The Human Responses and Nursing Diagnoses of Those Living With Infertility: A Qualitative Systematic Review

Resilience among involuntarily childless couples and individuals undergoing infertility treatment: a systematic review

Infertility is regarded as a highly stressful and challenging experience. However, the response to this unexpected moment varies from one individual to the other. The review explores research that studies resilience in the context of infertility and its treatment. The purpose was to study the protective and risk factors associated with resilience and to identify psychosocial factors that could play a crucial role in resilience among infertile couples and individuals who are seeking infertility treatment. Four major databases (PubMed, Scopus, ScienceDirect, and Wiley Online Library) were searched with appropriate keywords. A total of 4101 articles were retrieved from the databases and after following various levels of screening 18 articles were finalized. These articles explored resilience and other psychosocial factors in couples/individuals seeking infertility treatment. The protective factors associated with resilience were quality of life, coping, social support, and posttraumatic growth. The risk factors associated with resilience were infertility-related stress, anxiety and depression. The unexpected diagnosis of infertility might be disturbing for many, still, it may not be extremely agonizing for some. Individuals who are encouraged to utilize their own resources and seek support are able to deal with stressors associated with infertility.

The Resilience Scale in Portuguese Adults under Assisted Reproductive Techniques

Assessing resilience response to an adverse event such as infertility requires measuring the same construct adequately and accurately by nurses. The objective of this study was to explore the validity and reliability of the Portuguese version of the Resilience Scale for adults. A cross-sectional and methodological design was used, and factor analyses were performed. The sample comprised 140 adult Portuguese individuals under fertility treatment recruited from health-related websites. The findings yielded a bad fit of the hypothesized Resilience Scale structure with the observed data. Instead, a 21-item tool with a four-factor structure revealed high internal consistency (0.94). The tool correlated positively and significantly to the Portuguese version of the Spiritual Well-Being Questionnaire and was negatively associated and lacked correlation with the Fertility Adjustment Scale. The 21-item Resilience Scale is a reliable tool suitable to measure resilience in Portuguese adults under assisted reproductive techniques. This tool offers the opportunity of early recognition by health professionals aiming to enhance patients’ coping skills effectively and promote positive psychological and mental health outcomes.

Portuguese Version of the Spiritual Well-Being Questionnaire: Validation Study in People under Assisted Reproductive Techniques

Attention has been given to the experience of individuals undergoing assisted reproductive techniques. However, only recent literature has focused on the spiritual journey triggered by such an event and highlighted the nurses and midwives’ roles in the assessment of the spiritual needs of those living with infertility. This study aimed to perform a psychometric test of the factor structure of the Portuguese version of the Spiritual Well-being Questionnaire in a sample of people undergoing assisted reproductive techniques. This descriptive cross-sectional study was conducted between September 2019 and June 2020 on a sample of 104 Portuguese adults attending fertility treatment. An online questionnaire was released on fertility-related websites. A confirmatory factor analysis was conducted on six hypothesized models of the instrument. The findings provided evidence of an adequate internal consistency of the instrument, and the validity and reliability of the oblique four-factor model was confirmed. Spiritual well-being had a significant association with the nature of infertility and a higher score was achieved by participants that perceived religion as very important. This study provides a validated tool for nurses and midwives to assess spiritual well-being and promote an integrated reproductive healthcare approach. Further longitudinal research with bigger samples would provide more evidence of the spiritual needs of people living with this condition.

Validation of the Portuguese Version of the Fertility Adjustment Scale

There is an urgent need to provide healthcare professionals and midwives with validated tools as to improve fertility adjustment and promote well-being of couples with infertility. The purpose of this study was to test validity of the Fertility Adjustment Scale among people undergoing assisted reproductive techniques. A cross-sectional and methodological study was conducted, and a total of 104 Portuguese adults undergoing fertility treatment were recruited through fertility-related websites. The Fertility Adjustment Scale was administered along with the Spiritual Well-Being Questionnaire and the Resilience Scale for adults as a measure of concurrent validity. Scores revealed the sample’s lack of adjustment to fertility. A significant correlation with measures of resilience provided evidence of convergent validity. There was a significant association of fertility adjustment with time of consultation and the cause of infertility. A Fertility Adjustment Scale with six items is a reliable tool that offers early recognition of patients’ difficulties in adaptation to fertility problems during assisted reproductive techniques, which could be beneficial in not only an early recognition of healthcare intervention but of a more individualized approach to such patients.

One couple's experience with infertility: Nursing theory-based practice case study

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.

Nursing diagnoses: what about NANDA-I syndromes?

AIM

The aim of this paper is to propose a label structure for nursing diagnosis syndromes from NANDA-I.

BACKGROUND

Worldwide changes and human needs seem to get more complex, offering challenging opportunities for nursing care and to nursing knowledge. Nursing classifications represent nursing knowledge and are critical in guiding clinical practice and patient-centred care.

SOURCES OF EVIDENCE

This discussion paper is based on the analysis of NANDA-I Taxonomy II and related literature.

DISCUSSION/CONCLUSION

A total of 13 diagnoses comprise the term 'syndrome'; however, the labels are not consistent with the multiaxial system within the NANDA-I model of a nursing diagnosis. Syndromes require a more specific approach and definition when compared to other type of nursing diagnoses. A new format for describing the label is provided and would be useful in improving current syndromes and in reflecting a more individualized and patient-centred nursing care.

IMPLICATIONS FOR NURSING POLICY AND PRACTICE

The proposal provided in this paper could raise the quality of nurses' assessment, increase accuracy of NANDA-I nursing diagnoses, promote nurses' clinical reasoning and the adequacy of care. Ultimately, changes should be not only perceived in nurses´ practice but also in nursing education as curricula should promote a critical thinking. Nurse leaders and policymakers could additionally use this in the development of advanced programmes and protocols that could manage and monitorize implementation of advanced care.