Stress among the Wives of Alcoholics

Remya Rajesh Nair^1*, Nisha Biju Ck², Jobimol Jacob², Anubha Ekka², Choice Kwasomoshi² and Sudipta Tirkey^3
*Correspondence: Dr. Remya Rajesh Nair, Department of Psychiatric Nursing, St Johns College Of Nursing, Bangalore, India, Tel: 009743750500, Email:

Keywords

Stress • Perceived stress scale • Psychological problems

Introduction

Alcoholism consumption has been steadily increasing in developing countries like India. Stress is also a common term used today but has become difficult to define. Alcoholism has been labeled as a family disease because its effects lead to dysfunctional roles within their families. Alcoholism is the world’s 3rd largest risk factor in the burden of the family [1]. Alcoholism affects emotionally, physically, socially and psychologically. Spouses feel difficult to manage he married life and thus developing stress. They may experience psychological problems due to their spouse who is alcoholic. The wives experience high level of stress in the family. They also experience stress in rearing children, their education &their future life [2]. Apart from wives disturbed personality model &coping behaviour efforts to understand and explain the emotional experience of wives of alcoholics are still lacking in this field. Women are more emotionally more open than men to the concerns of their loved ones and therefore experience more stress.

Need for the study

The impact of alcoholism in a marriage is profound. This is one of the factors about alcohol addiction that makes it so unique in comparison to other chronic health conditions or disorders. All chronic health issues impact marriage and family relationships, but none in quite the same destructive manner as the same depth as alcoholism [3].

With most conditions, the individual inflicted doesn't engage in behaviours that hurt or destroy their relationship. The non-inflicted spouse usually gives them compassion, sympathy, understanding and support. They stand by their side through it all. They sometimes grow closer together as a result of the lessons learned through the process of illness and healing [4].

However, with alcoholism in the marriage, it is a slightly different story. Many non-alcoholic partners attempt to be loving, compassionate, understanding, etc., with their alcoholic partner initially, but then over time their patience is pushed to the limit as the alcoholic continues to do even more hurtful and damaging things to the marriage.

It is estimated that over half of all adults have had to deal with some form of alcoholism in their lives. In our country, men comprise 40%of the alcohol consumption and studies show that 43% of these alcoholics have had one or more family members who were affected with this disease as well [5]. Alcoholism threatens the stability of marriages and breaks down the foundation of families. Some alcoholics may temporarily hide their addiction for a short while, functioning at a somewhat normal level as they continue to perform their duties and responsibilities in everyday life. However, the addiction will soon overcome the person as their alcohol level increases. His or her behaviour patterns will eventually begin to disclose the severity of the disease. Some marriages will survive, although continued abuse of alcohol consumption often leads to the demise of the marriage and the downfall of the family [6].

It is easier in the beginning for the non-alcoholic partner to be supportive and show compassion with love and understanding. Though, as the disease progresses, the supportive partner can grow impatient and reach his or her limit of patience and forgiveness, just desperately wanting them to stop. The alcoholic will often make empty promises by Satisfying their partner with these broken promises gives them more time so they do not have to deal with the problem. With the continued effects brought on by the alcoholic's behaviour, it becomes increasingly difficult to be tolerant of his or her actions eventually fights worsen, communication is lost, trust is broken, and intimacy is gone [7]. There is no way to have a healthy, functioning relationship with an alcoholic that refuses to seek help for the addiction.

Feeling the unfairness of the situation, the non- alcoholic partner may become resentful of his or her partner due to the actualization of what this has done to their on life [8]. At this point, conflict is almost inevitable as the communication may start to fracture. Soon the marriage may begin to crumble under the pressure as each spouse starts pulling away from each other. This usually leads to the deterioration of emotional and sexual intimacy.The non- alcoholic partner may experience feelings of emptiness and an unsatisfying or unfulfilled relationship [9].

Problem statement

A study to assess the stress among the wives of alcoholics in selected urban areas at Bangalore.

Objectives: To assess the stress among the wives of alcoholics. To find out the association between the stress and demographic variables.

Assumptions: Wives of alcoholics experiences stress. Stress management techniques will help them to reduce stress.

Hypothesis: There will be significant association between the stress of wives of alcoholics and demographic variables at 0.05 levels.

Operational definitions

Stress: In this study stress refers to one’s feelings and thoughts to certain situations as elicited by Perceived Stress Scale (PSS).

Wives: In this study wife refers to a female between the age of 20- 60 years, living with alcoholic partner and do not have any psychiatric disorders.

Alcoholics: In this study alcoholic refers to a male who is consuming alcohol.

Delimitations: The study is limited to wives of alcoholic residing in community

Operational definitions

Stress: In this study stress refers to one’sIdentification of the factors by the nurse can be incorporated into health education and help the wives of alcoholics to cope up with their stress.

Literature Review

A study was done to assess the level of stress among spouse of alcoholic men in Dehradun aim of the study was to assess the stress level among spouse of alcoholic men and to find association between stress level and selected socio demographic variables [10]. The sample size was 50 spouses of alcoholic men in the age group 18-60 years. The sampling technique used was purposive sampling technique. Self-structured tool to assess the stress level was used [11]. The result of the study showed that the wives of alcoholic men is found under stress but the level of stress is differ from age, duration of marriage, drinking habits, religion, education and type of family.

A study was done to assess the stress level among the wives of alcoholics at Kasaracadi. Aim of the study was to assess the stress level among wives of alcoholics and to find dissociation of stress level of wives of alcoholics with demographic variables. The sample size was 100 wives of alcoholics using purposive sampling technique. The stress level assessed was self-structured questionnaire. The result showed that the wives of alcoholics were in severe stress 80% and 10% in moderate stress [12].

A comparative study was done to assess the stress level among wives of alcoholics and non-alcoholics in Kolar. Aim of the study was to assess the level of stress among wives of alcoholics and non-alcoholics and to determine the association between the level of stress and selected demographic variables of the wives of alcoholics. The sample size was 30 wives in alcoholic group and 30 wives in non-alcoholic group. The sampling technique used was convenience sampling. The tool used to assess the stress level, were measured by perceived stress scale. The result showed the stress level of the wives of alcoholics of mean score 29.46 and the mean score of wives of non-alcoholics were 27.53.

A descriptive correlation study was conducted in Melmaruvathur, to assess the level of stress and coping strategies among wives of alcoholics. The study consist of 70 wives of alcoholics by non-probability convenient sampling technique, the data was collected by using perceived stress scale and coping scale to assess stress and coping strategies of wives of alcoholics. The findings revealed that majority (42.86%) had moderate stress (42.86%) had average coping there was a positive correlation between the level of stress and coping strategies among wives of alcoholics. The study concluded that there was a positive correlation between the stress and coping strategies among the wives of alcoholics.

A descriptive study was conducted in NIMHANS to assess the stress, coping strategies and domestic violence in wives of alcohol dependent individual. The study consisted of 75 wives of alcoholics based on personal interview using sociodemographic information schedule, perceived stress scale, coping with drinking questionnaire and domestic violence questionnaire. The findings suggested wives of alcohol dependent patients had high level of perceived stress. Avoidance, discord, fearful withdrawal and sexual withdrawal were the most common coping components, testified. Domestic violence was found to increase the stress which influences the coping style of women.

A study is done by Nagesh VA to assess the stress and level of coping among the wives of alcoholics. A descriptive survey design was used. The sample size was 60 wives of alcoholics admitted in de-addiction centres of Mysore district. The mean wives f alcoholics stress score was 27.38 and median score was 28 with a standard deviation of 2.96147. 100% of the wives of alcoholic were having moderate level of stress. Findings revealed that age had significant association with perceived stress. The significant association was found among type of family, duration of marital life and other substance abuse at 0.05 level with coping.

An exploratory descriptive study to assess the stress, coping strategies and domestic violence in wives of alcohol dependent individuals was conducted. There were 107 couple units of both wives of alcoholics and wives of non-alcoholics. Wives of alcohol dependent patients had high levels of perceived stress. Avoidance, discord, fearful withdrawal and sexual withdrawal were the most common coping components identified. Domestic violence was experienced by 90% women, mostly intellectual (69%), emotional (59%), social (58%), physical (47%), economic (42%) and sexual violence (27%). Domestic violence was found to increase the stress and influences the coping styles of these women.

A study was done to examine the available social support, psychological and physiological health and effect of income on the psycho-physiological health of the wives of dunkers. A total of 99 female respondents were contacted t participate in study. Adapted version of CMIQ (female version) including the dimensions of nervous system genitourinary system, fatigability, frequency of illness, depression, anxiety, anger, social support and stress was used to get relevant information pertaining to the present objectives. The one-way ANOVA results revealed the impact of respondents’ age on several dimensions of psychological and physical health. Age also revealed significant effect on stress. It was also reported that high perceived support, age and income variable were significantly related to various dimensions of psycho-physiological health of the wives of drunkards.

A descriptive cross sectional study was conducted at selected villages of Doiwala block of Dehradun district in Uttarakhand. This study was carried out with the objective to assess the psychological distress of non-drinking female spouses of male drinkers. Structured interview was conducted among conveniently selected 60 non-alcoholic women whose husband consumes alcohol for at least 3-4 days a week and over a period of last two years or more. Standardized stress questionnaire and Gold Bug depression Scale was used. 65% of the women were assessed to have mild to moderate level of depression while 18-30% of them had severe depression. Study revealed that there was alarming level of stress and depression symptoms among non-drinking female spouses of male alcoholics.

A study was designed to measure the marital cognitions of wives whose husband drink alcohol. The objective of the study is to determine whether wives’ marital attributions for marital problems related to husband’s level of drinking and marital attributions for marital problems related to husbands’ level of drinking and marital satisfaction. 30 community wives married to alcohol users completed measures of marital attributions for marital problem areas, marital satisfaction and depression. The result shows that wives’ marital attribution of partner blame and globality were significantly associated with level of drinking even when controlling for depression. Wives’ marital attributions of partner blame, stability and globality were also significantly related to marital satisfaction.

A study was conducted to compare the response of wives of alcoholics to those of wives of non-alcoholics regarding perceived health status and its relationship to perceived stress and family satisfaction. A non-probability sample of 123 English speaking women, married with their mates was received from 2 groups:

• Wives of alcoholics (n=56) who were members of Al-Anon, clients of private therapists, or private hospital and

• Wives of non-alcoholics (n=67) who belongs to verity of women’s groups. Instrument used was perceived health scale, perceived stress scale and FACES III.

Result shows that wives of alcoholics demonstrated significantly lower educational attainment and socioeconomic status than wives of nonalcoholics. Pearson’s correlations found significant relationships between perceived health status and perceived stress for both groups, but perceived health status was significantly related to family satisfaction only for wives of alcoholics. Wives of alcoholics perceived themselves as significantly less healthy, more stressed and less satisfied with their families than did wives of non-alcoholics.

Materials and Methods

Source of data

Data was collected from the wives of alcoholics who were residing at Austin Town and who met the inclusion and exclusion criteria.

Research design

Descriptive design

Setting

The study was conducted in the community area (Austin Town).

Population

Population of the study was the wives of alcoholics in Austin Town.

Methods of data collection

Sampling technique: Purposive sampling was used in this study.

Sample size: The sample size for the study was 50.

Instruments: Section A: Socio-demographic proforma Section B: Perceived Stress Scale

Inclusion criteria: Wives of alcoholic with the age group of 20-60. Married couple living with alcoholic partner with current alcohol problems

Exclusion criteria: Wives of alcoholic above 60 yrs.

Data analysis and interpretation

Presentation of the data

• Section 1: The description of baseline variables of wives of alcoholics.

• Section 2: Assessment of stress of wives of alcoholics

• Section 3: Association of stress and baseline variables

Description of baseline variables of wives of alcoholics

Data in frequency and percentage of baseline variables of wives of alcoholics such as age, duration of marriage and duration of alcohol consumption of their husbands. The data shows that highest percentage (32%) of the samples were in the age group of 30-40 years whereas only 18% of the sample belonged to the age group of 50-60 years. Out of the total samples, maximum (36%) of them had duration of marriage between 10-20 years. Also the duration of alcohol consumption of their husbands was seen highest (34%) within the age group of 10-20 years (Table 1).

Data In Table 1(b) shows frequency and percentage of the baseline variables of wives of alcoholics. Among the total samples, majority (72%) of them had education below SSLC and most of them were unemployed (84%). The data also shows that most of the samples belonged to Hindu religion (58%), were from nuclear family (92%) and majority of them had children between 1-3 (62%). In this study the samples’ family incomes were mostly less than Rs.10, 000 per month (36%) (Table 2), (Figures 1 and 2).

Results and Discussion

Description of subjects interviewed in the study

In the present study the total sample size was 50 wives of alcoholics between the age group of 20-60 years in south road, Austin town the subjects were interviewed personally and stress level was assessed using perceived stress scale (Tables 3 and 4).

 

Description of baseline variables

The subjects in the study constituted of 50 wives of alcoholics. Among the wives of alcoholics the majority 32% belongs to the age group of 30-40 years, 72% had below 10th standard education, 86% are unemployed, 36% having duration of marriage 10-20years, 60% of wives are Hindu, 62% are having 1-3 number of children, 36% are having family income less than Rs. 10000/-, 36% are having duration of alcohol consumption 10-20 years, 92% are from nuclear family.

Description of stress of wives of alcoholics

In this study, the psychological parameters of stress were assessed using perceived stress scale (PSS) which consisted of 10 items. The stress level was categorized into low, moderate and high stress. The study findings revealed that 76% of the samples had moderate stress, 11% had high stress and only 2% of alcoholic wives had low stress whereas a study which was done in Dehradun district in Uttarakhand to assess the psychological distress of non- drinking female spouses of male drinkers revealed that 65% of the women were showed mild to moderate level of depression while 18.3% of them had severe depression, it also showed that there was an alarming level of stress and depression symptoms among non- drinking female spouses of male alcoholics.

Description of association between stress of wives of alcoholics and baseline variables

In this study baseline variables of wives of alcoholics like age, education, occupation, religion, type of family, and duration of alcohol consumption of husbands had no significant association with the level of stress. But the study revealed that duration of marriage of the alcoholic wives had an effect on the stress level (X2=52.9). The study findings also showed that the number of children also has significant association with the stress level (X2=12.33). The study showed that the family income also influences the level of stress (X2=13.76). According to the journal of psychosocial research, as study was done to examine the available social support, psychological and physiological health, and effect of income on the psychophysiological health of the wives of drunkards. The study revealed that there was significant effect on stress and reported that high perceived support age and income variables were significantly related to various dimensions of psycho-physiological health of wives of drunkards.

Conclusion

The study which we have done was to assess the stress among the wives of alcoholics in selected urban areas at Bangalore. The study revealed that wives of alcoholics are suffering from moderate stress and need to provide information regarding stress management and it is very important to note that a high degree of empathetic understanding is needed to help the wives of alcoholics in better coping.

Limitations

Study was limited to 50 number of sample.

Recommendations

• The study can be replicated on a larger sample to validate the findings and make generalization.

• The study can be done as a comparative study among the wives of alcoholics and non-alcoholics.

• The study can be undertaken to analyze the coping strategies among the wives of the alcoholics.

Acknowledgement

All the participants

Conflict of Interest

The authors declare that they have no conflict of interest.

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