Academic journal article Iranian Journal of Public Health

The Effect of Injury-Related Characteristics on Changes in Marital Status after Spinal Cord Injury

Academic journal article Iranian Journal of Public Health

The Effect of Injury-Related Characteristics on Changes in Marital Status after Spinal Cord Injury

Article excerpt


Spinal cord injury (SCI) has a noticeable effect on medical, social, psychological and economic conditions among affected individuals (1, 2). Higher rate of divorce has been demonstrated after SCI (3) which may affect patients' mental health as well. The association between mental health and marital status has already been described (4, 5). However, while some investigations have described the mental health advantages of being married (5) other studies do not support the relationship between marital status and overall wellbeing (6, 7).

Marriage has a positive impact on health because of greater social support in the context of disability (8). Being married among patients with SCI has been reported to be associated with higher life satisfaction and quality of life and better adjustment (9, 10). The estimation divorce rate after SCI has been reported to be 1.5-2.5 times higher than that of the general population (11). However the factors that are associated with divorce rate are poorly categorized. Higher divorce rate occurs mostly in the first three years after SCI (12, 13) which illustrates the effect of post injury duration. Other factors such as gender may affect patients' mental health after marital transitions since it has been demonstrated that dissolution of marriage after SCI may be experiences differently by men and women (14). Previous studies have tried to describe the factors that are associated with divorce after SCI. In this regard, demographic characteristics (including younger age at marriage, being female and lower education) and injury characteristics (indicative of more severe injuries) have been shown to be related to higher divorce rate (3). However social and cultural issues and the conditions that divorced couples should go through after divorce vary among different nations and may affect the probability of divorcing. Because of these cultural differences, the changes on marital status after SCI and its related variables should be evaluated in each nation separately.

In this study, we tried to assess the changes in marital status among Iranian men and females after SCI. Our purpose was to identify the factors that may affect divorce rate and marital longevity. To our knowledge, this is the first study which investigates changes in marital status and its related factors in a sample of Iranian population with disability.

Material and Methods

Study Design and Participants

In this cross-sectional study, data were collected from men and women with traumatic SCI referred to Brain and Spinal Cord Injury Research Center (Tehran, Iran) which is tertiary hospital-based rehabilitation center. Total of 241 patients were recruited. Inclusion criteria were traumatic spinal cord injury and age above 18 years old. Exclusion criteria included coincidental brain injury, nontraumatic SCI, previous history of severe chronic diseases before injury occurrence (cancer, mental disorders, renal failure, liver dysfunction etc.). Those with history of addiction to illegal drugs or alcohol before injury were excluded as well. Procedure of sampling was performed based on patient selection according to inclusion and exclusion criteria. According to previous study (15), the prevalence of SCI is 1.2-11.4 per 10,000 people and by considering the population of Tehran to be 8 million people, the estimated population size of patients with SCI is 970 and the calculated sample size with 5% error will be 275. However, in this investigation, 241 patients could be recruited.

Data were collected by interview from March 2014 to August 2014.

There were some concerns about patients' responsiveness when addressing marital and familial issues. To increase responsiveness, patients were assured about the confidentiality of their information. Informed consent has been obtained from each individual before enrollment. Participation in this investigation was voluntarily. This study was approved by Ethics Committee of Tehran University of Medical Sciences. …

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