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Exploring the Inhibitory Factors of Life Dynamics from the Perspective of Spouses of Individuals with Grand Mal Epilepsy

Document Type : Scientific Research

Authors

1 assistant Professor, Department of Psychology, Faculty of Humanities and social, Ardakan University, Ardakan, Iran.

2 M.Sc. student in Rehabilitation counseling, Department of counseling, Faculty of Humanities and social, Ardakan University, Ardakan, Iran.

10.30473/hpj.2026.77224.6391

Abstract

Objective: Chronic neurological disorders, particularly epilepsy, impose substantial psychosocial burdens not only on patients but also on their families. As primary informal caregivers, spouses often experience considerable physical, psychological, and social challenges that disrupt marital relationships and family functioning. Although caregiving burden has been widely investigated, limited evidence exists regarding the lived experiences of spouses of individuals with grand mal epilepsy in relation to barriers to life dynamism, defined as an active, flexible, and fulfilling family life. Therefore, this study aimed to explore the inhibiting factors affecting life dynamism from the perspective of spouses of individuals with grand mal epilepsy. Method: This qualitative study adopted a descriptive phenomenological design using Colaizzi's seven-step method. The study population consisted of spouses of individuals with grand mal epilepsy in Isfahan, Iran, in 2025. Participants were selected through purposive sampling, and data collection continued until theoretical saturation was achieved, resulting in 22 participants recruited through the Isfahan Epilepsy Charity Society. Inclusion criteria included being 15–50 years old, having at least three years of marriage, having a spouse diagnosed with grand mal epilepsy for at least three years, and providing informed consent. Data were collected through semi-structured, in-depth interviews exploring participants' experiences of life dynamism and its barriers. Interviews were audio-recorded, transcribed verbatim, and analyzed using Colaizzi's seven-step phenomenological approach. Trustworthiness was established based on Lincoln and Guba's criteria, including credibility, dependability, transferability, and confirmability, through prolonged engagement, member checking, and peer review. Results:  Analysis of the interviews identified a multidimensional network of barriers to life dynamism.Participants described life with an affected spouse as an exhausting and persistent cycle of caregiving. Continuous vigilance, fear of seizure recurrence, inadequate rehabilitation services, and heavy caregiving responsibilities resulted in emotional exhaustion and diminished quality of life. As one participant stated, “I feel the entire responsibility of another person's life is on my shoulders.” Caregivers also reported burnout, guilt, poor physical and mental health, and neglect of self-care. Simultaneously, many patients became passive, lost self-confidence, and withdrew from treatment participation and daily activities. Insufficient knowledge regarding epilepsy management among both patients and caregivers further intensified these challenges. A lack of social and institutional support emerged as another significant barrier. Participants described feelings of loneliness, limited assistance from relatives and healthcare services, and stigma associated with epilepsy, which often resulted in secrecy and withdrawal from social interactions because of fear of judgment. Financial and occupational difficulties further reduced family dynamism. High treatment expenses, reduced employment opportunities, and economic insecurity increased stress within families. Marital relationships were negatively affected by emotional distancing, reduced communication, sexual difficulties, and increased conflict. Lifestyle restrictions, including limitations on travel, recreation, and daily planning because of the unpredictability of seizures, contributed to a rigid and stressful family environment. Conclusion: This phenomenological study demonstrated that barriers to life dynamism among spouses of individuals with grand mal epilepsy are multidimensional and interconnected. Exhausting caregiving.demands, caregiver and patient deficits, socio-familial disconnection, and intra-life disruptions collectively undermine quality of life, marital satisfaction, and family functioning. These findings indicate that the consequences of epilepsy extend beyond clinical manifestations to psychological, social, and economic dimensions. The results highlight the need for comprehensive family-centered interventions, including caregiver education, stress-management and self-care training, psychological counseling, peer-support programs, stigma-reduction initiatives, and financial assistance. Strengthening formal support systems may substantially improve caregivers' well-being and family functioning. Future studies should evaluate the effectiveness of such interventions using longitudinal and experimental designs.

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References
Afshar, A. (2019). In translation of Basics of Qualitative Research. Strauss, A., & Corbin, J. (Authors). 8th ed. Tehran: Ney Publications, p. 34. (In Persian)
Alafif, N., AlShaikh, F., Albloushi, M., Alruwaili, N. W., Alfawaz, W., Almutairi, F.,... & Almutairi, K. M. (2025). A Descriptive Study of Caregivers’ Awareness, Practices, Challenges Faced, and Methods of Adherence to the Ketogenic Diet in Children with Refractory Epilepsy. Nutrients, 17(16), 1-5. https://doi.org/10.3390/nu17162605
Amani, A., Salarabadi, S., & Hamidi, A. (2023). Phenomenological exploration of lived experiences of couples with attachment trauma (insecure attachment) in marital relationships. Journal of Applied Psychological Research, 14(3), 163–184. https://doi.org/10.22059/japr .2023.333709.644077 (In Persian)
Ashrafiyan Lak, S., & Bagheri, N. (2022). A comparison of family communication patterns and personality traits between divorcing couples and normal individuals. Social Health, 8(1), 28–38. https://doi.org/10.22037/ch.v8i1.25648 (In Persian)
Atan, G., Oruç, F. G., & Atan, K. (2025). The relationship between caregiver burden and life satisfaction in caregivers of individuals with epilepsy: An example in eastern Turkey. Epilepsy & Behavior, 164(1), 11-27. https://doi.org/10.1016/j.yebeh.2025.110275
Balagandi, S. J., Viswanathan, L. G., Sinu, E., Nanjaiah, N. D., Asranna, A., Chowdary, M. R., ... & Sinha, S. (2025). Sexual dysfunction in men with epilepsy–An observational case-control study. Epilepsy & Behavior, 167(1), 11-38. https://doi.org/10.1016/j.yebeh.2025.110388
Bar‐Shachar, Y., Lopata, S., & Bar‐Kalifa, E. (2023). Relationship satisfaction during COVID‐19: The role of partners' perceived support and attachment. Family Relations, 72(1), 105-121. https://doi.org/10.1111/fare.12767
Beghi, E. (2020). The epidemiology of epilepsy. Neuroepidemiology, 54(2), 185-191. https://doi.org/10.1159/000503831
Behramnejad, F., Sanai, N., Moradi Majd, P., & Askari, P. (2019). Comprehensive guide to research methodology in medical sciences. Tehran: Jame’eh Negar Publications. (In Persian)
Bom, J., Bakx, P., Schut, F., & Van Doorslaer, E. (2019). Health effects of caring for and about parents and spouses. The Journal of the Economics of Ageing, 14(4), 100-106. https://doi.org/10.1016/j.jeoa.2019.100196
Büyükbayram, Z., Aksoy, M., & Yılmaz, R. (2023). Difficult lives: A descriptive and relational study on the coping with stress and care burden of caregivers of patients with epilepsy. Epilepsy & Behavior, 145 (1), 1-10. https://doi.org/10 .1016/j.yebeh.2023.109297
Çamcı, G., Yakar, H. K., Oğuz, S., & Erdoğan, H. (2025). How do anxiety, depression, and stigma affect quality of life in people with epilepsy?. Epilepsy & Behavior, 167(1), 11-39. https://doi.org/10.1016/j.yebeh.2025.110399
Celal Adıyaman, Y & Temel Eğinli, A. (2023). The effect of early maladaptive schemas on communication styles of romantic couples. Fundamentals of Mental Health. 25 (6), 353-362. http://jfmh.mums.ac.ir/
Chen, X., Li, Y., Sun, H., Wang, T., Xu, X., & Li, M. (2023). Dyadic communication quality and family resilience in gynecologic cancer survivors: a study on the mediating role of perceived spousal support. Supportive Care in Cancer, 31(1), 68-79. https://doi.org/10.1007 /s00520-022-07492-7
Ciuffini, R., Marrelli, A., Perilli, E., & Stratta, P. (2019). Epilepsy and suicide: a narrative review. J Psychopathol, 25(3), 155-161.
Delavar, A. (2004). Research methods in psychology and educational sciences. Tehran: Virayesh Publishing Institute. (In Persian)
Duca, D. S., Ursu, A., Bogdan, I., & Rusu, P. P. (2023). Emotions and emotion regulation in family relationships. Revista Romaneasca pentru Educatie Multidimensionala, 15(2), 114-131.  https://doi.org/10.18662/rrem/15.2/724
Emami Sighroodi, A., Dehghan Niri, N., Rahnavard, Z., & Nouri Saeid, A. (2012). Qualitative research methodology: Phenomenology. Comprehensive Nursing and Midwifery Journal, 2(68), 56–63. (In Persian)
Eriksson, E., Wejåker, M., Danhard, A., Nilsson, A., & Kristofferzon, M. L. (2019). Living with a spouse with chronic illness–the challenge of balancing demands and resources. BMC Public Health, 19(2), 1-9. https://doi.org/10. 1186/s12889-019-6800-7
Fazeli Mehrabadi, A., Najari Fooroshani, F., & Mehragan, M. (2024). An exploration of communication patterns among couples on the verge of separation. Journal of Behavioral Sciences Research, 21(4), 637–651. http://dx.doi.org/10.48305/21.4.637 (In Persian)
Fishbane, M. D. (2023). Couple relational ethics: From theory to lived practice. Family process, 62(2), 446-468. https://doi.org /10.1111/famp.12861
Gabr, W., & Kamal, M. (2025). University Students' Attitudes Towards Epilepsy in Madina. Applied Sciences Research Periodicals, 3(2), 59-68. https://doi.org/10.63002/asrp.32.789
Ghasemi Sheykhtabari, A., & Zadeh Mohammadi, A. (2024). Predicting marital instability based on dark personality traits and marital communication patterns among married individuals. Family Research, 20(1), 63–82. https://doi.org/10.48308/jfr.20.1.63 (In Persian)
Greenwood, N., Pound, C., Brearley, S., & Smith, R. (2019). A qualitative study of older informal carers’ experiences and perceptions of their caring role. Maturitas, 124(12), 1-7. https://doi.org/10.1016/j.maturitas.2019.03.006
Hansen, B., Szaflarski, M., Bebin, E. M., & Szaflarski, J. P. (2018). Affiliate stigma and caregiver burden in intractable epilepsy. Epilepsy & Behavior, 85(1), 1-6. https://doi.org/10.1016/j.yebeh.2018.05.028
Hasan Nia, S., Farahbakhsh, K., Esmaeili, M., Asgari, M., & Naeimi, A. (2020). Transformation in marriage: A phenomenological analysis of the formation process and its consequences in marital relationships. Journal of Psychological Sciences, 19(93), 1097–1113. doi: 20.1001.1.17357462. 1399.19.93.13.5 (In Persian)
Hussain, M. M., Zulfiqar, Z., Ishfaq, K., & Ghaffari, A. S. (2021). Psycho-social and economic problems faced by parent’s of children with epilepsy. Review of Education, Administration & Law, 4(2), 521-530. https://doi.org/10.47067 /real.v4i2.167
Idowu, J., Meades, C., Cross, J. H., Muggeridge, A., Lakhanpaul, M., Robinson, K., ... & Reilly, C. (2024). Mental health in secondary school-aged children with epilepsy and their primary caregivers: A case control study. Seizure: European Journal of Epilepsy, 120(1), 150-156. https://doi.org/10.1016/j.seizure.2024.07.002
Janadela, A. (2024). Experiencing chronic illness at the intersection of gender and social context: A study of women’s experiences of multiple sclerosis. Health Psychology Journal, 13(49), 55–70. https://doi.org/10.30473/hpj.2024.66541.5711 (In Persian)
Karimi, M., Charami, M., Ghazanfari, A., Sharifi, V., & Masoudi, M. (2021). A comparative study of the effects of group-based family empowerment program and self-compassion program on perceived stress and social stigma among family caregivers of individuals with epilepsy. Nursing, Midwifery and Paramedical Journal, 6(4), 32–45. http://sjnmp.muk.ac.ir/article-1-372-fa.html (In Persian)
Kasar, U., Dwivedi, A. K., Khandare, P. M., Dwivedi, A., & Khandade, P. (2023). Impact of Occupational Therapy Interventions on Sexual Dysfunction in Epilepsy: A Case Report. Cureus, 15(12), 1-5. https://doi.org/10.7759 /cureus.51153
Kharameh Nejad, A., Jahan, F., Sabahi, P., & Farakhte, S. (2024). A comparison of the effectiveness of acceptance and commitment therapy (ACT) and emotion regulation training on emotional dysregulation and depression in individuals with epilepsy. Psychological Studies, 1(9), 1–11. https://doi.org/10.22059/japr.2025.369345.644811 (In Persian)
Khuan, L., Iskan, N., & Rashid, N. A. A. (2024). The Caregivers’ Knowledge on Epilepsy and Its Relationship with Stress Levels. The Malaysian Journal of Nursing (MJN), 16(2), 108-117. https://doi.org/10.31674/mjn.2024.v16i02.011
Kolsi, S., Bouaziz, A., Ali, A. H., Medhaffar, K., Zitoun, K., Abbes, W., & Ellouz, E. (2025). Antiepileptic drugs and sexual dysfunction in patients with epilepsy. European Psychiatry, 68(1), 1142-1143. https://doi.org/10.1192 /j.eurpsy.2025.2312
Lai, S. T., Tan, W. Y., Wo, M. C. M., Lim, K. S., Ahmad, S. B., & Tan, C. T. (2019). Burden in caregivers of adults with epilepsy in Asian families. Seizure, 71(7), 132-139. https://doi.org/10.1016/j.seizure.2019.07.008
Lee, S. A., Han, S. H., Cho, Y. J., Kim, K. T., Kim, J. E., Shin, D. J., ... & Yeon, G. M. (2020). Factors associated with stigma and depressive symptoms in family members of patients with epilepsy. Epilepsy & Behavior, 110(1), 107-129. https://doi.org/10.1016/j.yebeh.2020.107129
Lincoln YS, & Guba EG. (1985). Naturalistic inquiry. Beverly Hills (CA): Sage Publications.
Mardani, F., Uousefi, S. A., Ghorbani, E., & Mirzaei, Z. (2023). The effectiveness of realistic acceptance and commitment therapy (RACT) on marital burnout and alexithymia in couples. Journal of Assessment and Research in Applied Counseling (JARAC), 5(1), 9-18. https://doi.org/10.61838/kman.jarac.5.1.2
Mishra, N., Garbinsky, E. N., & Shu, S. B. (2025). Discussing money with the one you love: How financial stress influences couples' financial communication. Journal of Consumer Psychology, 35(2), 288-296. https://psycnet.apa .org /doi/10.1002/jcpy.1430
Mohammadi Pour, M., Rafiee Nia, P., Parvin, S., Sabahi, P., & Najafi, M. (2020). A comparison of the effectiveness of mindfulness-based cognitive therapy (MBCT) and acceptance and commitment therapy (ACT) on improving quality of life components in patients with focal epilepsy. Journal of Novel Psychological Research, 15(57), 1–18. https://dor.isc.ac/dor/20. 1001.1.27173852.1399.15.57.1.9 (In Persian)
Munaf, Z. A., & Mohammed, S. I. (2024). Quality of life, adherence and knowledge of epileptic patients and the impact of a pharmacist‐led educational intervention: A review. Medicine Advances, 2(1), 29-42.
Nandwani, J. K., Hwang, S. A., Blank, L., Kummer, B. R., & Agarwal, P. (2025). Financial distress among individuals with epilepsy: Insights from a nationwide survey analysis. Seizure: European Journal of Epilepsy, 133(12), 29-36. https://doi.org/10.1016/j.seizure.2025.09.012
Navabinejad, S., Rostami, M., & Parsakia, K. (2023). The mediating role of emotional intelligence in the relationship between marital conflicts and tendency to marital infidelity in couples. Journal of Assessment and Research in Applied Counseling (JARAC), 5(1), 1-8. https://doi.org/10.61838/kman.jarac.5.1.1
Negussie, A. S., Dehan, M. F., Mekonnen, S. A., & Zelleke, T. G. (2024). Knowledge, attitudes, and practices of caregivers with children diagnosed with epilepsy attending a pediatric outpatient clinic: a descriptive, cross-sectional, questionnaire-based study in Addis Ababa, Ethiopia. BMC neurology, 24(1), 252-264. https://doi.org/10.1186/s12883-024-03766-1
Nevin, S. M., Wakefield, C. E., Schilstra, C. E., McGill, B. C., Bye, A., & Palmer, E. E. (2020). The information needs of parents of children with early-onset epilepsy: a systematic review. Epilepsy & Behavior, 112(7), 1-9. https://doi.org/10.1016/j.yebeh.2020.107382
Okiah, L., Olowo, S., Iramiot, S. J., Nekaka, R., & Ssenyonga, L. V. (2023). Lived experiences of caregivers of persons with epilepsy attending an epilepsy clinic at a tertiary hospital, eastern Uganda: A phenomenological approach. PLoS One, 18(7), 1-20. https://doi.org/10.1371/journal.pone.0274373
Onuorah, C., Oriji, S., Omoaregba, J., Aina, F., Erohubie, P., ANAJE, O., & Nwani, P. (2024). Caregiver Burden and Its Correlates in Caring for Adults With Epilepsy in a Nigerian Tertiary Hospital: A Cross-Sectional Study. Nigerian Journal of Psychiatry, 22(1), 40-40. http://dx.doi.org/10.5455/NJP.195207
Patil, V. (2025). Psychosocial Interventions for the Caregivers of patients with Epilepsy. European Psychiatry, 68(1), 734-735. https://doi.org /10.1192 /j.eurpsy.2025.1491
Péloquin, K., Boucher, S., Benoit, Z., Jean, M., Beauvilliers, L., Carranza‐Mamane, B., & Brassard, A. (2023). “We're in this together”: Attachment insecurities, dyadic coping strategies, and relationship satisfaction in couples involved in medically assisted reproduction. Journal of Marital and Family Therapy, 49(1), 92-110. https://doi.org/ 10.1111/jmft.12608
Pietromonaco, P. R, & Overall, N.C. (2021). Applying relationship science to evaluate how the COVID-19 pandemic may impact couples’ relationships. American Psychologist, 76(3), 438-448. https://doi.org/10.1037/amp0000714
Rafezi, Z., & Norbehesht, F. (2025). The relationship between pain coping strategies and body image dimensions with the moderating role of body mass index in patients with chronic pain. Health Psychology Journal, 14(54), 81–96. https://doi.org/10.30473/hpj.2025.73086.6154 (In Persian)
Sabzevari, P., Khoy Nejad, G., & Saffarian Tousi, M. (2021). The effectiveness of Bowen’s family-oriented approach in improving communication patterns and marital conflicts among women experiencing emotional divorce. Islamic Lifestyle Focused on Health, 23(6), 134–140. https://doi.org/10.22034/aftj.2022.322683.1331 (In Persian)
Sabzvari, T., Iqbal, M. A., Ranganatha, A., Daher, J. C., Freire, I., Shamsi, S. M. F., ... & Nazir, Z. (2024). A comprehensive review of recent trends in surgical approaches for epilepsy management. Cureus, 16(10), 1-15. https://doi. org/ 10.7759/cureus.71715
Seyedalshohadaei, M., Salighedar, Gh., & Haghani, H. (2021). The association between quality of life, chronotypes, and anxiety among individuals with epilepsy affiliated with the Iranian Epilepsy Association in 2020. Iranian Journal of Nursing, 34(132), 8–20. http://dx.doi.org /10.52547/ijn.34.132.8 (In Persian)
Shalchi, M., Ghiyoomi, P., & Sohrabi, Z. (2024). Emotions and quality of life in patients with epilepsy: The role of satisfaction of basic psychological needs. Medical Sciences Journal, 35(4), 337–349. http://dx.doi.org/ 10.61186/umj.35.4.337 (In Persian)
Sırtbaş, G., Yalnızoğlu, D., & Livanelioğlu, A. (2021). Comparison of physical fitness, activity, and quality of life of the children with epilepsy and their healthy peers. Epilepsy research, 178 (1), 1-6. https://doi.org/10.1016 /j.eplepsyres .2021.106795
Słowikowski, B., Owecki, W., Jeske, J., Jezierski, M., Draguła, M., Goutor, U., ... & Dorszewska, J. (2024). Epigenetics and the neurodegenerative process. Epigenomics, 16(7):473-491. https://doi .org /10.2217/epi-2023-0416
Todorov, E. H., Paradis, A., & Ha, T. (2023). Emotion Regulation Difficulties and Relationship Satisfaction in Adolescent Couples: The Role of Conflict Resolution Strategies. Journal of youth and adolescence, 52(8), 1753-1767. https://doi.org /10 .1007/s10964-023-01787-6
Viny, M., Trevino, A. Y., Bouldin, E. D., Kalvesmaki, A., Roghani, A., & Pugh, M. J. (2023). Caregiver burden and COVID-19: how epilepsy caregivers experienced the pandemic. Epilepsy & Behavior, 141(1), 1-8. https://doi.org/10.1016/j.yebeh.2023.109151
Vishwanathan, L. G., & Satishchandra, P. (2020). A Bitter Pill To Swallow–Drug Compliance and Adherence In Epilepsy. Neurology India, 68(5), 1257-1258. DOI: 10.4103/0028-3886.294828
Willie, M. M. (2025). A Scoping Review of Epilepsy Care in Low-Resource Settings: Addressing Stigma, Healthcare Disparities, and Socioeconomic Barriers. Journal of Indonesian Health Policy and Administration, 10(3), 2-12. https://doi.org/10.7454/ihpa.v10i3.1141
QUARTERLY JOURNAL OF HEALTH PSYCHOLOGY
Volume 15, Issue 58
July 2026
Pages 115-132
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