Research Article
Austin J Autism & Relat Disabil. 2023; 9(2): 1067.
Marital Relationship, Quality of Life, and Life Satisfaction for Saudi Parents of Children with Autism Spectrum Disorder
Ayah Moumenah¹*; Mamdouh Al Enazi²
¹Master of Clinical Psychology, College of Medicine, Al Faisal University, Riyadh, Saudi Arabia
²Consultant, Transplant Psychology/Neuropsychology, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
*Corresponding author:Ayah Moumenah Master of Clinical Psychology, College of Medicine, Al Faisal University, Riyadh, Saudi Arabia. Email: amoumenah@alfaisal.edu
Received: August 02, 2023 Accepted: August 18, 2023 Published: August 25, 2023
Abstract
It is very stressful for parents to raise children with Autism Spectrum Disorder (ASD), which can create marital conflicts and relationship dissatisfaction. A variety of circumstances, including the intensity of their child’s behaviors, quality of life, and life satisfaction it plays significant role on the parents. This study aims to investigate the satisfaction of having a child with autism, on the marital relationship, life, and quality of life of the Saudi parents. A quantitative descriptive approach was used. A total of 49 Saudi parents of autistic children completed an online questionnaire. Overall results indicated that Saudi parents with autistic children are satisfied with their life, marital relationship, and their quality of life. In addition, results showed significant differences in life satisfaction and QOL of divorced Saudi parents of autistic children. On the other hand, there was no significant differences of married Saudi parents of autistic children. Furthermore, the study indicate that significant differences wasn’t observed between the Saudi fathers and mothers of autistic children.
Keywords: Autism spectrum disorder; Marital relationship; Life satisfaction; Quality of life; Saudi parents
Introduction
ASD
ASD is a neuro developmental syndrome marked by communication difficulties, restricted interests, and repetitive activities [1]. ASD, which includes a multitude of cognitive deficits in children, is frequently recognized in the first few years of life [2]. These behaviors may result in parental embarrassment, social exclusion, and loneliness, which may affect not just the person with high functioning autism, but also their family [3]. Children with ASD when they are stressed or their daily routines change, they may demonstrate antisocial behaviors such as aggression, social disengagement, or the urge for self-stimulation. The societal consequences make it difficult for parents to raise their autistic children. Parental isolation, humiliation, and social withdrawal may come from these practices [4]. According to a review of the literature Zeina [5], the amount of children with ASD in Saudi Arabia is not properly prevalent. However, according to The Saudi Ministry of Health [6], one in every 160 kids has an ASD. Unfortunately, little is understood about ASD, and there is virtually no information available about the needs of parents and siblings of children with ASD [7]. Therefore, Saudi Arabia sponsors a number of private institutions and provides aid for the care of children with ASD and their families; however, these services are limited and only available in major cities. Parents of children with ASD in the Kingdom of Saudi Arabia have various challenges and problems in parenting their children due to the disease's toll on children in Saudi culture, as well as traditional cultural issues impacting their people and their expanding social life [8].
Quality of Marital Relationship of Children with ASD
Several studies show that parents of impaired children, particularly those with children who have ASD, exhibit lower levels of marital satisfaction when compared to couples with children who are not disabled [9]. According to Anna’s study [10]. The overall evaluation result (4 sten-low result) on the quality of the marital relationship in the group of wives and husbands indicates a lack of contentment with the marital connection. Individual aspect scores on the scale, on the other hand, range from 4 to 7, indicating low to moderate marital satisfaction. In terms of marital discontent, the females were more dissatisfied than the husbands. The study's result of poor overall marital happiness is puzzling because couples have choices for coping with stress. Despite disappointment and a willingness to make their relationship look different, they accept things as they are and manage the emotional, cognitive, and behavioral problems that come with caring for a child with ASD during the pandemic, even if the relationship's overall level of satisfaction may be lower.
Life Satisfaction in Parents of Children with ASD
Most fathers who have children who have been diagnosed with ASD do not quit their jobs to take on the role of main caregiver, due to the difficulties they have raising their autistic child at home, they work longer hours to get away from their house [11]. According to Montes [12] Mothers, on the other hand, stated that their child's disability had a significant personal impact on them and were honest about their feelings. Even though working women regularly missed work, they were frequently forced to acquire part-time employment or even give up their outside jobs in order to care for their autistic children. The level of care necessary in an autistic child's everyday life is a significant source of stress, particularly for mothers. All of these factors may have an influence on the enjoyment of the parents' life. Life satisfaction is a person's appraisal of their degree of contentment with their current position based on comparisons to criteria they have set for themselves [13].
Quality of Life (QOL) in parents of Children with ASD
Autism is becoming more common, prompting issues regarding its origins and how it affects the QOL of both people with autism and those who care for them in their families [14]. A study by Mohammad [15] on the QOL and its predictors of primary parents of autistic children revealed that gender, age, monthly income, and marital status were major factors of careers’ QOL for autistic children. Despite the acknowledged importance of QOL, research, and the significant impact of having a child with autism, the QOL of parents of children with autism has gotten very little attention in comparison to other childhood difficulties [16]. A good QOL among married participants in an Eastern Saudi Arabia study may have been a result of their partners' support and care, particularly while coping with autistic children, and an investigation of the effects of monthly income on parents of autistic children discovered that those with higher monthly incomes had better social functioning, mental health, and vitality than those with lower monthly incomes [17]. Autistic parents frequently report feeling less satisfied with their quality of life [18].
Materials and Methods
The study focused on Saudi parents of children with ASD. The information was gathered from 49 parents. The participant was given a link of the permission form. The length of the assessments was probably between 10 and 20 minutes. For the participants, there are no anticipated risks. Additionally, they had the option to interrupt the evaluation at any time and refuse to answer a particular question. All participants was informed that taking part in the study will not provide any additional advantages beyond advancing our understanding of the requirements of families with children with ASD.
Study Design
For this study, a qualitative descriptive design was employed. Finding summative trends in relation to the data set was the main goal of the descriptive design. Different measures have been used in the study to measure how satisfied parents of children with ASD are with their lives, their marriages, and their quality of life.
The Questionnaire Tool
1. Appendix E. Satisfaction with Life Scale (SWLS) in Arabic.
2. Appendix G. Relationship Questionnaire (RQ) in Arabic.
3. Quality of Life Scale in Arabic.
Statistical Analysis
Data were analyzed with the use of computer software. The Statistical Package for Social Sciences (SPSS) version 29.0.1.0 (171), the collected data was examined in accordance with the goals of the current study using various statistical procedures including the independent sample t-test and the mean. P<0.05 was considered as significant.
Results
The results of the mean in Table 1 suggested that Saudi parents with autistic children are satisfied with their life, marital relationship, and their quality of life.
SWLS Score
RAS Score
QOL Score
Mean
17.95918367
65.173913
144.782609
Std
3.807663236
16.533205
31.2622691
Var
14.49829932
273.34686
977.329469
SWLS: Appendix E. Satisfied with Life Scale, RAS: Appendix D. Relationship Assessment Scale, QOL: Quality of Life Scale, Std: standard deviation, Var: variance.
Table 1:
Results reported in Table 3 indicate that significant differences wasn’t observed t(41) = 2.019, p=0.129, in life satisfaction of Saudi parents of Autistic Children. The mean in table 2 indicate that the Saudi parents of Autistic Children are satisfied in their life. Findings further, suggested that significant differences wasn’t observed t(41) = 2.019, p=0.839, in marital relationship satisfaction. In table 2 the mean indicate that the Saudi parents of Autistic children are slightly satisfied in their marital relationship. It also indicate that quality of life satisfaction of Saudi mothers of Autistic children they are slightly satisfied about it. On the other hand, fathers of Autistic children are satisfied about their quality of life. Findings further, suggested in table 2 that significant differences wasn’t observed t(41) = 2.019, p=0.097.
Relation
N
Mean
Std. Deviation
Std. Error Mean
SWSL
Father
22
18.9545
3.28745
0.70089
Mother
21
17.2381
3.96112
0.86439
RAS
Father
22
64.7727
12.3015
2.62269
Mother
21
65.8095
20.29684
4.42913
QOL
Father
22
151.727
25.89941
5.52177
Mother
21
135.667
35.71881
7.79448
SWLS: Appendix E. Satisfied with Life Scale, RAS: Appendix D. Relationship Assessment Scale, QOL: Quality of Life Scale, N: number of participant.
Table 2:
Levene's Test for Equality of Variances
t-test for Equality of Means
F
Sig.
t
df
Significance
Mean Difference
Std. Error Difference
95% Confidence Interval of the Difference
One-Sided p
Two-Sided p
Lower
Upper
SWSL
Equal variances assumed
1.203
0.279
1.549
41
0.065
0.129
1.71645
1.10796
-0.52113
3.95403
Equal variances not assumed
1.542
38.921
0.066
0.131
1.71645
1.11284
-0.53462
3.96752
RAS
Equal variances assumed
5.768
0.021
-0.204
41
0.42
0.84
-1.0368
5.09095
-11.3182
9.2446
Equal variances not assumed
-0.201
32.66
0.421
0.842
-1.0368
5.1474
-11.5134
9.43981
QOL
Equal variances assumed
2.865
0.098
1.694
41
0.049
0.098
16.06061
9.48168
-3.08805
35.20926
Equal variances not assumed
1.681
36.384
0.051
0.101
16.06061
9.55217
-3.30499
35.4262
SWLS: Appendix E. Satisfied With Life Scale, RAS: Appendix D. Relationship Assessment Scale, QOL: Quality of Life Scale, F: false, t: t-test, df: degree of freedom.
Table 3:
Results reported in table 5 that significant differences wasn’t observed t(22) = 2.073, p=0.894 in life satisfaction of married Saudi parents of Autistic Children. The mean in table 4 indicate that the Saudi parents are satisfied in their life. Findings further, suggested in table 5 that, significant differences wasn’t observed, t(22) = 2.073, p=0.195, in marital relationship satisfaction of married Saudi parents of Autistic Children. It also indicate that significant differences wasn’t observed t(22) = 2.073, p=0.697, in quality of life satisfaction of married Saudi parents.
Group Statistics
Relation
N
Mean
Std. Deviation
Std. Error Mean
SWLS
Father, Married
11
18.1818
3.12468
.94213
Mother, Married
13
18.0000
3.43996
.95407
RAS
Father, Married
11
63.5455
12.77782
3.85266
Mother, Married
13
72.1538
17.77567
4.93008
QOL
Father, Married
11
149.1818
28.45986
8.58097
Mother, Married
13
144.3077
31.57896
8.75843
Table 4: For married sample.
Levene's Test for Equality of Variances
t-test for Equality of Means
F
Sig.
t
df
Significance
Mean Difference
Std. Error Difference
95% Confidence Interval of the Difference
One-Sided p
Two-Sided p
Lower
Upper
SWLS
Equal variances assumed
0.64
0.432
0.134
22
0.447
0.894
0.18182
1.35208
-2.62223
2.98586
Equal variances not assumed
0.136
21.865
0.447
0.893
0.18182
1.34084
-2.59992
2.96355
RAS
Equal variances assumed
3.385
0.079
-1.338
22
0.097
0.195
-8.60839
6.43284
-21.9493
4.73251
Equal variances not assumed
-1.376
21.507
0.092
0.183
-8.60839
6.25689
-21.6017
4.38488
QOL
Equal variances assumed
0.21
0.651
0.394
22
0.349
0.697
4.87413
12.3726
-20.7851
30.53333
Equal variances not assumed
0.398
21.89
0.347
0.695
4.87413
12.26145
-20.5619
30.31019
Table 5: For married sample.
Results reported in table 7 that significant differences was observed t(17) = 2.109, p<0.005, in life satisfaction of divorced Saudi parents of Autistic Children. In marital relationship satisfaction it indicate in table 7 that significant differences was observed t(17) = 2.109, p=0.187. Furthermore, results of quality of life satisfaction in divorced Saudi parents of Autistic children, showed that significant differences was observed t(17) = 2.109, p<0.05, in table 7. The mean in table 6 indicate that Saudi divorced mothers are slightly dissatisfied in their marital relationship. On the other hand divorced fathers are slightly satisfied.
Group Statistics
Relation
N
Mean
Std. Deviation
Std. Error Mean
SWLS
Father, Divorced
11
19.7273
3.40855
1.02772
Mother, Divorced
8
16.0000
4.65986
1.64751
RAS
Father, Divorced
11
66.0000
12.29634
3.70749
Mother, Divorced
8
55.5000
20.95574
7.40897
QOL
Father, Divorced
11
154.2727
24.17474
7.28896
Mother, Divorced
8
121.6250
39.64463
14.01649
Table 6: For Divorced sample.
Levene's Test for Equality of Variances
t-test for Equality of Means
F
Sig.
t
df
Significance
Mean Difference
Std. Error Difference
95% Confidence Interval of the Difference
One-Sided p
Two-Sided p
Lower
Upper
SWLS
Equal variances assumed
1.015
0.328
2.02
17
0.03
0.049
3.72727
1.84555
-0.1665
7.62104
Equal variances not assumed
1.92
12.213
0.039
0.079
3.72727
1.94177
-0.49531
7.94986
RAS
Equal variances assumed
2.356
0.143
1.376
17
0.093
0.187
10.5
7.63182
-5.60173
26.60173
Equal variances not assumed
1.267
10.484
0.116
0.232
10.5
8.28482
-7.84478
28.84478
QOL
Equal variances assumed
7.059
0.017
2.232
17
0.02
0.039
32.64773
14.62716
1.78711
63.50835
Equal variances not assumed
2.067
10.748
0.032
0.064
32.64773
15.79845
-2.22426
67.51972
Table 7: For divorced sample.
Results reported in Table 9 indicate that significant differences wasn’t observed t(44) = 2.011, p=0.214 in life satisfaction of Saudi parents who have low and high monthly income. In marital relationship satisfaction it indicate that significant differences wasn’t observed t(44) =2.015, p=0.633. Furthermore, results of quality of life satisfaction showed that significant differences wasn’t observed t(44) = 2.015, p=0.342, in Table 9. The mean in table 8 indicate that Saudi parents of children with ASD with high and low income are satisfied with their life, and they’re slightly satisfied with their marital relationship. On the other hand Saudi parents with low income are slightly satisfied with their QOL.
Group Statistics
Income
N
Mean
Std. Deviation
Std. Error Mean
SWLS
Low Income
24
17.4167
3.88885
0.79381
High Income
22
18.8182
3.62053
0.7719
RAS
Low Income
24
64.0417
18.94266
3.86665
High Income
22
66.4091
13.7725
2.93631
QOL
Low Income
24
140.5417
37.35957
7.62599
High Income
22
149.4091
22.86119
4.87402
Table 8:
Levene's Test for Equality of Variances
t-test for Equality of Means
F
Sig.
t
df
Significance
Mean Difference
Std. Error Difference
95% Confidence Interval of the Difference
One-Sided p
Two-Sided p
Lower
Upper
SWLS
Equal variances assumed
0.073
0.789
-1.262
44
0.107
0.214
-1.40152
1.11075
-3.64009
0.83706
Equal variances not assumed
-1.266
43.987
0.106
0.212
-1.40152
1.10723
-3.63301
0.82998
RAS
Equal variances assumed
4.015
0.051
-0.481
44
0.316
0.633
-2.36742
4.92221
-12.2875
7.55264
Equal variances not assumed
-0.488
41.911
0.314
0.628
-2.36742
4.85519
-12.1662
7.43137
QOL
Equal variances assumed
6.506
0.014
-0.96
44
0.171
0.342
-8.86742
9.23549
-27.4803
9.74547
Equal variances not assumed
-0.98
38.578
0.167
0.333
-8.86742
9.05051
-27.1802
9.44537
Table 9:
Discussion
Parents of autistic children confront challenges that put them at risk of psychological disorders and consequences. This study aimed to investigate if children with ASD will negatively impact the life satisfaction, marital relationship, and quality of life of the Saudi parents. Findings showed that they are satisfied in their life and the quality of it. On the other hand, the mean of the marital relationship showed they are slightly satisfied. Time spent raising children had a detrimental influence on relationship quality since it directly impacted the time parents could devote to their personal connection. According to previous researches, the autistic child had an impact on relationship satisfaction [19]. Furthermore, the majority of other research revealed that ASD has a significant negative influence on Arab parents' mental health and well-being [20].
Additionally, the study aimed to investigate if the Saudi mothers will show lower level of life satisfaction, and marital satisfaction, and quality of life when it compared to fathers. Result showed there are no significant differences between them in the three variables. Although the results of the mean in QOL showed difference between them. The Saudi mother’s mean score indicate that they are slightly satisfied about their QOL. On the other hand, Saudi fathers mean score indicate that they are satisfied about their QOL. According to other research caring for children with intellectual disabilities has a clear detrimental influence on Saudi Arabian family quality of life evaluations [21].
Furthermore, the study aimed to investigate if there is a significant difference between the divorced Saudi parents, and the married Saudi parents of children with ASD. The result showed there are no significant differences of the married Saudi parents. Although the results of the mean in their marital relationship showed difference. The married mothers are satisfied in their marital relationship, but the fathers are slightly satisfied. Findings further showed that significant difference was observed, in life satisfaction and quality of life of divorced parents. On the other hand, there are no significant differences between the divorced parents in the marital relationship satisfaction. Although the mean score showed a difference. Most of the divorced mothers are slightly dissatisfied, and most of the fathers are slightly satisfied. Several studies have demonstrated that marital status has an impact on the QOL of parents with autism [22]. Previous research found that married persons had higher QOL than single or divorced people because of the social support they receive from their spouse [23].
Finally, the study aims to investigate if the Saudi parents of children with ASD will be significantly impacted by their low monthly income. The mean of the Saudi parents of children with ASD, with a low and high income showed that they are satisfied with their life, and they are slightly satisfied in their marital relationship. Saudi parents with high income are satisfied with their QOL. On the other hand, Saudi parents with low income are slightly satisfied. Furthermore, the result showed there is no significant differences between Saudi parents of children with ASD with high and low monthly income. In other studies, no influence of family income was found. While several researches discovered that family wealth had a substantial influence on marital happiness [24], others did not [25].
Unfortunately, due to the small number of parents, these findings cannot be generalized. The findings can serve as a motivator for more study on Saudi families of autistic children, as well as a beginning point for future clinical intervention. Furthermore, it may be useful to investigate these variables in connection to other variables that might impact parents functioning, such as the parents' sense of stress or coping techniques employed to deal with the child's impairment. This study focused on Saudi parents of children with ASD, but it might also be applied to parents of children with other forms of disabilities, such as learning disabilities or ADHD. With a larger participant sample, the variables may show a statistical significance.
Conclusion
Life satisfaction and QOL of Saudi divorced parents with autistic children, were significantly different. Furthermore, the results of the mean in the marital satisfaction of the divorced Saudi mothers of autistic children suggested they’re slightly satisfied. As a result, the study emphasizes the need of psychological intervention as an indication of social supports for Saudi parents of autistic children in order to improve their marital relationship, and their skills in dealing with their children and improve their QOL.
Author Statements
Author Contributions
The author indicates sole responsibility for the following: study conceptualization and design, data collection, data analysis and interpretation, and manuscript preparation.
Funding
This research received no external funding.
Informed Consent Statement
All participants gave their informed permission.
Conflicts of Interest
The authors confirm that there are no associations with or participation in any group or institution that would have a vested financial or non-financial interest in the topics or resources covered in this paper.
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