Mediating role of psychological distress and domestic violence in the association of fear of COVID-19 with marital satisfaction and sexual quality of life among women of reproductive age: an Iranian cross-sectional study

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Alimoradi, Z, Bahrami, N, Khodaparast, S, Griffiths, MD ORCID: https://orcid.org/0000-0001-8880-6524 and Pakpour, AH, 2023. Mediating role of psychological distress and domestic violence in the association of fear of COVID-19 with marital satisfaction and sexual quality of life among women of reproductive age: an Iranian cross-sectional study. BMJ Open, 13 (2): e068916. ISSN 2044-6055

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Official URL: https://doi.org/10.1136/bmjopen-2022-068916

Abstract

Objectives: This study aimed to determine the mediating role of psychological distress and domestic violence in the association of fear of COVID-19 with marital satisfaction and sexual quality of life (QoL) among Iranian women of reproductive age.

Methods: A cross-sectional study comprising 324 married women was conducted. Online convenience sampling was used to collect data. SPSS PROCESS macro was used for the mediation analysis. The direct and indirect effects of the fear of COVID-19 on sexual QoL and marital satisfaction were estimated comprising a 95% CI using 5000 bootstrap samples. Pairwise comparisons between the mediators were calculated by Hayes’ macros.

Results: A positive/negative or suspected history of COVID-19 infection had marginally significant relationship with marital satisfaction (p=0.049). The total effect of fear of COVID-19 on sexual QoL was significant (b=−1.31, SE=0.20, p<0.001). Fear of COVID-19 had no significant direct effect on sexual QoL (b=−0.22, SE=0.19, p=0.24) but it had an indirect effect on sexual QoL via mediation of psychological distress (b=−0.34, SE=0.09, 95% CI: −0.53 to −0.19) and domestic violence (b=−0.75, SE=0.18, 95% CI: −1.12 to −0.40). The total effect of fear of COVID-19 on marital satisfaction was significant (b=−1.91, SE=0.32, p<0.001). Fear of COVID-19 had no significant direct effect (b=0.20, SE=0.25, p=0.42) on marital satisfaction but it had an indirect effect on marital satisfaction via mediation of psychological distress (b=−0.59, SE=0.13, 95% CI: −0.86 to −0.36) and domestic violence (b=−1.51, SE=0.29, 95% CI: −2.08 to −0.92).

Conclusion: The fear of COVID-19 during the pandemic indirectly decreased women’s marital satisfaction and sexual QoL via increased psychological distress and domestic violence. Consequently, in critical situations such as the COVID-19 pandemic, improving couples’ psychological health and reducing domestic violence are likely to improve women’s sexual QoL and marital satisfaction.

Item Type:	Journal article
Publication Title:	BMJ Open
Creators:	Alimoradi, Z., Bahrami, N., Khodaparast, S., Griffiths, M.D. and Pakpour, A.H.
Publisher:	BMJ
Date:	February 2023
Volume:	13
Number:	2
ISSN:	2044-6055
Identifiers:	Number Type 10.1136/bmjopen-2022-068916 DOI 1730011 Other
Rights:	© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
Divisions:	Schools > School of Social Sciences
Record created by:	Laura Ward
Date Added:	13 Feb 2023 16:24
Last Modified:	13 Feb 2023 16:24
URI:	https://irep.ntu.ac.uk/id/eprint/48272