The effect of Stress of COVID-19 Pandemic on Sexual Quality Of Life Female and Couples' Relationship Running title: Covid-19 and Sexual quality of life and Couples' Relationship

The effect of Stress of COVID-19 Pandemic on Sexual Quality Of Life Female and Couples' Relationship Running title: Covid-19 and Sexual quality of life and Couples' Relationship | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The effect of Stress of COVID-19 Pandemic on Sexual Quality Of Life Female and Couples' Relationship Running title: Covid-19 and Sexual quality of life and Couples' Relationship Parvin Abedi, Vahid Rahmanian, Afsaneh Ranjbar, safieh jamali, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-2728823/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background This study was conducted to determine the The effect of Stress of COVID-19 Pandemic on Sexual Quality Of Life Female and Couples' Relationship in women Methods The participant of this cross sectional study consisted of 395 women who employed online questionnaires using Google Form as the platform in the Iran between November 2022 and December 2022. the data gathering tool was The sexual quality of life-female (SQOL-F), Depression Anxiety Stress Scale(DASS), Relationship Rating Scale (RAS), fear of COVID-19 Scale. Data analysis was performed using descriptive statistics, In the analytical statistics section, independent t-test, one-way ANOVA, Tukey post hoc test and Univariate and Multiple linear regression were used. Results The mean score of the sexual quality of life in the participating women was 64.82 ± 11.93, 18.28 ± 4.48 from DASS, 22.48 ± 4.30 from RAS,and 12.88 ± 3.93 from fear of COVID-19 scale. The effect of fear of COVID-19, DASS, and age on sexual quality of life in women was significant and inverse (P < 0.05). This means that with an increase in the score of fear of COVID-19, DASS, and age the mean score of sexual quality of life decreases by 0.419, 0.136, and 0.582 respectively. Conclusions the anxiety and stress caused by covid-19 can reduce relationships and sexual performance and reduce the quality of sex. In this regard, studies are suggested a description of prevalence and psychological, communicative and sexual consequences in the country be taken so that vulnerable families can be identified with proper planning and the necessary psychological interventions can be adopted. COVID-19 Pandemic Sexual Quality Of Life Couples' Relationship Figures Figure 1 Introduction In 2019, The existence of a new virus called Covid-19 was announced to the World Health Organization (1). Finally, in March 2020, the World Health Organization described it as a pandemic disease. According to the World Health Organization, after Italy, Spain, United States, France and the United Kingdom, Iran had the highest number of deaths due to corona infection (2). This disease is actually a major social event that has been raised not only at the level of a region but at the level of the country and even the whole world, and it is necessary to pay attention to its psychological effects on the society. (3) Covid-19 caused many restrictions worldwide, including home quarantine. In these quarantine conditions, the stress caused by the corona virus can disrupt the home and create harmful conditions such as post-traumatic stress.(4). Experiencing such stresses is certainly not without impact and can show its effects in many dimensions; One of the dimensions of stress caused by the corona virus is marital and family relationships. (5 ,6). Yaxel's research showed that the stress caused by the corona virus lowers the quality of sexual intercourse and, as a result, causes sexual disorders. Therefore, it seems that such sexual inefficiencies are not ineffective in the occurrence of marital conflicts and violence; and cause negative interactions(7). A study in China indicated a 42% decrease in couples' relationships and sexual performance during quarantine. (9). Investigations in Iran showed that compared to pregnant women, lactating women had lower quality of life, mental health and sexual performance during this period (10). In America, the level of marital satisfaction of people has not changed much (11). Most of the cross-sectional studies [ 12 – 14 ] of the general population in the era of Covid-19, increased symptoms of depression, anxiety and stress related to this disease due to its lethality, changes in lifestyle, social isolation, economic burden and pessimism about the future, fear and confirm the concern of contracting the disease (15). Studies on psychological effects of the covid-19 pandemic on the family and couples in Iran are limited, but what is certain is that people have suffered many problems during the covid-19 epidemic, it is possible that marital and family problems will intensify. to catch more and more that this requires scientific investigation. Therefore, the current research aims to investigate stress-anxiety-depression and its relationship with the quality of sexual life and the quality of couples' communication Methods Design and participants A cross sectional study design was employed online questionnaires using Google Form as the platform. The sampling period lasted for 1 month between November 2022 and December 2022. This research was conducted with the approval of Ethics Council of Jahrom University of Medical Sciences (JUMS.REC.1401.017). Eligible women who matched the selection criteria were identified by being over 18 years old, residing in Iran, having a partner, having no history of smoking, alcohol or antidepressants, having no a medical problems and mental disorder history, having no history of stressful events in last six months. exclusion criteria was all the COVID-19 positive women. Before beginning of the study, all the participants gave their consent. Then, we proceeded to send the questionnaires. The initial sample consisted of 474 participants of whom 79 did not complete all of the questionnaires(Fig. 1). Sample Size Estimation The power of study considered was 80% and \(a=\) 0.05%.According to the formula the sample size was 288, and, by adding 20% for dropouts,the sample size was increased to 474. Out of the 474 cases, 395 completed the questionnaire, and 79 were excluded because they did not fill out the questionnaires completely. Measures In this study, the data gathering tool was a four part questionnaire. The first part included personal characteristics: including age, spouse's education, spouse's occupation). The second part consisted of The sexual quality of life-female (SQOL-F) questionnaire. Symonds and et al developed the questionnaire in 2005(16). The basis for the SQOL-F questionnaire involved physical, psychological, emotional and social components. This questionnaire of 18 items evaluates the quality of women's sexual life. This questionnaire will have a possible score range of 18 to 108. The quality of women's sexual life increases with higher questionnaire scores. Chesli et al validated it in Iran. Validity was showed that the CVI was 0.91 and the CVR was 0.84 The Cronbach’s alpha coefficient for the questionnaire was 0.73..(17). The third part of the questionnaire was Depression Anxiety Stress Scale (DASS) 21,A self-report scale designed to measure the negative emotional states of depression, anxiety and stress. Each of the three DASS-21 scales contains 7 items. In addition, scores for each subscale are categorised into five severity ranges: normal, mild, moderate, severe and extremely severe(18). In Antoni et al.'s study, the alpha coefficient for depression, anxiety and stress was 0.97, 0.92 and 0.95, respectively, and the correlation between depression and stress was 0.48, anxiety and stress were 0.53, and anxiety and depression were 0.28. (19). The validity and reliability of this questionnaire in Iran has been investigated by Samani and Jokar, the validity for depression, anxiety and stress scale is 0.80, 0.76, 0.77(20). Relationship Rating Scale (RAS) by Susan S. Hendrick was built in 1988. A 7-item scale designed to measure general relationship satisfaction. Respondents answer each item using a 5-point scale ranging from 1 (low satisfaction) to 5 (high satisfaction). Scoring is kept continuous. The higher the score, the more satisfied the respondent is with his/her relationship. The minimum score will be 7 and the maximum will be 35. The minimum possible score will be 7 and the maximum will be 35. Score between 7–14: satisfaction is low. A score between 14–21: moderate satisfaction. A score higher than 21: satisfaction is high (21). reliability of this questionnaire in Iran has been investigated by Dashiri (22) Statistical analysis Data analysis was done using SPSS version 22. At first, the Kolmogorov-Smirnov test was used to check the normality of the data. In the descriptive statistics section, the results were reported in the form of mean, standard deviation, frequency, and percentage. In the analytical statistics section, independent t-test, one-way ANOVA, and Tukey post hoc test were used. Univariate and Multiple linear regression by the ENTER method was applied to examine the association between RAS, fear of COVID-19, DASS, and demographic variables with sexual quality of life. The significance level was considered < 0.05. Results There were 395 females who participated in this study, and the subjects’ features are shown in Table 1 . Table 1 Baseline characteristics of participants Characteristic N (%) Total 395 (100%) Age (mean (SD)) 31.97(9.04) Age range < 30 202(51.1) 30–40 125(31.6) 40–50 47(11.9) 50+ 21(5.3) The age difference between couples < 5 263(66.6) 5–10 107(27.1) 10–15 17(4.3) 15+ 8(2.0) Husband's age (mean (SD)) 36.59(9.82) Husband's Age range < 30 167(42.3) 30–40 130(32.9) 40–50 68(17.2) 50+ 30(7.6) Marriage duration < 5 138(34.9) 5–10 97(24.6) 10–15 69(17.5) 15+ 91(23) Region Urban 291(73.7) Rural 104(26.3) Level of education illiterate 20(5.1) Middle school 52(13.2) High school 193(48.9) Graduation 130(32.9) Level of Husband's education illiterate 19(4.8) Middle school 43(10.9) High school 158(40) Graduation 175(44.3) Occupation status Housewife 186(47.1) Employed 209(52.9) Husband's Occupation Governmental 228(57.7) Non-governmental 167(42.3) The mean age of women participating in this study and their husbands was 31.97 ± 9.04 and 36.59 ± 9.82 years, respectively. 66.6% (263 people) of the age difference between participating women and their husbands was less than five years and 73.7% (291 people) lived in urban. In terms of education, 48.9% (193 people) of participants had high school, 32.9% (130 people) had a graduation education, and 52.9% (209 people) were employed (Table 1 ). The mean score of the sexual quality of life in the participating women was 64.82 ± 11.93. There was a significant difference in the mean score of sexual quality of life according to the subgroup of the age difference of couples, occupation status, and place of residence (p < 0.05)(Table 2 ). Table 2 Mean and standard deviation of Sexual quality of life, RAS, DASS, and Its dimensions by age, education level, and region Characteristic Sexual quality of life RAS Fear of COVID-19 DASS Depression Anxiety Stress Total 64.82 ± 11.93 22.48 ± 4.30 12.88 ± 3.93 27.50 ± 10.18 19.23 ± 7.64 17.47 ± 8.0 18.28 ± 4.48 Age range < 30 64.79 ± 13.17 22.51 ± 4.48 12.86 ± 3.97 27.56 ± 11.29 19.31 ± 8.28 17.42 ± 8.98 18.37 ± 8.00 30–40 64.19 ± 11.30 22.50 ± 4.60 12.78 ± 4.09 27.43 ± 9.44 19.20 ± 7.35 17.48 ± 7.05 18.17 ± 7.44 40–50 66.47 ± 9.85 22.19 ± 3.19 12.55 ± 3.62 27.00 ± 8.24 18.72 ± 6.41 16.59 ± 6.09 18.68 ± 6.36 50+ 65.14 ± 6.09 22.14 ± 2.92 14.48 ± 2.97 28.38 ± 7.15 19.72 ± 4.48 19.90 ± 6.88 17.14 ± 4.62 P-value* 0.740 0.987 0.275 0.964 0.957 0.475 0.880 Tukey Test NA NA NA NA NA NA NA The age difference between couples < 5 63.40 ± 11.74 22.82 ± 4.51 12.62 ± 3.83 26.20 ± 9.44 18.50 ± 7.58 16.47 ± 7.78 17.42 ± 7.40 5–10 66.56 ± 10.63 22.14 ± 3.82 13.33 ± 3.82 29.81 ± 9.31 20.42 ± 7.13 19.36 ± 7.37 19.83 ± 6.75 10–15 67.00 ± 9.90 21.47 ± 3.24 14.65 ± 4.41 33.41 ± 7.87 24.11 ± 6.26 20.35 ± 7.65 22.35 ± 5.53 15+ 83.38 ± 22.41 18.13 ± 5.22 11.63 ± 6.30 26.50 ± 21.94 16.75 ± 12.87 19.00 ± 14.42 17.25 ± 15.41 P-value* < 0.001 0.009 0.080 0.001 0.005 0.008 0.004 Tukey Test (< 5)< ( 15+) ( (15+) NA (< 5)<(10–15) (< 5)<(10–15) (< 5)<(10–15) (< 5)<(5–10) (< 5)<(10–15) Marriage duration < 5 63.52 ± 13.30 23.07 ± 4.47 12.20 ± 4.12 26.86 ± 10.90 19.21 ± 8.16 16.18 ± 8.86 18.30 ± 7.95 5–10 64.58 ± 11.82 22.64 ± 4.78 13.55 ± 3.79 27.47 ± 10.44 19.19 ± 7.77 18.07 ± 8.96 17.68 ± 7.67 10–15 67.68 ± 11.04 21.19 ± 4.27 13.49 ± 3.69 30.54 ± 10.10 20.52 ± 7.77 20.02 ± 7.39 20.52 ± 7.56 15+ 64.87 ± 10.18 22.41 ± 3.26 12.75 ± 3.82 26.19 ± 8.40 18.30 ± 6.44 16.85 ± 6.58 17.20 ± 6.10 P-value* 0.130 0.029 0.032 0.042 0.349 0.008 0.033 Tukey Test NA ((10–15) (< 5)( 15+) NA ((10–15) (10–15)>( 15+) Level of education illiterate 68.00 ± 12.26 21.70 ± 4.33 13.60 ± 3.81 28.70 ± 11.23 21.00 ± 6.30 17.40 ± 9.27 19.00 ± 8.81 Middle school 65.33 ± 11.29 21.98 ± 3.23 13.56 ± 2.98 28.02 ± 6.38 18.42 ± 5.66 19.11 ± 5.60 18.50 ± 5.13 High school 65.78 ± 10.55 22.59 ± 3.93 13.34 ± 3.55 28.79 ± 10.04 19.72 ± 7.24 18.91 ± 7.53 18.94 ± 8.69 Graduation 62.70 ± 13.74 22.65 ± 5.14 11.82 ± 4.59 25.18 ± 11.10 18.55 ± 8.95 14.70 ± 8.60 18.10 ± 7.68 P-value* 0.076 0.644 0.002 0.016 0.326 (Graduation), (High school)> (Graduation) High school > Graduation NA (Middle school) > (Graduation), (High school)> (Graduation) NA Occupation status Housewife 66.41 ± 11.64 22.38 ± 4.23 13.14 ± 3.55 27.46 ± 9.29 19.08 ± 6.81 18.00 ± 7.15 17.83 ± 7.34 Employed 63.40 ± 12.02 22.58 ± 4.38 12.65 ± 4.23 27.53 ± 10.94 19.35 ± 8.32 17.01 ± 8.67 18.67 ± 8.60 P-value** 0.012 0.641 0.218 0.950 0.724 0.222 0.266 Region Urban 63.97 ± 12.56 22.70 ± 4.64 12.45 ± 3.98 27.14 ± 11.02 19.16 ± 8.24 16.92 ± 8.39 18.18 ± 8.06 Rural 67.18 ± 9.61 21.88 ± 3.10 14.09 ± 3.52 28.49 ± 7.31 19.40 ± 5.64 19.01 ± 6.58 18.55 ± 5.57 P-value** 0.018 0.093 < 0.001 0.247 0.788 0.022 0.664 DASS: Depression Anxiety Stress Scale, RAS: NA: Not Applicable * One-Way ANOVA ** Independent t-test Significant level: P < 0.05 The mean score of relationship satisfaction in participating women was 22.48 ± 4.30, and the smaller the age difference with the spouse and the shorter the duration of the marriage, the higher the mean score of relationship satisfaction(p < 0.05) (Table 2 ). The mean score of fear of COVID-19 in female participants was 12.88 ± 3.93. The score of fear of COVID-19 was lower in urban women than those with graduation education (p < 0.05) (Table 2 ). The mean score of DASS and its dimensions include of depression, anxiety and stress in female participants were 27.50 ± 10.18, 19.23 ± 7.64, 17.47 ± 8.0 and 18.28 ± 4.48, respectively. The mean score of DASS was lower in women who had less than 5 years of age difference from their husbands and women with graduation education (p < 0.05) (Table 2 ). The results of univariate linear regression showed that the variables of the age difference of couples, husband's age, RAS, fear of COVID-19, DASS, marriage duration, place of residence, and occupation status are associated with sexual quality of life (p < 0.05) (Table 3 ). Table 3 Factors affecting Sexual quality of life using linear regression method, Model based on 395 observations, adjusted R-squared (Multiple models) = 31%, p = < 0.001. Variable Category Univariate linear regression Multiple linear regression B SE Standardized Coefficients Beta P-value* B SE Standardized Coefficients Beta P-value** Age - 0.034 0.067 0.026 0.613 -0.582 0.120 -0.441 < 0.001 The age difference of couples - 0.848 0.155 0.266 < 0.001 0.069 0.229 0.021 0.765 Husband's age - 0.195 0.060 0.161 0.001 0.590 0.110 0.485 < 0.001 RAS - 1.35 0.122 0.489 < 0.001 1.27 0.127 0.461 < 0.001 Fear of COVID-19 - -0.577 0.150 -0.184 < 0.001 -0.419 0.138 -0.138 0.003 DASS - -0.158 0.059 -0.135 0.007 -0.136 0.057 -0.116 0.017 Marriage duration < 5 0 - - - 0 - - - 5–10 -1.05 1.57 -0.038 0.503 1.20 1.39 0.044 0.386 10–15 -4.15 1.75 -0.133 0.018 1.38 1.70 0.044 0.415 15+ -1.34 1.60 0.048 0.402 3.07 2.94 0.121 0.296 Region Urban -3.21 1.35 -0.119 0.018 0.141 1.30 0.005 0.914 Rural 0 - - - 0 - - - Level of education illiterate 0 - - - 0 - - - Middle school 2.67 3.12 0.076 0.323 2.35 2.80 0.067 0.401 High school 2.22 2.78 0.093 0.426 1.62 2.58 0.068 0.531 Graduation 5.30 2.85 0.209 0.064 3.07 2.94 0.121 0.296 Level of Husband's education illiterate 4.19 3.23 0.110 0.195 0 - - - Middle school 0.509 2.84 0.021 0.858 3.16 2.80 0.083 0.259 High school 5.45 2.83 0.227 0.055 -1.42 2.50 -0.058 0.570 Graduation 4.19 3.23 0.110 0.195 1.04 2.62 0.043 0.692 Occupation status Housewife -3.00 1.19 -0.126 0.012 -1.71 1.02 -0.072 0.096 Employed 0 - - - 0 - - - Husband's Occupation Governmental 0.639 1.21 0.026 0.60 0.606 1.15 0.025 0.158 Non-governmental 0 - - - 0 - - - “_”: Not Applicable, DASS: Depression‚ Anxiety‚ Stress Scale, RAS: Significant level: P < 0.05, * Univariate linear regression,** Multiple linear regression using Enter technique, ⸸ Bold P-values means P < .05. The multiple regression results showed that the age of women, age of husband, RAS, fear of COVID-19, and DASS variables could explain 31% of the variance changes in sexual quality of life . The effect of fear of COVID-19, DASS, and age on sexual quality of life in women was significant and inverse (P < 0.05). This means that with an increase in the score of fear of COVID-19, DASS, and age the mean score of sexual quality of life decreases by 0.419, 0.136, and 0.582 respectively. In addition, for one unit of change in the score of the satisfaction score of the relationship, the mean score of sexual quality of life increases by 1.27 units (< 0.001)(Table 3 ). Discussion The results of this study indicated a significant relationship between the quality of sexual life with psychological characteristics, fear of covid-19 and couples' communication. our study showed that a relation between quality of sexual life and psychological statues ( anxiety, stress, and depression). Also, with the increase in the fear of contracting covid-19, the quality of sexual life also decreased. Rahimi et al. (2018). [ 23 ] reported that high level stress may contribute to lower level of quality of sexual function.The results of previous studies were consistent with our study(24,25,26). Karsiakali et al. determined that couples who had more stress and anxiety about Corona had lower sexual performance and satisfaction (27(. The lutake results also showed that half of the participants had a significant decrease in their sexual relations. Also, being young, having sexual fantasies and less stress increased sex (28). The results of our study stated that the fear of Covid-19 is related to the quality of romantic relationship. According to the surveys carried out inside the country, the level of fear of contracting the covid-19 disease is at a high level ( 29). The continuous emphasis on prevention and the fear of getting infected with Corona has caused a decrease in interpersonal interactions even in the form of physical distance (30). A person may be afraid of contracting a disease after any sexual intercourse. Following thoughts of fear, apathy and frustration in sex may be transformed and affect sexual performance (31) Studies have also shown the fear of contracting Covid and its effects on stress.(32,33). The fear of contracting the corona virus is an adaptive reaction that people feel due to the existence of danger or threat, which, considering the current situation of the corona pandemic, can be severe and affect people's mental health and marital life (34) Also, the results showed that couples' relationships have an impact on the quality of sexual life. Studies show different results. A study in China on couples showed that 40% of them mentioned a decrease in the number of sexual functions and 32% a decrease in satisfaction (35). Also, a study in Bangladesh showed that the participants did not change. They did not mention the number and sexual satisfaction (36). Coco in Italy stated that participants had increased sexual desire and decreased sexual satisfaction in the relationship (37). In our study, the participants mentioned high scores of stress, anxiety and depression, which has a negative impact on the emotional relationships of couples, and on the other hand, during the Covid-19 pandemic, staying at home has become the slogan of the World Health Organization and many countries. has been, during the time of home quarantine due to the inability of many couples to manage the duties of people at home and lack of understanding; There were many marital conflicts and sexual problems, which in some cases ended in divorce and separation (38). In addition to the problems of couples, the stress and possible conflicts of the spread of Covid-19 may have long-term consequences on the interactions and relationships of family members. While marital conflicts may increase the anxiety and stress of couples, (39). Other results of our study showed that the quality of sexual life in housewives and urban areas was lower and had a negative correlation, it seems that living in the conditions of Constantinople was more effective in the urban environment and the close relationship of couples in the home environment can be the tension resulting from increase these conditions. On the other hand, women working outside the home in relation to protocols related to sexual relations and ways transmission during the relationship had more information. And education related to sexual issues, the awareness of this group of people is more and for Compliance with the conditions is based on the possible knowledge that housewives were not informed or sometimes deprived of these policies. All these cases have a role on the couple's relationship and its quality. (40) Conclusion Relationships of couples and the quality of sexual life are affected by anxiety and stress caused by Covid-19. In our study, it showed that the anxiety caused by covid-19 can reduce relationships and sexual performance and reduce the quality of sex. Considering that our study was conducted at the end of the covid-19 epidemic, it seems that the effect of this chronic stress on relationships And the sexual quality of couples continues. Therefore, it is recommended that more studies should be done in this field after Corona. Limitations And Strengths This is the first study in Iran that examines the effects of chronic stress and anxiety caused by the Covid-19 epidemic on the quality and relationships of couples, so it is one of the strengths of our study. The results of this research included users of virtual networks, the data may not represent the entire population, and the generalization of the results should be done with caution. In this regard, it is suggested to carry out descriptive studies on the prevalence and future psychological consequences of Covid-19 and its effects on the quality of life and marital relationships in the country so that vulnerable families can be identified and interventions can be made with proper planning. adopted the necessary psychological Declarations Acknowledgements The authors thank all the women who participated in this projectandwe would like to appreciate the officials and staff of the Jahrom Clinic and all those who helped us in this study. Author contributions All the authors contributed to the conception and design of the study. SJ and PA were involved in writing the article and ZA, AR were involved in data collection. VR has been involved in the statistical analysis of the project . All authors read and approved the final manuscript. Funding This paper was conducted with the financial support of Jahrom University of Medical Sciences. The funding agency played no role in the design of the study, collection, analysis, and interpretation of data and writing the manuscript Availability of data and materials The datasets generated and/or analyzed during the current research are not publicly available as individual privacy could be compromised but are available from the corresponding author on reasonable request Ethics approval and consent to participate Ethics approval and consent to participate the Ethics Committee of the Jahrom University of Medical Sciences in Jahrom, Iran approved the protocol of this study (Code number: (JUMS.REC.1401.017). Written, informed consent was obtained from all participants. all methods were carried out in accordance with relevant guidelines and regulations under ‘Ethical Approval and Consent to Participate’ section. Consent for publication Not applicable. Competing interests The authors declare that they have no competing interests. Author details Safieh Jamali, Master of Reproductive Health, Faculty member of Jahrom University of Medical Sciences. Zahra Ahmadi., Medical student, Medical School, Jahrom University of Medical Sciences, Jahrom , Iran Parvin Abedi, PhD of Community Nutrition professor in midwifery department, menopause Andropause Research Centre, Ahvaz Jundishapur University of Medical Sciences, Iran. Vahid Rahmanian Assistant professor of Epidemiology, Department of Public Health, Torbat Jam Faculty of Medical Sciences, Torbat Jam, Iran. Afsaneh Ranjbar Department of Physiology, Jahrom University of Medical Sciences, Jahrom, Iran References World Health Organization. Coronavirus disease 2019 (COVID-19) situation report-34. Geneva: World Health Organization; 2020. [Link] Liu N, Zhang F, Wei C, Jia Y, Shang Z, Sun L, et al. Prevalence and predictors of PTSS during COVID-19 outbreak in China hardest-hit areas: Gender differences matter. 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A generic measure of relationship satisfaction, journal of Marriage and the Family, 50, 93-98. Dashiri GH, Mousavi F. Psychometric Properties of the Persian Version of the Relationship Assessment Scale among Couples Journal of Family Research 2016; 12(1): 141-154 . Rahimi M, Reshadat S, Farid Marandi B, Zakiei A. Factors associated with sexual function and sexual satisfaction in male patients with diabetes type 2. J Mazandaran Univ Med Sci. 2018;28(164):164–9 Lehmiller, J. J., Garcia, J. R., Gesselman, A. N., & Mark, K. P. (2020). Less Sex, but More Sexual Diversity: Changes in Sexual Behavior during the COVID-19 Coronavirus Pandemic. Leisure Sciences , 1-10. Panzeri, M., Ferrucci, R., Cozza, A., & Fontanesi, L. (2020). Changes in Sexuality and Quality of , E., Kaukinen, C., & Knaul, F. M. (2021). Evidence from a Systematic Review and Meta-Analysis: Domestic Violence during the COVID-19 Pandemic. Journal of Criminal Justice , 101806. Esposito, V., Rania, E., Lico, D., Pedri, S., Fiorenza, A., Strati, M. F., ... & Venturella, R. (2020). Influence of COVID-19 Pandemic on the Psychological Status of Infertile Couples. European Journal of Obstetrics & Gynecology and Reproductive Biology , 253 , 148-153. Karsiyakali, N., Sahin, Y., Ates, H. A., Okucu, E., & Karabay, E. (2021). Evaluation of the Sexual Functioning of Individuals Living in Turkey during the COVID-19 pandemic: an Internet-based Nationwide Survey Study. Sexual medicine , 9 (1), 100279. Luetke, M., Hensel, D., Herbenick, D., & Rosenberg, M. (2020). Romantic relationship conflict due to the COVID-19 Pandemic and Changes in Intimate and Sexual Behaviors in a Nationally Representative Sample of American Adults. Journal of Sex & Marital Therapy , 46 (8), 747-762. Asmundson GJ, Taylor S. Coronaphobia: Fear and the 2019-nCoV outbreak. J Anxiety Disord 2020; 70: 102196. Zhang Y, Ma ZF. Impact of the COVID-19 pandemic on mental health and quality of life among local residents in Liaoning Province, China: A cross-sectional study. Int J Environ Res 2020; 17(7): 2381. Gaspari V, Orioni G, Viviani F, Raone B, Lanzoni A, Bardazzi F. Does COVID‐19 influence sexual behaviors? Dermatol Ther 2020. Hosseini S, Bahrevar V, Rahmanian V, Hazar N. Fear of COVID 19 Pandemic :A case study in Iran. Pakistan J Medical Health Sci 2020; 14(2). [Farsi] Karagöz MA, Gül A, Borg C, Erihan İB, Uslu M, Ezer M, et al. Influence of COVID-19 pandemic on sexuality: a cross-sectional study among couples in Turkey. Int J Impot Res 2020; 1-9. Elemo AS, Satici SA, Griffiths MD. The Fear of COVID-19 Scale: Psychometric Properties of the Ethiopian Amharic Version. Int J Ment Health Addict 2020; 1-12. Bruce, L. D., Wu, J. S., Lustig, S. L., Russell, D. W., & Nemecek, D. A. (2019). Loneliness in the United States: a 2018 National Panel Survey of Demographic, Structural, Cognitive, and Behavioral Characteristics. American Journal of Health Promotion , 33 (8), 1123-1133. Naghizadeh, S., Mirghafourvand, M., & Mohammadirad, R. (2021). Domestic Violence and its Relationship with Quality of Life in Pregnant Women During the Outbreak of COVID-19 Disease. BMC pregnancy and childbirth , 21 (1), 1-10 Li W, Li G, Xin C, et al. Challenges in the practice of sexual medicine in the time of COVID-19 in China. J Sex Med. 2020;17:1225–1228. Available at: https://linkinghub.elsevier. com/retrieve/pii/S174360952030597X. Accessed March 24, 2021. Arafat SMY, Alradie-Mohamed A, Kar SK, et al. Does COVID-19 pandemic affect sexual behaviour? A cross-sectional, crossnational online survey. Psychiatry Res 2020; 289:113050 Available at: https://linkinghub.elsevier.com/ retrieve/pii/S0165178120309781. Accessed March 24, 2021 Cocci A, Giunti D, Tonioni C, et al. Love at the time of the Covid-19 pandemic: preliminary results of an online survey conducted during the quarantine in Italy. Int J Impot Res 2020;32:556–557. Available at: http://www.nature.com/ articles/s41443-020-0305-x. Accessed March 24, 2021. Lee H-H, Lee P-R, Kao W-T, Lee Y-L. The relationship between sex life satisfaction and job stress of married nurses. BMC Res Notes 2012; 5(1): 1-5. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-2728823","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":188861025,"identity":"f71033f9-ac36-4a5e-87e8-2a3deb64ce98","order_by":0,"name":"Parvin Abedi","email":"","orcid":"","institution":"Ahvaz Jundishapur University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Parvin","middleName":"","lastName":"Abedi","suffix":""},{"id":188861027,"identity":"18f80ae8-61fb-4b9d-a1ef-1a2381eb83ff","order_by":1,"name":"Vahid Rahmanian","email":"","orcid":"","institution":"Torbat Jam Faculty of Medical Sciences, Torbat Jam, Iran","correspondingAuthor":false,"prefix":"","firstName":"Vahid","middleName":"","lastName":"Rahmanian","suffix":""},{"id":188861030,"identity":"0d287732-9934-4600-a470-81fae862ee97","order_by":2,"name":"Afsaneh Ranjbar","email":"","orcid":"","institution":"Jahrom University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Afsaneh","middleName":"","lastName":"Ranjbar","suffix":""},{"id":188861031,"identity":"52d760ee-a00f-456f-ab27-d68b533b73da","order_by":3,"name":"safieh jamali","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA/klEQVRIie3PMWrDMBSA4Sc0ZApdO1VXUKYOpe1VZATxYkhHD6UEDO6Skq0QKD2Ds4R2e+aBu+gABi0OuUC6uUNpFScdHXssRP8gadCH9AB8vn8Zq5BNge9OqGIA2U24/COAyvQk4EgTsrQHEY/E8PMNBmfPVOH6lcTlIEGo41UrkUZDvjDAz+1YYrCi0fusUGxmbDuBCdIwdbNY1RCWlZHkLG0nYr4B+nZE2HCLwQvddhIoNZCbmksbuVemFHQSWW4gf3JkZKM7VEWoM1Oo/NgsYq759isFfWHD5bq+v7rOPpK8quMjH9v3ow+HpFmx6/6um8P+0Oeyz+fznVi/9Z5kRBs7RjIAAAAASUVORK5CYII=","orcid":"","institution":"PhD Student of Midwifery, Ahvaz Jundishapur University of Medical Sciences","correspondingAuthor":true,"prefix":"","firstName":"safieh","middleName":"","lastName":"jamali","suffix":""},{"id":188861033,"identity":"dfec3b46-51ec-412a-8bd9-697b8de77f47","order_by":4,"name":"zahra ahmadi","email":"","orcid":"","institution":"Jahrom University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"zahra","middleName":"","lastName":"ahmadi","suffix":""}],"badges":[],"createdAt":"2023-03-23 17:14:23","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-2728823/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-2728823/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":35335151,"identity":"5198b2dc-f751-41b2-ab15-269862fc421c","added_by":"auto","created_at":"2023-04-05 14:26:46","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":19345,"visible":true,"origin":"","legend":"\u003cp\u003eFlow diagram of the stud\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-2728823/v1/9aa4577415a0eaed07630d8f.png"},{"id":37700225,"identity":"b08b935c-fa9d-4eda-9396-0f3069614326","added_by":"auto","created_at":"2023-05-30 19:59:33","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":488998,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-2728823/v1/f8f5b4d4-a1cd-48b3-a153-6ffe54a0d1cb.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"The effect of Stress of COVID-19 Pandemic on Sexual Quality Of Life Female and Couples' Relationship Running title: Covid-19 and Sexual quality of life and Couples' Relationship","fulltext":[{"header":"Introduction","content":"\u003cp\u003eIn 2019, The existence of a new virus called Covid-19 was announced to the World Health Organization (1). Finally, in March 2020, the World Health Organization described it as a pandemic disease. According to the World Health Organization, after Italy, Spain, United States, France and the United Kingdom, Iran had the highest number of deaths due to corona infection (2). This disease is actually a major social event that has been raised not only at the level of a region but at the level of the country and even the whole world, and it is necessary to pay attention to its psychological effects on the society. (3) Covid-19 caused many restrictions worldwide, including home quarantine. In these quarantine conditions, the stress caused by the corona virus can disrupt the home and create harmful conditions such as post-traumatic stress.(4). Experiencing such stresses is certainly not without impact and can show its effects in many dimensions; One of the dimensions of stress caused by the corona virus is marital and family relationships. (5 ,6). Yaxel's research showed that the stress caused by the corona virus lowers the quality of sexual intercourse and, as a result, causes sexual disorders. Therefore, it seems that such sexual inefficiencies are not ineffective in the occurrence of marital conflicts and violence; and cause negative interactions(7). A study in China indicated a 42% decrease in couples' relationships and sexual performance during quarantine. (9). Investigations in Iran showed that compared to pregnant women, lactating women had lower quality of life, mental health and sexual performance during this period (10). In America, the level of marital satisfaction of people has not changed much (11). Most of the cross-sectional studies [\u003cspan additionalcitationids=\"CR13\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e] of the general population in the era of Covid-19, increased symptoms of depression, anxiety and stress related to this disease due to its lethality, changes in lifestyle, social isolation, economic burden and pessimism about the future, fear and confirm the concern of contracting the disease (15). Studies on psychological effects of the covid-19 pandemic on the family and couples in Iran are limited, but what is certain is that people have suffered many problems during the covid-19 epidemic, it is possible that marital and family problems will intensify. to catch more and more that this requires scientific investigation. Therefore, the current research aims to investigate stress-anxiety-depression and its relationship with the quality of sexual life and the quality of couples' communication\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eDesign and participants\u003c/h2\u003e \u003cp\u003eA cross sectional study design was employed online questionnaires using Google Form as the platform. The sampling period lasted for 1 month between November 2022 and December 2022. This research was conducted with the approval of Ethics Council of Jahrom University of Medical Sciences (JUMS.REC.1401.017). Eligible women who matched the selection criteria were identified by being over 18 years old, residing in Iran, having a partner, having no history of smoking, alcohol or antidepressants, having no a medical problems and mental disorder history, having no history of stressful events in last six months. exclusion criteria was all the COVID-19 positive women. Before beginning of the study, all the participants gave their consent. Then, we proceeded to send the questionnaires. The initial sample consisted of 474 participants of whom 79 did not complete all of the questionnaires(Fig.\u0026nbsp;1).\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eSample Size Estimation\u003c/h3\u003e\n\u003cp\u003eThe power of study considered was 80% and \u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(a=\\)\u003c/span\u003e\u003c/span\u003e0.05%.According to the formula the sample size was 288, and, by adding 20% for dropouts,the sample size was increased to 474. Out of the 474 cases, 395 completed the questionnaire, and 79 were excluded because they did not fill out the questionnaires\u003c/p\u003e \u003cp\u003ecompletely.\u003c/p\u003e\n\u003ch3\u003eMeasures\u003c/h3\u003e\n\u003cp\u003eIn this study, the data gathering tool was a four part questionnaire. The first part included personal characteristics: including age, spouse's education, spouse's occupation).\u003c/p\u003e \u003cp\u003eThe second part consisted of The sexual quality of life-female (SQOL-F) questionnaire. Symonds and et al developed the questionnaire in 2005(16). The basis for the SQOL-F questionnaire involved physical, psychological, emotional and social components. This questionnaire of 18 items evaluates the quality of women's sexual life. This questionnaire will have a possible score range of 18 to 108. The quality of women's sexual life increases with higher questionnaire scores. Chesli et al validated it in Iran. Validity was showed that the CVI was 0.91 and the CVR was 0.84 The Cronbach\u0026rsquo;s alpha coefficient for the questionnaire was 0.73..(17).\u003c/p\u003e \u003cp\u003eThe third part of the questionnaire was Depression Anxiety Stress Scale (DASS) 21,A self-report scale designed to measure the negative emotional states of depression, anxiety and stress. Each of the three DASS-21 scales contains 7 items. In addition, scores for each subscale are categorised into five severity ranges: normal, mild, moderate, severe and extremely severe(18). In Antoni et al.'s study, the alpha coefficient for depression, anxiety and stress was 0.97, 0.92 and 0.95, respectively, and the correlation between depression and stress was 0.48, anxiety and stress were 0.53, and anxiety and depression were 0.28. (19). The validity and reliability of this questionnaire in Iran has been investigated by Samani and Jokar, the validity for depression, anxiety and stress scale is 0.80, 0.76, 0.77(20).\u003c/p\u003e \u003cp\u003eRelationship Rating Scale (RAS) by Susan S. Hendrick was built in 1988. A 7-item scale designed to measure general relationship satisfaction. Respondents answer each item using a 5-point scale ranging from 1 (low satisfaction) to 5 (high satisfaction). Scoring is kept continuous. The higher the score, the more satisfied the respondent is with his/her relationship.\u003c/p\u003e \u003cp\u003eThe minimum score will be 7 and the maximum will be 35. The minimum possible score will be 7 and the maximum will be 35. Score between 7\u0026ndash;14: satisfaction is low. A score between 14\u0026ndash;21: moderate satisfaction. A score higher than 21: satisfaction is high\u003cb\u003e(21).\u003c/b\u003e reliability of this questionnaire in Iran has been investigated by Dashiri (22)\u003c/p\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eData analysis was done using SPSS version 22. At first, the Kolmogorov-Smirnov test was used to check the normality of the data. In the descriptive statistics section, the results were reported in the form of mean, standard deviation, frequency, and percentage. In the analytical statistics section, independent t-test, one-way ANOVA, and Tukey post hoc test were used. Univariate and Multiple linear regression by the ENTER method was applied to examine the association between RAS, fear of COVID-19, DASS, and demographic variables with sexual quality of life. The significance level was considered\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eThere were 395 females who participated in this study, and the subjects\u0026rsquo; features are shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBaseline characteristics of participants\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristic\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e395 (100%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge (mean (SD))\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e31.97(9.04)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge range\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e202(51.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e30\u0026ndash;40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e125(31.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e40\u0026ndash;50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e47(11.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e50+\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21(5.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eThe age difference between couples\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e263(66.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5\u0026ndash;10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e107(27.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10\u0026ndash;15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e17(4.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e15+\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8(2.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHusband's age (mean (SD))\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e36.59(9.82)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHusband's Age range\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e167(42.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e30\u0026ndash;40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e130(32.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e40\u0026ndash;50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e68(17.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e50+\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30(7.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarriage duration\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e138(34.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5\u0026ndash;10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e97(24.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10\u0026ndash;15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e69(17.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e15+\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e91(23)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRegion\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e291(73.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e104(26.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLevel of education\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eilliterate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20(5.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMiddle school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e52(13.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e193(48.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGraduation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e130(32.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLevel of Husband's education\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eilliterate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e19(4.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMiddle school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e43(10.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e158(40)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGraduation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e175(44.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOccupation status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHousewife\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e186(47.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e209(52.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHusband's Occupation\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGovernmental\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e228(57.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon-governmental\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e167(42.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe mean age of women participating in this study and their husbands was 31.97\u0026thinsp;\u0026plusmn;\u0026thinsp;9.04 and 36.59\u0026thinsp;\u0026plusmn;\u0026thinsp;9.82 years, respectively. 66.6% (263 people) of the age difference between participating women and their husbands was less than five years and 73.7% (291 people) lived in urban. In terms of education, 48.9% (193 people) of participants had high school, 32.9% (130 people) had a graduation education, and 52.9% (209 people) were employed (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe mean score of the sexual quality of life in the participating women was 64.82\u0026thinsp;\u0026plusmn;\u0026thinsp;11.93. There was a significant difference in the mean score of sexual quality of life according to the subgroup of the age difference of couples, occupation status, and place of residence (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05)(Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMean and standard deviation of Sexual quality of life, RAS, DASS, and Its dimensions by age, education level, and region\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristic\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSexual quality\u003c/p\u003e \u003cp\u003eof life\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRAS\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eFear of COVID-19\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eDASS\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eDepression\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eAnxiety\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eStress\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e64.82\u0026thinsp;\u0026plusmn;\u0026thinsp;11.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22.48\u0026thinsp;\u0026plusmn;\u0026thinsp;4.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.88\u0026thinsp;\u0026plusmn;\u0026thinsp;3.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e27.50\u0026thinsp;\u0026plusmn;\u0026thinsp;10.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e19.23\u0026thinsp;\u0026plusmn;\u0026thinsp;7.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e17.47\u0026thinsp;\u0026plusmn;\u0026thinsp;8.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e18.28\u0026thinsp;\u0026plusmn;\u0026thinsp;4.48\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge range\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e64.79\u0026thinsp;\u0026plusmn;\u0026thinsp;13.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22.51\u0026thinsp;\u0026plusmn;\u0026thinsp;4.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.86\u0026thinsp;\u0026plusmn;\u0026thinsp;3.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e27.56\u0026thinsp;\u0026plusmn;\u0026thinsp;11.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e19.31\u0026thinsp;\u0026plusmn;\u0026thinsp;8.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e17.42\u0026thinsp;\u0026plusmn;\u0026thinsp;8.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e18.37\u0026thinsp;\u0026plusmn;\u0026thinsp;8.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e30\u0026ndash;40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e64.19\u0026thinsp;\u0026plusmn;\u0026thinsp;11.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22.50\u0026thinsp;\u0026plusmn;\u0026thinsp;4.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.78\u0026thinsp;\u0026plusmn;\u0026thinsp;4.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e27.43\u0026thinsp;\u0026plusmn;\u0026thinsp;9.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e19.20\u0026thinsp;\u0026plusmn;\u0026thinsp;7.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e17.48\u0026thinsp;\u0026plusmn;\u0026thinsp;7.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e18.17\u0026thinsp;\u0026plusmn;\u0026thinsp;7.44\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e40\u0026ndash;50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e66.47\u0026thinsp;\u0026plusmn;\u0026thinsp;9.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22.19\u0026thinsp;\u0026plusmn;\u0026thinsp;3.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.55\u0026thinsp;\u0026plusmn;\u0026thinsp;3.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e27.00\u0026thinsp;\u0026plusmn;\u0026thinsp;8.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e18.72\u0026thinsp;\u0026plusmn;\u0026thinsp;6.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e16.59\u0026thinsp;\u0026plusmn;\u0026thinsp;6.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e18.68\u0026thinsp;\u0026plusmn;\u0026thinsp;6.36\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e50+\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e65.14\u0026thinsp;\u0026plusmn;\u0026thinsp;6.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22.14\u0026thinsp;\u0026plusmn;\u0026thinsp;2.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14.48\u0026thinsp;\u0026plusmn;\u0026thinsp;2.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e28.38\u0026thinsp;\u0026plusmn;\u0026thinsp;7.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e19.72\u0026thinsp;\u0026plusmn;\u0026thinsp;4.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e19.90\u0026thinsp;\u0026plusmn;\u0026thinsp;6.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e17.14\u0026thinsp;\u0026plusmn;\u0026thinsp;4.62\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP-value*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.740\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.987\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.275\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.964\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.957\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.475\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.880\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTukey Test\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNA\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eThe age difference between couples\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e63.40\u0026thinsp;\u0026plusmn;\u0026thinsp;11.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22.82\u0026thinsp;\u0026plusmn;\u0026thinsp;4.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.62\u0026thinsp;\u0026plusmn;\u0026thinsp;3.83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e26.20\u0026thinsp;\u0026plusmn;\u0026thinsp;9.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e18.50\u0026thinsp;\u0026plusmn;\u0026thinsp;7.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e16.47\u0026thinsp;\u0026plusmn;\u0026thinsp;7.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e17.42\u0026thinsp;\u0026plusmn;\u0026thinsp;7.40\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5\u0026ndash;10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e66.56\u0026thinsp;\u0026plusmn;\u0026thinsp;10.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22.14\u0026thinsp;\u0026plusmn;\u0026thinsp;3.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.33\u0026thinsp;\u0026plusmn;\u0026thinsp;3.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e29.81\u0026thinsp;\u0026plusmn;\u0026thinsp;9.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e20.42\u0026thinsp;\u0026plusmn;\u0026thinsp;7.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e19.36\u0026thinsp;\u0026plusmn;\u0026thinsp;7.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e19.83\u0026thinsp;\u0026plusmn;\u0026thinsp;6.75\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10\u0026ndash;15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e67.00\u0026thinsp;\u0026plusmn;\u0026thinsp;9.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21.47\u0026thinsp;\u0026plusmn;\u0026thinsp;3.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14.65\u0026thinsp;\u0026plusmn;\u0026thinsp;4.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e33.41\u0026thinsp;\u0026plusmn;\u0026thinsp;7.87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e24.11\u0026thinsp;\u0026plusmn;\u0026thinsp;6.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e20.35\u0026thinsp;\u0026plusmn;\u0026thinsp;7.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e22.35\u0026thinsp;\u0026plusmn;\u0026thinsp;5.53\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e15+\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e83.38\u0026thinsp;\u0026plusmn;\u0026thinsp;22.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18.13\u0026thinsp;\u0026plusmn;\u0026thinsp;5.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11.63\u0026thinsp;\u0026plusmn;\u0026thinsp;6.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e26.50\u0026thinsp;\u0026plusmn;\u0026thinsp;21.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e16.75\u0026thinsp;\u0026plusmn;\u0026thinsp;12.87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e19.00\u0026thinsp;\u0026plusmn;\u0026thinsp;14.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e17.25\u0026thinsp;\u0026plusmn;\u0026thinsp;15.41\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP-value*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.009\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.080\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.005\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.008\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.004\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTukey Test\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e(\u0026lt;\u0026thinsp;5)\u0026lt; ( 15+)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(\u0026lt;\u0026thinsp;5)\u0026gt; (15+)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(\u0026lt;\u0026thinsp;5)\u0026lt;(10\u0026ndash;15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e(\u0026lt;\u0026thinsp;5)\u0026lt;(10\u0026ndash;15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(\u0026lt;\u0026thinsp;5)\u0026lt;(10\u0026ndash;15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e(\u0026lt;\u0026thinsp;5)\u0026lt;(5\u0026ndash;10)\u003c/p\u003e \u003cp\u003e(\u0026lt;\u0026thinsp;5)\u0026lt;(10\u0026ndash;15)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarriage duration\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e63.52\u0026thinsp;\u0026plusmn;\u0026thinsp;13.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23.07\u0026thinsp;\u0026plusmn;\u0026thinsp;4.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.20\u0026thinsp;\u0026plusmn;\u0026thinsp;4.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e26.86\u0026thinsp;\u0026plusmn;\u0026thinsp;10.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e19.21\u0026thinsp;\u0026plusmn;\u0026thinsp;8.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e16.18\u0026thinsp;\u0026plusmn;\u0026thinsp;8.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e18.30\u0026thinsp;\u0026plusmn;\u0026thinsp;7.95\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5\u0026ndash;10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e64.58\u0026thinsp;\u0026plusmn;\u0026thinsp;11.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22.64\u0026thinsp;\u0026plusmn;\u0026thinsp;4.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.55\u0026thinsp;\u0026plusmn;\u0026thinsp;3.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e27.47\u0026thinsp;\u0026plusmn;\u0026thinsp;10.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e19.19\u0026thinsp;\u0026plusmn;\u0026thinsp;7.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e18.07\u0026thinsp;\u0026plusmn;\u0026thinsp;8.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e17.68\u0026thinsp;\u0026plusmn;\u0026thinsp;7.67\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10\u0026ndash;15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e67.68\u0026thinsp;\u0026plusmn;\u0026thinsp;11.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21.19\u0026thinsp;\u0026plusmn;\u0026thinsp;4.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.49\u0026thinsp;\u0026plusmn;\u0026thinsp;3.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e30.54\u0026thinsp;\u0026plusmn;\u0026thinsp;10.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e20.52\u0026thinsp;\u0026plusmn;\u0026thinsp;7.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e20.02\u0026thinsp;\u0026plusmn;\u0026thinsp;7.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e20.52\u0026thinsp;\u0026plusmn;\u0026thinsp;7.56\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e15+\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e64.87\u0026thinsp;\u0026plusmn;\u0026thinsp;10.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22.41\u0026thinsp;\u0026plusmn;\u0026thinsp;3.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.75\u0026thinsp;\u0026plusmn;\u0026thinsp;3.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e26.19\u0026thinsp;\u0026plusmn;\u0026thinsp;8.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e18.30\u0026thinsp;\u0026plusmn;\u0026thinsp;6.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e16.85\u0026thinsp;\u0026plusmn;\u0026thinsp;6.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e17.20\u0026thinsp;\u0026plusmn;\u0026thinsp;6.10\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP-value*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.130\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.029\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.032\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.042\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.349\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.008\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.033\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTukey Test\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(\u0026lt;\u0026thinsp;5)\u0026gt;(10\u0026ndash;15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e(\u0026lt;\u0026thinsp;5)\u0026lt;(5\u0026ndash;10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(10\u0026ndash;15)\u0026gt;( 15+)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(\u0026lt;\u0026thinsp;5)\u0026gt;(10\u0026ndash;15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e(10\u0026ndash;15)\u0026gt;( 15+)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLevel of education\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eilliterate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e68.00\u0026thinsp;\u0026plusmn;\u0026thinsp;12.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21.70\u0026thinsp;\u0026plusmn;\u0026thinsp;4.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.60\u0026thinsp;\u0026plusmn;\u0026thinsp;3.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e28.70\u0026thinsp;\u0026plusmn;\u0026thinsp;11.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e21.00\u0026thinsp;\u0026plusmn;\u0026thinsp;6.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e17.40\u0026thinsp;\u0026plusmn;\u0026thinsp;9.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e19.00\u0026thinsp;\u0026plusmn;\u0026thinsp;8.81\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMiddle school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e65.33\u0026thinsp;\u0026plusmn;\u0026thinsp;11.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21.98\u0026thinsp;\u0026plusmn;\u0026thinsp;3.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.56\u0026thinsp;\u0026plusmn;\u0026thinsp;2.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e28.02\u0026thinsp;\u0026plusmn;\u0026thinsp;6.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e18.42\u0026thinsp;\u0026plusmn;\u0026thinsp;5.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e19.11\u0026thinsp;\u0026plusmn;\u0026thinsp;5.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e18.50\u0026thinsp;\u0026plusmn;\u0026thinsp;5.13\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e65.78\u0026thinsp;\u0026plusmn;\u0026thinsp;10.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22.59\u0026thinsp;\u0026plusmn;\u0026thinsp;3.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.34\u0026thinsp;\u0026plusmn;\u0026thinsp;3.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e28.79\u0026thinsp;\u0026plusmn;\u0026thinsp;10.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e19.72\u0026thinsp;\u0026plusmn;\u0026thinsp;7.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e18.91\u0026thinsp;\u0026plusmn;\u0026thinsp;7.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e18.94\u0026thinsp;\u0026plusmn;\u0026thinsp;8.69\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGraduation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e62.70\u0026thinsp;\u0026plusmn;\u0026thinsp;13.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22.65\u0026thinsp;\u0026plusmn;\u0026thinsp;5.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11.82\u0026thinsp;\u0026plusmn;\u0026thinsp;4.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e25.18\u0026thinsp;\u0026plusmn;\u0026thinsp;11.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e18.55\u0026thinsp;\u0026plusmn;\u0026thinsp;8.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e14.70\u0026thinsp;\u0026plusmn;\u0026thinsp;8.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e18.10\u0026thinsp;\u0026plusmn;\u0026thinsp;7.68\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP-value*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.076\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.644\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.326\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.177\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTukey Test\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e(Middle school) \u0026gt; (Graduation),\u003c/p\u003e \u003cp\u003e(High school)\u0026gt; (Graduation)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eHigh school\u0026thinsp;\u0026gt;\u0026thinsp;Graduation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(Middle school) \u0026gt; (Graduation),\u003c/p\u003e \u003cp\u003e(High school)\u0026gt; (Graduation)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNA\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOccupation status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHousewife\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e66.41\u0026thinsp;\u0026plusmn;\u0026thinsp;11.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22.38\u0026thinsp;\u0026plusmn;\u0026thinsp;4.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.14\u0026thinsp;\u0026plusmn;\u0026thinsp;3.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e27.46\u0026thinsp;\u0026plusmn;\u0026thinsp;9.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e19.08\u0026thinsp;\u0026plusmn;\u0026thinsp;6.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e18.00\u0026thinsp;\u0026plusmn;\u0026thinsp;7.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e17.83\u0026thinsp;\u0026plusmn;\u0026thinsp;7.34\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e63.40\u0026thinsp;\u0026plusmn;\u0026thinsp;12.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22.58\u0026thinsp;\u0026plusmn;\u0026thinsp;4.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.65\u0026thinsp;\u0026plusmn;\u0026thinsp;4.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e27.53\u0026thinsp;\u0026plusmn;\u0026thinsp;10.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e19.35\u0026thinsp;\u0026plusmn;\u0026thinsp;8.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e17.01\u0026thinsp;\u0026plusmn;\u0026thinsp;8.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e18.67\u0026thinsp;\u0026plusmn;\u0026thinsp;8.60\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP-value**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.012\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.641\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.218\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.950\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.724\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.222\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.266\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRegion\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e63.97\u0026thinsp;\u0026plusmn;\u0026thinsp;12.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22.70\u0026thinsp;\u0026plusmn;\u0026thinsp;4.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.45\u0026thinsp;\u0026plusmn;\u0026thinsp;3.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e27.14\u0026thinsp;\u0026plusmn;\u0026thinsp;11.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e19.16\u0026thinsp;\u0026plusmn;\u0026thinsp;8.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e16.92\u0026thinsp;\u0026plusmn;\u0026thinsp;8.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e18.18\u0026thinsp;\u0026plusmn;\u0026thinsp;8.06\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e67.18\u0026thinsp;\u0026plusmn;\u0026thinsp;9.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21.88\u0026thinsp;\u0026plusmn;\u0026thinsp;3.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14.09\u0026thinsp;\u0026plusmn;\u0026thinsp;3.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e28.49\u0026thinsp;\u0026plusmn;\u0026thinsp;7.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e19.40\u0026thinsp;\u0026plusmn;\u0026thinsp;5.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e19.01\u0026thinsp;\u0026plusmn;\u0026thinsp;6.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e18.55\u0026thinsp;\u0026plusmn;\u0026thinsp;5.57\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP-value**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.093\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.247\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.788\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.022\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.664\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"8\"\u003eDASS: Depression Anxiety Stress Scale, RAS:\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"8\"\u003eNA: Not Applicable\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"8\"\u003e* One-Way ANOVA\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"8\"\u003e** Independent t-test\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"8\"\u003eSignificant level: P\u0026thinsp;\u0026lt;\u0026thinsp;0.05\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe mean score of relationship satisfaction in participating women was 22.48\u0026thinsp;\u0026plusmn;\u0026thinsp;4.30, and the smaller the age difference with the spouse and the shorter the duration of the marriage, the higher the mean score of relationship satisfaction(p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe mean score of fear of COVID-19 in female participants was 12.88\u0026thinsp;\u0026plusmn;\u0026thinsp;3.93. The score of fear of COVID-19 was lower in urban women than those with graduation education (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe mean score of DASS and its dimensions include of depression, anxiety and stress in female participants were 27.50\u0026thinsp;\u0026plusmn;\u0026thinsp;10.18, 19.23\u0026thinsp;\u0026plusmn;\u0026thinsp;7.64, 17.47\u0026thinsp;\u0026plusmn;\u0026thinsp;8.0 and 18.28\u0026thinsp;\u0026plusmn;\u0026thinsp;4.48, respectively. The mean score of DASS was lower in women who had less than 5 years of age difference from their husbands and women with graduation education (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe results of univariate linear regression showed that the variables of the \u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eage difference of couples, husband's age, RAS, fear of COVID-19, DASS, marriage duration, place of residence, and occupation status are associated with sexual quality of life\u003c/span\u003e(p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eFactors affecting Sexual quality of life using linear regression method, Model based on 395 observations, adjusted R-squared (Multiple models)\u0026thinsp;=\u0026thinsp;31%, p\u0026thinsp;=\u0026thinsp;\u0026lt;\u0026thinsp;0.001.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"10\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c6\" namest=\"c3\"\u003e \u003cp\u003eUnivariate linear regression\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c10\" namest=\"c7\"\u003e \u003cp\u003eMultiple linear regression\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eB\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSE\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eStandardized Coefficients\u003c/p\u003e \u003cp\u003eBeta\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eP-value*\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eB\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eSE\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eStandardized Coefficients\u003c/p\u003e \u003cp\u003eBeta\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eP-value**\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.034\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.067\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.026\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.613\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.582\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-0.441\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe age difference of couples\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.848\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.155\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.266\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.069\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.229\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.021\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.765\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHusband's age\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.195\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.060\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.161\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.590\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.110\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.485\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRAS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.122\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.489\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.127\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.461\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFear of COVID-19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.577\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.150\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.184\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.419\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.138\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-0.138\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDASS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.158\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.059\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.135\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.007\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.136\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.057\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-0.116\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.017\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eMarriage duration\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5\u0026ndash;10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-1.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.038\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.503\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.044\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.386\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10\u0026ndash;15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-4.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.133\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.044\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.415\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15+\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-1.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.048\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.402\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.121\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.296\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eRegion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-3.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.119\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.141\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.005\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.914\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eLevel of education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eilliterate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMiddle school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.076\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.323\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.067\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.401\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHigh school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.093\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.426\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.068\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.531\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGraduation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.209\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.064\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.121\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.296\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eLevel of Husband's education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eilliterate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.110\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.195\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMiddle school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.509\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.021\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.858\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.083\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.259\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHigh school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.227\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.055\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-1.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-0.058\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.570\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGraduation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.110\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.195\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.043\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.692\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eOccupation status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHousewife\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-3.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.126\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.012\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-1.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-0.072\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.096\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEmployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHusband's Occupation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGovernmental\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.639\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.026\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.606\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.025\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.158\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNon-governmental\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"10\"\u003e\u0026ldquo;_\u0026rdquo;: Not Applicable, DASS: Depression\u0026sbquo; Anxiety\u0026sbquo; Stress Scale, RAS: Significant level: P\u0026thinsp;\u0026lt;\u0026thinsp;0.05, * Univariate linear regression,** Multiple linear regression using Enter technique, ⸸ Bold P-values means P\u0026thinsp;\u0026lt;\u0026thinsp;.05.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe multiple regression results showed that the \u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eage of women, age of husband, RAS, fear of COVID-19, and DASS variables could explain 31% of the variance changes in sexual quality of life\u003c/span\u003e. The effect of fear of COVID-19, DASS, and age on sexual quality of life in women was significant and inverse (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). This means that with an increase in the score of fear of COVID-19, DASS, and age the mean score of sexual quality of life decreases by 0.419, 0.136, and 0.582 respectively. In addition, for one unit of change in the score of the satisfaction score of the relationship, the mean score of sexual quality of life increases by 1.27 units (\u0026lt;\u0026thinsp;0.001)(Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe results of this study indicated a significant relationship between the quality of sexual life with psychological characteristics, fear of covid-19 and couples' communication.\u003c/p\u003e \u003cp\u003eour study showed that a relation between quality of sexual life and psychological statues ( anxiety, stress, and depression). Also, with the increase in the fear of contracting covid-19, the quality of sexual life also decreased. Rahimi et al. (2018). [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e] reported that high level stress\u003c/p\u003e \u003cp\u003emay contribute to lower level of quality of sexual function.The results of previous studies were consistent with our study(24,25,26). Karsiakali et al. determined that couples who had more stress and anxiety about Corona had lower sexual performance and satisfaction (27(. The lutake results also showed that half of the participants had a significant decrease in their sexual relations. Also, being young, having sexual fantasies and less stress increased sex (28).\u003c/p\u003e \u003cp\u003eThe results of our study stated that the fear of Covid-19 is related to the quality of romantic relationship. According to the surveys carried out inside the country, the level of fear of contracting the covid-19 disease is at a high level ( 29). The continuous emphasis on prevention and the fear of getting infected with Corona has caused a decrease in interpersonal interactions even in the form of physical distance (30). A person may be afraid of contracting a disease after any sexual intercourse. Following thoughts of fear, apathy and frustration in sex may be transformed and affect sexual performance (31)\u003c/p\u003e \u003cp\u003eStudies have also shown the fear of contracting Covid and its effects on stress.(32,33). The fear of contracting the corona virus is an adaptive reaction that people feel due to the existence of danger or threat, which, considering the current situation of the corona pandemic, can be severe and affect people's mental health and marital life (34)\u003c/p\u003e \u003cp\u003eAlso, the results showed that couples' relationships have an impact on the quality of sexual life. Studies show different results. A study in China on couples showed that 40% of them mentioned a decrease in the number of sexual functions and 32% a decrease in satisfaction (35). Also, a study in Bangladesh showed that the participants did not change. They did not mention the number and sexual satisfaction (36). Coco in Italy stated that participants had increased sexual desire and decreased sexual satisfaction in the relationship (37). In our study, the participants mentioned high scores of stress, anxiety and depression, which has a negative impact on the emotional relationships of couples, and on the other hand, during the Covid-19 pandemic, staying at home has become the slogan of the World Health Organization and many countries. has been, during the time of home quarantine due to the inability of many couples to manage the duties of people at home and lack of understanding; There were many marital conflicts and sexual problems, which in some cases ended in divorce and separation (38). In addition to the problems of couples, the stress and possible conflicts of the spread of Covid-19 may have long-term consequences on the interactions and relationships of family members. While marital conflicts may increase the anxiety and stress of couples, (39). Other results of our study showed that the quality of sexual life in housewives and urban areas was lower and had a negative correlation, it seems that living in the conditions of Constantinople was more effective in the urban environment and the close relationship of couples in the home environment can be the tension resulting from increase these conditions. On the other hand, women working outside the home in relation to protocols related to sexual relations and ways transmission during the relationship had more information. And education related to sexual issues, the awareness of this group of people is more and for Compliance with the conditions is based on the possible knowledge that housewives were not informed or sometimes deprived of these policies. All these cases have a role on the couple's relationship and its quality. (40)\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eRelationships of couples and the quality of sexual life are affected by anxiety and stress caused by Covid-19. In our study, it showed that the anxiety caused by covid-19 can reduce relationships and sexual performance and reduce the quality of sex. Considering that our study was conducted at the end of the covid-19 epidemic, it seems that the effect of this chronic stress on relationships And the sexual quality of couples continues. Therefore, it is recommended that more studies should be done in this field after Corona.\u003c/p\u003e\n\u003ch3\u003eLimitations And Strengths\u003c/h3\u003e\n\u003cp\u003eThis is the first study in Iran that examines the effects of chronic stress and anxiety caused by the Covid-19 epidemic on the quality and relationships of couples, so it is one of the strengths of our study.\u003c/p\u003e \u003cp\u003eThe results of this research included users of virtual networks, the data may not represent the entire population, and the generalization of the results should be done with caution.\u003c/p\u003e \u003cp\u003eIn this regard, it is suggested to carry out descriptive studies on the prevalence and future psychological consequences of Covid-19 and its effects on the quality of life and marital relationships in the country so that vulnerable families can be identified and interventions can be made with proper planning. adopted the necessary psychological\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors thank all the women who participated in this projectandwe would like to appreciate the officials and staff of the Jahrom Clinic and all those who helped us in this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll the authors contributed to the conception and design of the study. SJ and PA were involved in writing the article and ZA, AR were involved in data collection. VR has been involved in the statistical analysis of the project . All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis paper was conducted with the financial support of Jahrom University of Medical Sciences. The funding agency played no role in the design of the study, collection, analysis, and interpretation of data and writing the manuscript\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated and/or analyzed during the current research are not publicly available as individual privacy could be compromised but are available from the corresponding author on reasonable request\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthics approval and consent to participate the Ethics Committee of the Jahrom University of Medical Sciences in Jahrom, Iran approved the protocol of this study (Code number: (JUMS.REC.1401.017). Written, informed consent was obtained from all participants. all methods were carried out in accordance with relevant guidelines and regulations under ‘Ethical Approval and Consent to Participate’ section.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor details\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSafieh Jamali, Master of Reproductive Health, Faculty member of Jahrom University of Medical Sciences. Zahra Ahmadi., Medical student, Medical School, Jahrom University of Medical Sciences, Jahrom , Iran Parvin Abedi, PhD of Community Nutrition professor in midwifery department, menopause Andropause Research Centre, Ahvaz Jundishapur University of Medical Sciences, Iran. Vahid Rahmanian Assistant professor of Epidemiology, Department of Public Health, Torbat Jam Faculty of Medical Sciences, Torbat Jam, Iran. \u003ca\u003eAfsaneh Ranjbar\u003c/a\u003e Department of Physiology, Jahrom University of Medical Sciences, Jahrom, Iran\u003c/p\u003e\n"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eWorld Health Organization. Coronavirus disease 2019 (COVID-19) situation report-34. Geneva: World Health Organization; 2020. [Link]\u003c/li\u003e\n \u003cli\u003eLiu N, Zhang F, Wei C, Jia Y, Shang Z, Sun L, et al. Prevalence and predictors of PTSS during COVID-19 outbreak in China hardest-hit areas: Gender differences matter. Psych Res. 2020; 287:112921. https://doi.org/10.1016/j.psychres.2020.112921\u003c/li\u003e\n \u003cli\u003eAlizadeh Fard S, Saffarinia M. [Predicting mental health based on anxiety and social correlation due to coronary heart disease (Persian)]. 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The relationship between sex life satisfaction and job stress of married nurses. \u003cem\u003eBMC Res Notes\u0026nbsp;\u003c/em\u003e2012; 5(1): 1-5.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"COVID-19 Pandemic, Sexual Quality Of Life, Couples' Relationship","lastPublishedDoi":"10.21203/rs.3.rs-2728823/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-2728823/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eThis study was conducted to determine the The effect of Stress of COVID-19 Pandemic on Sexual Quality Of Life Female and Couples' Relationship in women\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThe participant of this cross sectional study consisted of 395 women who employed online questionnaires using Google Form as the platform in the Iran between November 2022 and December 2022. the data gathering tool was The sexual quality of life-female (SQOL-F), Depression Anxiety Stress Scale(DASS), Relationship Rating Scale (RAS), fear of COVID-19 Scale. Data analysis was performed using descriptive statistics, In the analytical statistics section, independent t-test, one-way ANOVA, Tukey post hoc test and Univariate and Multiple linear regression were used.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe mean score of the sexual quality of life in the participating women was 64.82\u0026thinsp;\u0026plusmn;\u0026thinsp;11.93, 18.28\u0026thinsp;\u0026plusmn;\u0026thinsp;4.48 from DASS, 22.48\u0026thinsp;\u0026plusmn;\u0026thinsp;4.30 from RAS,and 12.88\u0026thinsp;\u0026plusmn;\u0026thinsp;3.93 from fear of COVID-19 scale. The effect of fear of COVID-19, DASS, and age on sexual quality of life in women was significant and inverse (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). This means that with an increase in the score of fear of COVID-19, DASS, and age the mean score of sexual quality of life decreases by 0.419, 0.136, and 0.582 respectively.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003ethe anxiety and stress caused by covid-19 can reduce relationships and sexual performance and reduce the quality of sex. In this regard, studies are suggested a description of prevalence and psychological, communicative and sexual consequences in the country be taken so that vulnerable families can be identified with proper planning and the necessary psychological interventions can be adopted.\u003c/p\u003e","manuscriptTitle":"The effect of Stress of COVID-19 Pandemic on Sexual Quality Of Life Female and Couples' Relationship Running title: Covid-19 and Sexual quality of life and Couples' Relationship","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2023-04-05 14:26:41","doi":"10.21203/rs.3.rs-2728823/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"02dc2edf-9836-4ffd-b807-1ef8f3c3b869","owner":[],"postedDate":"April 5th, 2023","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2023-05-30T19:59:24+00:00","versionOfRecord":[],"versionCreatedAt":"2023-04-05 14:26:41","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-2728823","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-2728823","identity":"rs-2728823","version":["v1"]},"buildId":"_2-kVJe1T_tPrBINL-cwx","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}