Middle Eastern Journal of Disability Studies

Abstract
Background & Objectives: Working at unusual hours disrupts the sleep–wake cycle, or the circadian rhythm, which has physiological and psychological consequences. One of the jobs that always involves shift work is health workers, especially nurses. Shift work in nurses can cause various physical and psychological complications and affect many aspects of their married life. Also, couples who have shift work have lower marital satisfaction, higher work–family conflicts, and sexual problems, and are also more likely to get divorced. Sexual relations have a significant contribution to marital satisfaction. As a result of its disruption, the level of dissatisfaction and other matrimonial problems increases over time, and this adverse effect affects all aspects of married life. Since nurses are more exposed to job stress than other professions, and the nursing job requires different work shifts more than any other job, the present study was conducted to explain the structural equation model of marital satisfaction based on sexual performance with the mediation of circadian rhythms in married nursing women.
Methods: The present study was correlational and used structural equation modeling. The statistical population of this study consisted of all married female nurses working in government hospitals west of Tehran, Iran, in 2023 (2361 nurses in total). A total of 330 nurses were selected through a multi–stage cluster sampling method. In this way, first among the government and non–government hospitals in the north, east, west, and south of Tehran, the government hospitals in the west of Tehran, which were all covered by the Iran University of Medical Sciences, were selected. Then, sample people were chosen from the 11 hospitals according to the inclusion criteria (married female nurses, 25–55 years old, having physical health, no severe psychiatric disorders and severe sleep problems) and exclusion criteria (failure to respond to questionnaires, lack of cooperation of participants, having severe marital problems, financial problems) and compliance with ethical considerations. The Marital Satisfaction Scale (Hudson et al., 1981), the Sexual Function Scale (Rosenhan et al., 1997), and the Circadian Rhythm Scale (Jafari Roudbandi et al., 2012) were used as data collection tools. The relationships between variables were considered structural equation modeling. Based on the research objective, the affected variable (marital satisfaction) was deemed dependent on the model. The sexual performance variable was considered independent, and the circadian rhythms variable was considered a mediator, so it was affected by sexual performance and affected the dependent variable. The present study analyzed data at two levels: descriptive and inferential. For descriptive analysis of the research data, descriptive statistics such as mean, standard deviation, skewness, kurtosis, and normality were calculated by SPSS version 27. In the inferential statistics section, structural equation modeling with a partial least squares approach was used and calculated by SmartPLS version 3 software. It was used to examine the validity and reliability of the model, structural fit, overall fit of the model, and analysis of the findings. The significance level was set at 0.05.
Results: The results showed that the direct path coefficients between sexual performance and marital satisfaction were positive and significant (p<0.001, β=0.66), and between sexual performance on circadian rhythm was also positive and significant (p<0.001, β=0.83). Also, the direct path coefficient of circadian rhythm on marital satisfaction was positive and significant (p=0.002, β=0.26). The coefficient of indirect effect of sexual performance on marital satisfaction was also positive and significant (p<0.001, β=0.21). The goodness of fit index of the model determined that circadian rhythms mediate the relationship between sexual performance and marital satisfaction (GOF=0.41).
Conclusion: Based on the research findings, by educating nurses about circadian rhythms, their sexual capabilities, and sexual satisfaction can be ensured, thereby providing marital satisfaction as the fundamental foundation of family strength.