@2024 Afarand., IRAN

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ISSN: 2008-2630    Iranian Journal of War & Public Health 2018;10(4):203-208

Background
One of the damaging factors of the family structure is the disability of one of its members, which can be caused by some events such as war [1].
Previous Studies
... [2]. Studies on the long-term effects of war on the psychosocial status of the veterans and their wives suggest that the veteran’s wife as his caregiver is directly influenced by the stresses that threaten the health of all family members [3]. According to a study done in Iran, a high level of depression and psychological pressure of caring in the veterans' wives have been reported [4]. ... [5-7]. In different studies, cohesion and psychological capital have been considered as appropriate factors to deal with stressful situations [8, 9]. ... [10, 11]. Sabri Nazarzadeh et al. [12] showed that the sense of coherence by influencing coping strategies, stress, and the enhanced ability of the individuals to tolerate their diseases can affect their mental health. Quintard et al. [13] also have stated that the sense of high coherence can lead to an increase in the sexual functioning of the women with cancer. Psychological capacities such as hopefulness, resilience, optimism, and self-efficacy can all introduce a factor called psychological capital [14]. It has been shown that people can be trained about the skills needed to have optimism and positivity, based on the reality and making them psychologically immunized to face difficulties [15]. ... [16]. According to the various studies in patients and caregivers, psychological capital and its components have a positive and significant relationship with psychological well-being, quality of life, mental health, self-efficacy, and job performance [21].
Aim(s)
The aim of this study was to predict the caregiver burden based on sense of coherence and psychological capital in the amputee veterans’ wives.
Research type
The present study is a descriptive-correlational study.
Research society, place and time
This study was conducted on the amputee veterans’ wives in Piranshahr in 2016.
Sampling method and number
Using available sampling method, 120 women with an amputee veteran spouse were selected, due to the minimum sample size in the correlation research (n=100) [22]. Inclusion criteria included the alive veterans, willingness to participate in the research, and being illiterate. The lack of cooperation, a history of the known mental disorder and chronic diseases were the exclusion criteria of the research. These criteria were announced by the veterans’ wives.
Used devices&materials
The following questionnaires were used as research tools: 1) Family Burden Interview Scale (FBIS): It has been developed by Pai and Kapur. This scale is a semi-structured interview assessing family burden in three areas: economic burden, routine disruption, and family relaxation. The questions are scored as follows: severe burden: 2, moderate burden: 1, no burden: 0, and the maximum score is 48. The scale has a high reliability coefficient (0.72) [4]. ... [23]. 2) Sense of Coherence Scale: The short form of sense of coherence scale was designed by Antonovsky in 1987 [11]. It is a 13-item scale, assessing three dimensions including perceived ability (5 items), management ability (4 items), and importance (4 items). The items are ranked on a five-degree Likert scale. Three items are scored in reverse order. The minimum and maximum scores are 4 and 14, respectively, and the high scores indicate stronger coherence. The scale also provides the total score in addition to the scores for each subscale. ... [24]. 3) Luthans’s Psychological Capital Questionnaire (QLPC): It was used to measure the psychological capital. It has 24 questions and four subscales including self-efficacy, resilience, optimism, and hope. The questions are answered on a six-degree Likert scale from "totally disagree" to "totally agree". In order to obtain a psychological capital score, first the subscale scores are calculated separately, and then their sum score is considered as the total score of the psychological capital. The minimum and maximum scores are 24 and 144, respectively, and a higher score indicates a higher psychological capital. The reliability of this questionnaire has reported 0.84 in 473 Chinese nurses, using Cronbach's alpha method [25]. ... [14]. The veterans' wives were selected from the Piranshahr Foundation of Martyrs and Martyr's Affairs and the questionnaires were distributed among the subjects for a specific time. Data was analyzed using SPSS 18. Kolmogorov-Smirnov test was used to investigate the normal distribution of data, Pearson correlation coefficient to determine the relationship between variables, and the stepwise regression test to determine the variables contribution and effects to predict caregiver burden. The sense of psychological coherence, psychological capital and their components were considered as predictive variables and caregiver burden as the criterion variable.
Findings by Text
The participants had an average age of 43.23±3.45 years. 78 subjects (65.0%) had below the diploma educational levels, 31 subjects (25.8%) had diploma, and 11 subjects (9.2%) had diploma and above degrees. The sense of psychological coherence had the highest mean scores among the variables (Table 1). There was a negative and significant correlation between caregiver burden and sense of coherence (r = -0.28), psychological capital (r=0.41) and its components including self-efficacy (r=-0.37), resilience (r=-0.36), optimism (R=-0.27), and hope (r=-0.21) in the veterans' wives (p<0.01). In fact, the sense of coherence and psychological capital were more effective in reducing caregiver burden of the veterans' wives (Table 2). The sense of coherence (β=-0.28) was significantly able to explain about 7% of the variance of caregiver burden in veterans’ spouses (F=8.85, p<0.001). Moreover, self-efficacy (β=-0.25) in the first step, and resilience (β=-0.23) in the second step through a decrease in the self-efficacy contribution, predicted 14% and 17% of the variance of caregiver burden in veterans’ wives (F=11.31, p<0.001), respectively. The hope and optimism were eliminated from the regression analysis due to lack of prediction.
Main comparison to the similar studies
There was a negative and significant correlation between the sense of coherence and caregiver burden. In other words, the sense of coherence was increased, as caregiver burden was reduced. No significant and direct research has been done in this regard; however the results of this study are indirectly consistent with the results of studies by Salmabadi et al. [10], Sabri Nazarzadeh et al. [12], and Braun-Lewensohn & Sagy [26]. Mikaeili et al. [27] have shown that veterans with post-traumatic stress disorder with the enhanced sense of coherence have higher psychological well-being. Valtonen et al. believe that in general, the enhanced sense of coherence can reduce tension and anxiety, disappointment in difficulties, and depression [28]. Self-efficacy and resilience had the most predictive roles for the caregiver burden compared with other four components of psychological capital, and as the self-efficacy and resilience increased, the caregiver burden was reduced in veterans’ wives. On the other hands, its other two components (optimism and hope) were automatically eliminated from the regression analysis due to lack of prediction and meaningfulness. In general, psychological capital played a major role in explaining the changes in the caregiver burden in veterans’ wives, which is indirectly consistent with the results of other studies. Pictet et al. [15] showed that optimism and positivism can immunize people to deal with difficulties. Li et al. [29] also found that psychological capital plays an important role in stress burden and burnout in different environments. According to the Loprinzi et al. [8] study, people with high psychological hardiness were more resistant to face difficulties and unavoidable stressors. When dealing with stressors and wearers such as being a caregiver of a veteran, individuals evaluate their abilities and characteristics along with other factors such as relatives’ support and other members of their own nuclear or extended families, psychological capital to overcome the difficulties and the necessary backgrounds to be strengthened and immunized [30]. ... [31-34].
Suggestions
Future studies on different Iranian population, different types of veterans, and other members of their families are suggested.
Limitations
This study was only done on the amputee veterans’ wives in Piranshahr, which can be considered as one of the most important limitations of the research.
Conclusions
The sense of coherence and psychological capital reduce caregiver burden in the spouses of amputee veterans.
Acknowledgments
The authors are grateful to the all participant, especially the veteran’s families and wives who helped us in this study
Conflict of interest
None declared.
Ethical Permissions
The essential agreements were made with the Piranshahr Foundation of Martyrs and Martyr's Affairs prior the study and questionnaires were completed without using the subjects’ names and personal details to obtain their consent. In addition, the participants were assured about the confidentiality of information and the subjects were psychologically prepared, as well.
Funding Sources
All sources of funding are provided by the authors.

TABLES and CHARTS

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