Investigating the Effect of Communication Skills Training for Married Women on Couples’ Intimacy and Quality of Life

The aim of this study was to investigate the effect of communication skills education for married women on couples’ intimacy and quality of life. The subjects of this study were married female students enrolled in the spring semester of 2011 at the Applied Sciences and Technology University (Tourism Unit) of Kerman in Iran, along with their husbands. Of the students who expressed interest in taking part in this study, 30 subjects were selected and randomly assigned to either an experimental or a control group. Subjects in the experimental group participated in a 12-session training for the improvement of communication skills in the context of marriage and family therapy. Comparison of these two groups indicated that communication skills training for married women can increase their intimacy and quality of life in their relationships with their husbands (p < .01). This study further revealed that this sort of training programs could also increase the quality of life of the husbands in their relationships with their wives (p < .01).


Introduction
Family is the basic unit in every society and currently marriage as the foundation of this important unit has faced a lot of challenges in modern societies (Olson & Olson, 1999).
Marital satisfaction, marital quality, and dyadic adjustment are terms that have been used to express quality of relationship in married couples (Askari, Noah, Hassan, & Baba, 2012;Harper, Schaalje, & Sandberg, 2000).
Intimacy is one of the marital process variables that can be affected when the couples' relationship is dissatisfactory. It has been shown that intimacy is strongly connected to quality of life in married couples (Harper & Elliott, 1988;Harper et al., 2000;Tolstedt & Stokes, 1983;Waring, 1988). Based on a definition proposed by Waring (1988), intimacy is a "multifaceted interpersonal dimension which describes the quality of marriage relationship at a point in time" (Harper et al., 2000, p23). There are other definitions for intimacy which involve the notions of conflict resolution and sharing hurt feeling (Harper et al., 2000;Holley & L'Abate, 1979). Schaefer and Olson (1981) have defined intimacy in the context of sharing intimate experiences, which include five factors: emotional, social, sexual, intellectual, and recreational (Harper et al., 2000). Harper and Schaalje have proved that intimacy is a mediator of daily stress effects on couples' relationships (Harper et al., 2000).
Communication skills training has been extensively studied in the context of couples' relationships and interactions (Bellack & Hersen, 1979). Lack of proper communication skills has been shown to be a major issue leading to dissatisfaction in couples' lives (Bellack & Hersen, 1979;Boland & Follingstad, 1987;Burleson & Denton, 1997;Mitchell, Bullard, & Mudd, 1962). Communication skills have been among top three significant problems reported in distressed marriages along with difficulties in sexual expression and personality factors (Bellack & Hersen, 1979;Birchler, 1977). Therefore, communication skills training seems to be an essential part of treatment programs for couples complaining of dissatisfaction in their relationships (Jacobson & Margolin, 1979).
Efficient communication is considered in forms of Speaker Skills in which the term "I" is used to address a specific message and Listener Skills in which a person listens to his or her partner in an active dynamic form and try to make 537085S GOXXX10.1177/2158244014537085SAGE OpenFarbod et al.  (Hahlweg, Revenstorf, & Schindler, 1984). Blanchard et al. (2009) have mentioned the correlation between Marriage and Relationship Education (MRE) and couples' communication skills. Based on their meta-analysis study, they have suggested the invention of better methodologies to evaluate the role of MRE in improvement of communication skills. Schilling et al. (2003) conducted a longitudinal study to investigate the effects of Prevention and Relationship Enhancement Program (PREP) on development of distress in marital relationships. They found that PREP can significantly increase the positive communication skills in men and women. An interesting finding in this study was the effect of increased positive communication skills in women which could lead to increased risk of male and female distress onset whereas increased positive communication skills in men predicted decreased risk of marital distress (Schilling et al., 2003).
Behavioral marital therapy (BMT) has been shown to be able to help couples improve their communication skills (Hahlweg et al., 1984). They have mentioned that lack of communication skills is one of the main complaints in couples seeking BMT and they have shown that BMT has a positive effect in increasing communication skills in couples. Boland and Follingstad (1987) have comprehensively reviewed all the literature related to relationship between communication skills and marital satisfaction, which has been addressed as a dominant and important correlation. The same sort of integrative review has been done by Burleson and Denton (1997).
Iranian couples live in a transitional society moving from being traditional to modern. In such a complex transitional state, couples' relationships, their quality of life and intimacy are affected. Problems related to communication skills in Iranian couples have been addressed in the literature but limited knowledge is available toward communication skills in relation with quality of life and intimacy of couples and also interventional methods to overcome these problems (Askari et al., 2012;Kalantarkousheh & Hassan, 2010;Rakhshani, Niknami, & Moghaddam, 2005).

Method
The research design in this study was pre-test and post-test research design with experimental and control groups. Subjects were 30 married female students enrolled in the spring semester of 2011 in Applied Sciences and Technology University (Tourism Unit) of Kerman in Iran and their husbands. They were randomly assigned to an experimental group (15 subjects) and a control group (15 subjects). We used pre-test and post-test to determine the effects of communication skills training on intimacy and quality of life of the women and their husbands.
Bagarozzi Intimacy Needs Survey Questionnaire (Bagarozzi, 2001) includes 41 questions and is a useful tool to measure total intimacy as a score. It uses eight factors for scoring intimacy: Emotional Intimacy, Psychological Intimacy, Intellectual Intimacy, Sexual Intimacy, Physical Intimacy, Spiritual Intimacy, Aesthetic Intimacy, and Social-Recreational Intimacy (Bagarozzi, 2001).
The psychometric properties of a quality of life scale (World Health Organization [WHO], 1996[WHO], , 2004, the WHO Quality of Life-BREF (World Health Organization Quality of Life Assessment-Brief,WHOQOL-BREF), has 26 items which measure physical health, psychological health, social relationships, and environmental factors. The WHOQOL-BREF is a shorter version of the original instrument, which can be used in larger studies and clinical trials (WHO, 1996(WHO, , 2004. We used Bagarozzi Intimacy Needs Survey Questionnaire and WHOQOL-BREF on all the married couples volunteered for this study among which all were female students enrolled in the spring semester of 2011 in Applied Sciences and Technology University (Tourism Unit) of Kerman in Iran. A total of 30 couples with the lowest scores were selected as subjects for this study.
Women in experimental group participated in a 12-session training on marital communication skills. The aim of this training was to increase positive communication skills and diminish negative communication behaviors. The control group received no training. We used analysis of covariance to test our hypotheses: Hypothesis 1: Communication skills training for married women increases their intimacy. Hypothesis 2: Communication skills training for married women increases their quality of life. Hypothesis 3: Communication skills training for married women increases their husbands' intimacy. Hypothesis 4: Communication skills training for married women increases their husbands' quality of life.

Results
After analysis of the data obtained through pre-test and postest, the effect of communication skills training had significantly (p < .01) increased women's intimacy, and Hypothesis 1 was approved. Hypothesis 2 was approved as well and communication skills training had significantly (p < .01) increased women's quality of life. Although communication skills training for women had not significantly increased the intimacy of their husbands (p > .1), it had a significant effect on increasing the husbands' quality of life (p < .01). The result is consistent with other studies done before (Askari et al., 2012), showing the importance of communication skills training program in treatment of distressed couples seeking different sorts of therapies. Sprecher (2002) has indicated that communication is an essential requirement for establishing an intimate relationship and giving rise to adaptability between couples. Effectiveness of communication skills training in fostering and maintaining positive intimate relationship between couples has been approved (Askari et al., 2012;Blanchard et al., 2009;Durana, 1997;Hahlweg et al., 1984;Halford, Markman, Kling, & Stanley, 2003;Miller, Nunnally, & Wackman, 1976;Schilling et al., 2003).

Discussion
Communication skills training helps couples to send their messages more explicitly and hence come to a deeper understanding of one another. Systematic training of positive communication skills to couples and at the same time practice of communication skills by couples will add positive habits into their behavioral repertoire and these habits will be used in conflict situation and avoid engaging in stress-induced behaviors such as criticisms, blaming, and taunting. Hrapczynski (2008) has shown that cognitive-behavioral therapy can reduce negative communication patterns and negative attitudes among couples, which will lead to increased satisfaction.
The result of this study showed the positive effect of communication skills education for married women on increasing their intimacy and quality of life. Although it has been observed that communication skills trainings have a genderdependent pattern on affecting couples' behaviors (Schilling et al., 2003), our results showed that communication skills education to women can just increase the intimacy of their husbands and not their quality of life. Schilling et al. (2003) had somehow a similar observation and found that increased positive communication skills in women not only cannot decrease the risk of male and female distress onset but also increases it. The dynamics behind these observations need to be studied in detail.
Nowadays in every society, family is the main source of security for individuals. However, families encounter different challenges and problems in modern societies. One of the most common problems families face is diminished marital intimacy and satisfaction, which leads to decreased quality of life of families. Interventional programs to prevent these problems are very helpful and communication skills training programs for couples are good examples for interventional measures.
Although the impact of communication skills training on intimacy, satisfaction, and quality of life of couples has been studied, the contents of these trainings and mechanism to be used for inducing positive practice of communication skills via educational and training programs need to be studied.

Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding
The author(s) received no financial support for the research and/or authorship of this article.