Educational Attainment, Country of Residence and Marital Status as Predictors of Women Spiritual Help-Seeking Behavior

Literature has consistently revealed across different countries of the world that large proportions of those who attend spiritual houses are women and they attend to seek help on diverse issues. However, it is not known if one’s country of residence, educational attainment and marital status will predict women spiritual help-seeking behavior. The objective of this study was to find out how the variables as indicated above would predict spiritual help-seeking behavior of women in Nigeria, Iran and Cameroon. Using an ex post facto design and multistage sampling, 314 participants that participated in the study were drawn from Nigeria, Iran and Cameroon. Validated scale was used to collect data and the hypothesis tested was accepted. Thus, country of residence and marital status significantly predicted spiritual help-seeking behavior of women, whereas educational attainment was not a significant predictor. Deriving from above, professionals should begin to focus on the development of cross-cultural spiritual therapeutic measures that will address African women’s specific problems as well as considering the level of educational attainment of help-seekers in addressing their problem. A limitation of the study however is the small sample size, which may be addressed in further researches.


Introduction
The process by which individuals seek help for problems or stressful life situations they experience has been a focus of inquiry in the literature for several decades and a great deal of research has examined the help-seeking process, resulting in a multitude of help-seeking correlates and predictors (Koenen, Goodwin, Struening, Hellman, & Guardino, 2003).Several of the available literature on help-seeking focused on financial help-seeking; students seeking academic help; patients seeking medical help from medical health professionals.Only very few foreign literature is available on help-seeking behavior of women and there seems to be non that actually focuses on spiritual help-seeking behavior of women in particular.This has left a vacuum in literature in this regard, more so when one looks at the fact that the few literature available has consistently revealed across different countries of the world that large proportions of those who attend spiritual houses are women and they attend to seek help on diverse issues (Rahaman, 2000).
In the African culture, irrespective of what the problem really is, Hinson and Swanson (1993) observed that people most often turn to family members or close friends for advice or support in dealing with there problems, since the problem of an individual is the problem of every member of the family.Hinson and Swanson (1993) further mentioned that, "If these 'natural helpers' are not able to provide adequate help, persons may turn to religious leaders".In general, people seek help, not only because they are experiencing distress, but also because they are inclined to perceive others as potential sources of support and help.
In most of African cultures, high value is placed on social support and the maintenance of the social networks.This of course has serious implications for when and where people seek help when the need arises for them to do so.Therefore, most African women (particularly those in the grass root) would prefer to seek help from informal sources than the orthodox established sources.
The implication of the above is that, several women have had delayed diagnosis and treatment (since they did not go to professionals for help); others have lost their lives and or, parts of their bodies in the process as a result of being attended to by quacks; some have even suffered more psychological damages.In the previous works of Oladipo and Balogun (2009); Balogun and Oladipo (2010), it has been established that topmost on the problems that African women seek spiritual help for is family, finance, health, career and persecutory reasons (respectively).The argument therefore is: if the spiritual help-givers are more patronized, yet they are not psychologically and medically equipped to give professional and adequate help to those who come to them, it is necessary for researchers to focus on them and intervene for the sake of the innocents who are turning to them for help and assistance.
There is a paucity of information regarding the influences of culture on the help-seeking behaviours of women, particularly within the African context.Previous studies have focused on cultural values, beliefs and practices in relation to either health, in particular mental health (e.g., Cauce, Domenech-Rodriguez, Paradise, Cochran, Shea, Srebnick, et al., 2002;Lian-Ding & Hui, 1995), or education (e.g., Kuo & Roysircar, 2004), generally of groups of individuals in countries other than Africa.This study, therefore aims at adding to the existing literature, morese so that understanding of cross-cultural influences on help-seeking behaviour will benefit potential helpers in assisting women help-seekers (e.g., Alexander, Kruczek, Ponterotto, 2005;Arredondo, Toporek, Brown, Jones, Loches, Sanchez, et al., 1996).
There is also no empirical document on women spiritual help-seeking behavior across African countries, despite the peculiarity of Africans in their beliefs in spirits and the spiritual world, which has invariably affected their help-seeking behavior particularly with regard to the usage of conventional help-centers.
There is no cross-culturally accepted psycho-spiritual therapeutic package for spiritual help-seekers and this could be traced to the fact that there is no empirical data to establish that help-seeking behavior of women across countries are similar or the same.Establishing a similarity between the help-seeking behaviors of women across different culture will be useful in the preparation of a cross-culturally acceptable therapeutic model.The fact also remains that Counsellors and other formal helpers need to develop their multicultural competencies in order to address the needs of individuals from culturally diverse backgrounds and raising awareness of cultural influences on behaviour is one means of achieving this goal (Parker & Schwartz, 2002;Russell-Chaplin & Ivey, 2004).
It is no longer news that more women have psychological problems, antisocial behaviors as well as major health problems.Such as High Blood Pressure, Stroke and other complex nervous disorders.And to handle these myriads of problems, they result to seeking spiritual help without any physical guarantee that they will be better off at the end of their consultation.Though researchers have noted that there is a correlation between spirituality and well-being, literature review has revealed that a lot still has to be done in the area of women and their spirituality as it relates to their life challenges and stressful life situations.
The purpose of this research therefore is to extend the previous work that has been done in Nigeria to two other countries since it is not known if there is a commonality in the problems women seek spiritual help for across different countries, or how one's country of residence, educational attainment and marital status will predict one's spiritual help-seeking behavior.Knowing these across countries will widen the scope of the work and afford the opportunity of providing a more generalisable finding that can help in the provision of a psycho-spiritual therapeutic module for women spiritual help-seekers across different cultures, beginning from African countries.More specifically, this work is interested in investigating the influence of educational attainment, country of residence and marital status on women spiritual help-seeking behavior.This has been informed by the previous works of Oladipo et al. (2009Oladipo et al. ( , 2010)), who have established that educational attainment and marital status are significant predictors of Nigerian women spiritual help-seeking behavior.
The study will compare women spiritual help-seekers drawn from Nigerian, Cameroon and Iran population in order to establish the difference or otherwise of their help-seeking behavior, with the aim of further studies geared towards the development of a cross-culturally effective psycho-spiritual therapy for spiritual help-seekers.
It is also the purpose of this study to contribute to available literature on women spiritual help-seeking behavior.
It is worthy of note that the study will also be a model and can be replicated by any interested researcher across the globe in order to widen the scope and work towards the development of a cross-culturally accepted psycho-spiritual therapy.

Design
The study is a descriptive survey research, hence; the ex post facto research design is adopted for the conduct of the study; more so, since the researchers will not consciously manipulate any of the variables of interest in the study.

Participants
The participants for this study were women who go to spiritual houses to seek for help and who show willingness to participate in the study.These were drawn from Nigeria, Cameroon and Iran.A total sample of 314 participated in the study.

Sampling Method
Multiple sampling methods were used in the course of the study.Purposive sampling method was used in the selection of the spiritual houses and the participants in the study.Only those spiritual houses that conduct counseling and related services for their attendees were the only ones included in the study.Those who hold general services were not included because they did not suit the purpose of this research since they do not have personal or interactive contact with the help-seekers as it is the case with those who hold counseling sessions.In addition, only women were considered and included in this study.I.e.only women were sampled as participants in this study because the researchers are specifically interested in looking at the help-seeking behavior of women and not of men, or men and women together.
Systematic random sampling was used in the selection of women who participated in the study.Usually, when people go for spiritual help, they are given numbers in the order of arrival; this number was used in randomly selecting the participants.I.e.prior to the selection of the participants, the ballot system was used to determine whether those with even or odd numbers would be included in the study.Through this system, help-seekers with odd numbers were selected for the study.
Quota sampling method was used in the selection of the number of participants that were selected from the three major religious groups (I.e.Christians, Muslims and Traditionalists).This was necessary because the result of pilot study indicated that more people patronize the Church and Mosque than the Traditional homes in Nigeria and Cameroon, but the reverse is the case in Iran, where more people patronized the mosque more.This implied that equal number of participants may not be available for sampling from the three groups hence the need for quota

Instrumentation
Women Spiritual Help-Seeking Behavior Measure (WSHSBM) developed by Oladipo (2008) was used for data collection.The WSHSBM is a 39-item, five dimensional, likert format scale with, responses ranging from '0' not applicable to '5' strongly agree.The entire scale has a Cronbach's Alpha reliability co-efficient of .98 and a Guttman split-half reliability of .96.The item total correlation for the scale is between .56 and .87.The scale was re-validated for use in Cameroon and Iran, with the Alpha reliability co-efficient of .96and .93respectively.An individual who has a mean score, or scores above the mean is regarded as having high spiritual help-seeking behavior, while an individual whose score is below the mean is considered as having low spiritual help-seeking behavior.

Procedure for Administration of Instrument
For uniformity, the same procedure was use for data collection in the three countries.Permission was obtained from the research and ethics committee since the research is to be conducted on human samples.The researchers, (along with research assistants that have been trained for the purpose of this research) went to secure appointment with each of the help-givers who were overseeing the spiritual houses that were sampled for this study for a date to administer the questionnaires on the respondents.On the appointed date for each of the spiritual houses, the questionnaires were taken down and administered to randomly selected participants who indicated their interest to participate in the study.The approximate time of completion of the questionnaire was 10minutes; it was therefore possible to retrieve the questionnaires the same day.The data thus gathered were analyzed and the result is presented in results section.

Hypothesis
Educational attainment, Country of residence and marital status will significantly independently and jointly predict women spiritual help-seeking behavior in Nigeria, Cameroon and Iran.

Statistics
Apart from the zero order correlation statistic that was first conducted to ascertain the relationship that exists among the variables of interest in the study, the step-wise multiple regression analysis was done to examine the independent and joint influence of the independent variables on the dependent variable.The result is presented below.

Results
The correlation analysis conducted revealed that there is a statistically significant positive relationship between the respondents' country of residence, marital status and spiritual help-seeking behavior.However, there was no significant relationship between the respondents' academic level and spiritual help-seeking behavior.
A stepwise regression analysis conducted revealed that educational qualification of help-seekers did not significantly, independently predict their help-seeking behavior.However, country of residence and marital status were significant independent and joint predictors of women spiritual help-seeking behavior in the three countries.The summary is presented in table 1.A post hoc test was also conducted and this revealed that there is a significant mean difference between the three countries on the variables of interest in the study, except educational attainment which seems not have any significant influence on spiritual help seeking behavior of women in the three countries where samples were drawn.The result is shown in table 2 A look at table 1 above shows that educational attainment did not significantly independently predict women spiritual help-seeking behavior.However, there is a significant joint prediction of educational attainment and country of residence on women spiritual help-seeking behavior.The R 2 change value increased from .51 to .71, with the p value at <.001, when educational attainment was regressed along with country of residence, thereby indicating a significant joint prediction of the two variables.In the same vein, the regression of marital status along with the other two variables also increased the R 2 change value from .051,.071 to .081 and the p value at < .05.Thus indicating a significant joint prediction of the three variables (educational attainment, country of residence and marital status) on women spiritual help-seeking behavior.Table 2 shows the mean difference on spiritual help-seeking behavior between the three countries and the result shows a significant mean difference with Cameroon being higher, followed by Iran and Nigeria respectively.

Discussion
The purpose of the present study was to find out if country of residence, educational attainment and marital status will influence women spiritual help-seeking behavior in three countries i.e.Nigeria, Cameroon and Iran.This was informed by the previous studies of Balogun et al, (2009), andOladipo et al (2010) who have established that marital status and educational status significantly predicted spiritual help seeking behavior of women in Nigeria.
With the result of the present study, country of residence significantly predicted women spiritual help seeking behavior.More Cameroonian women sought for spiritual help (Mean =152.77;SD = 28.44;P < .001).Iranian women also significantly sought for spiritual help (Mean =137.77;SD = 33.91;P < .001).There was significant mean difference when one compares women help seeking behavior in the three countries.This result shows that across the three countries where samples were drawn, prominence is given to spirituality in help seeking.This is in line with previous works of researchers who have asserted that Africans believe in spirits and the supernatural and can hardly be divorced from such beliefs.In the words of Nkemleke, (2011) spirituality is on the increase in Cameroon and the case is not very different in Iran, where Hassan, (2008) has reported that religiosity and spirituality is paramount to both individuals as well as the nation as a whole.The above may have accounted for the significant result observed, in the level of spiritual help seeking behavior of women in these countries and this thus means that several people who should seek for professional psychological help may end up at the desk of the spiritual help giver who may not be professionally qualified to render the services requested by the help-seekers.In the end, such help-seekers would not only waste their time and energy, they may never recover from the loss or losses thus incurred, as it may be too late for them to get professional help.
That each of these countries has recourse in the supernatural power and spirituality provides a common denominator to work with and a starting point for a culturally informed psycho-spiritual therapy that will be of great help to the help-seekers.If orthodox medicine has and professional psychological services are not patronized for cultural and other reasons (yet these services are of immense value and use to everyone), creating a way of blending such with the people's believe will go a long way in helping them out of their problems and they will be able to live a better life and thus reduce mortality rate in some way.
Marital status was also a significant predictor of women spiritual help-seeking behavior in the three countries.More married women and those who were never married, but are eager to marry, significantly sought for spiritual help more than others.In the African context, marriage is not taken with levity.Polygyny is still being practiced in most of African culture and it is not new to see women in such homes seek for spiritual cover to protect themselves and their children.It is the usual practice that women seek for spiritual fortification so that no 'attack' from the 'enemies' would prosper upon their lives and those of their children.Those who are not married are also seeking for spiritual intervention to their perceived problem of delayed marriage.It is believed that when all human help and efforts fail, the supernatural takes over, hence the need to seek for spiritual guidance and assistance.
The truth of the matter however, is that; a lot of the issues are not spiritual in nature, there are a lot of people who are deluded.They have delusion of grandeur, persecutory delusions and all sorts and go about seeking for witches and wizards that are responsible for their predicaments.In the long run, they are exploited and they develop more psychologically related problems.This gives more credence to the fact that there is an urgent need to attempt a provision of solution to this problem.Hence the need for a psycho-spiritual therapy that will blend the people's believe (which always determined where they go to seek for help), with professional psychological help, which has been tested and proved to be helpful in many instances.
It is interesting to note that academic qualification does not significantly predict women spiritual help-seeking behavior of women.One would have expected that with the level of development, globalization and increased enlightenment, several people with higher educational qualification would opt for professional help, as against spiritual help that is usually given by mostly untrained professionals.It follows that, cultural practice as well as spiritual beliefs seem to supersede educational attainment.It should therefore not be taken for granted that, because someone is well educated she will take the right decision (particularly if it has to do with help seeking).There should therefore be focused attention on the educated to properly create the needed awareness among them in terms of their help-seeking behavior.
Conclusively, we are asserting that spirituality and belief in spirits as well as believe in those who are regarded as the custodians of the supreme being is prominent among Africans, irrespective of their status.This cuts across African countries and it calls for urgent attention.Psychologists and other professional care-givers should begin to think toward the development of a cross-culturally relevant psycho-spiritual therapy that will take care of the missing link in this regard.It will not be out of place also for psychological bodies to give recognition to these help-givers by providing short courses for them and organizing training for them in order to gradually equip them for the services they are required to render by the people who come to them to seek help.It needs be mentioned however that, the small sample size may be a limitation to the study and further studies could look into expanding the sample size and also look at the addition of other relevant variables that may influence women spiritual help-seeking behavior.

Table 1 .
. Summary of step-wise regression analysis showing independent and joint prediction of educational attainment, country of residence and marital status on women spiritual help-seeking behavior Nigeria, Cameroon and Iran