{
  "abstract": "Introduction: Marital adjustment is a key indicator of relationship stability and durability. While various factors influencing marital adjustment have been studied in Iran, the role of social determinants, particularly among marginalized women, remains underexplored. Objective: This study aimed to provide a model of social determinants of marital adjustment in married women from suburban areas in Kermanshah, Iran. Materials and Methods: This is a descriptive-analytical correlational study that was conducted on 460 women of reproductive age in suburban areas of Kermanshah in 2023. Data were collected using a sociodemographic form, the Socio-Economic Status (SES) questionnaire, the Dyadic Adjustment Scale (DAS), the Sexual Self-Efficacy (SSE) scale, and the Index of Sexual Satisfaction (ISS). Pearson’s correlation test was used to determine the correlation between quantitative variables. Path analysis was used to assess the research question. P<0.05 was also considered statistically significant. Results: The mean age of women and their husbands was 30.8±5 years and 40.2±7.5 years, respectively. The mean scores of the SSE scale, ISS, DAS, and SES were 13.7±7.7, 75.1±24.3, 33.2±14.5, and 12.6±2.6, respectively. Path analysis demonstrated that sexual satisfaction had a significant positive direct effect on marital adjustment (β=0.31, 95% CI; 0.259, 0.361, P=0.001). SSE showed the strongest positive association with marital adjustment, with a significant total effect (β=0.531), including both direct (β=0.37, 95% CI; 0.213, 0.527, P=0.001) and indirect (β=0.161) effects. SES also had a significant direct effect on marital adjustment (β=0.2, 95% CI; 0.104, 0.296, P=0.001). The number of children had no statistically significant effect on marital adjustment. Conclusion: This study highlights the pivotal role of sexual satisfaction, SSE, and SES in marital adjustment of married women from marginalized areas in Iran. The findings underscore the importance of addressing sexual health, self-efficacy, and socioeconomic status of women in interventions for improving their marital adjustment. The results can help develop targeted programs to strengthen family relationships and enhance the quality of marital life in marginalized women.",
  "abstract_shown": true,
  "affiliations": [
    "PhD of Reproductive Health, Clinical Research Development Center, Motazedi Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran",
    "Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran",
    "Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran",
    "Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.",
    "PhD student, Department of Midwifery and Reproductive Health, Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Marzieh Bagherinia"
    },
    {
      "affs": [
        1
      ],
      "name": "Mahrokh Dolatian"
    },
    {
      "affs": [
        2
      ],
      "name": "Zoherh Mahmoodi"
    },
    {
      "affs": [
        3
      ],
      "name": "Giti Ozgoli"
    },
    {
      "affs": [
        4
      ],
      "name": "Behjat Khorsandi"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/4tymz3zv75spe.bib",
  "cited_by": 0,
  "doi": null,
  "fulltext_url": null,
  "id": "4tymz3zv75spe",
  "issns": [
    "2588-3712",
    "2588-3720"
  ],
  "landing_url": null,
  "language": "en",
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "RT1-120"
    ]
  ],
  "openalex": null,
  "pdf_url": "http://hnmj.gums.ac.ir/article-1-2483-en.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-01",
  "publisher": "Guilan University of Medical Sciences",
  "ris": "https://research.draconitic.com/paper/4tymz3zv75spe.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T13:44:41Z",
      "native_id": "d828742f3a4d431e9336ff44ed5f670f",
      "source": "doaj",
      "url": null
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "lcc:RT1-120",
      "subfield": "general"
    }
  ],
  "title": "Developing a model of social determinants affecting marital adjustment in marginalized married women: Path Analysis",
  "title_text": "Developing a model of social determinants affecting marital adjustment in marginalized married women: Path Analysis",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:44:41Z",
  "url": "https://research.draconitic.com/paper/4tymz3zv75spe",
  "venue": "Journal of Holistic Nursing and Midwifery",
  "versions": []
}