The Effect of Husbands' Education Regarding Menopausal Health on Marital Satisfaction of Their Wives

Abstract

Objectives
Marital satisfaction has an important effect on people's mental health. Due to the increasing average age and life expectancy of Iranian women, obtaining knowledge about sexual aspects of post-menopause women for partners can improve their health and quality of life. This study aimed to determine the effect of education for the husbands regarding menopause on marital satisfaction of their wives.

Methods
This randomized controlled trial was conducted on 100 women aged 45 to 55 years old and their husbands in Yazd in 2014. Subjects were randomly assigned to intervention group (50 couples) and control group (50 couples). The data gathering tools included two questionnaires, the first one contained questions about demographic information of women and men, and the other one was used to assess knowledge and practice in men about menopause and Enrich marital satisfaction. The second questionnaire was applied twice; before intervention and two months after that. In the intervention group an educational program in the form of three 60-minute sessions were conducted using speech, but the control group received no training. Analysis was performed through the statistical SPSS software, paired t-test, t-test and chi-square.

Results
In the intervention group, two months after the educational program the knowledge of menopausal health and women's marital satisfaction scores increased significantly (P<0.001). But there was no significant difference in control group.

Conclusions
Training menopausal health to husbands can increase women's marital satisfaction in the period of menopausal transition. Therefore, designing and implementing educational programs for husbands is recommended.

Full text

15
Received: October 2, 2016 Revised: December 24, 2016 Accepted: December 28, 2016
Address for Correspondence: Hamideh Mihanpour, Department of Occupational Health, Workplace & Occupational Health and Safety
Research Center, Shahid Sadoughi University of Medical Sciences, Shohadaye Gomnam Blv, Alem Sq, Yazd 8915173160, Iran
Tel: +98-91-3251-3816, Fax: +98-35-3820-9119, E-mail: h.mihanpour@gmail.com
Original Article
pISSN: 2288-6478, eISSN: 2288-6761
https://doi.org/10.6118/jmm.2017.23.1.15
Journal of Menopausal Medicine 2017;23:15-24
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Copyright © 2017 by The Korean Society of Meno pause
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/).
Introduction
Menopause marks the limits of the period of women's
fertility.
1
In fact, menopause is a normal event in women's
life and everywoman will experience it throughout her
life.
2
During the last century, due to promotion of public
health and application of modern methods in treatment, life
expectancy has almost doubled in the developing countries.
3
The Iranian population of postmenopausal women is
assumed to be approximately 3.5 million.
4
About 30 years of
women's lives are spent in the menopause or postmenopausal
period.
5
Preventing and postponing of women's disabilities
and maintaining their health is the most important issue of
public health at the present time and in future. Menopause
The Effect of Husbands' Education Regarding Menopausal
Health on Marital Satisfaction of Their Wives
Nooshin Yoshany1, Mohammad Ali Morowatisharifabad2, Hamideh Mihanpour3, Narjes Bahri4,
Khair Mohammad Jadgal1
1Department of Health Education & Health Promotion, Social Determinants of Health Research Center, 2Elderly Health Research Center,
School of Public Health, 3Department of Occupational Health, Workplace & Occupational Health and Safety Research Center, Shahid
Sadoughi University of Medical Sciences, Yazd, 4Department of Midwifery, School of Nursing and Midwifery, Gonabad University of Medical
Sciences, Gonanbad, Iran
Objectives: Marital satisfaction has an important effect on people’s mental health. Due to the increasing average age and life
expectancy of Iranian women, obtaining knowledge about sexual aspects of post-menopause women for partners can improve
their health and quality of life. This study aimed to determine the effect of education for the husbands regarding menopause on
marital satisfaction of their wives.
Methods: This randomized controlled trial was conducted on 100 women aged 45 to 55 years old and their husbands in Yazd in
2014. Subjects were randomly assigned to intervention group (50 couples) and control group (50 couples). The data gathering
tools included two questionnaires, the first one contained questions about demographic information of women and men, and
the other one was used to assess knowledge and practice in men about menopause and Enrich marital satisfaction. The second
questionnaire was applied twice; before intervention and two months after that. In the intervention group an educational program
in the form of three 60-minute sessions were conducted using speech, but the control group received no training. Analysis was
performed through the statistical SPSS software, paired
t
-test,
t
-test and chi-square.
Results: In the intervention group, two months after the educational program the knowledge of menopausal health and women's
marital satisfaction scores increased significantly (
P
< 0.001). But there was no significant difference in control group.
Conclusions: Training menopausal health to husbands can increase women's marital satisfaction in the period of menopausal
transition. Therefore, designing and implementing educational programs for husbands is recommended. (J Menopausal Med
2017;23:15-24)
Key Words: Education · Marriage · Menopause · Personal satisfaction

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is a kind of developmental stage and critical period that
entails many complications which can have impact on the
lives of women and undermine their sense of well-being.
6
During menopause, production of estrogen is stopped in
ovarian and vasomotor symptoms are declined. In addition,
women experience symptoms like hot flashes, night sweats,
atrophy in vaginal and vulva, and some other complications
that affect their quality of life.
5
Menopause in most cultures
is equal to aging in women. Many women in menopause
period feel a loss, such as loss of motherhood, youth,
beauty, and life.
7
However, some women experience positive
emotions at this time, for example it has been shown that
postmenopausal women have a better feeling of power
and freedom. Since there is no fear of pregnancy, they
experience sexual relationship with more pleasure. Relief
from menstrual and premenstrual syndrome was one of the
positive aspects cited by these women.
8
Marital satisfaction is the positive and enjoyable attitude
that a couple experience from different aspects of their
sexual relationships. Marital satisfaction is an identical
feeling of happiness, satisfaction, and joy experienced by
women or men when covers all common aspects of their
lives. Health and well-being of a family depends on healthy
and thriving relations of couples and if the family foundation
does not have the necessary strength, its negative
consequences will cause a variety of physical and mental
problems. Satisfying relationships bring many benefits for
couples. One of these benefits includes increasing mental
and physical health of women, their husbands and children,
as well as improving their flexibility in the pressures of
life.
9
One of the concerns in menopausal period is the loss
of sexual desire or sexual satisfaction. Sex satisfaction is
an important factor in marital satisfaction.
10
The decrease
of sexual attraction, sexual desire, and sexual activity are
the most common complaints in postmenopausal women,
which may be caused by the reduction of estrogen and
androgen hormones in post-menopause period.
11
Husband
is the most important and closest person who can support
his menopausal women through this developmental crisis
by proper understanding of the situation and the related
problems. Despite the fact that having the necessary
knowledge and awareness about menopause is necessary
for social support, unfortunately husbands' information
about menopause is very low.
12
According to the different
cultural contexts in different areas, such research must be
carried out in different areas. Also, most studies have been
conducted on training postmenopausal women while training
their husbands was rarely investigated. Hence, the present
study targeted to investigate the effect of health education of
postmenopausal women's husbands on the women's marital
satisfaction.
Materials and Methods
1. Participants and setting
The present study was a randomized controlled trial with
two parallel arms in which participants were selected with a
ratio of one to one. The study protocol was approved by the
Research Council of Shahid Sadoughi University of Medical
Sciences and Health Services, Yazd, Iran (registration code:
92/11). It was also registered on ClinicalTrials.gov with the
registration ID of NCT01652300.
A total number of 100 participants were randomly selected
and then classified in two equal groups (n = 50). The study
was conducted from May to August 2014 in Yazd, Iran. More
detail of study protocol is explained elsewhere.
13
2. Intervention program
The eligibility of the randomly selected participants was
evaluated through phone calls. The eligible individuals
were invited to participate in the study. All participants in
the intervention group were requested to attend a briefing
session with their spouses. At the beginning of the session,
written informed consent was obtained from all participants
and their spouses. The participants were then asked to
complete the demographic questionnaire and the Evaluation
and Nurturing Relationship Issues, Communication and
Happiness (ENRICH) questionnaire. The spouses also filled
out the demographic questionnaire and the questionnaires
on their knowledge and performance about menopausal
health. Afterward, the spouses attended the first training
session. The educational content, including symptoms and
complications of menopause and management options, as
well as the role of spouse support during transitional period,
was extracted from reference books and guidelines for health

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Nooshin Yoshany, et al. Impact of Education on Marital Satisfaction
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care during menopause provided by the Ministry of Health
and Medical Education of Iran.
14
The educational program
was comprised of three 60-minute sessions, in which a
combination of different educational methods (e.g., lectures
and questions and answers) and educational aids (e.g., video
projectors and video players) were used. The educational
sessions were held by the third author who was skilled in
the field of menopause. At the end of the program, the
participants were provided with training pamphlets and the
researcher’s telephone number (in case they had a question).
The control group did not receive any intervention. These
participants and their spouses were invited individually
to complete the questionnaires in the presence of the
researcher. They were also asked not to seek information on
menopause health during the study period.
Three months after the intervention, the ENRICH
questionnaire and the questionnaires on the men’s knowledge
and practice about menopause were completed again. To
observe research ethics, the control group was provided with
training pamphlets containing the content of the educational
sessions at the end of the study.
3. Study instruments
In addition to the mentioned questionnaires, ENRICH’s 47-
item (1990) questionnaire was applied to determine the
participants' level of marital satisfaction. The original form
of this inventory consisted of 115 questions and 12 scales
which was used by Olson to assess marital satisfaction. He
believed that each item in this inventory is related to one
of the most important areas of marital satisfaction. While
validity of marital satisfaction inventory was approved in
several studies, the reliability of ENRICH marital satisfaction
inventory was calculated as 0.95 in the present study.
Using Cronbach’s alpha (α) coefficient, Elson, Forinero, and
Drakman (1998, according to Eqbal, 2010) reported the
reliability of the questionnaire to be 0.92.
15
Soleimanian
16
calculated the test's correlation for the
first time in Iran and reported the long and short form
correlations equal to 0.93 and 0.95, respectively. Further,
the α coefficient for Soleimanian's questionnaire was equal
to 0.95.
15
This questionnaire consists of 47 items all of which
have to be answered on a 5-point Likert scale. One part of
items deals with satisfaction and is scored from 5 to 1, (i.e.,
5 = totally agree, 4 = agree, 3 = not agree not disagree, 2
= disagree, and 1 = totally disagree), the other part's scores
indicate dissatisfaction and disagreement and range from
1 to 5 (i.e., totally agree = 1, agree = 2, neither agree nor
disagree = 3, disagree = 4, totally disagree = 5). Scores can
range from 47 to 235, with higher scores indicating greater
marital satisfaction.
Marital satisfaction was investigated in the six following
categories: very unsatisfied, unsatisfied, satisfied, relatively
satisfied, very satisfied, and extremely satisfied.
4. The 9 scales of ENRICH inventory (47 items) include
1) Personality issues
This scale examines an individual’s perception of his or
her partner with regard to behavioral issues and the level of
satisfaction felt on those issues.
2) Communication
This scale is concerned with an individual’s feelings and
attitudes toward communication in his or her relationship.
Items focus on the level of comfort felt by the partner in
sharing and receiving emotional and cognitive information.
3) Conflict resolution
This scale assesses the partner’s perception of the
existence and resolution of conflict in the relationship. Items
focus on the openness of partners to recognize and resolve
issues and the strategies used to end arguments.
4) Financial management
This scale focuses on attitudes and concerns about the way
economic issues are managed within the relationship. Items
assess spending patterns and the care with which financial
decisions are made.
5) Leisure activities
This scale assesses activities in spending free time. Items
reflect social versus personal activities, shared versus
individual preferences, and expectations about spending
leisure time as a couple.

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6) Sexual relationship
This scale examines the partner’s feelings about the
affectional and sexual relationship. Items reflect attitudes
about sexual issues, sexual behavior, birth control, and
sexual fidelity.
7) Children and parenting
This scale assesses attitudes and feelings about having
and raising children. Items focus on decisions regarding
children's discipline and goals, as well as the impact of
children on the couple’s relationship.
8) Family and friends
This scale assesses feelings and concerns about
relationships with relatives, in-laws, and friends. Items
reflect expectations for and comfort in spending time with
family and friends.
9) Religious orientation
This scale examines the meaning of religious beliefs and
practices between the couple. Higher scores indicate more
importance of religion in the marriage (5 items).
Table 1 below represents this ENRICH inventory
questionnaire's descriptive information.
5. Statistical analysis
Continuous data were reported as mean ± standard
deviation (SD). The normality of data distributions was
tested using the one-sample Kolmogorov-Smirnov test.
Independent
t
-tests were performed to compare continuous
variables with normal distribution. Follow-up analyses
included an independent
t
-test at each time point. The
level of significance was set at
P
value less than 0.05. All
analyses were carried out using SPSS software (SPSS Inc.,
Chicago, IL, USA).
Results
Although 109 women were initially selected, 9 were
excluded and 100 women (50 in each group) completed the
study (Fig. 1).
13
The average age of men in the intervention and control
groups were 52.1 ± 3.3 and 52.2 ± 3.0 years, respectively,
while those of women in the intervention and control
groups were 49.8 ± 2.7 and 50.1 ± 2.5 years, respectively.
Further, the average ages of marriage for men in the
intervention and control groups were respectively 24.66 ±
3.44 and 25.1 ± 3.3 years. The average number of children
in the intervention group was 2.9 ± 1.2 while it was 2.8 ±
1.2 for the control group which according to the independent
t
-test no significant difference was observed in these
variables between the two groups (
P
> 0.05) thus it can be
said that the two groups matched (Table 2). In terms of
education, 18% of men and 22% of women had elementary
and secondary education, 57% of men and 57% of women
had high school and diploma education, and 25% of men
and 21% of women had academic degrees. 29% of men had
government jobs, 57% were self-employed, and 8% were
retired. Twenty-three percent of women were employed
while 77% were housewives. According to Chi-square test,
no significant difference was observed between the two
groups in terms of education and occupation (
P
> 0.05) (Table
3).
The average age of menopause in the intervention group
was 48.26 ± 1.34 and in the control group 48.32 ± 1.43
years, also, the average age of menarche in the intervention
and control groups were 11.84 ± 1.31 and 11.73 ± 1.4
years, in order. Based on the independent
t
-test there was
Table 1. The introduction of questions related to each of the scale
Scales Question no.
Personality issues 2, 4*, 12*, 22*, 40*
Communication 6*, 13*, 23*, 32*, 41*
Conflict resolution 7, 14*, 24*, 33*, 42*
Financial management 8*, 15*, 16*, 25, 34
Leisure activities 9, 17, 26, 35, 43*
Sexual relationship 10, 18*, 27, 36, 44
Children and parenting 11*, 19*, 28, 37*, 45
Family and friends 20*, 29, 31*, 38*, 46*
Religious orientation 5, 21*, 30*, 39*, 47*
1 and 3 questions represent a personal desire for answering to
the questionnaire
*Grading is done in the reverse question

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Nooshin Yoshany, et al. Impact of Education on Marital Satisfaction
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no significant difference between the two groups (
P
> 0.05)
(Table 2).
Before the intervention, the mean scores of knowledge
and performance of men in the intervention and control
groups as well as marital satisfaction scores among women
in these two groups showed no significant difference (
P
>
0.05).
The paired sample
t
-test results indicated a significant
difference between the men’s knowledge scores about
menopause before and after the educational program in
the intervention group (
P
= 0.001). But in control group
the average score of knowledge before the education
program and two months after it had no significant difference
(
P
= 0.729). Also, the average score of men’s performance
about menopause in the intervention group had significant
difference before the education and two months after it (
P
=
0.001), while in the control group no significant difference
was observed (
P
= 0.394).
Assessed for eligibility (n=753)
Randomized (n=109)
Allocation
Follow-up
Analysis
Analysed (n=50)
Excluded (n=644)
Not meeting inclusion criteria (n=613)
Declined to participate (n=31)
Other reasons (n=0)
Enrollment
Allocated to intervention group (n=56)
Discontinued intervention (n=6):
2 for failure in completing training sessions by spouse
3 for facing life event crisis during study
1 for errors in filling questionnaire
Allocated to control group (n=53)
Lost to follow-up (n=3):
2 for facing life event crisis during study
1 for errors in filling questionnaire
Analysed (n=50)
Fig. 1. Schematic representation of the study.
Table 2. Baseline sociodemographic characteristics of two groups
Variables Intervention group, (mean ± SD) Control group, (mean ± SD)
P
value
Women age 49.8 ± 2.7 50.1 ± 2.5 0.594
Men age 52.1 ± 3.3 52.2 ± 3.0 0.876
No. of children 2.9 ± 1.2 2.8 ± 1.2 0.875
Menarche age 11.84 ± 1.31 11.73 ± 1.4 0.803
Women marriage age 21.16 ± 3.23 21.7 ± 2.9 0.47
Men marriage age 24.66 ± 3.44 25.1 ± 3.3 0.648
Menopause age 48.26 ± 1.34 48.32 ± 1.43 0.843
No. of pregnancy 3.42 ± 1.3 3.04 ± 1.16 0.125
SD: standard deviation

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Although the two groups had no statistically significant
differences in terms of baseline scores of their knowledge
and performance (
P
> 0.05), post intervention knowledge
scores were significantly higher in the intervention group than
in the control group (
P
< 0.0001). Student’s
t
-test results also
indicated a significant improvement in husbands’ performance
about menopause in the intervention group two months
after the educational program (
P
< 0.0001). Moreover, in
the intervention group, paired
t
-test suggested significant
differences in the spouses’ knowledge and performance
scores before and two months after the intervention (
P
<
0.0001). No such significant differences were detected in the
Table 3. The distribution frequency of variables related to fertility, menopause, and women's health study in the intervention and control
groups
Variables Intervention group, n (%) Control group, n (%)
P
value
Women education 0.884
Guidance school 12 (24%) 10 (20%)
High school & diploma 28 (56%) 29 (58%)
College education 10 (20%) 11 (22%)
Men education 0.811
Guidance school 10 (20%) 8 (16%)
High school & diploma 27 (54%) 30 (60%)
College education 13 (26%) 12 (24%)
Women job
Housewife 29 (58%) 34 (68%)
Employee 14 (28%) 9 (18%)
Home job 7 (14%) 7 (14%)
Men job 0.741
Employee 16 (32%) 13 (26%)
Worker 3 (6%) 3 (6%)
Free 26 (52%) 31 (62%)
Retired 5 (10%) 3 (6%)
Menopausal status 0.919
Pre-menopausal 15 (30%) 16 (32%)
Peri-menopausal 8 (16%) 9 (18%)
Post-menopausal 27 (54%) 25 (50%)
The status of women suffering to chronic diseases* 0.500
Yes 18 (36%) 19 (38%)
No 32 (64%) 31 (62%)
Hormone replacement therapy 0.602
Yes 9 (18%) 8 (16%)
No 41 (82%) 42 (84%)
*Diabetes, high blood pressure, heart disease, etc.

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control group (Table 4).
The results of paired
t
-test showed that there was no
significant difference in control group before and after
the intervention, but the total average score of marital
satisfaction and its nine sub-scales, except in personality
scale, was significantly higher in the intervention group
than the control group (
P
< 0.05). This is while there was no
significant difference in the control group (
P
> 0.05) (Table
5).
The results of independent
t
-test showed that there was
no significant difference in women's total average score
of marital satisfaction and its nine sub scales between the
intervention and control groups before the intervention (
P
> 0.05). But after the intervention there was a significantly
higher score for the intervention group, except for the
personality, financial management, sexual orientation, and
religious orientation scales (
P
< 0.05).
Discussion
This study indicated a significant difference in total
satisfaction scores and scales of marital communication,
conflict resolution, leisure activities, marriage and children,
as well as relatives and friends between postmenopausal
women of the intervention group, whose husbands were
trained about menopause, than the members of the
control group whose husbands received no trainings. But
no significant difference was observed in the scales of
personality, financial management, and sexual and religious
orientations. This findings were in the same line with those
reported by Clements et al.
17
, Fincham et al.
18
, and Hahlweg
and Richter.
19
In order to clarify these findings, Hawkins
et al.
20
, showed that the training empowerment programs,
teach couples the required skills to face the challenges of
married life and prepare them to cope with marital problems
efficiently. One of the very important aspects of a marital
system is the amount of satisfaction that married couples
experience. Thus, policy makers in many countries are
trying to design and implement programs to help couples
who are experiencing marital problems and conflicts. They
are helping couples to face and achieve a successful and
reliable marital life. One of the most important parts of this
new policy in the field of family is to design and support
educational programs to empower couples.
21
Findings of the current study supports Olleya et al.,
22
results reporting that educational empowerment does
not have any significant effect on religious orientation
component, however, these findings are not consistent with
those reported by Ahmadi and Hossein-abadi
23
. To justify
Table 4. Comparison of men’s knowledge and performance about menopausal before and after the intervention in two groups
Variables Intervention group, (mean ± SD) Control group, (mean ± SD)
P
value*
Men’s knowledge about menopausal health
Baseline 8.3 ± 2.7 8.2 ± 2.6 0.826
Second month 14.0 ± 3.9 8.4 ± 2.7 <0.0001
Average difference 5.6 ± 1.6 0.26 ± 1.1 <0.0001
P
value†0.001 0.729
Men’s practice about menopausal health
Baseline 7.2 ± 1.8 7.3 ± 1.7 0.725
Two months after education 11.8 ± 1.9 7.5 ± 2.1 <0.0001
Average difference 4.5 ± 1.0 0.16 ± 1.3 <0.0001
P
value†0.001 0.394
*
P
values calculated using independent sample
t
-test
†
P
values calculated using paired
t
-test
SD: standard deviation

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Table 5. Comparison of women's marital satisfaction and its nine subscales' total average score before and after intervention in two groups
Variables Intervention group, (mean ± SD) Control group, (mean ± SD)
P
value*
Marital satisfaction
Baseline 135.08 ± 7.46 135.28 ± 7.77 0.896
Second month 159.82 ± 6.16 135.56 ± 6.63 0.001
P
value†0.001 0.626
Personality issues
Baseline 16.02 ± 2.78 15.9 ± 2.8 0.83
Second month 16.2 ± 2.57 16.06 ± 2.42 0.78
P
value†0.426 0.467
Communication
Baseline 14.8 ± 3.38 14.84 ± 3.45 0.953
Second month 19.06 ± 1.96 14.9 ± 3.46 0.001
P
value†0.729 0.001
Conflict resolution
Baseline 13.94 ± 3.35 13.92 ± 3.46 0.977
Second month 17.94 ± 2.37 14.16 ± 3.19 0.001
P
value†0.001 0.129
Financial management
Baseline 15.2 ± 2.49 15.5 ± 2 0.508
Second month 16.78 ± 2.48 15.24 ± 2.43 0.275
P
value†0.043 0.334
Leisure activities
Baseline 14.82 ± 2.71 14.86 ± 2.62 0.94
Second month 18.78 ± 1.99 14.96 ± 2.59 0.001
P
value†0.001 0.534
Sexual relationship
Baseline 11.88 ± 3.08 11.9 ± 3.00 0.974
Second month 13.98 ± 2.7 12.32 ± 2.82 0.235
P
value†0.039 0.06
Children and parenting
Baseline 14.34 ± 2.82 14.06 ± 2.74 0.616
Second month 17.96 ± 2.3 13.98 ± 2.59 0.000
P
value†0.001 0.663
Family and friends
Baseline 14.36 ± 2.28 14.56 ± 2.04 0.645
Second month 18.22 ± 1.95 14.48 ± 2.25 0.000
P
value†0.000 0.712

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Nooshin Yoshany, et al. Impact of Education on Marital Satisfaction
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these findings, it seems safe to say that the educational
program implemented for men to improve their marital
satisfaction was not sufficient on the religious orientation.
Arieta
24
introduced training, raising awareness, and couples'
control as the causes of gaining interpersonal skills and
marital satisfaction.
Lack of educational and communicational skills is related
to many of couples' problems. If couples be aware of each
other's needs and wishes in different ages and then be able
to satisfy these needs properly, they will certainly increase
their marital satisfaction. Trying to increase menopause
health awareness among men, can increase their wives'
confidence and help menopausal women to have a positive
attitude towards it. It also increases their marital satisfaction
and improves their life quality during menopause and after it.
Conclusion
The results of this study showed that implementation
of training programs and increasing men awareness
on menopause health, can increase their wives' marital
satisfaction. Since the educational programs conducted
for men in this study were cross-sectional and short-
term, one of the limitations of this study was the fact that
medium-term and long term results were not assessed
which should be examined in studies with larger samples
and a longer time. Hence husband is the closest person who
can support his menopausal wife in this critical development
by understanding her problems, it is recommended to
start educational programs about menopause health
several years before its occurrence for couples who are in
transition towards menopause and aging and continue them
continuously.
Acknowledgement
This article is adapted from the master's thesis in School
of Public Health, Shahid Sadoughi University of Medical
Sciences, Yazd, Iran, with the registration Code 92/11 and is
sponsored by Research Council of this University. Hereby,
we thank the efforts of teachers, school administrators,
University of Medical Sciences, all plan partners, and
especially couples who participated in the study.
Conflict of Interest
No potential conflict of interest relevant to this article was
reported.
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Table 5. Continued
Variables Intervention group, (mean ± SD) Control group, (mean ± SD)
P
value*
Religious orientation
Baseline 14.66 ± 2.74 14.72 ± 2.85 0.915
Second month 16.34 ± 2.53 14.6 ± 3.05 0.19
P
value†0.022 0.533
*
P
values calculated using independent sample
t
-test
†
P
values calculated using paired
t
-test
SD: standard deviation

Journal of Menopausal Medicine 2017;23:15-24
24 https://doi.org/10.6118/jmm.2017.23.1.15
J
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