Volume 34, Issue 133 (December 2021)                   IJN 2021, 34(133): 40-53 | Back to browse issues page

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Ghanbari S, Sadeghi H, Amini L, Haghani S. Comparing General Health and Happiness in Elderly Women With and Without a Spouse Referring to Health Centers in Bandar Abbas, Iran, in 2018. IJN 2021; 34 (133) :40-53
URL: http://ijn.iums.ac.ir/article-1-3193-en.html
1- Department of Community Education in the Health System, Virtual College, Medical Education and Management, Iran University of Medical Sciences, Tehran, Iran.
2- Department of Reproductive and Pregnancy Health Midwifery, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran. , sadeghi.ho.46@gmail.com
3- Department of Reproductive and Pregnancy Health Midwifery, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
4- Department of Biostatistics, Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran.
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1. Introduction
The dramatic increase in life expectancy in the 20th century has been one of the most outstanding health achievements in the world, which has led to an increasing trend in the overall age of the population compared to the past. With increasing life expectancy and declining fertility rates, in most countries, including Iran, the slope of population growth for people over 60 is higher than other age groups, and this trend causes the aging of the world's population.
According to the Iranian National Statistics Portal (2016), the life expectancy of Iranian men has increased from 45 to 69 and then 74 years in 1960, 2000, and 2015, respectively, and for women from 44 to 71 and then 76 years in the same years. Accordingly, the ratio of the elderly to the total population has been increasing in recent decades. It is estimated that the percentage of elderly people in Iranian society will be 6.6% in 2025, 19% in 2030, and 21.7% to 30.8% in 2050.
Because of the higher life expectancy of women, older women are more exposed to potential health threats, such as chronic diseases, loneliness and isolation, and lack of social support. This study aimed to compare the general health and happiness of elderly women with and without a spouse, referring to health centers in Bandar Abbas, one of the deprived cities in southern Iran, in 2018.
2. Materils and Methods
This descriptive-analytical study was performed on 390 women over 60 years of age (260 with spouses and 130 widows) referred to 8 selected health centers in Bandar Abbas, Iran, in 2018. They were chosen using the quota cluster sampling method. Data collection tools included a demographic information questionnaire, the Goldberg and Hiller general health questionnaire, and the Oxford happiness questionnaire. The collected data were processed using SPSS software version 21. Descriptive statistics (frequency, percentage, mean and standard deviation) and inferential statistics (the Chi-square, and independent t test, and analysis of covariance) were used to analyze the data at a significant level of P<0.05.
3. Results
In this study, out of 260 elderly women with a spouse, 218 (83.8%), and out of 130 elderly women without a spouse, 83 (63.8%) were under 70. Most women without a spouse (67.6%), and with a spouse (65%), have 5 to 9 children, and more than half of them in both groups (58.4% of the group with a spouse and 51.9% of the group without spouse) had 5 to 9 married children. About half of women in the two groups (48.5% in the group with a spouse and 50% in the group without a spouse) had primary education, and most (94.2% in the group with a spouse, and 95.4% in the group without a spouse) were housewives. In terms of economic status, most of the two groups (61.5% of each group) were at a moderate level, and almost half (48.1% of the group with a spouse and 50.8% of the group without a spouse) were financially dependent. The two groups were homogeneous regarding demographic variables except for age and years of living with a spouse (P<0.001). The results showed that although older women with a spouse had a higher level of general health and happiness than the other group, the analysis of covariance showed that this difference was not statistically significant.
4. Conclusion
According to the study results, the average general health score in both groups was lower than the cut-off points for the whole test, indicating that most women in both groups have a good level of health. However, the mean health score in this study is higher than the mean health score of the elderly in the Yazdani study in Tehran (Yazdani, 2010) and Nejati study in Qom (Nejati, 2005). These results show that the elderly in Tehran and Qom have better general health. Perhaps this result can be attributed to the deprivation of Bandar Abbas and the lower quality of health services provided to the elderly in deprived areas compared to the center.
Also, although the average general health score, and each of its areas, is lower in the group of women with a spouse, and it seems that women with husbands have higher general health, the results of analysis of covariance showed that this difference is not statistically significant (P=0.38).
Perhaps one of the reasons for the insignificance of this difference is the social support provided by children, which according to Okabayashi et al., can have a greater impact on the mental health of older women than other sources of support, including spouses, friends, and acquaintances.
Regarding the physical dimension of elderly women's health, Bennet found that the decrease in physical health in older women is more a function of burnout and aging than widowhood and lack of spouse support. This finding could justify the lack of significance of this relationship in our study.
This study also showed that the mean score of happiness is higher in women with a spouse, but this difference is not statistically significant (P=0.17). According to Hughes and Waite, regarding the role of marriage and its relationship with feelings of health and happiness, although some changes in physical and mental health can be explained by marital status, marriage seems to be only one part of this relationship. Also, Ryan, Ryan, and Willits believed that it is the quality of family relationships that matters to the psychological wellbeing of the elderly, not just the presence of a spouse and the number of children.
In a nutshell, although some changes in physical and mental health can be explained by marital status, other factors may affect the sense of wellbeing, health, and happiness of these older women, and identifying them requires further research.

Ethical Considerations
Compliance with ethical guidelines

This article was approved by the Ethics Committee of Iran University of Medical Sciences (Code: IR.IUMS.REC.1397.1175).

This article was extracted from the MA. thesis of the first author at the Department of Community Education in the Health System, Virtual College, Medical Education and Management, Iran University of Medical Sciences, Tehran (Code: 13-1-3-2016).

Authors' contributions
All authors equally contributed to preparing this article.

Conflict of interest
The authors declared no conflict of interest.

We want to thank the Iran University of Medical Sciences and the officials of the School of Nursing and Midwifery for their help.

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Type of Study: Research | Subject: nursing
Received: 2021/08/8 | Accepted: 2021/11/5 | Published: 2022/01/1

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