Introduction
Marriage is a longstanding divine tradition upheld by laws and regulations [1]. The success of this sacred bond and the well-being of the marriage extend beyond the :union: itself. In our culture and country, the family unit is established upon the marriage of two individuals [1, 2]. The family stands as the primary and most distinctive social institution; the society’s health and prosperity rely on the well-being and contentment of its members. The impact of any individual and relationship, whether positive or negative, is unparalleled in terms of duration, depth, and intensity, with its significance evident across various levels of the individual, the couple (husband and wife) and the family system. Furthermore, the reciprocal influence of this :union:’s quality is profound on other family members in areas such as education, employment, social interactions and related issues [2, 3].
The family is established through the marriage contract between a man and a woman. Marriage represents the initial emotional and legal commitment that an individual undertakes in adulthood and selecting a partner and formalizing a marriage contract marks a pivotal moment in personal maturation and progress [3]. Numerous factors contribute to the longevity of a marriage, with adaptation to stressful circumstances being the most crucial factor [3, 4]. In contemporary times, marital adjustment stands out as a widely utilized concept in studies related to families and marriages [4].
Marital adjustment is a multidimensional concept that illuminates various facets of marriage and represents a process that unfolds throughout a couple’s life [5]. It involves adjusting preferences, recognizing each other’s traits, establishing behavioral norms, and developing relationship dynamics. Marital adjustment signifies an evolving process between spouses, a concept utilized over the years without a consistent and definitive definition among researchers [5, 6]. It serves as a means through which married individuals, individually or collectively, adapt to sustain their marriage, proving to be one of the pivotal factors influencing the stability and continuity of married life [7, 8, 9].
Marital adjustment influences various aspects of individuals’ and society’s lives, serving as the cornerstone for effective family functioning. It facilitates parental roles, fosters economic development and enhances overall life satisfaction [9, 10]. Conversely, marital adjustment between spouses creates challenges in the aforementioned areas, resulting in difficulties in social interactions, inclinations towards social and moral deviations, and a decline in cultural values within couples [11]. According to the literature, factors impacting marital adjustment fall into three categories: Personal characteristics, situational factors, and life events [10, 11]. Additionally, variables such as family environment and attachment style exhibit a positive correlation, while factors like irrational thoughts and depression show a negative association with marital adjustment [12, 13]. 
In the US, approximately 55% of marriages, 42%in England and 37% in Germany ultimately result in divorce [12]. In Iran, as per the latest data from the Civil Registration Organization, the divorce rate surged by 19.1% in 2020 compared to previous years. Concurrently, marriage statistics saw a slight increase of 0.2%, with the divorce-to-marriage ratio reported as 47.5 in 2023 [12, 13]. Over the past two decades in Iran, significant transformations have occurred in the structure of families and the dynamics among their members. Many social science studies investigating the reasons behind the weakening of marital bonds and adjustment have focused on macro variables like social and economic status, income reduction, unemployment and cultural and social challenges. These factors have been identified as influential in the prevalence of marital discord and divorce in Iran [13-15]. Notably, there is a lack of comprehensive studies on the factors associated with marital adjustment in Iran.
Therefore, recognizing the pivotal role of adjustment in couples’ relationships and aiming to enhance the quality of married life, fortifying marital bonds and diminishing divorce rates while safeguarding the family unit underscores the comprehensive understanding of the factors linked to couples’ adjustment. Consequently, it is crucial to delve into and scrutinize this variable comprehensively, drawing insights from pertinent primary research studies to mitigate conflicts, address issues and elevate satisfaction within marital relationships. Rather than adopting a pathological perspective on factors contributing to marital adjustment and unsuccessful marriages, it is imperative to investigate the impact of social characteristics on marital adjustment [14-17]. Review studies, particularly narrative ones, are structured to address specific research inquiries and meticulously evaluate other original studies within the realm of the research question [18]. Therefore, the present study aims to review the factors associated with marital adjustment among couples.

Materials and Methods 
This review study adhered to the Joanna Briggs Institute (JBI) methodology [18]. It was conducted in five distinct steps: 1) Designing the research question, 2) Searching for and extracting relevant studies, 3) Selecting pertinent observational studies, 4) Tabulating and summarizing the gathered information and data, and 5)Reporting the outcomes [18]. 
Initially, the research team chose the research subject, leading to the formulation of the research question. Subsequently, keywords were identified using the Medical Subject Headings (MeSH) and relevant studies were retrieved. After eliminating duplicates, articles unrelated to the topic were sifted out based on their titles, abstracts, and full texts. The final article selection process was independently carried out by two researchers (Jila Ganji and Seyedeh Fatemeh Hashemi), with no conflicts or disagreements arising. Various databases, including Google Scholar, PubMed, Scopus, Library, ScienceDirect, Web of Science, Magiran and Scientific Information Database (SID), were explored to locate all electronically published articles without time constraints. Additionally, a manual search within journals was conducted to extract articles on related subjects from the references of identified articles. The search spanned from 2015 to April 1, 2024, a period chosen due to lifestyle changes observed over the past decade.

Search strategy
The search strategy using the keywords was as follows: [“factors” OR “agents”] AND [“related factors”] AND [“psychological factors” OR “anxiety” OR “stress” OR “depression” OR “bipolar disorder” OR “paranoid” OR “delusional disorder”] AND [“continuity” OR “durability” OR “permanence” OR “persistence” OR “stability”] AND [“physical factors” OR “diseases”] AND [“sexual factors”] AND [“economic factors” OR “social factors” OR “work" OR “job” OR “financial situation” OR “individual factors”].
All relevant studies concerning the factors linked to marital adjustment in couples were extracted during the search. Studies with undefined sample sizes, inconclusive results, and abstracts from conference articles lacking full text were excluded from the study. After eliminating duplicates, articles not aligned with the study’s focus were identified by scrutinizing titles, abstracts, and full texts. Two researchers also conducted the final article selection process. 
The quality of the articles was assessed using the appraisal tool for cross-sectional studies (AXIS) tool, designed for the critical appraisal of cross-sectional studies. This tool is commonly utilized in systematic reviews by physicians, guideline developers, journal clubs and other review studies within health research groups. The AXIS tool’s components were formulated through evidence, epidemiological processes, researchers’ experiences, and input from Delphi participants. The tool evaluates five main sections categorized as introduction, methods, results, discussion and other information, with some sections further divided into subsets, totaling 20 items. Seven items in the final questions (1, 4, 10, 11, 12, 16 and 18) pertain to the quality of reporting, seven items (2, 3, 5, 8, 17, 19 and 20) relate to study design quality, and six items (6, 7, 9, 13, 14 and 15) address potential biases in the study. Response options for the questions include yes, no, don’t know, or leave a comment. In this study, 16 items were utilized for critical evaluation and bias assessment (Table 1) [19].






Utilizing the specified keywords, a total of 1124 articles were acquired. To streamline the organization of studies, EndNote software, version 21 was employed. Additionally, three articles were identified through a manual search. Subsequently, utilizing the mentioned software and meticulously evaluating the titles and abstracts of articles meeting the inclusion criteria eliminated a significant portion due to their lack of relevance to the study’s objectives. Following this, duplicate and irrelevant studies were excluded, leaving 28 studies. After a review of the abstracts, seven studies were further eliminated and four more were removed upon full-text examination, resulting in a final selection of 18 studies (Figure 1). Upon scrutinizing the abstracts and full texts of these qualified articles, pertinent data were extracted to facilitate the composition of the present study. The essential data extracted from each study encompassed details such as author/year, location, objectives, sample size, research instruments, variables investigated, and outcomes. Subsequently, the extracted data from the articles were categorized and presented as a comprehensive review article (Table 2).





Results 
Participants 
Participants in the studies were comprised of both men and women, with sampling conducted among married individuals and singles (those without marriage experience, those with unsuccessful marriages and widows). The age range of participants varied from 15 to 50 years. All studies adhered to specific inclusion and exclusion criteria for participant selection. Inclusion criteria typically involved literacy in reading and writing, a willingness to participate in the study, and falling within the specified age group or aligning with the study’s objectives. Some studies also recorded the number of previous marriages and mental health records to mitigate the influence of confounding factors [20-36].

Data classification 
The findings were structured around addressing the primary research question concerning various factors: communication factors (interactions, communication style, empathy, and commitment) [22, 26, 29, 31, 33, 34], individual factors (number of children, age, marital status, history of previous marriages, and gender) [21, 24, 27, 29, 31, 32, 33, 34], psychological factors (emotional intelligence, personality traits, attachment style, stress, boredom, domestic violence, self-esteem, ego, and marital justice) [20, 22, 23, 26, 27, 28, 29, 34, 35], economic and social factors (financial status, employment status, and education) [21, 27, 28, 31, 32, 36], medical and physical factors (types of physical diseases, including incurable or chronic illnesses) [25, 30, 36, 34].

Description of studies
In the reviewed studies, interactions, communication style, the number of children, empathy, and commitment were identified as communication factors influencing the level of adjustment among couples [22, 26, 29, 31, 33, 34]. Communication factors represent individuals sharing information and emotions using verbal and non-verbal cues. Additionally, certain scenarios, such as the impact of the number of children on communication dynamics within a household, were categorized under communication factors. Enhanced levels of commitment and empathy within couples can foster an environment conducive to improved marital adjustment [22, 29, 33, 34]. Empathy, in this context, pertains to an individual’s cognitive and emotional responses to the experiences of others, with higher levels of empathy increasing the likelihood of providing assistance and demonstrating compassion.
Eight studies explored the correlation between individual factors and the level of marital adjustment among couples [21, 24, 27, 29, 31, 32, 33, 34]. Within these studies, individuals of older age are found to exhibit higher levels of adjustment compared to their younger counterparts. The history of an unsuccessful marriage has been identified in some studies as a factor contributing to marital adjustment [29], while in others, it is associated with an increase in adjustment [24, 31]. Furthermore, certain studies indicate that females are more compatible than males [31], with men being perceived as less compatible due to factors such as the presence of testosterone hormones and tendencies toward violence [31]. Conversely, men are deemed more compatible and peace-loving than women in other instances, attributed to factors like fatigue and boredom [24].
Eleven studies delved into the psychological aspects of individuals and their impact on marital adjustment, highlighting various dimensions such as self-esteem, personality traits, emotional intelligence, and attachment style as factors influencing adjustment between couples [20, 22, 23, 26, 27, 28, 29, 34, 35]. In these studies, high self-esteem is associated with enhanced adjustment, while certain personality traits like paranoia and narcissism were linked to lower marital adjustment. A secure attachment style also contributed to better adjustment among couples [20, 22, 26, 27, 28, 29, 34].
Social status and economic well-being are foundational for fostering positive and harmonious marital relationships [21, 27, 28, 31, 32, 36]. In some studies, employed women are considered a hindrance to favorable marital adjustment. At the same time, in other instances, employment challenges, such as job difficulty, long hours and shifts, and weakened marital adjustment, are mentioned as the culprits [21, 27, 29]. Physical health also plays a significant role in determining the level of adjustment in any relationship. Marriage compatibility between couples often hinges on the physical health of both partners, as an illness, depending on its severity, can impact the marital relationship and its compatibility [25, 30, 36, 34]

Discussion 
The present study aimed to explore the factors influencing marital adjustment among couples. This narrative study scrutinized the contents of the selected articles. Marital adjustment fosters optimal conditions for alignment and unity, grounded in heightened intimacy and enhanced moral, physical and psychological resilience. It is widely regarded as a pivotal factor in determining the stability and longevity of married life [6, 7]. Various factors, including women’s employment status, influence the adjustment between men and women within a family. Employment and education stand out as crucial contemporary themes aimed at enhancing women’s social and economic involvement, leading to significant transformations in the values, cultural norms and structural dynamics of families and societies [8, 9]. In various studies, women’s employment and the resulting fatigue have been identified as impediments to enhanced adjustment, leading to decreased continuity and increased conflict within marriages [21, 27, 29]. A woman’s inclination towards employment predominantly impacts the family dynamics, altering the relationships between spouses and children.
Consequently, the educational impact influenced by a later career choice sometimes yields contradictory effects on adjustment. However, it can also enhance women’s awareness and knowledge, fostering greater understanding and empathy. The correlation between education and marital adjustment is intertwined with additional factors, including the nature of the job, starting and working hours, the spouse’s job satisfaction, the couple’s personalities, financial status, and income levels [21, 27]. Interestingly, two studies reported no significant relationship between employment and marital adjustment [20, 21]. 
Some studies have delved into the psychological dimension of individuals in fostering harmony [20, 34]. The rationale behind the emphasis on this dimension lies in its resemblance to the psychological aspect [20, 22]. Adaptation is cultivated within the psychological realm of individuals and is occasionally influenced, like other psychological factors, by various dimensions of a person’s life [28, 29, 34]. Factors such as attachment style, intelligence, life stressors, self-esteem, and personality types play pivotal roles in determining the level of adjustment [34, 35]. In a study by AbdelJaber et al. (2023), the relationship between psychological stress and marital adjustment was explored in 60 couples, revealing that stress diminishes marital adjustment [20]. Onabamiro et al. highlighted a significant correlation between self-esteem, emotional intelligence and marital adjustment [26]. Hosseini noted that individuals with insecure attachment may, at times, exhibit higher marital adjustment, attributing this increase to the fear of losing or being rejected by their partner. Additionally, communication challenges can hinder proper marital adjustment between spouses [34].
Communication styles can stem from psychological issues and serve as the foundation for marital conflicts or the cultivation of intimacy [22, 26, 29, 31, 33, 34]]. Each individual employs communication methods to fulfill their desires. The selection of a communication style is influenced by environmental, psychological and, at times, physical and social conditions. A positive coping style can lay the groundwork for enhancing adjustment between couples, leading to increased marital satisfaction and improved quality of communication within relationships [26, 29].
Certain factors tied to an individual’s demographic characteristics, such as age, gender and past marital experiences, can influence the level of adjustment between two individuals [21, 24, 27, 29, 31, 32, 33, 34], with studies highlighting both positive and negative associations. Research indicates that older age can contribute to increased adaptability, and instances of past failures may lead to heightened adaptability due to fear of loss or decreased adaptability due to normalization of incompatibility and failure [24, 29, 31]. Al Fazari et al. identified a history of divorce as a key predictor of marital adjustment [24]. Another dimension relevant to marital adjustment is physical health. Individuals with better physical health tend to exhibit higher motivation levels for compromise and coexistence. At the same time, those with chronic or incurable illnesses may demonstrate lower levels of compromise depending on the nature and severity of the disease. Studies by Ruiz-Marin et al. [30] Göriş et al. [35] and Calandre et al. [25] have identified various chronic and incurable diseases as factors contributing to reduced marital adjustment, noting that the average adjustment among individuals with such conditions tends to be lower than that of the general population. Naturally, individuals experiencing physical fatigue may place less value on their marriage, potentially leading to diminished hope for shared longevity in such relationships.
One limitation of this study is that while the articles meeting the inclusion criteria were identified and reviewed, some published studies may have been overlooked due to limited access to languages other than Farsi and English and restricted access to databases like PsycINFO. Another limitation lies in the variation of adjustment assessment tools used across different studies. Additionally, the unavailability of full-text articles and excluding non-English or non-Persian language studies present further constraints. Despite these limitations, the study’s results can be valuable for developing intervention programs. 

Conclusions 
Various factors, including communication styles, individual traits, psychological aspects, economic and social conditions, and medical and physical considerations, are linked to marital adjustment among couples. These factors, as documented in the literature, can be leveraged to enhance adjustment in couples through the development of targeted intervention programs.

Educational application 
The study's findings shed light on the factors influencing marital adjustment. Understanding these factors can aid in identifying facilitators and barriers, ultimately fortifying the foundation of families. With proper planning and the assistance of psychological experts, it is hoped that tailored educational programs can be crafted to bolster family structures.

Clinical application 
This study delved into the factors associated with marital adjustment, highlighting predictive indicators of incompatibility that could inform the development of clinical trials focused on marital harmony.

Application in policy-making
Given that enhancing marital adjustment and fortifying family structures are key objectives in the country’s social development agenda, the study’s outcomes are anticipated to be instrumental in refining policies to enhance the quality of family-strengthening programs.

Ethical Considerations
Compliance with ethical guidelines
The authors of this study have meticulously adhered to ethical considerations and general publication standards, ensuring compliance with guidelines to prevent plagiarism, falsification, data manipulation, and the simultaneous submission of articles to multiple journals

Funding
This project was financially supported by Mazandaran University of Medical Sciences and the Student Research Committee of this University.

Authors' contributions
Supervision: Jila Ganji and Zeinab Hamzehgardeshi; Research and data collection: Seyedeh Fatemeh Hashemi and Jila Ganji; Data Analysis: Abolfazl Hosseinnataj And Seyedeh Fatemeh Hashemi; Conceptualization, methodology, writing–original draft, review, editing and funding department: All authors.

Conflict of interest
The authors declared no conflict of interest.

Acknowledgments
The authors sincerely appreciate Mazandaran University of Medical Sciences and the Student Research Committee for their cooperation and financial support.


References

1. Lamela D, Figueiredo B. Coparenting after marital dissolution and children's mental health: A systematic review. J Pediatr. 2016; 92(4):331-42. [DOI:10.1016/j.jped.2015.09.011] [PMID]
2. Wilson SJ, Andridge R, Peng J, Bailey BE, Malarkey WB, Kiecolt-Glaser JK. Thoughts after marital conflict and punch biopsy wounds: Age-graded pathways to healing. Psychoneuroendocrinology. 2017; 85:6-13. [DOI:10.1016/j.psyneuen.2017.07.489] [PMID]
3. Cribbet MR, Smith TW, Uchino BN, Baucom BRW, Nealey-Moore JB. Autonomic influences on heart rate during marital conflict: Associations with high frequency heart rate variability and cardiac pre-ejection period. Biol Psychol. 2020; 151:107847. [DOI:10.1016/j.biopsycho.2020.107847] [PMID]
4. Li X, Liu Q. Parent-grandparent coparenting relationship, marital conflict and parent-child relationship in Chinese parent-grandparent coparenting families. Child Youth Serv Rev. 2020; 109:104-10. [DOI:10.1016/j.childyouth.2019.104733]
5. Frankel LA, Umemura T, Jacobvitz D, Hazen N. Marital conflict and parental responses to infant negative emotions: Relations with toddler emotional regulation. Infant Behav Dev. 2015; 40:73-83. [DOI:10.1016/j.infbeh.2015.03.004] [PMID]
6. Moghaddam KK, Honarmand MM, Kiamanesh A, Hosseiniyan S. [The role of differentiation, meaningfulness in life and forgiveness in predicting martial satisfaction (Persian)]. J Fam Psychol. 2017; 3(2):71-82. ^[Link]
7. Teimory S, Ghafariyan G, Yazdanpanah F. [The effectiveness of dialectical behavioral therapy on marital satisfaction in couples conflict (Persian)]. Res Clin Psychol Couns. 2018; 8(2):101-15. [DOI:10.22067/ijap.v8i2.66503]
8. Lee WS, McKinnish T. Locus of control and marital satisfaction: Couple perspectives using Australian data. J Econ Psychol. 2019; 74:102-110. [DOI:10.1016/j.joep.2019.102205]
9. Xie J, Zhou ZE, Gong Y. Relationship between proactive personality and marital satisfaction: A spillover-crossover perspective. Pers Individ Differ. 2018; 128:75-80. [DOI:10.1016/j.paid.2018.02.011]
10. Najarzadegan F, Farhadi H. [The effectiveness of therapeutic quality of life on communication skills, cyberspace addiction, marital satisfaction and emotional self-regulation in couples (Persian)]. J Psychol Sci. 2018; 18(74):247-56. ^[Link]
11. Xie J, Shi Y, Ma H. Relationship between similarity in work-family centrality and marital satisfaction among dual-earner couples. Pers Individ Differ. 2017; 113:103-8. [DOI:10.1016/j.paid.2017.03.021]
12. Futouhi S, Mikaeili N, Atadokht A, Hajlu N. [The effectiveness of Farahijan-based couple therapy on marital adjustment and boredom in conflicted spouses (Persian)]. J Women Fam. 2016; 12(39):45-64. ^[Link]
13. Omrani S, Jomehri F, Ahadi H. [Prediction of marital adjustment based on metacognitive beliefs with mediating effect of marital conflicts (Persian)]. J Psychol Sci. 2018; 17(68):501-8. ^[Link]
14. Azam Y, Sohrabi F, Borjal A, Chopan H. [The effectiveness of teaching emotion regulation based on gross model in reducing impulsivity in drug-dependent people (Persian)]. Sci Res Addict. 2014; 8(30):127-41. ^[Link]
15. Andamikhoshk A, Golzar M, Esmaeilinasab M. [Role of nine strategies of cognitive emotion regulation in the prediction of resilience (Persian)]. Thought Behav Clin Psychol. 2013; 7(27):57-66. ^[Link]
16. Salehi A, Baghban I, Bahrami F, Ahmadi A. [The effect of emotion regulation training based on dialectical behavior therapy and gross process model on symptoms of emotional problems (Persian)]. Zahedan J Res Med Sci. 2012; 14(2):e93581. ^[Link]
17. Tompson MC, Langer DA, Hughes JL, Asarnow JR. Family-focused treatment for childhood depression: Model and case illustrations. Cogn Behav Pract. 2017; 24(3):269-87. [DOI:10.1016/j.cbpra.2016.06.003] [PMID]
18. Peters MDJ, Godfrey C, McInerney P, Munn Z, Tricco AC, Khalil H. Scoping reviews. In: Aromataris E, Munn Z, editors. Adelaide: JBI Manual for Evidence Synthesi; 2020. ^[Link]
19. Downes MJ, Brennan ML, Williams HC, Dean RS. Development of a critical appraisal tool to assess the quality of cross-sectional studies. BMJ Open. 2016; 6(12):e011458. [DOI:10.1136/bmjopen-2016-011458] [PMID]
20. AbdelJaber Muhammad DT. Psychological stress and its relation to marital compatibility among early married couples. J Sustain Dev Soc Environ Sci. 2023; 2(1):39-52. [DOI:10.21608/jsdses.2022.159800.1001]
21. Younis Sulaiman J, Al-Brwari MS. The obstacles facing women in balancing between work and home and its relationship to marital compatibility. Al-Adab J. 2023; 1(144):141-56. [DOI:10.31973/aj.v2i144.4033]
22. Fahimi M, Taghvaei D. [Predicting marital adjustment based on marital justice and marital burnout (Persian)]. Assess Res Appl Couns. 2022; 4(2):1-12. ^[Link]
23. Ahmadi L, Panagi L, Alsadat Sadeghi M. [The relationship between autonomy and intimacy of the family of origin with marital adjustment: The role of personality factors (Persian)]. Fam Res. 2017; 14(1):39-56. ^[Link]
24. Al Fazari MK, Amir SMA. Factors predicting marital adjustment in omani society. Int J Psychol Behav Anal. 2017; 3:131. [DOI:10.15344/2455-3867/2017/131]
25. Calandre EP, Ordoñez-Carrasco JL, Rico-Villademoros F. Marital adjustment in patients with fibromyalgia: Its association with suicidal ideation and related factors. A cross-sectional study. Clin Exp Rheumatol. 2021; 39(3):89-94. [DOI:10.55563/clinexprheumatol/pufzd6] [PMID]

26. Onabamiro AA, Owoyele JW, Elijah AO. Three-factor predictors of marital adjustment among couples in Abeokuta Metropolis, Ogun State, Nigeria. Univ J Psychol. 2017; 5(5):225-30. [DOI:10.13189/ujp.2017.050503]
27. Derakhshan S, Rahimi Pordanjani T, Amani M. The relationships between work-family conflict and marital adjustment in married female nurses: The moderating role of social support. Horiz Med Sci. 2019; 25(1):50-6. ^[Link]
28. Saemi H, Basharat MA, AsgharnejadFarid AA. [Predicting marital adjustment based on marital intimacy and deficit emotional regulate (Persian)]. J Psychol Sci. 2019; 18(78):635-46. ^[Link]
29. Nazari S, Javid F, Negarandeh R, Afshar Farokhnezhad P. [Relationship of identity styles and coping strategies with marital adjustment in nurses (Persian)]. Iran J Psychiatry Clin Psychol. 2022; 28(3):374-85. ^[Link]
30. Ruiz-Marin CM, Molina-Barea R, Slim M, Calandre EP. Marital adjustment in patients with cancer: Association with psychological distress, quality of life, and sleep problems. Int J Environ Res Public Health. 2021; 18(13):7089. [DOI:10.3390/ijerph18137089] [PMID]
31. Durğut S, Kısa S. Predictors of marital adjustment among child brides. Arch Psychiatr Nurs. 2018; 32(5):670-6. [DOI:10.1016/j.apnu.2018.03] [PMID]
32. Can FG, Tufekci FG. Factors influencing the marital adjustment and life satisfaction of parents who have children with disabilities. Int J Caring Sci. 2021; 14(1):88-99. ^[Link]
33. Mohammadi P, Arefi M. [The relationship between self-worth and communication styles and marital adjustment in women (Persian)]. Shenakht J Psychol Psychiatry. 2015; 2(4):11-22. ^[Link]
34. Hoseini Hoseinabad SF, Ghobari Banab B, Mashayekh M, Sodagar S, Farrokhi N. An investigation of predictive marital adjustment base of attachment styles in married women. J Commun Health Res. 2018; 7(3):147-54. ^[Link]
35. Göriş S, Ceyhan Ö, Taşcı S, Doğan N. Do symptoms related to hemodialysis affect marital adjustment? Sex Disabil. 2016; 34:63-73. [DOI:10.1007/s11195-016-9428-x]
36. Yılmaz FA, Avci D. The relationship between personality traits, menopausal symptoms, and marital adjustment. Health Care Women Int. 2022; 43(10-11):1142-57. [DOI:10.1080/07399332.2021.1893732] [PMID]