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Wotango BY, Mengiste B, Solomon S. Health-related quality of life and its associated factors among infertile women compared with fertile women in public hospital Addis Ababa, Ethiopia: a comparative cross-sectional study. BMC Womens Health 2024; 24:417. [PMID: 39044177 PMCID: PMC11264358 DOI: 10.1186/s12905-024-03163-3] [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: 10/24/2023] [Accepted: 05/28/2024] [Indexed: 07/25/2024] Open
Abstract
BACKGROUND Infertility can have detrimental physical, psychological, and social effects that significantly impact health-related quality of life. Although the impact of infertility on quality of life is well established, there is a lack of research comparing the quality of life between fertile and infertile women in Ethiopia. METHODS A hospital-based comparative cross-sectional study was conducted among 287 infertile and 301 fertile women. Participants were selected using systematic random sampling. A structured, validated tool was used to collect data. An independent sample t-test was conducted to determine if there was a difference in the study participants' quality of life domains and the mean total quality of life score. Multiple linear regressions were used to correlate quality of life scores with significant predictor factors for the infertile group. RESULTS Infertile women had a mean total Herbal of 66.54 ± 10.18, and fertile women (72.68 ± 7.57) were found to be statistically different between the groups. All domains except the physical domain were significantly different between the groups. Duration of marriage (β = -0.529), number of previous sexual partners (β = -0.410), total number of working hours per day (β = -0.345), types of infertility (β = -0.34), and history of the sexually transmitted disease (β = -0.277), in decreasing order of effect, were found to be associated with the quality of life of infertile women (R2 = 0.725). CONCLUSIONS The study found that infertile women had a lower mean HRQoL score compared to fertile women, with all domains except for the physical domain being significantly different between the two groups. This suggests that infertility can have a significant impact on various aspects of a woman's life, including her emotional well-being, social functioning, and psychological health. The factors associated with the quality of life of infertile women were the duration of marriage, the number of previous sexual partners, the total number of working hours per day, the types of infertility, and the history of sexually transmitted diseases, with duration of marriage having the strongest association. These findings highlight the need for healthcare providers to address the psychological and social aspects of infertility.
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Affiliation(s)
- Biniam Yohannes Wotango
- Clinical Governance and Quality Improvement Directorate, Gandhi Memorial Hospital, Addis Ababa, Ethiopia.
| | - Bezatu Mengiste
- School of Public Health, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Samrawit Solomon
- School of Public Health, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
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Pace R, Goldstein KM, Williams AR, Clayton-Stiglbauer K, Meernik C, Shepherd-Banigan M, Chawla N, Moss H, Skalla LA, Colonna S, Kelley MJ, Zullig LL. The Landscape of Care for Women Veterans with Cancer: An Evidence Map. J Gen Intern Med 2024:10.1007/s11606-024-08903-7. [PMID: 38965201 DOI: 10.1007/s11606-024-08903-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Accepted: 06/17/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND Women are the fastest growing veteran group in the US and the number of women veterans (WVs) with cancer is rising; however, little is known about this population. Cancer care for WVs is complex and it is essential to understand their unique needs and care coordination challenges to provide evidence-based care. The purpose of this review is to map the quantity, distribution, and characteristics of literature describing cancer and its treatment among WVs. METHODS We searched MEDLINE (via PubMed), Embase (Elsevier), and Web of Science Core Collection (Clarivate) from inception through January, 2024. Publications were eligible that reported gender-specific data on any aspect of cancer care among WVs. Data was abstracted by a single investigator with over-reading. RESULTS Forty-six reports were included; 44 were observational and 19 had a women-only sample. There were no interventional reports and no qualitative reports had a patient sample. Breast cancer was the most commonly addressed (n = 19). There were six additional reports on sex-specific cancers. Many reports used large VA databases or previous trial data, creating the potential for patient overlap between reports. Among VA-specific areas of interest, only three reports evaluated the potential implications of racial differences and only two included a transgender population. No reports examined the effects of toxic exposures on cancer. Within the NCI Cancer Control Continuum, crosscutting areas were more commonly represented; over half (25) of the reports addressed epidemiology. There were few reports on focus areas and little overlap between focus and crosscutting areas. DISCUSSION Existing literature provides an inadequate understanding of the population of WVs with cancer. There is scant information regarding the population of WVs with cancer, their care preferences or experiences, or how to best identify and address unmet healthcare needs. It is imperative to expand research to provide evidence-based care for this population.
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Affiliation(s)
- Rachel Pace
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Healthcare System, Durham, NC, USA.
| | - Karen M Goldstein
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Healthcare System, Durham, NC, USA
- Division of General Internal Medicine, Duke University School of Medicine, Durham, NC, USA
| | - April R Williams
- Division of Hematology and Oncology, Durham VA Healthcare System, Durham, NC, USA
- Cooperative Studies Program Epidemiology Center, Durham VA Healthcare System, Durham, NC, USA
- Million Veteran Program, Boston Coordinating Center, Boston, MA, USA
| | | | | | - Megan Shepherd-Banigan
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Healthcare System, Durham, NC, USA
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
- Duke-Margolis Institute for Health Policy, Duke University, Durham, NC, USA
- Mid-Atlantic Mental Illness Research Education and Clinical Center (MIRECC), Durham VA Healthcare System, Durham, NC, USA
| | - Neetu Chawla
- VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Haley Moss
- Division of Hematology and Oncology, Durham VA Healthcare System, Durham, NC, USA
- Department of Obstetrics and Gynecology, Duke University Healthcare System, Durham, NC, USA
| | - Lesley A Skalla
- Duke University Medical Center Library and Archives, Duke University School of Medicine, Durham, NC, USA
| | | | - Michael J Kelley
- Division of Hematology and Oncology, Durham VA Healthcare System, Durham, NC, USA
- Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA
- National Oncology Program, Department of Veterans Affairs, Washington, DC, USA
| | - Leah L Zullig
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Healthcare System, Durham, NC, USA
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
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Assefa MT, Adamson MM, Proctor LB, Moeder S, Ashford JW, Jennings JS. A Multipronged Approach to Caring for Women Veterans With Military Environmental Exposures. Womens Health Issues 2024; 34:325-330. [PMID: 38890077 DOI: 10.1016/j.whi.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 04/25/2024] [Accepted: 05/09/2024] [Indexed: 06/20/2024]
Affiliation(s)
- Mehret T Assefa
- Women's Operational Military Exposure Network Center of Excellence (WOMEN CoE), VA Palo Alto Health Care System, Palo Alto, California.
| | - Maheen M Adamson
- Women's Operational Military Exposure Network Center of Excellence (WOMEN CoE), VA Palo Alto Health Care System, Palo Alto, California; Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, California
| | - Lindsey B Proctor
- Women's Operational Military Exposure Network Center of Excellence (WOMEN CoE), VA Palo Alto Health Care System, Palo Alto, California; California War Related Illness and Injury Study Center (CA WRIISC), VA Palo Alto Health Care System, Palo Alto, California
| | - Stacy Moeder
- Women's Operational Military Exposure Network Center of Excellence (WOMEN CoE), VA Palo Alto Health Care System, Palo Alto, California; California War Related Illness and Injury Study Center (CA WRIISC), VA Palo Alto Health Care System, Palo Alto, California
| | - J Wesson Ashford
- Women's Operational Military Exposure Network Center of Excellence (WOMEN CoE), VA Palo Alto Health Care System, Palo Alto, California; California War Related Illness and Injury Study Center (CA WRIISC), VA Palo Alto Health Care System, Palo Alto, California; Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California
| | - Jennifer S Jennings
- Women's Operational Military Exposure Network Center of Excellence (WOMEN CoE), VA Palo Alto Health Care System, Palo Alto, California; California War Related Illness and Injury Study Center (CA WRIISC), VA Palo Alto Health Care System, Palo Alto, California
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Azize Diallo A, Anku PJ, Darkoa Oduro RA. Exploring the psycho-social burden of infertility: Perspectives of infertile couples in Cape Coast, Ghana. PLoS One 2024; 19:e0297428. [PMID: 38271436 PMCID: PMC10810504 DOI: 10.1371/journal.pone.0297428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 01/04/2024] [Indexed: 01/27/2024] Open
Abstract
Infertility is a complex and often sensitive issue with far-reaching psycho-social ramifications for couples and their families. This study therefore seeks to delve into the psycho-social burden of infertility in Cape Coast, a major city in Ghana. Specifically, we explored the impact of infertility on the psychological and social health of infertile couples receiving fertility treatment. It also delves into the strategies they adopt to cope with their conditions. The study employs a qualitative approach to inquiry using phenomenology as a study design to explore the experiences of the study participants. In-depth interviews were conducted using interview guides, voice recorded and transcribed verbatim. Both inductive and deductive/framework coding techniques were used to code the data leading to the generation of themes and sub-themes. The results show that most of the study participants dealing with infertility faced psychological burdens from different sources including their families, society and themselves. These burdens take a toll on their mental health, pushing them into a state of desperation and depression. It was, however, revealed that infertile couples are able to cope with the help of their family, spouses and the church. Curiously, some of them opt for withdrawal from social events as a coping mechanism. Infertility exerts an enormous negative psycho-social impact on affected couples, especially women. The family and society serve as the main sources of stressors for infertile couples. Therefore, programmes that are aimed at fertility treatment should deliberately consider addressing the psychosocial burden of infertility through education targeting actors, especially interpersonal-level actors.
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Affiliation(s)
- Abdoul Azize Diallo
- Department of Obstetrics and Gynaecology, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
- Department of Population and Health, Faculty of Social Sciences, College of Humanities and Legal Studies, University of Cape Coast, Cape Coast, Ghana
| | - Prince Justin Anku
- Department of Population and Health, Faculty of Social Sciences, College of Humanities and Legal Studies, University of Cape Coast, Cape Coast, Ghana
| | - Rhodalyn Adwoa Darkoa Oduro
- Department of Obstetrics and Gynaecology, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
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Buechel J, Spalding CN, Brock WW, Dye JL, Todd N, Wilson C, Fry-Bowers EK. A Grounded Theory Approach to Navigating Infertility Care During U.S. Military Service. Mil Med 2024; 189:352-360. [PMID: 35772964 PMCID: PMC10824476 DOI: 10.1093/milmed/usac174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 05/03/2022] [Accepted: 06/24/2022] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION In this study, we aimed to understand how active duty service members and their partners navigate the infertility care process within the Military Health System (MHS) while managing a military career. MATERIALS AND METHODS We obtained Institutional Review Board approval to employ a qualitative design using grounded theory methods. We recruited participants using purposive sampling, followed by theoretical sampling. We derived data from demographic questionnaires and semi-structured interviews. Consistent with grounded theory methods, we began analysis with line-by-line coding and moved to focused coding. We employed constant comparative analysis throughout the process to name, categorize, and conceptualize data and relationships. RESULTS The participants included 28 patients, five partners, nine health care providers, and two military leaders. The infertility care process began with active duty service members and their partners recognizing the desire to have a child and discovering infertility, followed by deciding to seek infertility care. The experience was temporally bound within the context of the military environment. We identified the following themes, which described facilitators and barriers to accessing care: Duty station location, career stage, military versus the civilian cost of services, command climate, and policy. These facilitators and barriers varied widely across the Department of Defense (DoD), which resulted in fragmented and inconsistent care cycles, contributed to emotional and physical stress, and created tension between career progression and family formation. CONCLUSIONS Understanding how military couples perceive and manage demands of infertility care may enhance access to care, decrease patient costs, improve outcomes, result in better support for military couples who experience infertility, and ultimately improve the health and military readiness of our armed forces. The results support the need for action by providers, policy makers, and military leaders to develop effective infertility treatment programs and policies in the DoD.
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Affiliation(s)
- Jennifer Buechel
- Naval Submarine Medical Research Laboratory, Groton, CT 06349, USA
| | - Carmen N Spalding
- Bioskills Simulation Training Center, Navy Medicine Readiness and Training Command San Diego, San Diego, CA 92134, USA
| | - Whitney W Brock
- Department of Pediatrics, Neonatal Intensive Care Unit, Kaiser Permanente San Diego Medical Center, San Diego, CA 92123, USA
- University of California San Diego Health, La Jolla, CA 92037, USA
- Rady Children's Hospital San Diego, San Diego, CA 92123, USA
| | - Judy L Dye
- San Diego State University School of Nursing, San Diego, CA 92182, USA
| | | | - Candy Wilson
- Daniel K. Inouye Graduate School of Nursing, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Eileen K Fry-Bowers
- Hahn School of Nursing and Health Science, University of San Diego, San Diego, CA 92110, USA
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Mattocks KM, Marteeny V, Walker L, Kroll-Desrosiers A, Mengeling M. Examining Veterans' Experiences With In Vitro Fertilization Provided Under P.L. 114-223. Med Care 2023; 61:192-199. [PMID: 36689683 PMCID: PMC10006296 DOI: 10.1097/mlr.0000000000001831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Until recently, the Department of Veterans Affairs (VA) medical benefits package has expressly excluded in vitro fertilization (IVF) services for Veterans experiencing fertility problems. However, P.L. 114-223 (2016) allows VHA to provide Assisted Reproductive Technology, including IVF, to certain eligible Veterans. Little is known regarding Veterans' experiences accessing IVF through VA Community Care contracts with IVF providers. OBJECTIVE To examine Veterans' experiences with IVF services provided under the auspices of P.L. 114-223. RESEARCH DESIGN Telephone or video interviews were conducted with male and female Veterans and opposite-sex spouses of Veterans who had been approved for IVF. Interviews were recorded, transcribed, and analyzed using content analysis techniques. Major themes and representative quotes were derived from the analyses. RESULTS Ninety-six Veterans and 14 spouses participated in our interviews. Six major themes arose from these interviews, including (1) the need for improved communication regarding IVF benefits, (2) the need for expanded IVF benefits, (3) the lack of a comprehensive care coordination program, (4) poor access to IVF providers in some areas of the country, (5) special services needed for Veterans with spinal cord injuries, and (6) the IVF policy may be discriminatory in nature to single and LGBTQ Veterans. CONCLUSIONS Many Veterans with service-connected conditions related to reproductive health have taken advantage of the IVF benefit, though limitations on these benefits have prevented other Veterans from taking advantage of the IVF benefit. Further attention needs to be paid to improving communication and coordination of IVF services with ongoing VA care and ensuring special populations, including those living in rural areas and Veterans with spinal cord injuries, have access to IVF services as needed.
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Affiliation(s)
- Kristin M. Mattocks
- Department of Quantitative Health Sciences, UMass Chan Medical School, Worcester, MA, USA
- VA Central Western Massachusetts Healthcare System, Leeds, MA, USA
| | - Valerie Marteeny
- VA Central Western Massachusetts Healthcare System, Leeds, MA, USA
| | - Lorrie Walker
- VA Central Western Massachusetts Healthcare System, Leeds, MA, USA
| | - Aimee Kroll-Desrosiers
- Department of Quantitative Health Sciences, UMass Chan Medical School, Worcester, MA, USA
- VA Central Western Massachusetts Healthcare System, Leeds, MA, USA
| | - Michelle Mengeling
- Center for Access & Delivery Research and Evaluation (CADRE) and Veterans Rural Health Resource Center-Iowa City (VRHRC-IC), Iowa City VA Health Care System, Iowa City, IA, USA
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA
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Gaviria D, Ammerman A. Eating disorders and disordered eating in servicemen and women: A narrative review. J Clin Psychol 2023; 79:316-373. [PMID: 35938917 DOI: 10.1002/jclp.23424] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 06/09/2022] [Accepted: 07/14/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Eating disorders (EDs) are mental illnesses impacting all aspects of an individual's life. Recent research has examined EDs and disordered-eating behaviors in the military, a population subject to body composition standards, fitness requirements, and extreme stress. The purpose of this narrative review was to investigate ED and disordered-eating prevalence and their risk factors in ROTC (reserve officers' training corps), active-duty, and veteran servicemembers. The secondary purpose was to provide policy recommendations to reduce the burden of these conditions in the military. METHODS PubMed and PsycINFO were reviewed for relevant articles. All studies including data on EDs or disordered eating in U.S. active-duty, ROTC, or veteran populations were considered. RESULTS Results revealed a high burden of EDs and disordered eating with bulimic- and binge-type behaviors being the most common. Servicemembers exposed to trauma, including military sexual assault, and those with comorbidities like PTSD showed a higher prevalence. Body composition and fitness testing were also associated with a higher risk. Qualitative studies suggest these conditions serve as coping mechanisms for aspects of military life. CONCLUSIONS The high prevalence of EDs and disordered eating in the military points toward the importance of identification, treatment, and prevention. Policy change is necessary to protect servicemembers.
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Affiliation(s)
- David Gaviria
- Department of Nutrition, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Alice Ammerman
- Center for Health Promotion and Disease Prevention, Department of Nutrition, Schools of Public Health and Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Plaut S. Scoping review and interpretation of myofascial pain/fibromyalgia syndrome: An attempt to assemble a medical puzzle. PLoS One 2022; 17:e0263087. [PMID: 35171940 PMCID: PMC8849503 DOI: 10.1371/journal.pone.0263087] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 01/11/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Myofascial Pain Syndrome (MPS) is a common, overlooked, and underdiagnosed condition and has significant burden. MPS is often dismissed by clinicians while patients remain in pain for years. MPS can evolve into fibromyalgia, however, effective treatments for both are lacking due to absence of a clear mechanism. Many studies focus on central sensitization. Therefore, the purpose of this scoping review is to systematically search cross-disciplinary empirical studies of MPS, focusing on mechanical aspects, and suggest an organic mechanism explaining how it might evolve into fibromyalgia. Hopefully, it will advance our understanding of this disease. METHODS Systematically searched multiple phrases in MEDLINE, EMBASE, COCHRANE, PEDro, and medRxiv, majority with no time limit. Inclusion/exclusion based on title and abstract, then full text inspection. Additional literature added on relevant side topics. Review follows PRISMA-ScR guidelines. PROSPERO yet to adapt registration for scoping reviews. FINDINGS 799 records included. Fascia can adapt to various states by reversibly changing biomechanical and physical properties. Trigger points, tension, and pain are a hallmark of MPS. Myofibroblasts play a role in sustained myofascial tension. Tension can propagate in fascia, possibly supporting a tensegrity framework. Movement and mechanical interventions treat and prevent MPS, while living sedentarily predisposes to MPS and recurrence. CONCLUSIONS MPS can be seen as a pathological state of imbalance in a natural process; manifesting from the inherent properties of the fascia, triggered by a disrupted biomechanical interplay. MPS might evolve into fibromyalgia through deranged myofibroblasts in connective tissue ("fascial armoring"). Movement is an underemployed requisite in modern lifestyle. Lifestyle is linked to pain and suffering. The mechanism of needling is suggested to be more mechanical than currently thought. A "global percutaneous needle fasciotomy" that respects tensegrity principles may treat MPS/fibromyalgia more effectively. "Functional-somatic syndromes" can be seen as one entity (myofibroblast-generated-tensegrity-tension), sharing a common rheuma-psycho-neurological mechanism.
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Affiliation(s)
- Shiloh Plaut
- School of Medicine, St. George’s University of London, London, United Kingdom
- * E-mail:
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The associations between infertility-related stress, family adaptability and family cohesion in infertile couples. Sci Rep 2021; 11:24220. [PMID: 34930989 PMCID: PMC8688530 DOI: 10.1038/s41598-021-03715-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 12/01/2021] [Indexed: 12/15/2022] Open
Abstract
To explore the association between infertility-related stress, family adaptability and family cohesion in infertile couples and the determinants of infertility-related stress in infertile couples. Fertility Problem Inventory (FPI) and Family Adaptability and Cohesion Evaluation Scales (FACESII-CV) were used to measure the infertility-related stress and family adaptability and cohesion of infertile couples. T-test, ANOVA and multiple comparisons (LSD) were conducted to compare the FPI scores of different demographic characteristics subgroups. Stepwise multivariate linear regression was used to explore the determinants of infertility-related stress. Women had greater global stress than men (P < 0.001). Women scored higher on desired family adaptability, cohesion dissatisfaction and adaptive dissatisfaction than men (P = 0.039, P = 0.036, P = 0.008). FPI scores were higher in men and women who lived in rural (P < 0.001, P < 0.001). Family cohesion and education level was negatively correlated with infertility-related stress in men. Family adaptability and education level was negatively correlated with infertility-related stress in women. Healthcare providers should pay more attention and give more support to infertile couples who lived in rural or with low education level, and provide easier medical accessing for them. Moreover, healthcare providers should value more the family function and family support in intervention of reducing infertility-related stress.
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Shin H, Lee J, Kim SJ, Jo M. Associations of Symptoms of Depression, Social Support, and Quality of Life Among Korean Women Who Experience Infertility. J Obstet Gynecol Neonatal Nurs 2021; 50:e1-e12. [PMID: 34310903 DOI: 10.1016/j.jogn.2021.06.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To describe the quality of life (QOL) of Korean women experiencing infertility based on sociodemographic and infertility characteristics and to examine the associations among symptoms of depression, social support, and QOL. DESIGN Cross-sectional, descriptive study. SETTING Participants were recruited from July to August 2019 on one of the largest South Korean websites where individuals share pregnancy and parenthood experiences. PARTICIPANTS Adult women (N = 186) who received infertility treatment. METHODS Participants completed an online survey using the Korean version of the Patient Health Questionnaire 9 to measure symptoms of depression, the Multidimensional Scale of Perceived Support, and the Fertility Quality of Life (FertiQOL) scale. Data were analyzed using descriptive statistics, correlation, analysis of variance, and multiple regression. RESULTS There was a significant negative relationship between scores on the Patient Health Questionnaire 9 and FertiQOL (r = -0.557) and a significant positive relationship between scores on the Multidimensional Scale of Perceived Support and FertiQOL (r = 0.404). The length of time from diagnosis of infertility to data collection, past and current treatments, cost burden, and degree of inhibition of daily life due to infertility also significantly affected participants' FertiQOL scores. Symptoms of depression, the burden of treatment, and inhibition of daily life activities explained 46% of the variance in QOL. CONCLUSION Women experiencing infertility and symptoms of depression had lower FertiQOL scores. Health care providers, who are most familiar with and attentive to patients, could provide a first line of defense against poor QOL in this population. By continuously assessing the levels of psychosocial stress in women with infertility, nurses could provide timely resources and design interventions to improve women's QOL.
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Alur-Gupta S, Lee I, Chemerinski A, Liu C, Lipson J, Allison K, Gallop R, Dokras A. Racial differences in anxiety, depression, and quality of life in women with polycystic ovary syndrome. F S Rep 2021; 2:230-237. [PMID: 34278359 PMCID: PMC8267396 DOI: 10.1016/j.xfre.2021.03.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 03/09/2021] [Accepted: 03/09/2021] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE To evaluate racial differences in the anxiety and depression prevalence and scores in women with polycystic ovary syndrome (PCOS). DESIGN Cross-sectional. SETTING Academic institution. PATIENTS Reproductive-aged women with PCOS (n = 272) and controls (n = 295). INTERVENTIONS Hospital anxiety and depression scale and modified PCOS quality-of-life survey (MPCOS-Q). MAIN OUTCOME MEASURES Differences in depression and anxiety scores and quality-of-life score measured using the hospital anxiety and depression scale and MPCOS-Q were determined between White and Black women with PCOS. Multivariable correlation regressions assessed the association of the Ferriman-Gallwey score, total testosterone, body mass index (BMI), and homeostatic model assessment of insulin resistance with anxiety, depression, and quality-of-life scores. RESULTS Multivariable regression controlling for age, BMI, and socioeconomic status showed that White women with PCOS had a significantly higher prevalence of anxiety than Black women with PCOS (75.9% vs. 61.3%) and significantly higher anxiety scores (mean ± SD, 10.3 ± 4.1 vs. 8.7 ± 4.6). The prevalence of depression (24.4% vs. 29%) and depression scores (4.8 ± 3.6 vs. 5.1 ± 4.0) was not significantly different. In multivariable correlation regressions, the interaction between BMI and race in its association with anxiety scores was significant. The association of race with Ferriman-Gallwey score, total testosterone, or homeostatic model assessment of insulin resistance was not significant. In multivariable models, although the total MPCOS-Q scores were similar, the infertility domain was significantly lower in Black women with PCOS (mean ± SD, 12.6 ± 7.8 vs. 17.5 ± 6.8) indicating a lower quality of life related to infertility. CONCLUSION Racial differences identified in the prevalence of anxiety and MPCOS-Q domains suggest the importance of routine screening and provide an opportunity for targeted interventions based on race.
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Affiliation(s)
- Snigdha Alur-Gupta
- Department of Obstetrics and Gynecology, Perelman School of Medicine at the University of Pennsylvania Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Iris Lee
- Department of Obstetrics and Gynecology, Perelman School of Medicine at the University of Pennsylvania Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Anat Chemerinski
- Department of Obstetrics and Gynecology, Perelman School of Medicine at the University of Pennsylvania Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Chang Liu
- University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jenna Lipson
- Pennsylvania Hospital, Philadelphia, Pennsylvania
| | - Kelly Allison
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Robert Gallop
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Anuja Dokras
- Department of Obstetrics and Gynecology, Perelman School of Medicine at the University of Pennsylvania Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
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Farren AT, DiBenedetto A. One couple's experience with infertility: Nursing theory-based practice case study. Int J Nurs Knowl 2021; 33:49-56. [PMID: 34019321 DOI: 10.1111/2047-3095.12330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 04/23/2021] [Accepted: 05/03/2021] [Indexed: 11/27/2022]
Abstract
Infertility can be devastating for some couples. The purpose of this paper is to demonstrate a translation of knowledge and nursing theory-based practice regarding nursing care of couples experiencing infertility through a case study approach. It is important to consider the translation of knowledge to probable scenarios so that we may have opportunities to be better prepared when addressing such situations in actual nursing practice. Data sources include current literature, theoretical perspectives on power as knowing participation in change and nursing classifications. Data synthesis is illustrated within the context of a simulated case study of a couple experiencing unexplained secondary infertility through the application of a theory-based practice methodology, health patterning. The authors conclude that the theoretical perspectives of unitary science and the theory of power as knowing participation in change can be applied in practice. Theory-based practice methodologies such as health patterning offer an opportunity to provide holistic care to couples experiencing infertility. Using these theoretical perspectives, nurses can engage with couples expressing a readiness for enhanced power for a desired change. Nursing implications include the value of theory-based practice and the essential view of couples as unique human beings. In addition, it demonstrates the ongoing usefulness of case study approaches for nursing education as vehicles to enhance awareness of unitary experiences, updates to clinical care, and demonstration of the application of theory to practice.
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Affiliation(s)
- Arlene T Farren
- Associate Professor Emerita, College of Staten Island/City University of New York, New York City, New York
| | - Arianna DiBenedetto
- Student, RN to BS Program and Verrazano Honors Program, College of Staten Island/City University of New York, New York City, New York
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