Perceived control over the medical procedure and its association with adjustment to a low-control situation: the case of infertility

Perceptions of Infertility and Reproductive Concerns in Adolescent and Young Adult Female Cancer Survivors

This cross-sectional survey study explores the fertility perceptions of adolescent and young adult female cancer survivors (n = 111) and relationships to fertility counseling and reproductive distress. Satisfaction with post-treatment fertility counseling (β = -0.20, p = 0.04), perceived consequences of cancer-related fertility changes (β = 0.26, p = 0.03), and understanding of one's reproductive health (β = -0.22, p = 0.03) correlated with reproductive distress, controlling for covariates (F(10, 88) = 3.50, p < 0.001). Findings suggest that post-treatment counseling may be important to addressing survivors' perceptions of fertility and reproductive potential, which influences levels of distress and to create a greater sense of control on their road to parenthood.

Influence of illness representations on coping strategies and psychosocial outcomes of infertility: Systematic review and meta-analysis

BACKGROUND

This systematic review and meta-analysis was based on the Common Sense Model, applied to infertility.

AIMS

The aim was to examine the relationships between cognitive (i.e. cause, coherence, consequences, controllability, identity and timeline) or emotional representations of infertility and both coping (i.e. maladaptive and adaptive) and psychosocial outcomes (i.e. distress, anxiety, depressive symptoms, social isolation, low well-being and poor quality of life), reporting followed PRISMA guidelines.

MATERIALS & METHODS

Five databases (PubMed, PsycINFO, PsycARTICLES, PubPsych and CINAHL) were searched, and 807 articles were initially identified.

RESULTS

Seven cross-sectional studies (N = 1208 participants) were retained in qualitative and quantitative analyses. These studies assessed the associations of seven types of representations with either maladaptive or adaptive coping (20 effect sizes), or with psychosocial outcomes (131 effect sizes). A multivariate meta-analysis revealed that none (0/2) of the associations between the sole type of representation considered (i.e. controllability) and coping strategies were statistically significant, whereas three (3/7) of the associations between representations of infertility and psychosocial outcomes were statistically significant. Regardless of p-values, pooled estimates ranged from low (r = .03) to very high (r = .59).

DISCUSSION

Future studies should validate specific measurement tools for measuring cognitive and emotional representations of infertility.

CONCLUSION

Our results highlight the influence of representations of infertility (particularly cognitive representations of consequences and emotional representations) on the psychosocial outcomes of infertility.

'How did you cope with such concerns?': insights from a monitored online infertility peer support forum

The Research Question posed was 'What coping strategies do fertility patients and trained peer supporters discuss in an online infertility peer support forum?' A thematic analysis was used to examine 244 online posts from a sample of 39 users (37 women and two men) for themes in coping with fertility-related stressors. Data were collected from Connect, a monitored online discussion forum with trained peer supporters. Connect users ranged from 27 to 44 years of age (mean = 34.38) and 33 (84.6%) were nulliparous at the time of the study. A variety of cognitive-reappraisal and practical management coping strategies was discussed across four themes: (i) balancing interpersonal relationships; (ii) partner support; (iii) uncertainty and lack of control; and (iv) positivity and negativity. Experiences of uncertainty and lack of control related to time and schedule, outcomes and waiting for physical symptoms, and the clinic. Connect users commonly discussed the helpfulness of coping strategies. Connect users actively requested experiential information about ways of coping from other patients and peer supporters, highlighting the importance of lived experience to those currently in treatment. Findings support conceptualizations of infertility coping as a process that is unique to the infertility treatment context and that may change throughout a patient's treatment. Trained peer supporters may benefit fertility patients by normalizing, reappraising, and providing practical strategies to ameliorate difficult infertility-related challenges.

The association of cognitive representations with psychological adjustment in experience of infertility and fertility treatment: A systematic review

INTRODUCTION

The aim of this systematic review was to examine studies describing the association of cognitive representations with psychological adjustment or maladjustment during the experience of infertility and its treatment in light of the Common-Sense Model. According to this theoretical model cognitive perceptions about an illness can be associated with emotional adaptation.

METHODS

A systematic search of four electronic databases (PubMed, APA PsycINFO, SCOPUS, ScienceDirect) was performed. This review considered only quantitative, primary studies in the English language without geographical limitations, published during the period 1996–2020 and relevant to the objective. The population of interest was infertile individuals who are having or not having infertility treatment. Only studies that examined the association between independent variables, such as perceived causes, timeline, controllability, consequences, symptoms, illness coherence and emotional representations, with psychological variables, such as anxiety, worry, distress, depression and well-being, were included. Two authors performed an independent extraction of articles using predefined data fields. Relevant articles were critically appraised and a narrative synthesis was conducted.

RESULTS

Seven cross-sectional studies met the inclusion and methodological criteria and were included in the review. The review results revealed that all components of cognitive representations of infertility and its treatment may correlate with psychological adaptation of people who deal with a fertility problem, at intrapersonal and interpersonal level.

CONCLUSIONS

This systematic review suggested that the Common-Sense Model is an appropriate theoretical model to be applied in the experience of infertility and health professionals can make interventions based on modifying cognitive perceptions of a fertility problem that may increase levels of psychological well-being and decrease levels of distress.

Relationship between coping/attachment styles and infertility-specific distress in Iranian infertile individuals: A cross-sectional study

BACKGROUND

Infertility has been recognized as a stressful clinical condition, significantly affecting couples' emotional functioning.

OBJECTIVE

To investigate the relationship between coping/attachment styles and infertility-specific distress (ISD) in infertile participants.

MATERIALS AND METHODS

Atotal number of 240 infertile participants (120 women and 120 men) who attend the Outpatient Infertility Clinic in Sari, Iran between February and October 2017 were selected using the convenience sampling method. Data were collected using a questionnaire addressing sociodemographic variables. In addition, coping and attachment styles were evaluated via the Coping Strategies Questionnaire and the Revised Adult Attachment Scale by Collins and Read (1990); respectively. Ultimately, the Infertility Distress Scale was used to assess ISD.

RESULTS

The mean ISD score was 42.53 ± 9.63. Secure and insecure attachment styles were observed in 37.9% and 62.1% of the cases, respectively. There was a significant difference among ISD and different groups of attachment styles (p = 0.001) and emotion-focused coping style (p = 0.021). However, no significant relationship was found between problem-focused coping style and ISD (p = 0.985).

CONCLUSION

Considering the relationship between coping/attachment styles and ISD, it was recommended to implement stress prevention and coping education within the framework of coping/attachment theories for infertile individuals.

'Your face freezes and so does your life': A qualitative exploration of adults' psychosocial experiences of living with acquired facial palsy

OBJECTIVES

Facial palsy (FP) is a highly visible appearance-affecting condition and can have a significant impact on facial function. Qualitative research focussing on adults' experiences of living with acquired FP is limited. This study aimed to explore the psychosocial impact of acquired FP and to gain a greater understanding of patients' experiences of treatment and care in the United Kingdom.

DESIGN

A qualitative interview study with individuals living with acquired FP.

METHODS

Ten adults with acquired FP were recruited. Their experiences were explored using semi-structured telephone interviews. Data were analysed using thematic analysis.

RESULTS

Five master themes were identified through the thematic analysis: 1) grappling with a new identity, 2) the psychosocial impact of living with facial palsy, 3) isolation: dealing with 'one hell of a problem on your own', 4) a life on hold, 5) coping strategies. Findings indicated high levels of distress and significant challenges in managing the functional and psychosocial changes associated with acquiring FP. Participants expressed grief for their former appearance and identity, with photographs and mirrors acting as agonizing reminders. Many reported a sense of abandonment due to uncoordinated care and, as a result, engaged in an endless and often fruitless pursuit to gain control over FP by experimenting with their own treatment. Many reported the negative impact of their altered facial expressions on social interactions and a fear of being negatively evaluated.

CONCLUSIONS

This study highlights a pressing need to review how FP is managed in the UK. To improve patient well-being, health care professionals could benefit from FP education, and patients from timely access to psychological support and clearer standards of care following diagnosis.

Factors associated with women's desire for control of healthcare during childbirth: Psychometric analysis and construct validation

The desire for control of healthcare is a significant moderator of outcomes related to childbirth. Researchers have shown that a sense of control of healthcare during childbirth is strongly correlated with postpartum maternal well-being. The aims of this study were to examine (a) the psychometric characteristics of an instrument to assess women's desire for control of healthcare during childbirth, and (b) examine desire for control in relation to parity, medical complications of pregnancy, and women's choices of childbirth providers and setting. The study design was cross-sectional using two different samples totaling 385 pregnant women. In Sample 1, (n = 193) we conducted an exploratory factor analysis to reduce the initial item pool. In Sample 2, (n = 192) we conducted a confirmatory factor analysis (CFA) of the final 12-item instrument and examined factors related to the desire for control. Results of the analysis in Sample 1 were supportive of a single-factor structure reflecting women's desire to influence the childbirth healthcare environment and decision-making. The final 12-item instrument had high internal consistency reliability (Cronbach's alpha = 0.93). CFA in Sample 2 was supportive of the single-factor structure with good model fit. The desire for control was directly correlated with an internal locus of control. Nulliparous women reported a lower desire for control compared with multiparous women. The desire for control among women with self-reported medical complications of pregnancy was comparable to that among women without pregnancy complications. The desire for control was a predictor of choosing midwives (vs. obstetricians), home or birth center (vs. hospitals), and professional labor support (e.g., doulas). Implications for future research on the impact of desire for control on maternal health outcomes are discussed.

Men's experiences of recontact about a potential increased risk of prostate cancer due to Lynch Syndrome: "Just another straw on the stack"

The practice of recontacting patients to provide new health information is becoming increasingly common in clinical genetics, despite the limited research to evidence the patient experience. We explored how men with Lynch Syndrome (LS) understand and experience being recontacted about a potential increased risk of prostate cancer. Sixteen men with LS (Meanage 51 years) were recruited from an Australian screening study to undergo a semi-structured interview. A modified grounded theory approach was used to guide data collection and thematic analysis. Qualitative coding was shared by the research team to triangulate analysis. The practice of recontact was viewed by participants as acceptable and was associated with minimal emotional distress. The majority of men understood that they may be above population risk of prostate cancer, although evidence was still emerging. Men reported high engagement with personal and familial health, including regular screening practices and familial risk communication. Findings suggest that men's carrier status and beliefs about the actionability of the new cancer risk information influence their response to recontact. Recontact practices that include the offer of risk management strategies may lead to improved patient outcomes (e.g., reduced cancer worry and increased health engagement), if perceived as valuable by recipients.