. Awareness programs can be arranged for the whole community regarding infertility
  3. Counseling and guidance can be conducted to improve coping skills and to empower them to become more self-reliant.
Recommendations

On the basis of the present study, the following recommendations have been made for further studies:

  1. The present study may be replicated on a larger sample
  2. A comparative study may be conducted between rural and urban couples
  3. A comparative study may be conducted between young couples and old couples in order to assess their stress and coping behavior
  4. A study may be conducted to know the impact of group psychological interventions on pregnancy rates in infertile couple
  5. A study may be conducted to assess the cultural differences among the infertile couple between various states
  6. A study can be conducted to find out the beliefs and practice of couple related to infertility
  7. A study can be conducted to find out the stigma associated with infertility.

  Conclusion Top


A child in a home brings a lot of happiness. The workload and stress of everyday life is minimized by the joy a child brings in their lives. The study showed that both husbands and wives had moderate stress and average coping behavior towards childlessness. However, wives exhibited better coping behavior than husbands.

 
  References Top

1.American Infertility Association and Organon Pharmaceuticals. Breaking the cycle of stress and sadness, 2004. Available from: http://www.focusoninfertility.org. [Last cited 2008 Oct 23]; [Screens 2].  Back to cited text no. 1
    
2.Adashi EY, Cohen J, Hamberger L, Jones HW Jr, de Kretser DM, Lunenfeld B, et al. Public perception on infertility and its treatment: An international survey. The Bertarelli Foundation Scientific Board. Hum Reprod 2000;15:330-4.  Back to cited text no. 2
    
3.Jenkins J, Corrigan L. Current thinking on management of infertility. Clin Pulse 2004;5:20-3.  Back to cited text no. 3
    
4.Yassini MD, Khalili MA, Hashemian Z. The level of anxiety and depression among Canadian infertile couples undergoing in vitro fertilization or intra cytoplasmic sperm injection cycles. J Res Med Sci 2005;10:1231-7.  Back to cited text no. 4
    
5.Tamres LK, Janicki D, Helgeson VS. Sex differences in coping behaviour: A meta-analytic review and an examination of relative coping. J Pers Soc Psychol 1998;71:452-6.  Back to cited text no. 5
    
6.Abbey A, Halman LJ, Andrews FM. Psychosocial, treatment, and demographic predictors of the stress associated with infertility. Fertil Steril 1992;57:122-8.  Back to cited text no. 6
    
7.Pohlman H, Jambunathan J. Stress, depression and coping in infertile men and women. J Perinatol 2007;9:247-53.  Back to cited text no. 7
    


    Figures

  [Figure 1], [Figure 2]
 
 
    Tables

  [Table 1], [Table 2]



 

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Abstract
Introduction
Materials and Me...
Results
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