Comparing the mental health of
housewives and day shift working women in Yazd County,
Iran, 2010
Kholasezadeh Gh, MD
1*, Vaseghi H 2, Ahmadi
N, MSc 3, Abedinzadeh M, MD 4
1- Assistant Prof., Dept. of Psychiatry, Yazd Shahid Sadoughi University of Medical
Sciences, Yazd, Iran. 2. Medical student, Tehran university of medical
sciences, Tehran, Iran. 3- Msc
Clinical Psychology., Clinical Psychologist of Counseling Center of Imam
Hussain, Yazd,
Iran. 4. Assistant Prof., Dept. of
urology,
Moradi hospital, Rafsanjan University of Medical Sciences,
Rafsanjan, Iran
Abstract
Received: August 2011, Accepted: November
2011
Background: There are studies reporting the
adverse effects of working outside the house on women’s mental health. As the
mental health is affected by the structure and culture of each society, this
study was conducted to compare the mental health of housewives and working
woman in Yazd county, Iran (2010). Materials
and Methods:
This cross-sectional study was done in Yazd county in 2010. Three hundred
women were studied in two groups; group 1 consisted of 150 housewives and group 2 included 150 working women. The symptom
checklist 90 (SCL-90) questionnaire was utilized for testing their mental
health. SPSS-15 was used for analyzing
the data. Results: The results indicated that
working women had better mental health than housewives (p= 0.0001). Moreover
among the working women, the medical group had better mental health than the
other groups (p= 0.006). There was no significant relationship between SCL-90
score and the number of children and also working history of women. But,
there was a significant relationship between mental health of working women
and their husbands´ satisfaction of their jobs (p=0.002). Conclusion:
Findings of
this study showed that working women have better mental health than
housewives. Also a significant association was found between the type of job
and working women’s mental health. |
Key words: Mental Health, Working Women, Housewives
Introduction
According to
sexual division of labor in family, men are considered as the breadwinners,
whereas women should be responsible for houseworks. Traditional roles of women
have changed, to some extent, by beginning of the industrial revolution, so
they spend most of their time doing outdoor activities instead of doing just
houseworks [1]. Because of the valuable role of women in inter-familial
affairs, job stressors have adverse effects on them and other family members
and would reduce their quality of life [2]. Numerous researches all over the world
show that there is always a role conflict between women’s indoor and[*]outdoor
activities and facing these problems is considered as a risk factor for their
mental health. Recognition of these conflicts in order to reduce the problems
induced by them shows the importance of this kind of researches [1]. Mental
health is not just limited to description of causes of mental disorders; its
main purpose is preventing occurrence of disturbances by creating factors which
supplement healthy and normal life and also treating minute behavioral
disorders in order to prevent severe mental disorders [3].
In a research,
maternal and marital roles were shown to be natural and stress-free roles,
whereas job was shown as an unnatural role with a lot of adverse effects on
women [4]. In 1992, the United Nations reported occupational stress as the
illness of 20th century and after that world health organization
reported it as an epidemic problem in the world [5]. Also, in a study done by Kawakami in 1999 occupational stressors were
reported to be the strongest cause of psychological damages especially
depression [6]. Some systematic researches reported that working women are
healthier (physiologically or psychologically) than housewives [7-13], but in
some other studies no significant
statistical differences in satisfaction with marriage and family life or
anxiety level between working and nonworking women was found [14,15]. It was
shown in Spain in 2004 that unemployment is related to low level of mental
health. According to Thomas research, men and women’s job loss is related to
their poor mental health and getting a job is directly related to mental health
improvement [16].
Results of some
studies reported a significant relation between the
type of work and mental health. They also reported that having a decent
job and doing it correctly causes an increase in self-confidence and would
improve mental health [17, 18]. There are also beliefs based on this issue that
women’s jobs have negative effects on their maternal, marital and child caring
roles [4,19], but there was no psychological or physiological differences
between employed and unemployed women’s children in Rosenfeld study [7]. The
frequency of mental disorders in Iran is reported to be 21% [20]. The study of
society’s mental health is valuable for educational, treatment and prevention
programs. Most of the women with psychiatric problems such as depression,
anxiety, sleep disorders, etc referred to researchers’ psychiatry clinics were
housewives, and the prevalence of different types of psychiatric disorders
among Yazdian women was reported to be 25% through
Mohammadi's study [21]. Because of these reasons, inconsistent results in this
context, the important role of women in the mental health of family, the effect
of culture on psychiatric problems and lack of such studies, this study was
done to survey the differences between mental health of working women and
housewives of Yazd county in 2010.
Materials and
Methods
This is a cross
sectional descriptive study which was done in Yazd county in 2010. Three
hundred women were studied in two groups; group1 was composed of 150 housewives
and group 2 consisted of 150 working women. Considering the significance level
of 5% and 90% potency of the test and for attaining a minimum significant
difference of 20% in mental health of women in the two groups sample size of
150 was calculated using the formula below:
The inclusion
criteria included: 1) working women’s minimal working period to be at least 6
months and housewives minimal marriage period to be at least 1 year. 2) age of respondents
be between 20-50 years. 3) All of the workers be employed and working during
daytime shifts.
Exclusion criteria
included: 1) women who had faced stressful situations during the last 3 months like the death of a family members. 2) All of the
single employees, employees who were studying, women who were out of age range
and those who had a history of psychiatric disorders. 3) Housewives who had
another work apart from their house works and taking care of children. In order
to include 150 housewives, we selected 6 health centers of Yazd county through
cluster sampling method from the list of Yazd county health centers (Safaiieh,
Maskan va shahr sazi, Shahedieh, Azadshahr and Fahadan were the chosen health
centers). The researchers reffered to each center and selected 30 women
randomly among the housewives who had referred to the center in order to
vaccinate their children, for periodic checkup or health education.
Respondents were
divided into three groups based on their jobs. Group 1: Physicians and nurses
who were employed in Hospitals of Yazd
county from 3 hospitals which were selected through cluster sampling
method from the list of Yazd county hospitals (Hospitals: Rahnamoon, Shahid
Sadooghi and Mortaz). Group2: Teachers who worked in Yazd county elementary,
middle and high schools from 3 schools which were selected through cluster
sampling method from the list of Yazd county schools. Group 3: Employees of
Yazd county offices from 3 offices which were selected through cluster sampling
method from the list of Yazd county offices (agriculture, transportation and
health center offices were selected). Researchers reffered to these places and
randomly selected 50 workers for each group. After communicating with them,
explaining the importance of mental health, explaining the questionnaire itself
for them and asking about some data
that were needed (like their educational level, number of children and working
history) a symptom checklist 90 (SCL-90) questionnaire was given to each
person. SCL-90 is a psychological self-report inventory. The 90 items in the
questionnaire are scored on a five-point Likert scale, indicating the rate of
occurrence of the symptom during the time reference. SCL-90 has been proved to
be an adequate psychiatric research instrument [22]. The test measures 9
primary symptoms dimensions and each symptom include 6-12 questions and the
average score for questions of each 9 domains is computed. The average score of
SCL-90 test could be between 0-4; mental health level will decrease by the
increase in test score [22, 23].
In this study,
samples with 0-1 average score which was considered mentally healthier were
compared with samples with more than 1 average scores statistically. We asked
about working women spouses´ satisfaction of their working with an extra
question at the end of the questionnaire. Then we collected the data and
analyzed them with SPSS-15 by using chi-square test.
Table 1:
Comparing mental health of housewives and working women
job |
Mental health mean score* |
total |
||||
0 - 1 |
1 < |
|||||
No |
Percent |
No |
Percent |
No |
Percent |
|
Housewife |
63 |
42 |
87 |
58 |
150 |
100 |
Working women |
104 |
69.3 |
46 |
30.7 |
150 |
100 |
Total |
167 |
55.7 |
133 |
44.3 |
300 |
100 |
Chi-square =
22.7, df (degree of freedom) = 1,
p-value = 0.0001
* -Mental health
mean score less than 1 shows a better situation.
Results
In this research,
300 married women were studied in 2 groups (group 1: 150 housewives, group2:
150 employees). According to table 1 working women
had better mental health compared with the housewives. Considering the
educational level of samples, there was a significant association between
mental health and the educational level of housewives (p-value = 0.004).
But in
the working group there was not any significant association. There was a
significant association between mental health and the type of job. In this
regard, the medical group had better mental health among the working women.
Table 2: Comparing mental health of respondents based
on the type of their job.
Job |
||||||||
Test score |
Medical group |
Teacher |
employee |
total |
||||
No. |
Percent |
No. |
Percent |
No. |
Percent |
No. |
Percent |
|
0 - 1 |
43 |
41.3 |
32 |
30.8 |
29 |
27.9 |
104 |
100 |
1 < |
7 |
15.2 |
18 |
39.1 |
21 |
45.7 |
46 |
100 |
Total |
50 |
100 |
50 |
100 |
50 |
100 |
150 |
100 |
Chi-square =
10.22 df = 2 p-value = 0.006
Table3: Comparing health parameters between
housewives and workers
Studied criteria |
Studied group |
Mental health mean score |
p-value |
df |
Chi-square |
|||
0-1 |
1 < |
|||||||
No. |
Percent |
No. |
Percent |
|||||
Hostility |
Housewives |
80 |
53.3 |
70 |
46.7 |
0.00001 |
1 |
14.81 |
workers |
112 |
74.7 |
38 |
25.3 |
|
|
||
Anxiety |
Housewives |
72 |
48 |
78 |
52 |
0.0001 |
1 |
24.9 |
workers |
114 |
76 |
36 |
24 |
||||
Depression |
Housewives |
58 |
38.7 |
92 |
61.3 |
0.0003 |
1 |
12.82 |
workers |
89 |
59.3 |
61 |
40.7 |
||||
Interpersonal sensitivity |
Housewives |
63 |
42 |
87 |
58 |
0.0005 |
1 |
12.01 |
workers |
93 |
62 |
57 |
38 |
||||
Obsessive–compulsive |
Housewives |
38 |
25.3 |
112 |
74.7 |
0.00004 |
1 |
16.59 |
workers |
72 |
48 |
78 |
52 |
||||
Psychoticism |
Housewives |
117 |
78 |
33 |
22 |
0.004 |
1 |
8.04 |
workers |
135 |
90 |
15 |
10 |
||||
Paranoid ideation |
Housewives |
53 |
35.3 |
97 |
64.7 |
0.0005 |
1 |
16.4 |
workers |
88 |
58.7 |
62 |
41.3 |
||||
Somatization |
Housewives |
55 |
37.5 |
95 |
63.3 |
0.0001 |
1 |
25.8 |
workers |
99 |
66 |
51 |
34 |
||||
Phobic anxiety |
Housewives |
114 |
76.5 |
35 |
23.5 |
0.009 |
1 |
6.8 |
workers |
132 |
88 |
18 |
12 |
There was no
significant association between SCL-90 score and number of children and also
occupational history. After analyzing the data with chi-square test there was a
significant difference between housewives and working women in all of the
health parameters. For 64 (61.5%) working women husband´s support was reported. This group of working women
had better mental health than those who did not have this support.
Table 4: Association between mental
health of working women and their husband satisfaction
Satisfaction |
||||||||||
Test Score |
Quite |
Somewhat |
Very low |
Any |
Total |
|||||
NO |
P |
NO |
P |
NO |
P |
NO |
P |
NO |
P |
|
0 - 1 |
64 |
61.5 |
34 |
34.6 |
2 |
1.9 |
2 |
1.9 |
104 |
100 |
1 < |
21 |
45.7 |
18 |
39.1 |
4 |
8.7 |
3 |
6.5 |
46 |
100 |
Total |
85 |
56.7 |
54 |
36 |
6 |
4 |
5 |
3.3 |
150 |
100 |
Chi-square = 7.4 df = 3 P-value = 0.002
Chi-square test showed
a significant association between mental health of working women and their
husbands´ satisfaction (p-value = 0.002)
Discussion
Mental health of
women has an essential role in the society and the family, so it should be
placed on the top of the health programs. Therefore in order to check the effective
factors on mental health of women this study was performed. According to other
studies, different theories about positive or negative effects of occupation on
mental health of women have been made [4,7,11,16,17]. In this study,
housewives’ SCL-90 scores were significantly more than working women. In other
words, working women were mentally healthier than housewives. This result is in
consistency with some other studies [7, 11, 17], but does not agree with studies that demonstrate adverse effects of
occupation [4, 16]. The increase in social contact and social support on the
job may reduce the risk of illnesses and psychiatric disorders among working
women, in fact their higher confidence (due to the financial factors) could be
the reason for this fact. Moreover, Waldron found
that housewives reported more chronic illnesses than employed women and were
more likely to rate their health as poor or fair compared to the employed women
[17]. Although there are many working stressors for women in the society,
working women were mentally healthier according to the results of our study and
these stressors did not have a significant effect on their mental health. It
might be explained by the fact that through the revolution in the culture and
women’s tendency to work outside the house, unemployment is a greater stress
itself than working stressors. Furthermore, housewives are at home most of the
time and do repetitious works that could increase the feeling of uselessness
about them.
In this study, the
association between the type of job and mental health was also studied.
According to the results, test scores of employees were the highest and physicians
and nurses’ had the lowest scores. Therefore among the employed women physicians
and nurses had better mental health. Although nurses and Physicians face more
risk factors due to their higher working hours and severe working stressors,
through results of this study, they were shown to be mentally healthier. Maybe
it could be explained by their work satisfaction, high occupational level, and
social role of them in the society or may be as they work for the people´s
health and lives they are more satisfied with their jobs. In a study about work
stresses of Ahvazian women, more work dissatisfaction was seen between the laborers.
the study mentioned high social status as a factor which could reduce stress [24].
Furthermore, the adverse effects of work load on
women´s health were found in another study [25].
As
working women have social roles in addition to their role as mothers or wives,
they usually have problems with their husbands. Therefore, the relation between
husband´s satisfaction and their mental health was studied. According to the
results, test scores of women whose husbands were dissatisfied with their job
test score were the highest and in women whose husbands were satisfied with
their jobs were the lowest. In other words, working women´s mental health is in
direct positive association with husbands’ satisfaction. It could be hypothesized
that husbands’ satisfaction could increase their cooperation in family and
houseworks, therefore, it would reduce women’s family role stressors [1]. This
stress reduction could be an effective factor in improving their mental health.
Having a family increases the women’s responsibilities and problems, but as
they face individual or social problems often husbands and sometimes children
protect them mentally and emotionally which has an important role in reducing
their stress and depression. According to the results of this study, there was
no significant association between mental health and the number of children.
Studies conducted by Ahmadnia and Lam also showed the same results [9, 26]. In
this study, the relations between samples´ level of education and mental health
was also studied. Results showed that test scores of uneducated housewives were
the highest, but among housewives with bachelor’s degree and higher educational
levels these scores were the lowest. In other words, by increasing educational
level of housewives, their mental health would also increase. Test scores of
under high school diploma employed women were the highest, while that of women
with doctorate levels were the lowest. But there was no significant association
between mental health of working women and their educational level. It shows
the essential effect of working on mental health of women. Ahmadnia also
demonstrated the same results in his research [9].
Finally, each of
the parameters of mental health test rate between housewives was significantly
higher than the working women. Between the health parameters, the rate of obsession
and compulsion in both housewives and employed groups was more than the other
parameters. In the study, we did not measure the effect of culture on the
difference between mental health of housewives and working women. This factor
could be measured in future studies. Also, some studies could be conducted in
order to determine factors which cause better mental health in working women
than housewives.
Conclusion
Findings of this
study showed that working women have better mental health than housewives, and
between working women medical group had better mental health than both teachers
and employees groups. Furthermore, there was a significant association between
mental health of working women and their husband´s satisfaction. But, according
to the results, no significant association between mental health of working
women and the number of their children and also working history was found.
Acknowledgment:
We would like to
thank Dr Kobra Abedinzadeh, Firoozgar Clinical Research Development Center
(FCRDC), Dr Seyed-Mohammad Fereshtehnejad Dr Mohammad Aboohoseini Tabari, Dr
hoseyn phalah zade and Dr hamidreza gafaryeh which
helped us with this research.
Conflict of
interest: Non
declared
References
1.
Maghsoudi S,
Bostan Z. Study of the problems caused by concurrency of domestic and social
roles of employed women in Kerman city. Study of women magazine 2004;
5(2):129-150. (Persian).
2.
Souri H, Saadabad
AR. Occupational stresses in women. Hakim magazine 2004; 6(1):65-72. (Persian).
3.
Shamlou S (2009).
Mental health. 1nd ed. Tehran: Roshd. P18.
4.
Barnett RC. Women
and multiple roles: myths or reality. Harv Rev Psychiatry 2004; 12(3):158-64.
5.
Tangri RP
(2003). What
Stress Costs. Halifax: Chrysalis Performance Strategies Inc.
6.
Kawakami N,
Haratani T.
Epidemiology of job stress and health in Japan: review of current evidence and
future direction. Ind Health 1999; 37(2):174-86.
7.
Rosenfeld JA.
Maternal work outside the home and its effect on women and their families. J Am Med
Womens Assoc 1992; 47(2):47-53.
8.
Artazcoze L,
Borell C, Cortes I, Benach J, Imma C. Women family demands and health: A study
of employed women in Sweden. Scand J Public Health 2008; 36(1):7-21.
9.
Ahmad- Nia S.
Women´s work and health in Iran: a comparison of working and non-working
mothers. Soc Sci Med 2002; 54(5):753-65.
10.
Melchior M, Caspi
A, Milne BJ, Danese A,
Poulton R,
Moffitt TE.
Work stress Precipitates depression and anxiety in young, working women and
men. Psychol Med 2007; 37(8):1119-29.
11.
La Rosa JH.
Women, work, and health: employment as a risk factor for coronary heart
disease. Am
J Obstet Gynecol
1988; 158(6 pt 2):1597-602.
12.
Herman H. long-
term outcome and rehabilitation. Curr Opin Psychiatry 1998; 11:175-182.
13.
Devries MW,
Wilkerson B. Stress, work and mental health: A global perspective. Acta
Neuropsychiatrica 2003; 15(1):44.
14.
Park C.
Sex-role attitudes and employment status as predictors of perceived life
satisfaction among married women in Korea. Korea J Popul Dev 1991;
20(1):23-45.
15.
Mukhopadhyay
S, Dewanji A,
Majumder PP.
Working status and anxiety levels of urban educated women in Calcutta. Int J Soc Psychiatry
1993; 39(3):200-7.
16.
Thomas C,
Benzeval M, Stansfeld SA. Employment transitions and mental health: an analysis
from the British household panel survey. J Epidemiol Community Health. 2005; 59(3):243-9.
17.
Waldron I.
Employment and women's health: an analysis of causal relationships. Int J Health
Serv 1980; 10(3):435-54.
18.
Lotf Abadi H.
charecteretics of youths and their occupational identity. Occupation and
society magazine 2002; 47:27. [Persian].
19.
Staland- Nyman C,
Alexanderson K, Hensing G. Associations between strain in domestic work and
self-rated health: a study of employed women in Sweden. Scand J Public Health
2008; 36(1):7-21.
20.
Artazcoz L,
Benach J, Borrell C, Cortes I. Unemployment and mental health: understanding
the interactions among gender, family roles, and social class. Am J Public
Health 2004; 94(1):82-8.
21.
Mohammadi MR,
Bagheri Yazdi SA, Rahgozar M, et al. Epidemiology of psychiatric disorders in
Yazd county in 2001. Yazd Shahi Sadooghi university of medical sciences
magazine 2003; 11(3):28-37. [Persian].
22.
Holi M.
Assessment of psychiatric symptoms using the SCL-90. Unpublished Science,
Medical Faculty, Helsinki 2003.
23.
Derogatis LR,
Rickels K, Roch AF. The SCL-90 and the MMPI: a step in the validation of a new
selfreport scale. Br J Psychiatry 1976; 128:280-9.
24.
Souri H, Hatami
Saadabad AR. Occupational stress in employed women in Ahvaz. Hakim
magazine 2003; 6(1):27-44. [Persian].
25.
Gjerdingen D,
McGovern P,
Bekker M,
Lundberg U, Willemsen T. Women's work roles and their impact on health,
well-being, and career: comparisons between the United States, Sweden, and The
Netherlands. Women Health. 2000; 31(4):1-20.
26.
Lam LT.
Aggression exposure and mental health among nurses. Australian Journal for the
advancement of mental health 2002; 1(2):1-12.
[*]
corresponding author: Gholrasteh
Kholasezadeh, Dept. of Psychiatry, Yazd Shahid Sadoughi University of Medical
Sciences, Yazd, Iran.
Email:
fa.net87@yahoo.com