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PSYCHO-SOCIAL PROBLEMS AND COPING OF WOMEN WITH ALCOHOLIC SPOUSES IN RURAL MALWA

AREA, DIST. LUDHIANA, PUNJAB – A PILOT STUDY

Prof. Dr. Arindam Kanta Banerjee, MBBS, MS*

*Director, Sadbhavna Centre of Addiction Science & Mental Health Research Ms. Ramneek Kaur, BSc (N)** Ms. Manpreet Kaur, BSC (N)**

** Lecturer, Sadbhavna College of Nursing, Raikot 141109, Ludhiana, Punjab, India

Contact Author

Prof. Dr. Arindam Kanta Banerjee, MBBS, MS

Sadbhavna Centre of Addiction Science & Mental Health Research, Raikot 141109, Dist. Ludhiana, Punjab, India

09878055066, 09316633561, sadbhavnasociety@yahoo.com

Brief Biography of Authors

Dr. AK Banerjee

Qualification MBBS, MS [Surgery]
Vocation Professor, dept. of Surgery, RKDF Medical College & Hospital, Bhopal, MP, India
Total Publications 18
Enterprise Sadbhavna Hospital, Raikot
Sadbhavna Centre of Addiction Science & Mental Health Research
Sadbhavna College of Education for Women, Raikot Sadbhavna College of Management & Technology Sadbhavna College of Nursing
Sadbhavna Publications
Contact No 9878055066, 9316633561, sadbhav nasociety@yahoo.com

Ms. Ramneek Kaur & Ms. Manpreet Kaur

Qualification BSc (Nursing)
Vocation Lecturer, Sadbhavna College of Nursing, Raikot

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PSYCHO-SOCIAL PROBLEMS AND COPING OF WOMEN WITH ALCOHOLIC SPOUSES IN RURAL MALWA AREA, DIST. LUDHIANA, PUNJAB – A PILOT STUDY

ABSTRACT

The present study was conducted to assess the psychosocial problems and coping of women with alcoholic spouse, in village Gahour, 56 km from Raikot city in distt. Ludhiana. The objectives of this study were : 1. To assess the psychosocial problem of women with alcoholic spouse 2. To assess the coping of women with alcoholic spouse 3. To find the relationship between the psychosocial problem and coping of women with alcoholic spouse 4. To find the relationship of psychosocial problems with the selected variables. i.e. age, education, family income per month, occupation, type of family, duration of addiction of spouse, religion, duration of marriage, number of children

5. To find the relationship of coping with selected variables. i.e. age, education, family income per month, occupation, type of family, duration of addiction of spouse, religion, duration of marriage, number of children. The conceptual framework is based on Roy’s adaptation model. An exploratory approach and non experimental research design was used for the study. Purposive sampling technique was used and 60 women with alcoholic husbands were interviewed. The independent variables were age, education, family income per month, occupation, type of family, duration of addiction of spouse, religion, duration of marriage and number of children. The dependent variables were psychosocial problem and coping of women with alcoholic spouse. The study found that majority of women had physiological problems [13.13%] followed by psychological problems [12.79%] and psycho- social problems [7.40%]. While 6.6% women had financial problems, only 3.92% stated to have sexual problems.

71.1% women had adoptive and 28.3% showed mal-adoptive coping. Age, Education, Vocation, Economic status, Family type, religion, Duration of Marriage, Duration of Addiction and number of Children had No Impact on Psycho-Social problems. Among these variables, only age and duration of addiction had impacted coping strategy

of women.

KEY-WORDS

Alcoholism, Alcoholic Spouse, Wife, Psychosocial problems, Coping, Rural Punjab

INTRODUCTION

Alcoholism is defined in dictionary as a disease condition due to excessive use of alcoholic beverages. American psychiatric association listed the following criteria for diagnosis of Alcoholism : Physiological problems (hand tremors and blackouts), Psychological problems, ( an obsessive desire to drink), Behavioral problems that affect work or social life. WHO estimates that there about two billion people worldwide who consume alcohol and 76.3 million with diagnosable alcohol use disorders. Globally alcohol causes 3.2% of all deaths (1.8million deaths). Alcoholism is a disease that gets worse the more the person keeps drinking. Without treatment, it can destroy mental, physical and social health and can lead to death of the alcoholic and devastation in the family.
In a nation where family is the basic unit of the society, health of the nation is measured in terms of the health of its families.
The relationship between an alcohol abuser and his family is complex. Family members report experiencing guilt, shame, anger, fear, grief and isolation due to the presence of an alcoholic in the family. They are often subjected to moderate to severe harassment, conflict, anxiety and tension. The major problems that arise in the family as a result of alcohol abuse of husband include:-
1. Long absence from home.
2. Destruction of household objects in rage.
3. Lack of communication between the alcohol abuser and the other family members.
4. Domestic violence and hostility.

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A comparative study was conducted by Marie Dethier et al (1997) to assess the marital adjustment and self esteem of wives. And the results revealed that the couples with an alcoholic husband had lower marital satisfaction and lower self esteem than the couples with healthy and non alcoholic husband.
The national family survey (2010) results indicate that among the Indian population 17% of men and 2% of women aged 15yrs and above is consuming alcohol. In India, 62.5 million people are alcohol abusers. In the 15-year period from 1976 to 1990, the per caipta consumption has increased by 106.7%. I the last few decards, the mean age of starting alcohol consumption has been declined from 23.6 yrs to 19.45 years.
Statistics regarding the gross sales of alcohol and related substances shows that Punjab stands first in the per capita consumption. i.e. 11.5 liters. In 2008- 09, Rs. 3974.14 crores worth of alcohol was sold. In 2009 – 10, it rose to Rs. 4376.24 crores and during 2010-11, Rs. 4776.80 crores. Punjab total population is 22,77,04,234 and there are approximately 90% alcohol dependent person.

STUDY STATEMENT

An exploratory study to assess the psychosocial problem and coping of women with alcoholic spouse in rural community of village Gahaur, Ludhiana, Punjab

OBJECTIVES

1. To assess the psychosocial problems of women with alcoholic spouse.
2. To assess the coping of women with alcoholic spouse.
3. To find the relationship between the psychosocial problem and coping of women with alcoholic spouse.
4. To find the relationship of psychosocial problems with the selected variables. i.e. age, education, family income per month, occupation, type of family, duration of addiction of spouse, religion, duration of marriage, number of children.
5. To find the relationship of coping with selected variables. i.e. age, education, family income, religion, occupation, type of family, duration of addiction of spouse, religion, duration of marriage, and number of children.

OPERATIONAL DEFINITIONS

1. Psychosocial problems: These are altered behavioral changes which are expressed in form of psychological, psychosocial and the other factors such as the physiological, sexual, support and financial insecurities which contribute to the problems faced by the alcoholic husband.
2. Coping: Refers to the specific adaptive and maladaptive, cognitive or behavioral efforts of wives of alcohol spouse in order to manage the problem resulting from their husband drinking habit.
3. Women: In this study women refers to females who are married with an alcoholic spouse.
4. Alcoholism : It refers a person who indulges in uncontrollable and excessive drinking of alcohol on a daily basis.
5. Lickert’s scale
6. Roy’s coping checklist.
7. Roy’s adaptation model is based on General System Theory as applied to an individual. Sister Callista Roy (1979) developed an adaptation model of nursing. It comprises four domains, person, environment, health and nursing and involves six steps of nursing process. This theory states the person as, “A bio-psychosocial being and recipient of nursing care.” The person is an open adaptive system, who uses the coping skills to deal with psychosocial problems. The study is based on modified conceptual framework of Callista Roy’s adaptation model and the person is the woman whose husband is alcohol dependent. Roy’s states the environment as, “All the conditions, circumstances and influences surrounding and affecting the development of an organism.”It states health as, “the person
encounters adaptation problems in changing environment”. In this study ,the health of person includes

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psychological health, physiological health and sexual health. In this study nursing refers to promotion of adaptations for the individual by providing education.
A women needs medical and nursing interaction such as medical and nursing assessment, effective communication, therapeutic relationship, psychotherapy and marital counseling. Roy states that contextual stimulus is the combination of all stimuli pressed in the situation that contributes to the effect of focal stimuli. In this study contextual stimuli are : age, education, family income, occupation, types of family, duration of marriage, religion, no of children and duration of addiction of spouse.
Roy’s theory states than focal stimuli are internal or external stimuli most immediately confronting the human system. In this study focal stimuli are psychosocial problem. It states that residual stimuli are the environmental factors within or without human systems which affects the current situation that are unclear. In this study residual stimuli are attitudes, beliefs, traits.

ASSUMPTION

Women with alcoholic spouse do have psychosocial problems and they do cope with these problems.

DELIMITATION

60 Women with alcoholic spouse residing in Village Gahaur, dist. Ludhiana, a rural area

SELECTION AND DESCRIPTION OF FIELD OF STUDY

The main study was conducted in Gahour, Ludhiana, Punjab . Approximate population of the village is 4500. The facilities in the village are: one primary health center and one primary school. The status of alcoholism is 40%-60%
of women with alcoholic spouse.

SAMPLE AND SAMPLING TECHNIQUES

The purposive sampling technique was used.
Inclusion Criteria : the study includes women with alcoholic spouse who are willing to participate in the study. Exclusion Criteria : the study excludes women of alcoholic spouse, who do not want to participate or unable to follow the instruction or are busy in household work.

Table-1

PERCENTAGE DISTRIBUTION OF SAMPLE CHARACTERISTICS


Variables N Percentage

d)more than 51 12 20%

Education a)Illitrate

11

18.3%

b)Matric

24

40%

c)Senior secondary

14

23.3%

d)Graduate and above

11

18.3%

Family income per month a)Less than or equal to 5000

8

13.4%

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b)5001 to 10,000 13 21.6%

c)Senior secondary

14

23.3%

d)Graduate and above

1

18.3%

Occupation a)House wife

40

66.8%

b)Self employed

2

3.3%

c)Government job

5

8.3%

d)Private job

13

21.6%

Type of family a)Nuclear

35

58.3%

b)Joint

23

38.4%

c)Extended

2

3.3%

Duration of addiction of spouse

a)Less than 1 year

4

6.6%

b)1year to 2 years

8

13.4%

c)2 years to 3 years

5

8.4%

d)3 years to 4 years

7

11.6%

e)More than 4 years

36

60%

Number of children

a)None

3

5%

b)1

16

26.6%

c)2

30

50%

d)3 and above

11

18.4%

DEVELOPMENT AND DESCRIPTION OF TOOL

The tool was made to assess the psychosocial problem and coping of women with alcoholic spouse. The interview schedule was developed with the help of review of literature, expert opinion, and investigator’s own experience. Kiran Roy modified checklist was used for coping.

PSYCHOSOCIAL PROBLEM

The three point Likerts scale was used to assess the psychosocial problems. The final tool was divided into three parts :-

Psychological problems

Psychosocial problems

Problems contributing to psychological and sociological issues (physiological, financial, sexual problems and support)

RELIABILITY OF TOOL

The reliability of the tool was computed by split half method to check the internal consistency of tool. Reliability of tool psychosocial problem was 0.83 and coping was 0.82.

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OBSERVATION & ANALYSIS

OBJECTIVE-1 : To assess psychosocial problems of women with alcoholic spouse

TABLE-2

MEAN, MEAN PERCENTAGE AND RANK ORDER OF PSYCHOSOCIAL PROBLEMS OF WOMEN

Psychosocial Psychosocial problems score of women with alcoholic spouse


Problems Score mean mean percentage rank order

Psychological problems

20

11.7

12.79

2

Physiological problems

24

12.08

13.13

1

Psychosocial problems

16

6.82

7.40

3

Financial problems

12

6.08

6.60

4

Support

10

3.40

3.69

6

Sexual problems

10

3.62

3.92

5

Total

92

Maximum score=92
Minimum score=0
It is concluded that most of the women had physiological problems due to their alcoholic spouce.

TABLE-3

MEAN AND PERCENTAGE DISTRIBUTION OF WOMEN ACCORDING TO PSYCHOSOCIAL PROBLEMS



Level of psychosocial psychosocial problem score of women with alcoholic spouse


problem score n mean percentage Mild 0-30 5 69 8.3% Moderate 31-62 46 45.39 76.7% Severe 63- 92 9 21.77 15%
Maximum=68
Minimum=0
Hence it is concluded that majority of women had moderate level of psychosocial problems.

OBJECTIVE-2 To assess the coping of women with alcoholic spouse

Table-4

MEAN AND PERCENTAGE DISTRIBUTION OF WOMEN ACCORDING TO LEVEL OF COPING

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Level of coping score of women with alcoholic spouse


Coping Score n percentage Maladaptive 0-34 17 28.3% Adaptive 35-68 43 71.7% Maximum=68
Minimum=0
It is concluded that majority of women used adoptive coping strategy

OBJECTIVE 3- To find the relationship between the psychosocial problem and coping of women

TABLE-5

CORRELATION OF PSYCHOSOCIAL PROBLEMS AND COPING OF WOMEN

N=60

Dependent Mean scores

Variables n mean S.D. r

Psychosocial 60 43.77 13.720

Problems .361(**) Coping 60 38.03 4.780
**significant at p=0.01 level
It is concluded that there is negative correlation between Psycho-Social problems and coping

OBJECTIVE-4 - To find the relationship of psychosocial problem with selected variables that is age, education, family income per month, occupation, type of family, duration if addiction, religion, duration of marriage and number

of child.
It is concluded that age of wife, educational status, family Income, occupation, family type, duration of addiction of spouse, religion, duration of marriage or number of children have NO impact on psycho-social problems of women.

TABLE-6

MEAN PSYCHOSOCIAL SCORE PROBLEM OF WOMEN ACCORDING TO AGE.

N=60

Mean score of psychosocial problems of women with alcoholic spouse


Age(year) n mean S.D. df f
18-28 10 39.70 10.023
3

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29-39 21 40.67 13.955 1.447NS
56
40-50 17 48.47 11.891
≥51 12 45.92 17.181

Maximum=92 NS=non significant at p=0.05 level
Minimum=0

TABLE -7

MEAN SCORE OF PSYCHOSOCIAL PROBLEM OF WOMEN ACCORDING TO EDUCATION.

N=60

Education Mean score of psychosocial problem of women with alcoholic spouse

n mean S.D. df f

Illiterate 11 52.18 16.296
3
Matric 24 41.63 13.81 1.760NS
56
Sen. Secondary 14 42.21 7.81
Graduate and above 11 42.00 15

Maximum=92 NS=Non significant at p=0.05 level
Minimum=0

TABLE-8

MEAN SCORE OF PSYCHOSOCIAL PROBLEM OF WOMEN TO FAMILY INCOME

N=60

Family mean score of psychosocial problem of women with alcoholic spouse

Per month n mean S.D. df f

≤5000 8 54.50 15.97
3
5001-10000 13 42.92 14.33 2.226NS
56
10001-15000 15 39.73 11.54

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More than 15000 24 43.17 12.86

Maximum =92 NS= Non significant at p=0.05 level
Minimum=0

TABLE- 9

MEAN SCORE OF PSYCHOSOCIAL PROBLEM OF WOMEN ACCORDING TO OCCUPATION

N=60

Mean score of psychosocial problem of women
Occupation n mean S.D. df f

House wife 40 44.40 14.047
3
Self employed 2 58 18.385 1.261NS
56
Govt-job 5 36.60 15.093
Private job 13 42.38 11.027

Maximum=92 NS=Non significant at p=0.05 level
Minimum=0

TABLE -10

MEAN SCORE OF PSYCHOSOCIAL PROBLEMS OF WOMEN ACCORDING TO FAMILY TYPE

N=60

Family type Mean score of psychosocial problem of women with alcoholic spouse

n mean S.D. df f


Nuclear 35 41.4 13.047
2
Joint 23 46.74 14.095 2.060NS
57
Extended 2 56 14.142

Maximum=92 NS=Non significant at p=0.05 level
Minimum=0

TABLE=11

MEAN SCORE OF PSYCHOSOCIAL PROBLEM OF WOMEN WITH DURATION OF ADDICTION.



N=60

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Duration of mean score of women with psychosocial problems

addiction n mean S.D. df f

Less than 1 year 4 38 12.57
4
1-2 year 8 39.75 16.75
.807NS
2-3 year 5 41 5.38
55
3-4 year 7 40.43 16.34
More than 4 year 36 46.33 13.45

Maximum=92 NS=Non significant at p=0.05 level
Minimum=0

TABLE=12

MEAN SCORE OF PSYCHOSOCIAL PROBLEM OF WOMEN ACCORDING TO RELIGION.


N=60
Mean score of psychosocial problem of women

Religion n mean S.D. df f

Sikhism 48 43.08 14.311 1

0.591NS Hinduism 12 46.50 11.156 58
Maximum=92 NS=Non significant at p=0.05 level
Minimum=0

TABLE 13

MEAN SCORE OF PSYCHOSOCIAL PROBLEM OF WOMEN ACCORDING TO DURATION OF MARRIAGE.

N=60

Duration of mean score of psychosocial problem of women with alcoholic spouse

Marriage n mean S.D. df f

≤ 1 year 2 34 16.971
3
1 + to 2 year 3 41 5.196

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NS
2+ to 3 year 10 36.70 15.840
0.199
56
3+ to 4 year 6 51.33 9.750
≥ 4 year 39 45.13 13.477

Maximum=92 NS=Non significant at p=0.05 level
Minimum=0

TABLE 14

Mean Score Of Psychosocial Problem Of Women According To Number Of Children

N=60



Number of mean score of psychosocial problem of women According to number of children children n mean S.D. df f none 3 35.67 12.66
3
1 16 38.63 12.61 2.129NS
56
2 30 45.90 14.30
3 and above 11 50.36 11.52

Maximum =92 NS=Non significant at p =0.05 level
Minimum=0

TABLE- 15

MEAN SCORE OF COPING OF WOMEN ACCORDING TO FAMILY INCOME PER MONTH.



Family Mean score coping of women with alcoholic spouse
Income n mean S.D. df f

≤5000 8 36.37 3.536
3
5001-10000 13 38.77 3.700 .296NS
10001-15000 15 37.87 4.969
N=60

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56
More than 15000 24 38.17 5.631

Maximum = 68 NS=Non significant at p =0.05 level
Minimum=0

TABLE 16

MEAN SCORE OF COPING OF WOMEN ACCORDING TO DURATION OF ADDICTION.


N=60
Duration mean score of coping of women with alcoholic spouse

Of
Addiction n mean S.D. df f

Less than 1 yr 4 42.00 4.899
4
1 to 2 yr. 8 40.88 4.643
2 to 3 yr 5 42.00 4.301 3.698s
3 to 4 yr. 7 36.57 3.409
55
More than 4 yr. 36 36.69 4.458

Maximum=68 NS=Non Significant at p=0.05 level
Minimum=0
It is concluded that duration of addiction of spouse has impact on the coping used by their women.

TABLE 17

MEAN SCORE OF COPING OF WOMEN ACCORDING TO RELIGION


N=60

RELIGION Mean score of coping of women with alcoholic spouse
N mean S.d df f
Sikhism 48 38.44 4.762 1
1.737NS
Hinduism 12 36.42 4.699 58


Maximum=68 NS=Non Significant at p= 0.05 level
Minimum=0

Table 18

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MEAN SCORE OF WOMEN ACCORDING TO DURATION OF MARRIAGE

N=60

Duration of Mean score of coping of women with alcoholic spouse

marriage

n

mean

S.D.

df

f

≤ 1 year

2

43.50

6.364


1-2 year 3 41.67 4.726
4
2-3 year 10 39.40 4.300 1.853NS
3-4 year 6 38.67 5.354
55
More than 4 year 39 37.03 4.568

Maximum=68 NS= Non significant at p =0.05 level
Minimum=0

TABLE 19

MEAN SCORE OF COPING OF WOMEN ACCORDING TO NUMBER OF CHILDREN.



Number mean score of coping
Of children n mean S.D. df f

None 3 44.33 5.508
3
One 16 38.69 4.270
2.296NS Two 30 37.40 4.896
56
3 and above 11 37.09 4.184

Maximum=68 NS=Non significant at p=0.05 level
Minimum=0
It is concluded that age of women and duration of addiction of husbands have impacted their coping strategy. However, educational status, family income, occupation, family type, religion, duration of marriage and number of children have NO impact of coping strategy.

CONCLUSION

Observation and analysis of data obtained from 60 women with alcoholic spouses from rural community of Malwa area, dist. Ludhiana of Punjab exhibits that :

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35% of women belong to 29-39 yrs age group

40% are educated upto Matric

40% have family income more than 15000/- per month

66.8% are housewives

58.3% have nuclear family

60% have a duration of addiction of spouse of more than 4 years

80% belong to Sikh religion

65.4% women have a duration of marriage more than 4 years

50% have 2 children

13.13% of Women have physiological problem due to their alcoholic spouse

12.79% of women have moderate level of psychological problem

71.1% of women used adoptive coping

There is negative correlation between psychological problem and coping of women with alcoholic spouse.

Age, Education, Vocation, Economic status, Family type, religion, Duration of Marriage, Duration of Addiction and number of Children had No Impact on Psycho-Social problems. Among these variables, only age and duration of addiction had impacted coping strategy of women.

RECOMMENDATION

The study should be replicated to larger sample to validate and generalize its finding. A comparative study can be conducted to assess the psychosocial problems and coping strategies of women with alcoholic spouse in rural area and urban area. A non experimental study can also be conducted to compare the psychosocial problems and
coping strategies of women with alcoholic spouse with non alcoholic spouse.

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