Abstract
Maternal psychological distress is often associated with domestic violence. Spiritual well-being can affect the psychological capacity to deal with distress. This study aimed to investigate the relationship between psychological distress and spiritual well-being in pregnant women exposed to domestic violence. This cross-sectional study was conducted on 305 pregnant women subjected to domestic violence in southern Iran. The participants were selected using the census method. Data were collected using the Spiritual Well-being Scale (SWB), the Kessler Psychological Distress Scale (K10), and the Hurt, Insult, Threaten, Scream (HITS) screening tool (short form) and were analyzed with descriptive and inferential statistics (t-test, ANOVA, the Spearman correlation coefficient, and multiple linear regression) in SPSS software version 24. The mean scores ± standard deviation of the participants’ psychological distress, spiritual well-being, and domestic violence were 24.68 ± 6.43, 79.89 ± 18.98, and 11.24 ± 1.5, respectively. The results showed that psychological distress had a significant negative correlation with spiritual well-being (ρ = − 0.84, P < 0.001) and domestic violence (ρ = − 0.73, P < 0.001). The results of the multiple linear regression analysis also showed that spiritual well-being and domestic violence could predict the psychological distress of pregnant women who were exposed to domestic violence, which explained 73% of the psychological distress in the participants. According to the study results, spiritually oriented education can be provided for women to reduce their psychological distress. Also, it is recommended that necessary interventions be used to reduce domestic violence and empower women to prevent it.
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References
Almeida, F. S. J., Coutinho, E. C., Duarte, J. C., Chaves, C. M. B., Nelas, P. A. B., Amaral, O. P., & Parreira, V. C. (2017). Domestic violence in pregnancy: Prevalence and characteristics of the pregnant woman. Journal of Clinical Nursing, 26(15–16), 2417–2425. https://doi.org/10.1111/jocn.13756
Andrews, G., & Slade, T. (2001). Interpreting scores on the Kessler psychological distress scale (K10). Australian and New Zealand Journal of Public Health, 25(6), 494–497. https://doi.org/10.1111/j.1467-842x.2001.tb00310.x
Ansari, H., Noroozi, M., Yadegari, M., Javaheri, M., & Ansari, S. (2013). Physical, mental and sexual abuse among the married women in south eastern Iran, 2009. Hormozgan Medical Journal, 16(6), 491–499. [In Persian]. https://hmj.hums.ac.ir/Article/88070
Antoniou, E., & Iatrakis, G. (2019). Domestic violence during pregnancy in Greece. International Journal of Environmental Research and Public Health, 16(21), 4222–4233. https://doi.org/10.3390/ijerph16214222
Azar, N. S., Radfar, M., & Baghaei, R. (2020). Spiritual self-care in stroke survivors: A qualitative study. Journal of Religion and Health, 61(1), 493–506. https://doi.org/10.1007/s10943-020-01030-7
Barton, K., Redshaw, M., Quigley, M. A., & Carson, C. (2017). Unplanned pregnancy and subsequent psychological distress in partnered women: A cross-sectional study of the role of relationship quality and wider social support. BMC Pregnancy and Childbirth, 17(44), 1–9. https://doi.org/10.1186/s12884-017-1223-x
Bramhankar, M., & Reshmi, R. (2021). Spousal violence against women and its consequences on pregnancy outcomes and reproductive health of women in India. BMC Women’s Health, 21(382), 1–9. https://doi.org/10.1186/s12905-021-01515-x
Chehrazi, M., Faramarzi, M., Abdollahi, S., Esfandiari, M., & Shafie rizi, S. (2021). Health promotion behaviours of pregnant women and spiritual well-being: Mediatory role of pregnancy stress, anxiety and coping ways. Nursing Open, 8(6), 3558–3565. https://doi.org/10.21203/rs.2.24050/v1
Conway, L. J., Cook, F., Cahir, P., Brown, S., Reilly, S., Gartland, D., Mensah, F., & Giallo, R. (2021). Children’s language abilities at age 10 and exposure to intimate partner violence in early childhood: Results of an Australian prospective pregnancy cohort study. Child Abuse & Neglect, 111(1), 104794–104806. https://doi.org/10.1016/j.chiabu.2020.104794
Dolatian, M., Mahmoodi, Z., Dilgony, T., Shams, J., & Zaeri, F. (2017). The structural model of spirituality and psychological well-being for pregnancy-specific stress. Journal of Religion and Health, 56(6), 2267–2275. https://doi.org/10.1007/s10943-017-0395-z
Ellison, C. W. (1983). Spiritual well-being: Conceptualization and measurement. Journal of Psychology and Theology, 11(4), 330–338. https://doi.org/10.1177/009164718301100406
Fekadu, E., Yigzaw, G., Gelaye, K. A., Ayele, T. A., Minwuye, T., Geneta, T., & Teshome, D. F. (2018). Prevalence of domestic violence and associated factors among pregnant women attending antenatal care service at University of Gondar Referral Hospital, Northwest Ethiopia. BMC Women’s Health, 18(138), 1–8. https://doi.org/10.1186/s12905-018-0632-y
Finnbogadóttir, H., Baird, K., & Thies-Lagergren, L. (2020). Birth outcomes in a Swedish population of women reporting a history of violence including domestic violence during pregnancy: A longitudinal cohort study. BMC Pregnancy and Childbirth, 20(183), 1–10. https://doi.org/10.21203/rs.2.15975/v1
Gariepy, A. M., Lundsberg, L. S., Miller, D., Stanwood, N. L., & Yonkers, K. A. (2016). Are pregnancy planning and pregnancy timing associated with maternal psychiatric illness, psychological distress and support during pregnancy? Journal of Affective Disorders, 205(1), 87–94. https://doi.org/10.1016/j.jad.2016.06.058
Ghaffarihosseini, F., Nadoushan, A. H. J., Alavi, K., & Bolhari, J. (2021). Supporting the victims of domestic violence in Iran: Two decades of effort. Journal of Injury and Violence Research, 13(2), 161–164.
Gholamhosseini, M., Dehghan, M., Forouzi, M. A., & Roy, C. (2021). Effectiveness of spiritual counseling on the enhancement of hope in Iranian muslim patients with myocardial infarction: A two-month follow-up. Journal of Religion and Health, 61(5), 3898–3908. https://doi.org/10.1007/s10943-021-01283-w
Glasheen, C., Colpe, L., Hoffman, V., & Warren, L. K. (2015). Prevalence of serious psychological distress and mental health treatment in a national sample of pregnant and postpartum women. Maternal and Child Health Journal, 19(1), 204–216. https://doi.org/10.1007/s10995-014-1511-2
Golchin, N. A. H., Hamzehgardeshi, Z., Hamzehgardeshi, L., & Ahoodashti, M. S. (2014). Sociodemographic characteristics of pregnant women exposed to domestic violence during pregnancy in an Iranian setting. Iranian Red Crescent Medical Journal, 16(4), e11989-11996. https://doi.org/10.5812/ircmj.11989
Gonçalves, J. P., Lucchetti, G., Menezes, P. R., & Vallada, H. (2015). Religious and spiritual interventions in mental health care: A systematic review and meta-analysis of randomized controlled clinical trials. Psychological Medicine, 45(14), 2937–2949. https://doi.org/10.1017/s0033291715001166
Haghighat, M., Mirghafourvand, M., Mohammad-Alizadeh-Charandabi, S., Malakouti, J., & Erfani, M. (2018). The effect of spiritual counseling on stress and anxiety in pregnancy: A randomized controlled clinical trial. Iranian Red Crescent Medical Journal, 20(4), e64094-64102. https://doi.org/10.5812/ircmj.64094
Hajebi, A., Motevalian, A., Amin-Esmaeili, M., Rahimi-Movaghar, A., Sharifi, V., Hoseini, L., Shadloo, B., & Mojtabai, R. (2018). Adaptation and validation of short scales for assessment of psychological distress in Iran: The Persian K10 and K6. International Journal of Methods in Psychiatric Research, 27(3), e1726-1735. https://doi.org/10.1002/mpr.1726
Hajnasiri, H., Gheshlagh, R. G., Sayehmiri, K., Moafi, F., & Farajzadeh, M. (2016). Domestic violence among Iranian women: A systematic review and meta-analysis. Iranian Red Crescent Medical Journal, 18(6), e34971-34983.
Hall, P., Bacheller, L. L., & Desir, C. (2019). Spirituality and psychological well-being in adults of Haitian descent. Mental Health, Religion & Culture, 22(5), 453–466. https://doi.org/10.1080/13674676.2019.1581151
Hisasue, T., Kruse, M., Raitanen, J., Paavilainen, E., & Rissanen, P. (2020). Quality of life, psychological distress and violence among women in close relationships: A population-based study in Finland. BMC Women’s Health, 20(85), 1–10. https://doi.org/10.1186/s12905-020-00950-6
Hussain, H., Hussain, S., Zahra, S., & Hussain, T. (2020). Prevalence and risk factors of domestic violence and its impacts on women’s mental health in Gilgit-Baltistan, Pakistan. Pakistan Journal of Medical Sciences, 36(4), 627–631. https://doi.org/10.12669/pjms.36.4.1530
Jahanfar, S., & Malekzadegan, Z. (2007). The prevalence of domestic violence among pregnant women who were attended in Iran University of Medical Science Hospitals. Journal of Family Violence, 22(8), 643–648. https://doi.org/10.1007/s10896-007-9084-0
Jamshidimanesh, M., Soleymani, M., Ebrahimi, E., & Hosseini, F. (2013). Domestic violence against pregnant women in Iran. Journal of Family & Reproductive health, 7(1), 7–10.
Jesse, D. E., & Reed, P. G. (2004). Effects of spirituality and psychosocial well-being on health risk behaviors in Appalachian pregnant women. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 33(6), 739–747.
Kessler, R. C., Andrews, G., Colpe, L. J., Hiripi, E., Mroczek, D. K., Normand, S. T., Walters, E. E., & Zaslavsky, A. M. (2002). Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychological Medicine, 32(6), 959–976. https://doi.org/10.1017/s0033291702006074
Khalili, Z., Navaee, M., Shakiba, M., & Navidian, A. (2019). The effect of supportive-educational intervention on psychological distress in pregnant women subjected to domestic violence: A randomized controlled trial. Journal of Hayat, 25(2), 151–167. [In Persian]. https://hayat.tums.ac.ir/browse.php?a_id=2970&sid=1&slc_lang=en
Kharaghani, R., Shariati, M., Yunesian, M., Keramat, A., & Moghisi, A. (2016). The Iranian integrated maternal health care guideline based on evidence-based medicine and American guidelines: A comparative study. Modern Care Journal, 13(2), 1–10. https://doi.org/10.17795/modernc.9455
Koirala, P., & Chuemchit, M. (2020). Depression and domestic violence experiences among Asian women: A systematic review. International Journal of Women’s Health, 12(1), 21–33. https://doi.org/10.2147/ijwh.s235864
Nejatizade, A. A., Roozbeh, N., Yabandeh, A. P., Dabiri, F., Kamjoo, A., & Shahi, A. (2017). Prevalence of domestic violence on pregnant women and maternal and neonatal outcomes in Bandar Abbas, Iran. Electronic Physician, 9(8), 5166–5171. https://doi.org/10.19082/5166
Nikfarjam, M., Heidari-Soureshjani, S., Khoshdel, A., Asmand, P., & Ganji, F. (2017). Comparison of spiritual well-being and social health among the students attending group and individual religious rites. World Family Medicine Journal: Incorporating the Middle East Journal of Family Medicine, 15(8), 160–166. https://doi.org/10.5742/mewfm.2017.93071
Noorisanchooli, H., Asadibidmeshki, E., Rahnama, M., & Haghighi, M. J. (2018). The employed women’s experience of spousal violence: A qualitative study. Medical Science, 22(94), 560–565.
Philipsen, M. T., Knudsen, U. B., Zachariae, R., Ingerslev, H. J., Hvidt, J. E. M., & Frederiksen, Y. (2022). Sleep, psychological distress, and clinical pregnancy outcome in women and their partners undergoing in vitro or intracytoplasmic sperm injection fertility treatment. Sleep Health, 8(2), 242–248. https://doi.org/10.1016/j.sleh.2021.10.011
Pournaghash-Tehrani, S. (2011). Domestic violence in Iran: A literature review. Aggression and Violent Behavior, 16(1), 1–5. https://doi.org/10.1016/j.avb.2010.12.001
Rabiepoor, S., Sadeghi, E., & Sayyadi, H. (2019). Spiritual health and physical activity among Iranian pregnant women. Journal of Religion and Health, 58(2), 506–515. https://doi.org/10.1007/s10943-017-0487-9
Rafati, F., Mashayekhi, F., & Dastyar, N. (2019). Caregiver burden and spiritual well-being in caregivers of hemodialysis patients. Journal of Religion and Health, 59(6), 3084–3096. https://doi.org/10.1007/s10943-019-00939-y
Rahpaymaelizehee, S., Fallahi, B., & Kojouri, R. J. (2015). The national policy of Iran toward violence against women. Espaço Jurídico: Journal of Law, 16(2), 321–332.
Seyed Bagheri, S. H., Dehghan, M., Alavi, S. H., Iranmanesh, S., & Khoshab, H. (2017). Burst out of the dead land by the help of spirituality: A case study of living with blindness and cancer. Journal of Religion and Health, 56(3), 896–906. https://doi.org/10.1007/s10943-016-0284-x
Sherin, K. M., Sinacore, J. M., Li, X.-Q., Zitter, R. E., & Shakil, A. (1998). HITS: a short domestic violence screening tool for use in a family practice setting. Family Medicine, 30(7), 508–512.
Smigelsky, M. A., Gill, A. R., Foshager, D., Aten, J. D., & Im, H. (2017). “My heart is in his hands”: The lived spiritual experiences of Congolese refugee women survivors of sexual violence. Journal of Prevention & Intervention in the Community, 45(4), 261–273. https://doi.org/10.1080/10852352.2016.1197754
Soleimani, M. A., Sharif, S. P., Allen, K. A., Yaghoobzadeh, A., Nia, H. S., & Gorgulu, O. (2017). Psychometric properties of the Persian version of spiritual well-being scale in patients with acute myocardial infarction. Journal of Religion and Health, 56(6), 1981–1997. https://doi.org/10.1007/s10943-016-0305-9
Sotudeh, T., Hasanpoor-Azghady, S. B., & Amiri-Farahani, L. (2022). Relationship between religious coping, pain severity, and childbirth self-efficacy in iranian primipara women. Obstetrics and Gynecology International, 2022(1), 2338683–2338690. https://doi.org/10.1155/2022/2338683
Vehmeijer, F. O., Balkaran, S. R., Santos, S., Gaillard, R., Felix, J. F., Hillegers, M. H., El Marroun, H., & Jaddoe, V. W. (2020). Psychological distress and weight gain in pregnancy: A population-based study. International Journal of Behavioral Medicine, 27(1), 30–38. https://doi.org/10.1007/s12529-019-09832-0
Woods, S. M., Melville, J. L., Guo, Y., Fan, M.-Y., & Gavin, A. (2010). Psychosocial stress during pregnancy. American Journal of Obstetrics and Gynecology, 202(1), 61–67. https://doi.org/10.1016/j.ajog.2009.07.041
Zahrani, S. T., Rafiei, E. H., Hajian, S., Majd, H. A., & Izadi, A. (2020). The correlation between spiritual health and maternal-fetal attachment behaviors in pregnant women referring to the health centers in Qazvin, Iran. International Journal of Community Based Nursing and Midwifery, 8(1), 84–91.
Zheng, B., Zhu, X., Hu, Z., Zhou, W., Yu, Y., Yin, S., & Xu, H. (2020). The prevalence of domestic violence and its association with family factors: A cross-sectional study among pregnant women in urban communities of Hengyang City, China. BMC Public Health, 20(620), 1–9. https://doi.org/10.1186/s12889-020-08683-9
Acknowledgements
The authors would like to appreciate the Vice-Chancellor for Research and Technology of Jiroft University of Medical Sciences, all the participants, and the sincere and honest cooperation of the midwives who helped us in conducting this study.
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All authors FR, PMSH, ND, MP, AM contributed to conceptualized the study, and all were major contributors in writing the manuscript. All authors approved the final manuscript.
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Rafati, F., Mangolian Shahrbabaki, P., Dastyar, N. et al. Relationship Between the Psychological Distress and Spiritual Well-Being in Pregnant Women Exposed to Domestic Violence: A Cross-Sectional Study in Iran. J Relig Health 62, 3252–3266 (2023). https://doi.org/10.1007/s10943-023-01785-9
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DOI: https://doi.org/10.1007/s10943-023-01785-9