Developing a Structural Model of Women's Marital Satisfaction Based on Positive Attitudes Toward Extramarital Relationships and Health Literacy in Their Diabetic Spouses Through Sexual Satisfaction Mediation

Chronic diseases such as diabetes can lead to marital incompatibility and affect family health. The purpose of this study was to develop a structural model of womenchr('39')s marital satisfaction based on positive attitudes toward extramarital relationships and health literacy in their diabetic spouses through sexual satisfaction.

The present study is descriptive-correlation. The statistical population of this study includes all couples with husbands with type 1 and 2 diabetes who lived in Ahvaz and were registered in the Diabetes Association of Khuzestan province until 2020, whose total population is 2000 people. According to the inclusion criteria, 330 patients and their spouses were selected as a sample based on the Krejcie & Morgan table by simple random sampling using a random number table. Finally, 285 couples were willing to cooperate and completed the questionnaires. In order to collected data demographic questionnaire, the “ENRICH Couple Scale”, the “Attitudes Toward Infidelity Scale”, the “Health Literacy for Iranian Adults”, and the “Sexual Satisfaction Questionnaire”, were used. The validity and reliability of the instruments have been confirmed in previous studies. Data analysis was performed by using SPSS.24 and Amos.23. 

The proposed model had a good fit. There is a significant relationship between men positive attitudes toward extramarital relationships with women marital satisfaction (P<0.01), between men positive attitudes toward extramarital relationships with women sexual satisfaction (P<0.01), between men health literacy with women sexual satisfaction (P<0.01), between women sexual satisfaction with women marital satisfaction (P<0.01), but there was significant relationship between health literacy with marital satisfaction (P>0.05). Also indirect pathways are significant positive attitudes toward extramarital relationships with marital satisfaction with mediating role of sexual satisfaction (P<0.01), health Literacy with marital satisfaction with mediating role of sexual satisfaction (P<0.01). 

The proposed model had a good fit and is an important step in understanding the factors related to marital satisfaction of women with spouses with diabetes. It is suggested that in the treatment of marital problems of patients with diabetes, the role of positive attitude variables in extramarital relationships and health literacy mediated by sexual satisfaction in predicting marital satisfaction should be considered.