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© Borgis - New Medicine 4/2016, s. 153-161 | DOI: 10.5604/14270994.1228182
Zsuzsanna Soósnè Kiss1, Brigitta Keserü1, Magdolna Sinka2, Ibolya Lipiennè Krèmer3
Difficulties, health problems and professional support of divorced fathers living separately from their children – experiences in Hungary
1Institute for Health Promotion and Clinical Methodology, Department of Clinical Studies, Semmelweis University Faculty of Health Sciences, Budapest, Hungary
Head of Department: Professor Klára Gadó, MD, PhD
2Institute for Health Promotion and Clinical Methodology, Department for Epidemiology, Semmelweis University Faculty of Health Sciences, Budapest, Hungary
Head of Department: István Barcs, PhD
3Institute of Applied Health Sciences, Department of Clinical Studies in Obstetrics and Gynaecology, Semmelweis University Faculty of Health Sciences, Budapest, Hungary
Head of Department: Professor János Rigó, MD, PhD
1, 2, 3Semmelweis University Faculty of Health Sciences, Budapest, Hungary
Head of Faculty: Professor Zoltán Zsolt Nagy, MD, PhD
Summary
Introduction. The situation of divorced men who live separetely children is difficult in Hungary, as well as in many other countries. The effects of divorce on all family members is considerable, therefore, the topic seems worth investigating.
Aim. The aim of our study was to examine the situation, difficulties and problems of divorced Hungarian fathers who live separately from their children, and their need for professional help.
Material and methods. The research was conducted among men of legal age who had undergone divorce for the first time, had at least one child together with their ex-wife, and the divorce had taken place in the last 1 to 5 years. A self-made questionnaire composed of four parts (6 open and 60 closed questions) was presented to the participants. The questionnaire was available online between 21/11/2015 and 20/01/2016. 100 fathers who filled in the questionnaire correctly were included in the study.
Results. Only 18.0% of the fathers had not noticed any physical, mental or behavioural symptoms after divorce. 49.0% of them noticed all three types of symptoms. Several fathers’ work performance declined. One third (32.0%) of the fathers had such serious symptoms that they decided to consult a medical specialist. 80.0% of the fathers were not satisfied with financial support offered to them, 76.0% of them were not satisfied with the social allowances available to them, and 74.0% were not satisfied with the psychological and psychiatric support they are offered.
Conclusions. Fathers are not prepared to face the divorce. Physicians should be increasingly aware that divorce can be the source of physical symptoms. Fathers feel the lack of financial, social and psychological support, as well as of legal support. They would like to be involved in the family care of the Hungarian health visitors’ network after divorce.



INTRODUCTION
The situation of divorced men living separetly from their children is difficult in Hungary, as well as in other countries. The effects of divorce on all family members is considerable, therefore, the topic seems worth investigating. The significance of this study lies also in the scarcity of both international and national research on the situation of divorced fathers. We know of only one similar comprehensive research project conducted in Hungary in 2005 (1).
International and Hungarian statistics clearly prove that a high number of families undergo breakdown (2).
Modern societies now face a new problem – a growing number of divorces among remarried couples. Spouses decide to part sooner during their second marriage, as it is a solution of their marital problems that is already known to them (3). Although in Hungary the number and the percentage of divorces has been decreasing from 2010 (in 2010 – 23.873; 2.4‰ of all marriages; in 2014 – 19.576; 2.0‰), but the breakup year of all the couples has not changed significantly (4). Most married couples divorce 5-9 years after marriage (4). Minors are typically also involved in this legal procedure. In Hungary, approximately 30,000 children (4-7) – and thus nearly the same number of mothers and fathers – are faced with family breakdown each year.
About 60.0% of the broken families have minor children (8). One third of the couples who divorced in 2010 had one child together, one fifth had two children, and 7.0% had three or more minor children together (8). It is estimated that in 2012, the total number of divorced parents’ children below 18 was between 200 and 220 thousand, and so, more than 10.0% of the total number of children in Hungary lived in families that had undergone divorce (9).
About 30.0-35.0% of children experience are not raised by two parents living in marriage (9).
The effect of divorce on children had been studied by international and Hungarian experts (10). In Hungary, scientific interest in this matter raised in 1970s, when it was observed that health problems were common in more children from divorced families (11). By now, the reactions of children of different age to the divorce had been well studied (11). It is known that children undergo multiple phases when facing parents’ separation (12, 13). There is great discussion in scientific society on how divorce precisely affects minors, but there is general consensus that they experience psychological problems that are not only due to incorrect parental behaviour, but also to the fact that they are to leave one or both of their parents, move out, and experience financial problems of their parents (14-18). New parents, as well as siblings, may also appear in their lives (14-18).
Some studies focus on factors that influence children’s ability to cope with parents’ divorce. Positive influence of having stable relationship with both parents and having a chance to express their feelings and ideas to their parents was observed (10, 11). Cooperation between separated parents, their healthy attitude to the situation, as well as their general health, enable child’s healthy development (19). Generally speaking, the more clearly settled relationship between the parents is and the better they cooperate in raising their children after the divorce, the less harmful is their divorce to the children (19).
For the parents, divorce is also a challenging psychological experience. For the mother and father, divorce results in the disintegration of the original family structure and familiar way of life (20). The powerful feeling of belonging together in a family correlates with the quality of life (21). On the other hand, the lack of support from the family is related to self-destructive behaviours, such as nicotinism, alcoholism and suicide attempts (21).
The separated parent may also be challenged by their child, as the child attempts to protect the parents they live with (22).
In the past, children generally remained with one of their parents after divorce – typically with their mother – and the other parent could contact the children as a separately living parent. Over the time, this solution had become less and less satisfactory for separated parents – typically fathers – who wanted to spend more time with their children and tried to have a more active role in their children’s lives (23). According to our experience, physical breakup and actual separation is one of the biggest source of stress and problems for divorced fathers. Our research also shows that the separation of the parents from their children and its difficulties typically affect fathers (24). According to the findings of another survey we conducted on the changes of relationship between father and child after divorce (25), one fourth of the fathers declared that their relationships with children improved, 12.0% of them declared that they did not change, and 54.0% of them feel their relationship with their children deteriorated, e.g.: “I have not talked to him for almost ten years. Last year, I went to see him, but it did not have much sense. He is not interested in me, we have not spoken for months. I’ve tried to contact him, but in vain. There is a huge distance between us. Perhaps now, after ten years, the situation is getting better”.
In terms of legislation, several positive changes have been made in Europe and Hungary in the last few years. Several European countries suggest to use shared custody and emphasize the need for cooperation of both parents after the divorce, so that both parents take responsibility for children after divorce (19). Shared custody or other arrangement in which parents exercise custody in turns has been adopted as default in many European countries (23). Children’s interests are given priority in all the aspects, including divorce cases, with the aim of ensuring proper physical and mental development, as regulated by national acts and international conventions (19, 26, 27). New Hungarian Civil Code from 2013 regulates family law, including matters such as divorce and parental custody (19, 28). Joint custody is the option of choice, however, it is only possible when full agreement and maximal cooperation between parents is achievable. Mediation was legally introduced in Hungary in 2002, and in 2012, judicial mediation was regulated (19). Legal focus on the good of the child with adequate regulations enables to take best possible care of interests of the child in case of divorce of the parents (19, 26-28).
In professional healthcare, the predominant attitude of attributing all the symptoms to somatic causes can be an obstacle in helping persons suffering from unsolved family problems, as they are often overlooked by medical professionals (29). Personal crises, such as divorce, can cause various physical symptoms, including insomnia, weight loss, problems in professional life, spasmodic sobbing, suicidal thoughts, abdominal pain and heart malfunctioning (29).
In Hungarian public healthcare, help to families undergoing divorce can be provided not only by physicians, psychologists and health development specialists, but also by health visitors (30). This system is unique for Hungary and has been developed from 1915, when the Stefánia Association was founded (31). Health visitors can work only after obtaining health visitor’s diploma (32, 33). The role of a health visitor is to offer help and advice to pregnant women and parents of children up to 18 years of age (32, 33). Health visitors have an important role in the health promotion (physical, mental, psychical, and social well-being), health development, early recognition of physical, mental, psychical, and social disorders (32, 33). Health visitors are healthcare professionals who are the first to meet with pregnant women and family members, and give the family tools to primary prevention of physical and mental health of the family (34). They visit every pregnant women and families with children up to 3 years of age at their homes (32, 34). They also have the possibility to refer the family to adequate specialists in case of possible family crises (34, 35).
AIM
The aim of our study was to examine the situation, difficulties and problems of divorced Hungarian fathers who live separately from their children, and their need for professional help.
First, we wanted to assess main difficulties, complaints and health problems that divorced fathers had to face. This knowledge is necessary for health care professionals, including health visitors, to provide efficient help. Moreover, Hungarian experiences can serve international community, as they can help social workers, healthcare workers and other professionals whose duties are similar to those of health visitors.
In this study, we examined health status of fathers who had undergone divorce (1), their physical, mental and behavioural symptoms that may suggest diseases (2). We also wanted to determine whether they had sought professional help in treating these symptoms, and if so, what specialists they had consulted and what medications they had been taking. We wanted to explore whether, in their opinion, professional help available to them was sufficient and what kind of help they needed (3). We focused on health visitor’s opportunities.
MATERIAL AND METHODS
The research was conducted among men of legal age who had undergone divorce for the first time, had at least one child together with their ex-wife, and the divorce had taken place in the last 1 to 5 years. A self-made questionnaire composed of four parts was presented to the participants. The parts were: (1) social and demographic data; (2) situation before the divorce (breakdown of own marriage, measures taken in order to save the marriage); (3) situation after the divorce (change of residence, work, children, state of health, and their view on divorce); (4) professional support, with primary focus on the health visitor’s role.
The questionnaire contained 6 open and 60 closed questions. It took about 15 minutes to fill in. The participation was anonymous and voluntary, and the use the data exclusively for scientific purposes was warranted. The questionnaire was available online between 21/11/2015 and 20/01/2016 after having been successfully pre-tested. The hyperlink to the survey was placed on the websites of several national associations, groups and forums assisting divorced fathers in Hungary. 100 fathers who filled in the questionnaire correctly were included in the study. The data were processed with Microsoft Office Excel, Microsoft Office Word, Google Docs Questionnaire and Google Tables software.
In this study, we exclusively investigate the topics included among the research aims, and only focus on presenting the results from this field, while not including results from other topics.
RESULTS
All respondents lived in Hungary: in the capital city (36.0%), county seats (17.0%), smaller towns (35.0%) and villages (12.0%). The mean age of the participants was 40.23 years. 30.0% of the fathers surveyed were between 36 and 40 years of age, 19.0% – between 31 and 35, 22.0% – between 41 and 45, 21.0% – between 46 and 55, 7.0% – younger than 30 years old, and 1.0% – between 56 and 64. No older respondents participated in the study.
Most of the surveyed had secondary (50.0%) or higher education (46.0%) and 4.0% had primary education. 61.0% of them had been married and had divorced, while 39.0% of them had been living in cohabitation and had decided to separate. They declared that their relationship with their spouse had started to change for worse on average 6.1 years after the wedding or start of cohabitation. The mean length of their partnership was 8.9 years. Divorce/separation happened on average 2.7 years before filling in the questionnaire. Women (67.0%) made the decision about the divorce more frequently than men.
58.0% of the participants had one child, 34.0% of them had two children, 7.0% had three children and one participant (1.0%) had five children. A total of 152 children were affected and the mean number of children per family was 1.52. During the divorce process, parental custody was given to the mother in 75.0% of cases, to the father in 10.0% of cases. In 7.0% of cases, it was agreed to exercise joint custody, and other solutions were ordered by court in 8.0% of cases.
After the separation, 52.0% of the fathers moved out of the shared house, while the same was true for 24.0% of mothers. Both spouses moved out in 24.0% of cases.
36.0% of fathers did not have an opinion on whether separation had had good influence on their children’s healthy development, 35.0% declared they thought it was good for their children, and 29.0% of them decided they thought it affected their children negatively.
The living standard of the divorced fathers decreased, since part of their income had to be given by them to the mother of their child. 72.0% of the participants paid alimony on a regular, monthly basis. 65.0% of all fathers felt that their standard of living has decreased and 47.0% of all fathers were not satisfied with their standard of living.

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otrzymano: 2016-09-02
zaakceptowano do druku: 2016-11-07

Adres do korespondencji:
*Zsuzsanna Soósnè Kiss
Faculty of Health Sciences Department of Clinical Studies Semmelweis University
17 Vas Str., 1088 Budapest, Hungary
tel. +36-1-486-5978
tel.: e-mail: soosne@se-etk.hu

New Medicine 4/2016
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