Application of the International Classification of Functioning,Disability and Health (ICF) in clinical practice

Purposes: We first aimed to describe demographic and audiological characteristics of adults referred to a university hospital for hearing aid (HA) fitting and rehabilitation. Our second aim was to employ an inventory that assesses life consequences of hearing impairment (HI) in terms of perceived activity limitation and participation restriction for the first time in a Norwegian adult outpatient population. A third aim was to study life consequences by audiological and demographic characteristics.

Subjects and methods: During one year consecutive patients (n?=?343) were requested to answer the Hearing Disability and Handicap Scale (HDHS) assessing activity limitation and participation restriction in relation to an audiological examination and medical consultation. The mean threshold of hearing (MTH) was ascertained by pure tone thresholds at 0.5?–?1?–?2?–?4 kHz in the better ear.

Results: Activity limitation and participation restriction were both higher for HA experienced than HA naïve subjects ( p?2) was 43.4% with MTH, perceived duration, and severity of hearing problems as predictor variables. Correspondingly, the explained adjusted variance of participation restriction was 28.4% for a model with MTH, age, gender and perceived severity of hearing problems as predictors.

Conclusions: As a standard supplement to audiometric tests, HDHS may be successfully applied as a clinical tool among similar hearing impaired outpatients in order to assess activity limitation and participation restriction as part of audiological rehabilitation.     

Participation frequency and perceived participation restrictions at older age: applying the International Classification of Functioning,Disability and Health (ICF) framework

Purpose.?To identify variables from different components of International Classification of Functioning, Disability and Health (ICF) associated with older people's participation frequency and perceived participation restrictions.

Method.?Participants (N == 186) were community-living, 65–88 years old and 52%% men. The dependent variables, participation frequency (linear regression) and perceived participation restrictions (logistic regression), were measured using The Late-Life Function and Disability Instrument. Independent variables were selected from various ICF components.

Results.?Higher participation frequency was associated with living in urban rather than rural community (β == 2.8, p < 0.001), physically active lifestyle (β == 4.6, p < 0.001) and higher cognitive function (β == 0.3, p == 0.009). Lower participation frequency was associated with being older (β == ?0.2, p == 0.002) and depressive symptoms (β == ?0.2, p == 0.029). Older adults living in urban areas, having more advanced lower extremities capacity, or that were employed had higher odds of less perceived participation restrictions (adjusted odds ratio [[OR]] == 5.5, p == 0.001; OR == 1.09, p < 0.001; OR == 3.7, p == 0.011; respectively). In contrast, the odds of less perceived participation restriction decreased as depressive symptoms increased (OR == 0.8, p == 0.011).

Conclusions.?Our results highlight the importance of capturing and understanding both frequency and restriction aspects of older persons' participation. ICF may be a helpful reference to map factors associated with participation and to study further potentially modifiable influencing factors such as depressive symptoms and advanced lower extremity capacity.     

Activity limitation and participation restriction in adults seeking hearing aid fitting and rehabilitation

PURPOSES: We first aimed to describe demographic and audiological characteristics of adults referred to a university hospital for hearing aid (HA) fitting and rehabilitation. Our second aim was to employ an inventory that assesses life consequences of hearing impairment (HI) in terms of perceived activity limitation and participation restriction for the first time in a Norwegian adult outpatient population. A third aim was to study life consequences by audiological and demographic characteristics. SUBJECTS AND METHODS: During one year consecutive patients (n = 343) were requested to answer the Hearing Disability and Handicap Scale (HDHS) assessing activity limitation and participation restriction in relation to an audiological examination and medical consultation. The mean threshold of hearing (MTH) was ascertained by pure tone thresholds at 0.5 - 1 - 2 - 4 kHz in the better ear. RESULTS: Activity limitation and participation restriction were both higher for HA experienced than HA na?ve subjects ( p < 0.01). In a multivariable model, the explained adjusted variance of activity limitation (R2) was 43.4% with MTH, perceived duration, and severity of hearing problems as predictor variables. Correspondingly, the explained adjusted variance of participation restriction was 28.4% for a model with MTH, age, gender and perceived severity of hearing problems as predictors. CONCLUSIONS: As a standard supplement to audiometric tests, HDHS may be successfully applied as a clinical tool among similar hearing impaired outpatients in order to assess activity limitation and participation restriction as part of audiological rehabilitation.     

Reliability of the LIFE-H satisfaction scale and relationship between participation and satisfaction of older adults with disabilities

Purpose.?To (1) document the test–retest reliability of the Assessment of Life Habits (LIFE-H 3.1) in measuring the satisfaction of older adults with disabilities regarding their level of participation and (2) explore the relationships between level of participation and satisfaction with the level of participation achieved.

Methods.?Thirty older adults having functional disabilities were interviewed twice using the LIFE-H. This questionnaire assesses the (1) participation in daily activities and social roles (life domains), and (2) satisfaction with this participation.

Results.?The test–retest intraclass correlation coefficients (ICC) of the satisfaction total score and its two subscores revealed high reliability (ICCs ≥ 0.84). Moderate to excellent ICCs were also obtained for the life domains (ICCs = 0.65–0.88). Satisfaction was positively associated with participation for the daily activities subscore and LIFE-H total score (p < 0.05) but not the social roles subscore. Half of the life domains showed significant correlations between participation and satisfaction scores (p < 0.01).

Conclusion.?The results support the reliability of the LIFE-H satisfaction scale in older adults having functional disabilities. Also, as satisfaction is only partly related to the level of participation, the study emphasizes the relevance of considering both participation and satisfaction of older adults with disabilities when evaluating their needs.     

Examining changes in self-perceived quality of life in children and adolescents with physical disability using a longitudinal design

Purpose.?The study aimed to investigate the changes in self-perceived quality of life (QOL) of children and adolescents with physical disability (PD).

Method.?Two hundred students aged 10–18 with PD were recruited from primary and high schools in Taiwan to participate in this longitudinal study. The Student Version of the Comprehensive Quality of Life Scale (COMQOL-S) was used to measure self-perceived QOL, which was recorded at baseline, and 6, 12 and 18 months post-baseline. Statistically, linear mixed models were used to compare the QOL scores among the four time points.

Results.?At the second, third and fourth visit, 192, 151 and 128 participants completed COMQOL-S, respectively. Significant changes over time were found in overall objective and subjective OQL scores (slope == 0.8, p == 0.002 and slope == ?1.3, p < 0.001, respectively). Specifically, significant reductions of the subjective QOL scores over the period of the four visits were observed in five domains, namely, Productivity (slope == ?1.7, p == 0.005), Intimacy (slope == ?1.6, p == 0.004), Safety (slope == ?1.6, p == 0.008), Place in community (slope == ?1.4, p == 0.019) and Emotional wellbeing (slope == ?2.5, p < 0.001). Age was negatively correlated with the change of overall subjective score. Positive correlation was found between the change in mean objective scores and mean subjective scores in the Intimacy and Productivity domains.

Conclusions.?Even though the conditions of material wellbeing and health can be kept steady, the overall QOL of children and adolescents with PD could still decline over time. This might be attributable to the fact that social life becomes more sophisticated when children become older.     

Classification of childhood hearing impairment: implications for rehabilitation in developing countries

Aim:?To ascertain the rehabilitation needs of hearing impaired school entrants in developing countries based on current criteria for evaluating classification of childhood hearing impairment.

Methods:?The profile of hearing impairment was examined in 50 children from eight randomly selected mainstream schools, based on findings from medical history, physical examination, otoscopy, pure-tone audiometry and tympanometry. The hearing thresholds across frequencies 0.25?–?8.0 kHz were analysed. The results were compared with conventional pure-tone averages (0.5?–?4.0 kHz) and WHO's criteria/threshold for disabling hearing impairment.

Results:?Seventeen (94.4%) of the 18 children with conductive hearing loss based on conventional audiometry had high-frequency hearing loss. Similarly, 10 children (83.3%) of the 12 children with sensorineural hearing loss and 19 children (95%) of the 20 children with mixed hearing loss had high-frequency hearing loss. Forty-six hearing impaired children (92%): comprising those with permanent unilateral hearing loss >?30 dBHL, permanent hearing loss would have been missed by WHO criteria.

Conclusions:?Conventional school audiometry and WHO criteria for disabling hearing impairment are unlikely to detect the full spectrum of hearing disability in relation to activity limitation and participation restriction. The rehabilitation needs of the affected children cannot therefore be appropriately addressed by these approaches.     

The role of sensory and cognitive function in the onset of activity restriction in older people

Background: Extending healthy active life expectancy is a priority if we are to achieve gains in both the quality and quantity of life lived at older ages. We investigated the role of sensory (vision and hearing) and cognitive function on the onset of activity restriction in older people.

Methods: A survey of a total population (N?=?1579) of people aged 75 years and older, registered with a large general population in Melton Mowbray, Leicestershire, England, was undertaken in 1988 and linked with subsequent routine health assessments (up to a maximum of five) over 10 years. Activity restriction was defined as having difficulty performing on their own, requiring help or aids or not doing any one of seven Activities of Daily Living (ADLs). The study population comprised the 643 persons who were not restricted at baseline. Cox proportional hazard regression models were fitted to time of onset of activity restriction with those dying before activity restriction was reported being censored at time of death.

Results: After adjustment for confounding factors (socio-demographic and psychosocial factors, physical health and physical functional limitations), difficulty with both vision and hearing conferred a doubling of risk of activity restriction (RR?=?2.36, 95% CI 1.31 to 4.28). A unit decrease in the Information/Orientation subtest was associated with a 10% increase in risk (RR?=?1.10, 95% CI 1.02 to 1.19), even after adjustment for vision and hearing as well as other confounding factors, though baseline Mini-Mental State Examination score was not indicative of increased risk (RR?=?1.02, 95% CI 0.98 to 1.06).

Conclusion: Differentiating whether disability is a result of physical, sensory or cognitive functional limitations, is necessary to identify need and the direction in which efforts should be targeted to improve active life expectancy in older people.     

Health-related and subjective quality of life of older adults with visual impairment

Purpose.?To document health-related quality of life (HRQOL) and subjective quality of life (SQOL) and explore their correlates in older adults seeking services for visual impairment (VI).

Method.?A convenience sample of 64 participants (79.3?±?5.9 years) with VI was interviewed at home. HRQOL was measured with the Visual Function Questionnaire-25 and SQOL with the Quality of Life Index. The potential correlates were as follows: personal factors (sociodemographic characteristics, co-morbidity, depressive symptoms, activity level), environmental factors (technical aids, social support) and participation in daily activities and social roles (level and satisfaction).

Results.?Compared to normative data from previous studies of older adults, the participants had lower HRQOL but similar SQOL. Greater level of participation in social roles, higher perceived activity level, use of a writing aid and greater satisfaction with participation in social roles together explained better HRQOL (R²?=?0.66). Fewer depressive symptoms, greater satisfaction with participation in social roles and with social support and fewer co-morbidities together explained better SQOL (R²?=?0.70).

Conclusions.?HRQOL of older adults with VI is mainly explained by level of participation correlates, while their SQOL is mainly explained by depressive symptoms and satisfaction variables. The results also underscore the importance of social roles for HRQOL and SQOL of this population.     

Letter to the editor in response to the article of Dekkers and Søballe (Activities and impairments in the early stage of rehabilitation after Colles' fracture; Vol. 26, No. 11, June 3, 2004)

Aim.?To study psychological well-being (health-related quality of life) in a population of adults 20 years and over with hearing impairment (HI) and its relation to audiological factors, consequences of the HI, sense of humour, and use of communication strategies.

Subjects and methods.?Consecutive adults (n = 343) at the outpatient Unit of Audiology of a Norwegian university hospital answered the Psychological General Well-being inventory (PGWB), Hearing Disability and Handicap Scale (HDHS), Sense of Humour Questionnaire-6 (SHQ-6), and Communication Strategies Scale (CSS) in relation to an audiological examination and medical consultation.

Results.?Mean PGWB index for the whole sample was 81.4 (SD 14.3) and females reported a significantly lower psychological well-being. In multiple linear regression analyses well-being was negatively associated with high levels of activity limitation and participation restriction. PGWB index was positively associated with high sense of humour, but was neither explained by audiological factors nor use of communication strategies.

Conclusions.?Psychological well-being was associated with the outcome of a standard HI assessment of activity limitation and participation restriction, but not with degree of HI and use of communication strategies.     

Activities,participation and satisfaction one-year post stroke

Purpose. To evaluate the chronic consequences of stroke in terms of activity limitations, restricted participation and dissatisfaction from life, and the relationship between these variables, in stroke survivors living in the community one-year post onset.

Method. A total of 56 stroke patients (mean age: 57.7) who completed an in-patient rehabilitation programme, were evaluated one-year post onset in their homes, using the following instruments: Functional Independence Measure (FIM), Instrumental Activities of Daily Living Questionnaire (IADLq), Activity Card Sort (ACS), a work questionnaire, Life-Satisfaction Questionnaire (Li-Sat 9) and the Geriatric Depression Scale (GDS).

Results. One year post stroke onset the mean FIM motor score was 75.88 (max score: 91), yet more than 50% of the sample still required assistance (usually mild to moderate) in dressing, bathing and use of stairs. The majority of the sample required full assistance in some IADL domains, notably meal preparation (77%), housekeeping (70%) and laundry (82%). Only one subject returned to paid employment and the mean activity level (ACS), representing the percentage of leisure and IADL activities retained from before stroke, was 42.8%. Satisfaction ratings were generally low but varied between domains. Only 39% were satisfied from ‘life as a whole’. The lowest satisfaction rates were noted for ‘vocational situation’ (14%), ‘leisure situation’ (34%) and ‘ability in self-care’ (43%), whereas the satisfaction rate from family life was high (84%). Significant correlations were found between overall life satisfaction scores and the overall FIM motor, IADLq, and ACS scores (Pearson r values: 0.32, 0.48 and 0.57, respectively). Activity level was found to be a significant predictor of satisfaction (p = 0.007) beyond that accounted for by demographic variables and depression.

Conclusions. Stroke survivors dwelling in the community demonstrate long-standing dissatisfaction one-year post onset, correlating with activity limitation and restricted participation. The findings present a compelling need for rehabilitation services with a focus on participation in IADL and leisure activities, in order to improve the satisfaction of this population.     

Measurement properties of a modified Reintegration to Normal Living Index in a community-dwelling adult rehabilitation population

Purpose.?To examine the validity and reliability of a modified Reintegration to Normal Living Index (mRNL Index) with a sample of community-dwelling adults with mixed diagnoses.

Method.?Forty-six adults (mean 55.2 ± 20.3 years) were recruited through convenience sampling from outpatient rehabilitation services. They completed the mRNL Index, Community Integration Measure (CIM) and Life Space Assessment (LSA) and were invited to complete them again 2 weeks later.

Results.?Construct validity of the mRNL Index was confirmed by good fit to the Rasch measurement model. The mRNL Index demonstrated acceptable internal consistency (Cronbach's α == 0.80), as did the Daily Functioning subscale (Cronbach's α == 0.80) and Personal Integration subscale (Cronbach's α == 0.82). Test-retest reliability was also acceptable (intraclass correlation coefficient (3,1) == 0.83, p == .0001). As hypothesised, the LSA did not correlate with the Personal Integration subscale (Spearman rho == 0.08) and moderately correlated to the Daily Functioning subscale (Spearman rho == 0.59). The CIM was moderately correlated with the Personal Integration subscales (Spearman rho == 0.54) and the Daily Functioning subscale (Spearman rho == 0.53), though higher correlation was expected with the latter.

Conclusion.?Modifications to the phrasing, rating scale and subscales improved the validity of the original RNL Index for a mixed rehabilitation, community-dwelling population.     

Are satisfaction with and self-management of personal assistance services associated with the life satisfaction of persons with physical disabilities??

Purpose.?To examine the relationships between satisfaction with and self-management of personal assistance services ((PAS)) and the quality of life ((QoL)) of persons with disabilities. To test the postulate that consumer-directed PAS can fulfil the human need for control and contribute to a satisfactory life.

Method.?A survey compared the perspectives of persons using consumer-directed PAS versus those using agency-directed. A Personal Data Form obtained demographics and PAS characteristics. The Quality of Life Inventory measured life satisfaction. A PAS questionnaire measured perceptions about the management of, desire for control of, and satisfaction with PAS. Data were analysed using SPSS®? 14.

Results.?Significant relationships were found between QoL and satisfaction with PAS ((p < 0.001)) and between perceived control of PAS and satisfaction with PAS ((p < 0.001)). Significant group differences were also found. Consumer-directed participants reported higher satisfaction with their PAS ((p < 0.01)), greater control over services ((p < 0.001)) and greater QoL than agency-directed participants, ((p == 0.001)).

Conclusions.?The relationships found between self-management, PAS satisfaction, and QoL support the value of consumer-directed programmes. Rehabilitation professionals can use this knowledge to develop, implement and research practises that enable self-management.     

Perceived participation and problems in participation are determinants of life satisfaction in people with spinal cord injury

Purpose. To determine the relationships between perceived participation and problems in participation, and life satisfaction in people with spinal cord injury (SCI).

Method. A total of 157 men and women with SCI completed the Swedish versions of the Impact on Participation and Autonomy Questionnaire (IPA) and the Life Satisfaction Questionnaire (LiSat-9).

Results. The respondents' perceived participation in the five domains of the IPA was significantly correlated with their satisfaction with life as a whole (P < 0.01) and in most of the eight other domains of life satisfaction (P < 0.05 to P < 0.01) in the LiSat-9. The respondents' life satisfaction decreased gradually with increasing frequency of severe problems in participation and significant differences within groups of increasingly severe problems were found. The level of life satisfaction in respondents that perceived no severe problems with participation was similar to those of a normal population.

Conclusions. Perceived participation and problems in participation are determinants of life satisfaction in people with SCI. The results emphasize the importance to focus on severe problems with participation in order to optimize life satisfaction during the rehabilitation after SCI.     

Measuring participation in individuals with Parkinson disease: relationships with disease severity,quality of life,and mobility

Purpose.?Our aims were to: (1) describe participation in people with Parkinson disease (PD), (2) evaluate the relationship between quality of life and participation and (3) determine the mobliity measures which are predictive of participation.

Methods.?Participants with idiopathic PD (n == 62) were tested off medication for participation (Activity Card Sort), quality of life (PDQ-39), disease severity (MDS-UPDRS) and mobility (Berg Balance Scale, Five Time Sit to Stand (FTSTS), Six Minute Walk, forward walking velocity, dual-task walking velocity and Freezing of Gait Questionnaire (FOGQ)). Relationships of all variables to participation were examined using Pearson correlations. Subsequent regression analysis was employed to determine the mobility measures which best predicted the participation.

Results.?Participants with PD retained, on average, 78.3%% (SD == 15.6%%) of total activities. Participation was negatively correlated with all PDQ-39 domains (r range ?0.36 to ?0.78, all p < 0.005) with the mobility domain having the strongest correlation. All mobility measures were significantly correlated with participation, with the final regression model including only FTSTS and FOGQ which combined explained 37%% of the variance in participation.

Conclusions.?Participation is highly related to mobility-related QOL and may be most impacted by ability to stand up from a chair and freezing of gait in those with PD.     

Is social participation associated with quality of life of older adults with physical disabilities?

Purpose:?To explore the relationships between subjective quality of life and social participation of older adults with physical disabilities.

Method:?A cross-sectional design was used with a convenience sample of 46 people aged 60 to 90 living in the community. Subjective quality of life was estimated with the Quality of Life Index and social participation with the Assessment of Life Habits.

Results:?Only a weak relationship was found between total scores of quality of life and social participation. Interpersonal relationships, responsibilities, fitness and recreation were the categories of social participation most associated with quality of life. Social roles were more associated with quality of life than daily activities. Finally, satisfaction with the accomplishment of life habits was also more associated with quality of life than the performance itself.

Conclusions:?The importance of social participation in regard to the quality of life of older persons with physical disabilities living in the community is partially supported by these findings. Other studies are needed to clarify how social participation influences quality of life in this population.     

An examination of social support influences on participation for older adults with chronic health conditions

Abstract

Social support can improve participation in everyday activities among older adults with chronic health conditions, but the specific types of support that are needed are unclear. Purpose: This study examined the types of social support that most strongly predict participation in everyday activities. Method: Two hundred and twenty-seven participants completed a self-administered cross-sectional survey. The sample included adults aged 60 years or more with arthritis, diabetes, chronic obstructive pulmonary disease and/or heart disease. Participation was defined as satisfaction with participation in 11 life areas. Social support was defined as availability of tangible, affectionate, emotional/informational and positive social interaction support. Results: Multiple regression analyses showed that participants who perceived greater tangible support and positive social interaction support had higher satisfaction with participation than participants with lower levels of these types of support. Conclusions: Targeting and developing tangible and social interaction support may help to facilitate satisfaction with participation for older adults with chronic conditions. Creating networks for companionship appears equally as important as providing support for daily living needs.

• Implications for Rehabilitation

• Varying types of social support can improve participation in older adults with chronic health conditions.

• Tangible support and positive social interaction support are the strongest predictors of participation.

• Creating networks for companionship may be equally as important as providing support for daily living needs.

     

Peer support need fulfillment among adults with spinal cord injury: relationships with participation,life satisfaction and individual characteristics

Purpose: To test the hypothesis among people with spinal cord injury (SCI) that greater fulfillment of peer support needs to be associated with greater participation and life satisfaction. A secondary objective was to identify characteristics of people in great need of SCI peer support. Method: The participants consisted of a population-based sample of 1549 adults with SCI. The participants completed a survey with questions on peer support, participation, life satisfaction and provided demographic and SCI-related information. A secondary analysis of cross-sectional survey data was conducted. A set of regression analyses tested the primary purpose and a partition analysis was conducted to examine the secondary objective. Results: In regression analyses, peer support need fulfillment was positively associated with autonomous-outdoors participation (p?p?p?p?Conclusions: The results provide some evidence that SCI peer support plays an important role in promoting participation and life satisfaction. Individuals with many SCI-related unmet needs are most likely to report a need for peer support.

• Implications for Rehabilitation

• The receipt of peer support after a spinal cord injury (SCI) is positively related to aspects of social participation and life satisfaction.

• Provision of peer support can play an important role in the SCI rehabilitation process.

• Education, injury-related characteristics, and the number of other unmet needs are factors that rehabilitation professionals can use to identify those in particular need of peer support.

• Rehabilitation professionals should encourage patients who have sustained an SCI, to participate in peer support programs.

     

Life Satisfaction Among Elders in Senior Residences: A Pilot Study

ABSTRACT

Objective: This pilot study investigated predictors of life satisfaction among elders residing in senior residences with a focus on feeling valued and important (FVI), a seldom-studied predictor that has the potential for late-life changes through occupational therapy intervention. Method: Using existing data from an intervention study (N = 47), simultaneous multiple regression analysis was employed. Results: The regression model, which included predictors of self-rated health, education level, and FVI, was significant F(3,43) = 21.16, p < 0.001. Further, FVI was a stronger predictor of life satisfaction than the well-established predictor of self-rated health. Conclusion: FVI is a significant predictor of life satisfaction in older adults residing in senior residences. Practice implications include promoting participation in occupations that provide the opportunity for meaningful contributions to family and society.     

Relationship between participation in life situations and life satisfaction in persons with late effects of polio

Purpose. To assess the relationship between participation and problems with participation in life situations, and life satisfaction in persons with late effects of polio.

Methods. One hundred fifty-eight persons with late effects of polio responded to a postal questionnaire including the Swedish versions of the Impact on Participation and Autonomy Questionnaire (IPA-S) and Life Satisfaction Questionnaire (LiSat-11).

Results. The persons' perceived participation in the five domains of participation in the IPA-S was significantly correlated with their satisfaction with life as a whole and with most of the 10 domains of life satisfaction. Significant differences in satisfaction with life as a whole and with eight of the 10 domains in LiSat-11 were found between groups of increasing severe problems with participation. Greater number of reports of severe problems with participation corresponded with gradually decreased satisfaction with life as a whole and with satisfaction in the eight domains in LiSat-11.

Conclusions. Perceived participation and problems with participation in life situations are determinants of life satisfaction in persons with late effects of polio. This implies that addressing participation and problems with participation in the rehabilitation of persons with late effects of polio may lead to an enhanced life satisfaction.     

Perceived sexual satisfaction among women with drug-dependent husbands in Iran

Abstract

Background: Sexual satisfaction is known as one of the most important components of relationship satisfaction and quality of life. The present study aimed to evaluate the associated parameters of sexual satisfaction among female spouses of male drug dependents as one of the hidden populations in Iran.

Method: A total of 138 women with drug-dependent husbands were included in this cross-sectional study. Sociodemographic characteristics, anxiety and depression scores, sexual function and emotional parameters were entered into a stepwise linear regression model to find the possible predictors.

Findings: Mean age, marital length and spousal drug use length were 35?±?8, 14?±?10 and 12?±?8 years, respectively. Perceived lack of security [p?<?0.001, B?=?0.630, 95%?confidence interval (CI)?=?0.364–0.897], history of physical abuse by husband (p?<?0.001, B?=?0.297, 95%?CI?=?1.912–5.771) and marital length (p?=?0.003, B?=?0.142, 95%?CI?=?0.048–0.236) were found to be significantly associated with sexual satisfaction among female spouses of male drug dependents in Iran.

Conclusion: Results of the current study highlight the need for more attention to environmental and sociocultural parameters as the associated parameters of sexual satisfaction among female spouses of male drug dependents. Further research is needed with respect to a multidimensional evaluation of sexual satisfaction among this vulnerable hidden population in Iran, especially to find causative relations.