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Bagade T, Mersha AG, Majeed T. The social determinants of mental health disorders among women with infertility: a systematic review. BMC Womens Health 2023; 23:668. [PMID: 38093258 PMCID: PMC10720205 DOI: 10.1186/s12905-023-02828-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 12/04/2023] [Indexed: 12/17/2023] Open
Abstract
INTRODUCTION Infertility is associated with mental health disorders in women, even if a successful pregnancy resolves infertility. However, the link between social determinants of health (SDoH) and mental health in women with infertility is not well understood. We aimed to investigate the determinants thoroughly so that mental health screening and services can be tailored to suit women with infertility who are vulnerable to mental health disorders. METHODOLOGY All observational studies that included women participants of reproductive age with infertility and assessed social determinants associated with mental health disorders were searched using a combination of keywords from MEDLINE, EMBASE, CINAHL, PsycINFO, Scopus, and Web of Science databases and published in English. Two reviewers conducted screening, data extraction, quality assessment and risk of bias. The protocol was registered on PROSPERO (number CRD42022343962). RESULTS The systematic review included 32 studies out of 3405 screened articles from January 1st 2010 to 16th October 2023. Compared to women without infertility, the prevalence of mental health disorders, including anxiety, depression, psychological distress, and stress, is high among women with infertility, with the severity being influenced by social determinants-those with higher education, employment, higher personal or family income, private health insurance, higher social support, stronger religious beliefs, and higher spiritual well-being reported better mental health outcomes. CONCLUSION The study highlights the need for early detection, tailored interventions, and integrated and comprehensive support systems to address the mental health needs of women with infertility and improve their well-being.
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Affiliation(s)
- Tanmay Bagade
- School of Medicine and Public Health, College of Health, Medicine, and Wellbeing, The University of Newcastle, Callaghan, NSW, 2285, Australia.
| | - Amanual Getnet Mersha
- School of Medicine and Public Health, College of Health, Medicine, and Wellbeing, The University of Newcastle, Callaghan, NSW, 2285, Australia
| | - Tazeen Majeed
- School of Medicine and Public Health, College of Health, Medicine, and Wellbeing, The University of Newcastle, Callaghan, NSW, 2285, Australia
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Weerasinghe K, Rishard M, Brabaharan S, Walpita Y. Physiotherapy training and education prior to elective Caesarean section and its impact on post-natal quality of life: a secondary analysis of a randomized controlled trial. BMC Res Notes 2023; 16:270. [PMID: 37833802 PMCID: PMC10571237 DOI: 10.1186/s13104-023-06550-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 10/01/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Caesarean section (CS) is associated with numerous complications that lead to the delayed return to functional activities that have a negative influence on the post-natal quality of life (QOL). It is evident that providing regular evidence-based physiotherapy training and education prior to elective CS helps to enhance the post-natal QOL by improving physical, mental, social, and general well-being. The purpose of this study was to examine the effectiveness of physiotherapy training and education prior to elective CS on post-natal QOL. METHODS This single-blind parallel randomized controlled study was carried out at De Soysa Hospital for Women (DSHW), Colombo. The study enrolled 54 women who were scheduled to undergo elective CS. The intervention group (n = 27) of women received physiotherapy training and education, while the control group (n = 27) received standard nursing care. In addition to the primary outcome measures, post-natal QOL was measured. The results were examined using descriptive statistics and the independent samples t-test in IBM SPSS 20. RESULTS The intervention group showed a higher post-natal QOL for the domains of physical function, role limitation due to physical health, energy/fatigue, and pain than the control group (p < 0.05). CONCLUSION Physiotherapy training and education prior to elective CS play a pivotal role in improving the physical health-related domains of QOL following CS. TRIAL REGISTRATION The Sri Lanka Clinical Trials Registry ( https://www.slctr.lk ). REGISTRATION NUMBER SLCTR/2019/029-APPL/2019/028; Registration date: 6th of September 2019.
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Affiliation(s)
- Kalani Weerasinghe
- Health and Wellness Unit, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
- Department of Allied Health Sciences, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
| | - Mohamed Rishard
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | | | - Yasaswi Walpita
- Department of Community Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
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Abeysuriya V, Seneviratne SL, De Silva AP, Mowjood R, Mowjood S, de Silva T, de Mel P, de Mel C, Wijesinha RS, Fernando A, de Mel S, Chandrasena L. Postdischarge outcomes of COVID-19 patients from South Asia: a prospective study. Trans R Soc Trop Med Hyg 2022; 116:1129-1137. [PMID: 35483750 PMCID: PMC9129199 DOI: 10.1093/trstmh/trac039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 03/26/2022] [Accepted: 04/08/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) may cause clinical manifestations that last for weeks or months after hospital discharge. The manifestations are heterogeneous and vary in their frequency. Their multisystem nature requires a holistic approach to management. There are sparse data from the South Asian region on the outcomes of hospital-discharged COVID-19 patients. We assessed the posthospital discharge outcomes of a cohort of Sri Lankan COVID-19 patients and explored the factors that influenced these outcomes. METHODS Data were prospectively collected from patients who were discharged following an admission to the Nawaloka Hospital, Sri Lanka with COVID-19 from March to June 2021. At discharge, their demographic, clinical and laboratory findings were recorded. The patients were categorised as having mild, moderate and severe COVID-19, based on the Sri Lanka Ministry of Health COVID-19 guidelines. Following discharge, information on health status, complications and outcomes was collected through clinic visits and preplanned telephone interviews. A validated (in Sri Lanka) version of the Short Form 36 health survey questionnaire (SF-36) was used to assess multi-item dimensions health status of the patients at 1, 2 and 3 mo postdischarge. RESULTS We collected data on 203 patients (male, n=111 [54.7%]). The level of vaccination was significantly associated with disease severity (p<0.001). Early recovery was seen in the mild group compared with the moderate and severe groups. At 3 mo, on average 98% of mild and 90% of moderate/severe patients had recovered. Based on the SF-36, physical functioning dimensions, role limitation due to physical and emotional health, energy/ fatigue, emotional well-being, social functioning, pain and general health were significantly different in the moderate/severe vs mild COVID-19 groups at 1, 2 and 3 mo postdischarge (p<0.05). Twenty-three patients developed complications, of which the most common were myocardial infarction with heart failure (n=6/23; 26.1%), cerebrovascular accident (n=6/23; 26.1%) and respiratory tract infections (n=3/23; 13.01%) and there were six deaths. CONCLUSIONS In our cohort, receiving two doses of the COVID-19 vaccine was associated with reduced disease severity. Those with mild disease recovered faster than those with moderate/severe disease. At 3 mo posthospital discharge, >90% had recovered.
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Affiliation(s)
| | - Suranjith L Seneviratne
- Nawaloka Hospital Research and Education Foundation, Nawaloka Hospitals PLC, Colombo-02, Sri Lanka,Institute of Immunity and Transplantation, Royal Free Hospital and University College London, NW3 2PP, UK
| | - Arjuna P De Silva
- Department of Medicine, Faculty of Medicine, University of Kelaniya, P.O Box 6, Sri Lanka
| | - Riaz Mowjood
- Department of Respiratory Disease, Nawaloka Hospitals PLC, Colombo-02, Sri Lanka
| | - Shazli Mowjood
- Department of Respiratory Disease, Nawaloka Hospitals PLC, Colombo-02, Sri Lanka
| | - Thushara de Silva
- Department of Respiratory Disease, Nawaloka Hospitals PLC, Colombo-02, Sri Lanka
| | - Primesh de Mel
- Nawaloka Hospital Research and Education Foundation, Nawaloka Hospitals PLC, Colombo-02, Sri Lanka
| | - Chandima de Mel
- Nawaloka Hospital Research and Education Foundation, Nawaloka Hospitals PLC, Colombo-02, Sri Lanka
| | - R S Wijesinha
- The Princess Alexandra Hospital, the Princess Alexandra Hospital NHS Trust, Hamstel Rd, Harlow CM20 1QX, UK
| | | | - Sanjay de Mel
- Department of Haematology-Oncology, National University Cancer Institute, National University Health System Singapore, Singapore
| | - Lal Chandrasena
- Nawaloka Hospital Research and Education Foundation, Nawaloka Hospitals PLC, Colombo-02, Sri Lanka
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Nik Hazlina NH, Norhayati MN, Shaiful Bahari I, Nik Muhammad Arif NA. Worldwide prevalence, risk factors and psychological impact of infertility among women: a systematic review and meta-analysis. BMJ Open 2022; 12:e057132. [PMID: 35354629 PMCID: PMC8968640 DOI: 10.1136/bmjopen-2021-057132] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES To assess the prevalence, risk factors and psychological impact of infertility among females. This review summarises the available evidence, effect estimates and strength of statistical associations between infertility and its risk factors. STUDY DESIGN Systematic review and meta-analysis. DATA SOURCES MEDLINE, CINAHL and ScienceDirect were searched through 23 January 2022. ELIGIBILITY CRITERIA The inclusion criteria involved studies that reported the psychological impact of infertility among women. We included cross-sectional, case-control and cohort designs, published in the English language, conducted in the community, and performed at health institution levels on prevalence, risk factors and psychological impact of infertility in women. DATA EXTRACTION AND SYNTHESIS Two reviewers independently extracted and assess the quality of data using the Joanna Briggs Institute Meta-Analysis. The outcomes were assessed with random-effects model and reported as the OR with 95% CI using the Review Manager software. RESULTS Thirty-two studies with low risk of bias involving 124 556 women were included. The findings indicated the overall pooled prevalence to be 46.25% and 51.5% for infertility and primary infertility, respectively. Smoking was significantly related to infertility, with the OR of 1.85 (95% CI 1.08 to 3.14) times higher than females who do not smoke. There was a statistical significance between infertility and psychological distress among females, with the OR of 1.63 (95% CI 1.24 to 2.13). A statistical significance was noted between depression and infertility among females, with the OR of 1.40 (95% CI 1.11 to 1.75) compared with those fertile. CONCLUSIONS The study results highlight an essential and increasing mental disorder among females associated with infertility and may be overlooked. Acknowledging the problem and providing positive, supportive measures to females with infertility ensure more positive outcomes during the therapeutic process. This review is limited by the differences in definitions, diagnostic cut points, study designs and source populations. PROSPERO REGISTRATION NUMBER CRD42021226414.
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Affiliation(s)
- Nik Hussain Nik Hazlina
- Women's Health Development Unit, Universiti Sains Malaysia - Kampus Kesihatan, Kubang Kerian, Kelantan, Malaysia
| | - Mohd Noor Norhayati
- Department of Family Medicine, Universiti Sains Malaysia - Kampus Kesihatan, Kubang Kerian, Kelantan, Malaysia
| | - Ismail Shaiful Bahari
- Department of Family Medicine, Universiti Sains Malaysia - Kampus Kesihatan, Kubang Kerian, Kelantan, Malaysia
| | - Nik Ahmad Nik Muhammad Arif
- Women's Health Development Unit, Universiti Sains Malaysia - Kampus Kesihatan, Kubang Kerian, Kelantan, Malaysia
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Religious Women's Coping with Infertility: Do Culturally Adapted Religious Coping Strategies Contribute to Well-Being and Health? Int J Behav Med 2019; 26:154-164. [PMID: 30443734 DOI: 10.1007/s12529-018-9757-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Infertility is a source of stress, particularly in pronatalist societies in which a lifestyle without children is viewed as an unacceptable option. The present study examined the relationship between the use of culturally adapted religious coping strategies and emotional adjustment among women coping with fertility problems. METHODS This is a cross-sectional correlational study. One hundred and eighty-six religious Israeli women undergoing fertility treatment filled out questionnaires assessing their use of culturally adapted religious coping strategies and emotional adjustment (distress/well-being). RESULTS A path analysis showed that the culturally adapted religious coping strategies of seeking the support of Rabbis and seeking the support of God had a strong correlation with reduced psychological distress, but not with enhanced psychological well-being. Seeking approval and recognition from the community was correlated with reduced distress and enhanced well-being. However, seeking ties and belonging to the community was correlated with increased psychological distress and reduced psychological well-being. Finally, women without children experienced greater psychological distress than women with children and sought more support of Rabbis and fewer ties with the community. CONCLUSIONS In a pronatalist culture that sanctifies childbirth, infertility is a source of significant distress. Professionals' awareness of the culturally adapted religious coping strategies utilized by their clients may help them conduct culturally sensitive intervention, which may greatly help to enhance emotional adjustment. Future research is recommended to develop instruments that measure culturally adapted strategies and their influence on emotional adjustment over time, in different states of health while comparing different cultures.
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Li X, Ye L, Tian L, Huo Y, Zhou M. Infertility-Related Stress and Life Satisfaction among Chinese Infertile Women: A Moderated Mediation Model of Marital Satisfaction and Resilience. SEX ROLES 2019. [DOI: 10.1007/s11199-019-01032-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Chandradasa M, Rathnayake LC. Gender disparity as a threat to the mental well-being of young Sri Lankan women. BJPsych Int 2018; 16:90-92. [PMID: 32167095 PMCID: PMC7054333 DOI: 10.1192/bji.2018.29] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Sri Lanka ranks highest in the region for human development. Despite producing the first female head of state in the world, the country has failed to achieve substantial gains in the gender inequality indices in the past decade. In recent years, the proportion of females in secondary education has equalled that of males, and young women have become the majority among the university entrants. These educated young women are likely to face psychosocial distress in a patriarchal society where they would be expected to fulfil traditional gender roles. This article describes gender disparities that could affect the mental well-being of young Sri Lankan women and the need for awareness among mental health professionals in the country.
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Affiliation(s)
- Miyuru Chandradasa
- Lecturer, Department of Psychiatry, Faculty of Medicine, University of Kelaniya, Sri Lanka. .,Honorary Senior Lecturer, Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia
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Li X, Wang K, Huo Y, Zhou M. The effect of infertility-related stress on Chinese infertile females' mental health: The moderating role of marital adjustment. Psych J 2018; 8:232-239. [PMID: 30468007 DOI: 10.1002/pchj.255] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Revised: 09/11/2018] [Accepted: 10/02/2018] [Indexed: 11/09/2022]
Abstract
Although the impacts of infertility-related stress on mental health have been testified in the literature, the underlying mechanism between them is still not clear. In response to this issue, 286 Chinese women who were pursuing medical treatment for fertility problems in two state-owned hospitals were invited to complete the survey, including the 7-item Dyadic Adjustment Scale (DAS), the Fertility Problem Inventory (FPI), the 5-item Mental Health Inventory (MHI-5), and demographic variables (e.g., age). The multiple linear regression method (SPSS 16) was used to investigate the impact of infertility-related stress and marital satisfaction on infertile women's mental health. Results showed that the total FPI score-and the specific domains of Social Concern, Relationship Concern, and Rejection of Child-Free Lifestyle in particular-had a significant negative relation with infertile women's mental health and marital satisfaction as a moderator between them. Therefore, the core of marital relationship and specific infertility-related stress should be addressed in psychological intervention programs for people facing infertility in mainland China.
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Affiliation(s)
- Xiaoshan Li
- School of Psychology, Jiangxi Normal University, Nanchang, China.,Center of Mental Health Education and Research, School of Psychology, Jiangxi Normal University, Nanchang, China
| | - Kaikai Wang
- School of Psychology, Jiangxi Normal University, Nanchang, China
| | - Yafen Huo
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Mingjie Zhou
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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Burns R, Wickramage K, Musah A, Siriwardhana C, Checchi F. Health status of returning refugees, internally displaced persons, and the host community in a post-conflict district in northern Sri Lanka: a cross-sectional survey. Confl Health 2018; 12:41. [PMID: 30305841 PMCID: PMC6166297 DOI: 10.1186/s13031-018-0176-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 09/07/2018] [Indexed: 11/10/2022] Open
Abstract
Background Although the adverse impacts of conflict-driven displacement on health are well-documented, less is known about how health status and associated risk factors differ according to displacement experience. This study quantifies health status and quality of life among returning refugees, internally displaced persons, and the host community in a post-conflict district in Northern Sri Lanka, and explores associated risk factors. Methods We analysed data collected through a household survey (n = 570) in Vavuniya district, Sri Lanka. The effect of displacement status and other risk factors on perceived quality of life as estimated from the 36-item Short Form Questionnaire, mental health status from 9-item Patient Health Questionnaire, and self-reported chronic disease status were examined using univariable analyses and multivariable regressions. Results We found strong evidence that perceived quality of life was significantly lower for internally displaced persons than for the host community and returning refugees, after adjusting for covariates. Both mental health status and chronic disease status did not vary remarkably among the groups, suggesting that other risk factors might be more important determinants of these outcomes. Conclusions Our study provides important insights into the overall health and well-being of the different displaced sub-populations in a post-conflict setting. Findings reinforce existing evidence on the relationship between displacement and health but also highlight gaps in research on the long-term health effects of prolonged displacement. Understanding the heterogeneity of conflict-affected populations has important implications for effective and equitable humanitarian service delivery in a post-conflict setting.
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Affiliation(s)
- Rachel Burns
- 1Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Kolitha Wickramage
- International Organisation for Migration (UN Migration Agency), Sri Lanka Country Mission, 62 Ananda Coomaraswamy Mawatha, Colombo, 00300 Sri Lanka
| | - Anwar Musah
- 1Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Chesmal Siriwardhana
- 1Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Francesco Checchi
- 3Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
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Gremigni P, Casu G, Mantoani Zaia V, Viana Heleno MG, Conversano C, Barbosa CP. Sexual satisfaction among involuntarily childless women: A cross-cultural study in Italy and Brazil. Women Health 2016; 58:1-15. [PMID: 27922291 DOI: 10.1080/03630242.2016.1267690] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Infertility has been negatively associated with sexual satisfaction. This study aimed to estimate the relation of infertility to sexual satisfaction from a cross-cultural perspective, comparing Italian and Brazilian women. Between June 2012 and January 2013, 528 women seeking assisted reproduction technology (ART) treatment in Italy (39%) or Brazil (61%) completed self-reports of sexual satisfaction (ISS) and infertility-related stress in the marital domain (IRS). IRS was the same across countries. ISS differed, with 34.31% of the Italians and 43.52% of the Brazilians being sexually dissatisfied at a clinical level (ISS score >30). Multiple logistic regression models showed that being sexually dissatisfied at a clinical level was associated with lower education and higher IRS among Italian women, regardless of having a diagnosed cause of infertility. It was instead associated with higher IRS only among the Brazilian women who had a diagnosed cause of infertility. These findings suggest that, regardless of nationality, sexual satisfaction and infertility-related stress need to be addressed in the treatment of infertile women turning to ART. However, as factors associated with these dimensions vary across countries, interventions to promote sexual satisfaction among infertile women should be adapted to their specific socio-cultural context.
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Affiliation(s)
- Paola Gremigni
- a Department of Psychology , University of Bologna , Bologna , Italy
| | - Giulia Casu
- a Department of Psychology , University of Bologna , Bologna , Italy
| | - Victor Mantoani Zaia
- b School of Medical and Health Sciences , Methodist University , São Paulo , Brazil
| | | | - Ciro Conversano
- c Department of Surgical, Medical, Molecular & Critical Area Pathology , University of Pisa , Pisa , Italy
| | - Caio Parente Barbosa
- d Ideia Fértil Institute and Graduate Program of Faculdade de Medicina do ABC , São Paulo , Brazil
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Ying LY, Wu LH, Loke AY. Gender differences in experiences with and adjustments to infertility: A literature review. Int J Nurs Stud 2015; 52:1640-52. [DOI: 10.1016/j.ijnurstu.2015.05.004] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 05/10/2015] [Accepted: 05/10/2015] [Indexed: 11/16/2022]
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