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November 2017 -
Volume 15, Issue 9

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Original contribution/Clinical Investigation
Diabetes Mellitus - Knowledge, Management and Complications: Survey report from Faisalabad-Pakistan
Ijaz Anwer, Ahmad Shahzad, Kashmira Nanji, Farah Haider, Muhammad Masood Ahmad

Alanine aminotransferase indicates excess weight and dyslipidemia
Mehmet Rami Helvaci, Orhan Ayyildiz* Mustafa Cem Algin, Yusuf Aydin, Abdulrazak Abyad, Lesley Pocock

Comparative Analysis of Antimicrobial Peptides Gene Expression in Susceptible/Resistant Mice Macrophages to Leishmania major Infection

Hamid Daneshvar, Iraj Sharifi, Alireza Kyhani, Amir Tavakoli Kareshk, Arash Asadi

Does socio-economic status of the patients have effect on clinical outcomes after coronary artery bypass grafting surgery?
Forough Razmjooei, Afshin Mansourian, Saeed Kouhpyma

Comparison of the uterine artery Doppler indices during pregnancy between gestational diabetes and diabetes mellitus and healthy pregnant women
Nazanin Farshchian, Farhad Naleini, Amir Masoud Jaafarnejhad,
Parisa Bahrami Kamangar

Survey single dose Gentamicin in treatment of UTI in children with range of 1 month to 13 years old in Jahrom during 2015
Ehsan Rahmanian, Farideh Mogharab,
Vahid Mogharab

Evaluation of control of bleeding by electro cauterization of bleeding points of amplatz sheath tract after percutaneous nephrolithotomy (PCNL) in Jahrom Peymanieh hospital during year 2015-2016
Ali Reza Yousefi , Reza Inaloo

Comparison of the three-finger tracheal palpation technique with triple ID formula to determine endotracheal tube depth in children 2-8 years in 2016-2017
Anahid Maleki, Alireza Ebrahim Soltani, Alireza Takzare, Ebrahim Espahbodi,
Mehrdad Goodarzi , Roya Noori

Effect of Sevoflurane and Propofol on pulmonary arterial pressure during cardiac catheterization in children with congenital heart diseases
Faranak Behnaz, Mahshid Ghasemi , Gholamreza Mohseni, Azim Zaraki
Population and Community Studies

Prevalence and risk factors of obesity in children aged 2-12 years in the Abu Dhabi Islands
Eideh Al-Shehhi, Hessa Al-Dhefairi, Kholoud Abuasi, Noora Al Ali, Mona Al Tunaiji, Ebtihal Darwish

Study and comparison of psychological disorders in normal students and students with multiple sclerosis in Shahrekord
Neda Ardestani-Samani, Mohammad Rabiei, Mohammad Ghasemi-Pirbalooti, Asghar Bayati, Saeid Heidari-Soureshjani

Comparative study of self-concept, physical self-concept, and time perspective between the students with multiple sclerosis and healthy students in Shahrekord
Neda Ardestani-Samani, Mohammad Rabiei, Mohammad Ghasemi-Pirbalooti, Asghar Bayati, Saeid Heidari-Soureshjani

Relationship between Coping Styles and Religious Orientation with Mental Health in the Students of the Nursing-Midwifery Faculty of Zabol
Nasim Dastras, Mohsen Heidari Mokarrar, Majid Dastras, Shirzad Arianmehr

Tuberculosis in Abadan, Iran (2012-2016): An Epidemiological Study
Ali-Asghar ValiPour, Azimeh Karimyan, Mahmood Banarimehr, Marzieh Ghassemi, Maryam Robeyhavi, Rahil Hojjati,
Parvin Gholizadeh

Family Stability and Conflict of Spiritual Beliefs and Superstitions among Yazdi People in Iran: A Qualitative Study
Zahra Pourmovahed , Seyed Saied Mazloomy Mahmoodabad ; Hassan Zareei Mahmoodabadi ; Hossein Tavangar ; Seyed Mojtaba Yassini Ardekani ; Ali Akbar Vaezi

A comparative study of the self-actualization in psychology and Islam
Simin Afrasibi, Zakieh Fattahi

The effectiveness of cognitive - behavioral therapy in reducing the post-traumatic stress symptoms in male students survivors of earthquake in the central district of Varzeghan
Sakineh Salamat, Dr.Ahad Ahangar, Robab Farajzadeh

Reviews

Effects and mechanisms of medicinal plants on stress hormone (cortisol): A systematic review
Kamal Solati, Saeid Heidari-Soureshjani, Lesley Pocock

Comparing Traditional and medical treatments for constipation : A Review Article
Mohammad Yaqub Rajput

A review of anti-measles and anti-rubella antibodies in 15- 25 year old women in Jahrom City in 2011
Ehsan Rahmania , Farideh Mogharab, Vahid Mogharab

Review of percutaneous nephrolithotomy in children below 12 years old in Jahrom hospital, during 2010-2014
Ali Reza Yousefi , Reza Inaloo

Physical and mental health in Islam
Bahador Mehraki, Abdollah Gholami

International Health Affairs

The Challenges of Implementation of Professional Ethics Standards in Clinical Care from the viewpoint of Nursing Students and Nurses
Saeedeh Elhami, Kambiz Saberi, Maryam Ban, Sajedeh Mousaviasl, Nasim Hatefi Moadab, Marzieh Ghassemi

Cognitive Determinants of Physical Activity Intention among Iranian Nurses: An Application of Integrative Model of Behavior Prediction
Arsalan Ghaderi, Firoozeh Mostafavi, Behzad Mahaki, Abdorrahim Afkhamzadeh,
Yadolah Zarezadeh , Erfan Sadeghi

Effect of resilience-based intervention on occupational stress among nurses
Hossein Jafarizadeh, Ebrahim Zhiyani, Nader Aghakhani, Vahid Alinejad, Yaser Moradi

Education and Training

Calculation of Salaries and Benefits of Faculty Members in the Ministry of Health and Medical Education of Iran
Abdolreza Gilavand

The effect of education on self-care behaviors of gastrointestinal side effects on patients undergoing chemotherapy
Shokoh Varaei, Ehsan Abadi Pishe, Shadan Pedram Razie, Lila Nezam Abadi Farahani

Creating and Validating the Faith Inventory for Students at Islamic Azad University of Ahvaz
Solmaz Choheili, Reza Pasha, Gholam Hossein Maktabi, Ehsan Moheb

Creating and Validating the Adjustment Inventory for the Students of Islamic Azad University of Ahvaz
Homa Choheili, Reza Pasha, Gholam Hossein Maktabi, Ehsan Moheb

Evaluating the Quality of Educational Services from the Viewpoints of Radiology Students of Ahvaz Jundishapur University of Medical Sciences
Abdolreza Gilavand, Jafar Fatahiasl

An Investigation of Psychosocial aspect of Iranian Nursing Students' Clinical Setting
Mahsa Boozaripour , Zanyar Karimi, Sima Zohari Anbohi, Amir Almasi-Hashiani, Fariba Borhani

Clinical Research and Methods

Comparison of the Antibacterial Effects of Chlorhexidine Mouth washes with Jaftex Mouth wash on Some Common Oral Microorganisms (An in Vitro Study)
Ebrahim Babadi, Zahra Bamzadeh, Fatemeh Babadi

Study of the effect of plasma jet on Fusarium isolates with ability to produce DON toxins
Elham Galin Abbasian, Mansour Bayat, Arash chaichi Nosrati, Seyed Jamal Hashemi, Mahmood Ghoranneviss

The comparison of anti-inflammatory effect in two methods of topical dexamethasone injection and topical application of ginger alcoholic extract after removing mandibular wisdom teeth
Sahar Zandi, Seyyed Muhammadreza Alavi, Kamran Mirzaie, Ramin Seyedian, Narges Aria, Saman Jokar

The effect of curcumin on growth and adherence of major microorganisms causing tooth decay
Leila Helalat, Ahmad Zarejavid, Alireza Ekrami, Mohammd Hosein Haghighizadeh, Mehdi Shiri Nasab


Middle East Quality Improvement Program
(MEQUIP QI&CPD)

Chief Editor -
Abdulrazak Abyad MD, MPH, MBA, AGSF, AFCHSE

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November 2017 - Volume 15, Issue 9

Family Stability and Conflict of Spiritual Beliefs and Superstitions among Yazdi People in Iran: A Qualitative Study


Zahra Pourmovahed (1)
Seyed Saied Mazloomy Mahmoodabad
(1)
Hassan Zareei Mahmoodabadi
(2)
Hossein Tavangar
(3)
Seyed Mojtaba Yassini Ardekani (4)
Ali Akbar Vaezi
(3)

(1) Department of Health Education and Promotion, Social Determinants of Health Research Center, School of Public Health, Shahid Sadoughi University of Medical sciences, Yazd, Iran.
(2) Department of Education and Psychology, Yazd University, Yazd, Iran
(3) Department of Nursing Education, Research Center for Nursing and Midwifery Care, Shahid Sadoughi Yazd University of Medical Sciences, Yazd, Iran
(4) Department of Psychology, Research Center of Addiction and Behavioral Sciences, Shahid Sadoughi University of Medical Sciences,Yazd , Iran

Corresponding author:
Hassan Zareei Mahmoodabadi
Yazd University, Safaeeye, Yazd, Iran.
Mobile Phone: +98 9132571279
Email: zareei_h@yahoo.com

Abstract


Background:
The people living in central Iran are well-known as a religious society with powerful spiritual beliefs while some of them also believe in several superstitions which affect their interactions, decision-making, loyalty to familial life, tolerating life problems, and finally, family health and stability.

Objectives: This qualitative study was conducted with the purpose of exploring the experiences of family and marriage experts and also couples’ experiences with religious beliefs and superstitions running in families.

Materials and Methods: Data were collected via digitally audio-recorded deep semi-structured interviews with 9 experts of family and marriage and 4 couples living in Yazd (Iran). The participants were selected using purposive sampling. The analysis was interpreted through directed content analysis methods.

Results: Using the data obtained from 17 participants, two themes with 7 subthemes emerged. The main theme of “spiritual beliefs” including the categories of praying, spiritual mediation, effective spirituality and spiritual forgiving and also the main theme of “superstition” including the categories of wrong beliefs, resorting to superstitions for fleeing from life problems, and imposed traditional marriage were conceptualized.

Spiritual beliefs and superstitions are among the major factors affecting the stability or instability of families. In the case of reduced control on life affairs, some families resort to spiritual beliefs while some others turn to superstitions.

Conclusions: Families could be trained to find some correct and suitable solutions along with reinforcement of spiritual beliefs to cope with the use of superstitions in solving familial life problems and increase family health and stability.

Key words: Family; Health; Stability; Spirituality; Beliefs; Superstitions


BACKGROUND

Family is a social institution with various biological, economical, legal, psychological, and sociological aspects which forms the most fundamental social foundation reflecting social orders or disorders (1). Indeed, the family unit is one of the most important factors affecting community health of which underpins society (2). The increased rate of divorce in the present community of Iran and Yazd, central Iran, necessitates the investigation of the factors influencing couples’ compatibility and family stability. One of the factors affecting family stability is spiritual beliefs which may affect familial interactions, decision-making, and loyalty or adherence to familial life. The role of these beliefs is of utmost importance in the incidence and resolving of marital disputes and disparities (3). Family stability is related to several factors one of which is spiritual well-being (4). Spirituality is used as a compatibility mechanism in reaction to life pressures and other daily difficulties such as familial disaster, disease, and mourning (5). Adherence to spirituality and religion is an important factor in marital stability and satisfaction. On the contrary, the greater the disparity in the couples’ spiritual beliefs, the greater their discrepancies (6).

Moreover, adherence to spirituality in couples can produce reciprocal respect and confidence while lack of adherence to spirituality leads to irresponsibility in the couple’s behavior, thereby resulting in reduced marital satisfaction (7). Unfortunately, parallel to deep spiritual beliefs, some superstitions with a tinge of spirituality have imposed themselves on families. The Iranian territory has been invaded by many different nations, specially the Mongols, over past history. One notorious gift of these invasions has been the prevalence of superstitious beliefs specifically in the cultural domain which have been transmitted to the succeeding generations as well. Superstition is an attitude or behavior striking the mind of an individual on the basis of fear, threat, habit, and some unknown causes to prevent unfavorable events. This behavior is not founded on the basis of logical action and cause-and-effect relationships. Although increased education and the public culture of the community leads to decreased superstitious beliefs, it must be emphasized that even modern humans cannot reject superstition entirely or free themselves from it practically (8). Given that the Iranian nation, specifically the people of Yazd, are a well-known religious community with powerful spiritual beliefs and values and at the same time some of them hold superstitious beliefs, these two factors affect the intra-familial relationships influencing significantly the stability or instability of the family. Consequently, it is mandatory to note the effect of spirituality and superstition on their performance in studies on family. The concepts related to this field should be analyzed carefully and this is only possible via qualitative studies since these types of studies enable the researchers to enter the internal world of the participants and determine the concepts formed in a culture, and their related variables, and explain them (9).

OBJECTIVES

The present study aims to identify and describe the spiritual beliefs and superstitions among the families in Yazd to pave the way for future studies aimed at stabilizing and empowering the family foundation. To do so, this study was conducted using directed content analysis on the basis of the constructs of McMaster’s model.

MATERIALS AND METHODS

This local study was conducted as part of a multi-centered larger study on determining the experiences of experts in family and marriage and also the practical experiences of couples in Yazd, Iran. It tried to identify and describe the spiritual beliefs and superstitions among the Yazidi families on the basis of McMaster’s model using directed content analysis in 2016. Sometimes, there are the results of previous studies on a phenomenon that are not complete or require more refinement or description. In this case, the researcher decided on directed content analysis (10) . The goal of directed content analysis is to validate and develop the conceptual framework of the theory or to expand the theory itself. The directed content analysis enjoys a more structured process than other content analysis methods (11,12).

Since McMaster’s model is one of the effective and suitable models for investigating the performance of families in Iran which can be used to prevent familial and marital problems round the country (13) , it was applied in this study.

The participants of the study included 9 family experts with a mean work experience of 14.2 years and 8 espouses in Yazd, Iran, selected on the basis of purposive sampling method.

In this method, the researcher selects individuals who are equipped with a rich experience in the subject under study. The participants were chosen from among the family and marriage experts on the basis of three inclusion criteria: holding a PhD or MSc degree, having at least 5 years of work experience as consultant and treatment of the couples and families, and inclination for participation. The couples were, furthermore, selected on the basis of the following criteria: enjoying complete awareness, negative history of affliction with major psychological disorders, and inclination for participation.

The data were collected using semi-structured and deep interview on the basis of McMaster’s model. At the beginning of the speech, we prepared a general question such as “Please relay your experiences of one day in your routine daily activities” .Then there were some questions to cover criteria in attitude, for example: “Which problem have you faced recently and how did you approach it in your family? ”or “what is the role of spirituality in your life?”. Of course, the sentences were not previously defined, and we tried to use their own words. Next questions were asked during the interview process. Having obtained the required permission, all the interviews were recorded and then completely transcribed at the end of each interview and analyzed using directed content analysis. The average duration of the interviews was between 45 to 60 min which were performed with appointments made beforehand in the locations at the experts’ workplace or in the center determined by the couples which the participants felt were convenient and in a quiet and pleasing atmosphere. The
criteria for stopping data collection from the samples was data saturation when no new data could be extracted from the participants any more.

This study used descriptive content analysis which included the following:
Transcription of the whole interview immediately after its completion, reviewing the whole text for arriving at a general understanding of its content, determining the semantic units and the primary codes, classification of the similar primary codes in more comprehensive categories and determining the main theme of the categories (14).

1. Data Analysis

The analysis process was repeated with the addition of each interview and the codes and categories were refined and improved. The reliability and validity of the data was established using sufficient participation, close interaction with the participants, variety in the participants regarding age, gender, work experience, etc., data integration, repeated review of data, data review by the participants, and ethical perspectives of outsider observers. Also we selected couples from different socioeconomic areas. Besides an individual analysis, we did a total analysis by combining interviews. This was difficult and time consuming, but increased external validity.

2. Ethical Issues
This study was approved by the ethics committee of Health School of Shahid Sadoughi University of Medical Sciences, Yazd, Iran (approval code::IR.SSU.SPH.REC.1395.52). All participants in the study were assured of the confidentiality of their personal information and absence of any constraint to participate in the study. Because our study was qualitative and conducted based on interview with the participants, they entered the study with their consent and desire. Our interviews did not contain any individuals, name.

RESULTS

We analyzed 17 semi-structured interviews that were conducted with 9 family experts (FE) and 8 espouses (E) in Yazd, Iran (Table 1). With the use of purposive sampling method, we identified 2 main themes and 7 subthemes (Table 2).

Table 1: Participants Characteristics

Click here for Table 2: Identified Themes, Subthemes and Subcategories

The results of the themes of “spiritual beliefs” are as follows:
1. Praying
…I say my prayers and cry whenever I face difficulties, I pray to God to make me patient so that I can tolerate the disasters…” (woman 1).

2. Spiritual Mediation
…my daughter says: why does not daddy say his prayers? When I reach the age of religious puberty, I should say my prayers. I say you can ask it from your Quran teacher when you go there…” ( woman 2 ).

3. Effective Spirituality
One of the experts said:”…religious beliefs prevent people from retaliating. Even if they do not do a good thing to you, they do not do a bad thing against you, either. This reduces the marital tensions. Spiritual beliefs affect the whole life, breeding of children, and relations with the spouse’s family or with our own family…” ( expert doctor 9) .

4. Spiritual Forgiving
…but when matters of faith play a role, she says: though my husband is not that generous, he has other good features which overcome this weakness. Or when she sees that her husband commits a mistake, if she says you did this wrong thing, so I do the same to you, they put themselves in a pickle….religious beliefs hinder these types of affairs…” ( expert 8 ) .

Moreover, the results of the theme of “superstition” were as the following:

5. Wrong Beliefs
…we have different types of couples; in many cases the educated wife wants to work outside
home, but the husband opposes her and prevents her working outside due to his own wrong
beliefs. He insists that she should just do the housework and be a housekeeper…” ( expert doctor 5).

6. Writing Talisman, Doing Black Magic, and Seeing the Fortune-teller
…some families are not at all familiar with the new psychological approaches; they use the local therapists superstitiously like fortune-telling, performing black magic, going to the soothsayer, augur, …they follow hundreds of incorrect treatments and finally after failure, they turn to us when it is too late…” (expert doctor, 5 ).

…many attendances in recent years have been related to sexual disorders which, as they are taboo, they turn to the specialists less frequently and seek treatment from traditional therapies and talisman writing…” ( expert 2 ) .

7. Traditional Imposed Marriage
One of the experts asserts in this regard: “…this morning a young boy and girl came to me to have a pre-marriage consultation. To me, they were not a suitable couple to get married as they had opposite personality poles. The girl’s family told their daughter that the boy is not an addict and says his prayers regularly as a Muslim and you must accept to marry him. The girl says that she does not like him for his job and education. She says that her family do not allow her to express her heart-felt beliefs and feelings…” (expert 8) .

Regarding obligatory adherence and loyalty to marital relations, one of the experts said:

“…extramarital relations means that a man or a woman who has formal ethical commitment and is obligatorily bound to their marital life, is attracted to an alien person for some reasons and forms an emotional relation with that individual, so they form a cold feeling towards their spouses…” ( expert doctor , 7 ).

DISCUSSION

On the basis of the findings of this study, it seems that families seek resort to several solutions to resolve their familial disputes and disparities. In this respect, some families resort to spiritual beliefs while others resort to superstition. The presence of spirituality exerts a significant effect on family stability. Faith in God makes the individuals’ attitude toward the whole existence meaningful and purposeful. On the other hand, it causes people to acquire internal consistency and equilibrium. This is the origin of many disputes and discrepancies in families. Also, adherence to spirituality plays a pivotal role in marriage stability and marital satisfaction. The greater the spiritual discrepancy of the couples, the greater their disputes (6). Numerous studies have emphasized the efficacy of spirituality in marital satisfaction and reinforcing the relations between couples (15-18). Demaris et al. (2010) stated that religion is the most important parameter in understanding between the couples and lack of spiritual homogeneity makes the wives depressed and anxious indicating that women are more deeply affected by this religious inequality (19).

This study showed that the family members, specifically women, resort to praying to relieve their mental pain. Praying is a spiritual activity and for many it is a religious activity (20). The families in Yazd, especially women, pray to God to solve their problems and ask Him to bestow patience on them. They also pray to God to promote their resistance against disastrous difficulties. It is not a new phenomenon to believe that spiritual beliefs and praying can be effective in individuals’ psychosomatic improvement. The pure heart-felt faith in God may even cure a fatal disease and save the patient’s life in a miraculous manner. The history of praying, its intrinsic origin, and an analysis of the jargon of praying displays the fact that the language of praying is an international one and is shared by all human beings. It needs no training and the intelligence for it is equally latent in all races of humans in all places and at all times (21). In this study, asking for others’ help in matters of faith (asking faith-related questions) was a manifestation of spiritual mediation. The mother advised her offspring to ask her faith question from her divinities teacher since she was not able to answer her daughter’s question. In this regard, Morse (2009) declares that asking faith questions from a clergyman is an art since listening to the speeches of a person who is talking about sacred spiritual matters requires creative attention to the subject. The spiritual individuals have no expectations to compensate for this spiritual guidance because they believe that God is there. Humans are not seeking the philosophy of these questions when they ask it, rather, they want to know the position of God in their life. Ultimately, when the internal emotions and spiritual doubts of a person are deeply discovered, their life environment becomes safe and full of mercy (22).

Another subcategory of the theme of “spiritual beliefs“ in this study was “effective spirituality” (adherence to spirituality is manifested as better management of familial life). Being concerned with spirituality and religion increases individuals’ resistance against life problems. Several studies indicate the significant effect of spirituality on increased marital stability and satisfaction (23-26). Given that the Iranian nation, especially the Yazidi people, are particularly religious, so, spirituality plays a major role in the relations among the family members.

Another a subcategory of the theme of “spiritual beliefs” is “spiritual forgiving”. In the present study, forgiving the spouse’s faults and weaknesses due to adherence to spirituality and avoiding retaliation are manifestations of spiritual forgiving. The religious beliefs and actions enable the person to internally control themselves physiologically, cognitively, and emotionally to be able to accept the responsibility of their actions in conflicts. From the inter-personal point of view, spirituality creates conditions that make the person attend to God at times of anger and avoid opposition to their spouse and, thus, ignore their faults and weakness. Relation with God plays an interactional and compensatory role in marital relations. Of course, the marital satisfaction could be promoted and disputes could be resolved with self-knowledge. It can change the deficient attitude towards existence and give a new meaning to life. It further creates intuition towards one’s behavior, corrects the thoughts and illogical expectations, and increases compatibility and forgiving between the couple (27).

A further concept discovered in this study was superstition and unwise beliefs running in families. According to Bidney (1953) superstition is defined as a kind of fear based on illogical or mythological beliefs which usually originate from some taboos (28). Wagner (1928) also refers to superstition as illogical or unwise beliefs (29). Thalbourne (1977) defines superstition as a belief which if enacted, brings up either happiness or misery, while there is no generally accepted or logical basis for such a belief (30).

Moreover, Peltzer (2003) states in this regard that although the logical method is emphasized for preventing the incidence of events, sometimes the illogical method is adopted in the literature of every nation (31). In fact, superstition is a wide range of beliefs and behaviors that occur on the basis of the property of establishment of some incorrect cause-effect processes due to ignorance, fear of the unknown, belief in black magic or fortune or an inaccurate perception. This behavior has acquired a high position in the folkloric culture and psychology (32).

Additionally, in this study, with respect to incorrect beliefs, manifestations such as the incorrect beliefs of the husband towards the wife’s working outside home and lack of social activity of women due to the superiority of the traditional attitudes specially in low-educated families were achieved. Also, the manifestations of “imposed marriage” included “disliking the husband due to traditional marriage, continuation of relations with another person for pro-marriage emotional relations, and obligatory adherence to marital relations after marriage”. Other superstitious beliefs of people included: seeing the soothsayer and fortune-teller to create love and remove the marital disputes, believing in the detrimental effect of the evil eye in creating marital dispute, burning wild rue seeds in fire to counteract the evil eye, and believing that the girl should enter the husband’s house with a white veil and leave it in a white shroud.

It appears that in conditions that families’ ability for controlling life affairs and reducing life problems is decreased, some of them resort to spiritual beliefs to reach internal tranquility and to increase their tolerance against difficulties while some other superstitious individuals seek treatment in actions like writing talisman, black magic, and seeing soothsayers and fortune-tellers.

CONCLUSION


Spiritual beliefs and superstitions are among the major factors affecting the stability or instability of families. In the case of reduced control on life affairs, some families resort to spiritual beliefs while some others turn to superstitions. So, families could be trained to find some correct and suitable solutions along with reinforcement of spiritual beliefs to cope with the use of superstitions in solving familial life problems and increase family stability.

Limitations
The participating couples were selected based on the goals of our study, therefore, may not represent all of couples’ experiences of family health and stability. Also, the experts within the study were selected due to their willingness and availability to participate in the study. Therefore, it is possible that those who chose to participate in the study are those who are more enthusiastic and committed to the study.

Acknowledgements
This article is distilled from part of a PhD dissertation concerned with social determinants of health. Our special thanks should go to the School of Public Health in Shahid Sadoughi University of Medical Sciences. We should also thank all the experts, couples, Psychiatrists, psychologists, etc. who supported us patiently.

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