Iran Journal of Nursing

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Safari S, Hasanpoor Azghady S, Ghafarizadeh A, Amiri Farahani L. Dimensions of Forgiveness and the Influential Factors in Infertile Couples. IJN 2020; 33 (126) :69-81
URL: http://ijn.iums.ac.ir/article-1-3322-en.html

Background & Aims: Infertility is an important life crisis that leads to psychological complications and severely stressful experiences. Infertility stress disrupts marital adjustment, and the subsequent incompatibility increases over time. In this regard, numerous factors may affect couples' relationship, and forgiveness between couples has been suggested as a major influential factor in family strength. Forgiveness could a potent mechanism to end a broken relationship or help resolve conflicts between couples and provide the conditions for reconciliation, thereby increasing couples' satisfaction with each other. Couples' forgiveness is a process that allows gaining a greater understanding of themselves, each other, and their relationships in order to become free of the dominance of negative thoughts, feelings, and behaviors after experiencing an unpleasant interpersonal event. To date, no studies have investigated the influential factors in forgiveness, and no interventional research has been focused on forgiveness in infertile couples in Iran. Prior to forgiveness-based interventions, it is essential to evaluate the dimensions and influential factors in different research communities, so that the design and formulation of support programs for infertile couples would be based on the related variables to achieve the desired outcomes. The present study aimed to assess the dimensions of forgiveness and its influential factors in infertile couples.
Materials & Methods: This cross-sectional study was performed on 200 infertile couples referring to Omid Royan Infertility Center in Arak, Iran; the cause of infertility was of the female origin. The subjects were selected via continuous sampling during December 2018-September 2019. The inclusion criteria were Iranian nationality, age of 18-49 years, literacy, no drugs abuse, no use of medications for mental disorders, no psychiatric disorders (self-report of subjects), no adopted children, first marriage in both couples, and a minimum of one year since the diagnosis of infertility. Data were collected using demographic and infertility questionnaire and family forgiveness scale (FFS). Face and content validity was used to assess the validity of the demographic and infertility questionnaire. FFS was designed and developed by Pollard et al. in 1998 to measure forgiveness in families and couples, as well as the dimensions of forgiveness. The questionnaire consists of 40 items and two sections. The first 20 items are focused on the family of origin, and the second 20 items are focused on primal relationship (nuclear family). Since the infertile couples in our study were childless, only the second section of the questionnaire (primal relationship) was used, which has five subscales of realization, recognition, reparation, restitution, and resolution. Each subscale has four items, which are scored based on a four-point Likert scale (Never True=1, Almost Always True=4). Notably, the 10-point scoring of this questionnaire is inverse. The scores of each subscale are within the range of 4-16, and the score range of the entire scale is 20-80, with the higher scores indicating more forgiveness. Pollard et al. obtained the Cronbach's alpha coefficient for the subscales of the questionnaire, which are calculated to be within the range of 0.55-0.86. FFS has been psychometrically measured for the Iranian population by Seif and Bahari (2003). In a study on a sample of 766 married couples in Tehran (Iran), the reliability of the second section of the scale (primal relationship) was reported to be 85% based on Cronbach's alpha. Data analysis was performed in SPSS version 16 using independent t-test, Mann-Whitney U test, one-way ANOVA, Kruskal-Wallis test, and Pearson's correlation-coefficient, and the P-value of less than 0.05 was considered as significant.
Results: The mean forgiveness score of men and women was 64.38 ± 4.89 and 64.14±6.16, respectively. The highest mean score in the dimensions of forgiveness in both women and men was achieved the dimension of resolution (14.10 ± 1.84 and 13.94 ± 2.18, respectively), while the lowest mean score was in the dimension of recognition in women and men (10.80 ± 1.75 and 10.58 ± 1.34, respectively). A significant positive correlation was observed between the forgiveness of infertile women and the forgiveness of their spouses (r=0.44; P<0.001). Among the studied variables, the forgiveness of infertile women was correlated with the variables of male and female education level, female occupation status, residential status, and type of marriage. On the other hand, spousal forgiveness was only correlated with male education level, male occupation status, and the number of failed pregnancies.
Conclusion: According to the results, the mean forgiveness scores of men and women had no significant difference. The highest mean score in both women and men was achieved in the dimension of recovery, while the lowest mean score belonged to the acknowledgment of error. Increased forgiveness in one of the spouses was accompanied by enhanced forgiveness on behalf of the other spouse. Among the studied variables, forgiveness in infertile women was correlated with the variables of male and female education level, female occupation status, residential status, and type of marriage, while the forgiveness of men was only correlated with male education level and occupation status and the number of failed pregnancies. Attention must be paid to the influential factors in forgiveness in the development and formulation of counseling or educational programs based on forgiveness, along with other methods of psychological support for infertile couples in order to improve marital relations and couples' adaptation to the issues and stresses caused by infertility and its treatment.