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Khalesi ZB, Kenarsari FJ. Anxiety, depression, and stress: a comparative study between couples with male and female infertility. BMC Womens Health 2024; 24:228. [PMID: 38589804 PMCID: PMC11003146 DOI: 10.1186/s12905-024-03072-5] [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: 12/18/2023] [Accepted: 04/02/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND AND AIM Although infertility as a significant cause of marital crises is prevalent almost equally in men and women, infertile women are under more pressure and distress than infertile men. Therefore, this study was conducted aiming to compare anxiety, depression, and stress between couples with male and female infertility. METHODS In this descriptive-analytical cross-sectional study, 40 couples (n = 80) with male infertility and 40 couples (n = 80) with female infertility were referred to the infertility clinic of Al-Zahra Educational and Medical Center, Rasht, Iran. Eligible infertile couples were selected by convenience sampling method. The data collection tool was a two-part questionnaire consisting of a demographic information form and a short form of the standard Depression Anxiety Stress Scale-21 (DASS-21). Data analysis was carried out using descriptive and inferential statistical tests at a significant level of p < 0.05. RESULTS The severity of depression, anxiety, and stress also had a statistically significant difference between men and women. The severity of depression was mild in 57.5% of infertile women and moderate in 40% of infertile men. The severity of anxiety was moderate in 42.5% of infertile women and mild in 57.5% of infertile men. The severity of stress was Severe in 37.5% of infertile women and mild in 40% of infertile men. There was a statistically significant difference between infertile women and men in terms of depression (t=-4.213, df = 1619, p < 0.001), anxiety (t=-7.261, df = 2274, p < 0.001), and stress (t=-9.046, df = 2308, p < 0.001) subscales, and the total scores (t=-7.709, df = 2315, p < 0.001). The depression, stress and anxiety levels were higher in infertile women than in healthy women with infertile spouses. This difference was statistically significant (p < 0.01). The depression, anxiety, and stress levels were significantly different between infertile men and healthy men with infertile wives (p < 0.001). CONCLUSION The results of this study indicated that depression, anxiety, and stress were more prevalent in infertile women than in infertile men. The severity levels of depression, anxiety, and stress in the wives of infertile men were higher than those in the spouses of infertile women.
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Affiliation(s)
- Zahra Bostani Khalesi
- Department of Midwifery, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran.
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Woods BM, Bray LA, Campbell SB, Holland A, Mrug S, Ladores S. A phenomenological exploration of the mental health experiences of young women with diminished ovarian reserve. Res Nurs Health 2024; 47:220-233. [PMID: 37837429 DOI: 10.1002/nur.22347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/30/2023] [Accepted: 09/30/2023] [Indexed: 10/16/2023]
Abstract
Infertility is a reproductive disease affecting one in six individuals that renders an individual unable to conceive. One cause of infertility is diminished ovarian reserve (DOR), which reduces the quantity and/or quality of a female's oocyte pool. Although typically indicating normal ovarian aging during the late 30s and early 40s, DOR can also impact younger women, increasing their risk for psychological distress from an unexpected diagnosis of infertility. A phenomenological approach examined the mental health experiences and perceptions of infertility-related mental health care of young women with DOR. Women diagnosed with DOR by age 35 in the United States who experienced emotional distress during infertility were recruited from infertility-specific social media and via snowball sampling. Participants completed a demographic survey and semi-structured individual interview that was audio-recorded, transcribed verbatim, and analyzed using a phenomenological approach. Ten women ages 27-41 completed the study. On average, participants were 30 years of age at the time of DOR diagnosis (age range 25-35), primarily Caucasian (90%), and married (90%). Two main themes were found: (1) Young women with DOR feel like a "forgotten community" coping with an invisible disease; and (2) Not all fertility clinics are created equal. Participants perceived their diagnosis as devastating and hopeless and urged others to find a provider with ample experience treating patients with DOR. This study helped to understand how young women with DOR perceive their mental health and identified a significant need for advancing towards more holistic infertility healthcare that encompasses both physical and mental health.
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Affiliation(s)
- Brittany M Woods
- Department of Family, Community and Health Systems, University of Alabama at Birmingham School of Nursing, Birmingham, Alabama, USA
| | - Leigh Ann Bray
- Capstone College of Nursing, University of Alabama, Tuscaloosa, Alabama, USA
| | - Sukhkamal B Campbell
- Division of Reproductive Endocrinology & Infertility, University of Alabama at Birmingham Medicine, Birmingham, Alabama, USA
| | - Aimee Holland
- Department of Family, Community and Health Systems, University of Alabama at Birmingham School of Nursing, Birmingham, Alabama, USA
| | - Sylvie Mrug
- Department of Psychology, University of Alabama at Birmingham College of Arts and Sciences, Birmingham, Alabama, USA
| | - Sigrid Ladores
- Department of Family, Community and Health Systems, University of Alabama at Birmingham School of Nursing, Birmingham, Alabama, USA
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Tang N, Pei M, Xie L, Liang X, Hu J, Gao Y. Relationship Between Dyadic Coping with Anxiety and Depression in Infertile Couples: Gender Differences and Dyadic Interaction. Psychol Res Behav Manag 2023; 16:4909-4919. [PMID: 38089528 PMCID: PMC10710950 DOI: 10.2147/prbm.s437808] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 10/24/2023] [Indexed: 09/08/2024] Open
Abstract
BACKGROUND This study aims to examine the relationship between anxiety and depression and dyadic coping in infertile couples, exploring gender differences and dyadic interactions in these associations. METHODS A cross-sectional study was conducted involving 288 couples recruited from the First Affiliated Hospital of Lanzhou University between November 2021 and November 2022. The Dyadic Coping Scale, Anxiety Scale, and Depression Scale were utilized to measure dyadic coping, anxiety, and depression, respectively. The Actor-Partner Interdependence Model was used to analyze the actor effect and partner effect. RESULTS Wives exhibited significantly higher anxiety and depression scores compared to husbands (p<0.001). No statistically significant difference was found in dyadic coping between wives and husbands. Positive dyadic coping in infertile couples had significant actor effects on anxiety and depression (p<0.05) and partner effects (p<0.05). Positive dyadic coping negatively predicted anxiety and depression of oneself and one's partner. Negative dyadic coping in infertile couples also had significant actor effects on anxiety and depression (p<0.05) and partner effects (p<0.05). Negative dyadic coping positively predicted anxiety and depression of oneself and one's partner. CONCLUSION The dyadic coping style of infertile couples has both actor and partner effects on their own and their partner's anxiety and depression. Anxiety and depression in infertile couples are influenced by their own and their partner's dyadic coping style, respectively. Therefore, dyadic coping serves as an important indicator for predicting psychological outcomes in these couples.
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Affiliation(s)
- Nan Tang
- Department of Nursing, 1th Medical Centre of PLA General Hospital, Beijing, People’s Republic of China
- School of Nursing, Lanzhou University, Lanzhou, Gansu, People’s Republic of China
| | - Mengyue Pei
- School of Nursing, Lanzhou University, Lanzhou, Gansu, People’s Republic of China
- Henan Kaifeng College of Science Technology and Communication, Kaifei, Henan, People’s Republic of China
| | - Lei Xie
- School of Nursing, Lanzhou University, Lanzhou, Gansu, People’s Republic of China
- Renji Hospital, Shanghai Jiaotong University, Shanghai, People’s Republic of China
| | - Xueping Liang
- School of Nursing, Lanzhou University, Lanzhou, Gansu, People’s Republic of China
| | - Junping Hu
- School of Nursing, Lanzhou University, Lanzhou, Gansu, People’s Republic of China
- The First hospital of Lanzhou University, Lanzhou, Gansu, People’s Republic of China
| | - Yuan Gao
- Department of Nursing, 1th Medical Centre of PLA General Hospital, Beijing, People’s Republic of China
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Chai Y, Li Q, Wang Y, Niu B, Chen H, Fan T, Ke X, Zou H. Cortisol dysregulation in anxiety infertile women and the influence on IVF treatment outcome. Front Endocrinol (Lausanne) 2023; 14:1107765. [PMID: 37383394 PMCID: PMC10299854 DOI: 10.3389/fendo.2023.1107765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 05/23/2023] [Indexed: 06/30/2023] Open
Abstract
Introduction Dysregulation of the stress-regulatory hormone cortisol is associated with anxiety, but its potential impact on infertile women and in vitro fertilization (IVF) treatment remains unclear. This prospective cross-sectional study aimed at evaluating the dysregulation of cortisol and its correlation to anxiety in infertile women. The influence of stress on IVF outcomes was also investigated. Methods A point-of-care test was used for the measurement of morning serum cortisol in 110 infertile women and 112 age-matching healthy individuals. A Self-Rating Anxiety Scale (SAS) was used for the anxiety assessment of infertile women, and 109 of them underwent IVF treatment starting with the GnRH-antagonist protocol. If clinical pregnancy was not achieved, more IVF cycles were conducted with adjusted protocols until the patients got pregnant or gave up. Results Higher morning serum cortisol level was identified for infertile patients, especially for the elder. Women with no anxiety showed significant differences in cortisol levels, monthly income, and BMI compared with those with severe anxiety. A strong correlation was found between the morning cortisol level and the SAS score. When the cutoff value is 22.25 μg/dL, cortisol concentration could predict the onset of anxiety with high accuracy (95.45%) among infertile women. After IVF treatments, women with high SAS scores (>50) or cortisol levels (>22.25 μg/dL) demonstrated a lower rate of pregnancy (8.0%-10.3%) and more IVF cycles, although the impact of anxiety was not affirmative. Conclusion Hypersecretion of cortisol related to anxiety was prevalent among infertile women, but the influence of anxiety on multi-cycle IVF treatment was not affirmative due to the complicated treatment procedures. This study suggested that the assessment of psychological disorders and stress hormone dysregulation should not be overlooked. An anxiety questionnaire and rapid cortisol test might be included in the treatment protocol to provide better medical care.
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Affiliation(s)
- Yujuan Chai
- Department of Biomedical Engineering, School of Medicine, Shenzhen University, Shenzhen, Guangdong, China
| | - Qihang Li
- Department of Biomedical Engineering, School of Medicine, Shenzhen University, Shenzhen, Guangdong, China
| | - Yang Wang
- Department of Management, Shenzhen University, Shenzhen, Guangdong, China
| | - Ben Niu
- Department of Management, Shenzhen University, Shenzhen, Guangdong, China
| | - Huijia Chen
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Tingxuan Fan
- Greater Bay Area International Institute for Innovation, Shenzhen University, Shenzhen, Guangdong, China
| | - Xiatong Ke
- Research Department III, Shenzhen Health Development Research and Data Management Center, Shenzhen, Guangdong, China
| | - Heng Zou
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Ni Y, Shen H, Yao H, Zhang E, Tong C, Qian W, Huang L, Wu X, Feng Q. Differences in Fertility-Related Quality of Life and Emotional Status Among Women Undergoing Different IVF Treatment Cycles. Psychol Res Behav Manag 2023; 16:1873-1882. [PMID: 37250753 PMCID: PMC10216870 DOI: 10.2147/prbm.s411740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 05/18/2023] [Indexed: 05/31/2023] Open
Abstract
Objective The present study aimed to provide more insight into the possible differences in the fertility-related quality of life (FertiQoL) and emotional status of women undergoing different cycles of in vitro fertilization (IVF) treatments. Methods A prospective cohort study was performed, and a total of 432 women undergoing IVF treatment were recruited. FertiQoL scale, self-rating anxiety scale (SAS), self-rating depression scale (SDS), and perceived social support scale (PSSS) were used to analyze fertility-related QoL and emotional status. Data were analyzed comparing women undergoing different cycles of IVF treatments. Results A significant decrease in FertiQoL scores occurred in women with increased cycles of IVF treatment. Both anxiety and depression scores significantly increased with increased cycles of attempting IVF treatment. There was no significant difference detected in perceived social support among groups. Conclusion With the increase in the number of IVF treatment cycles, women's FertiQoL gradually decreased, while the risk of anxiety and depression gradually increased.
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Affiliation(s)
- Ying Ni
- Department of Gynecology and Obstetrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Hao Shen
- Department of Gynecology and Obstetrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Haihui Yao
- Xianda College of Economics and Humanities, Shanghai International Studies University, Shanghai, People’s Republic of China
| | - Enming Zhang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
| | - Chenye Tong
- Department of Gynecology and Obstetrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Wen Qian
- Department of Gynecology and Obstetrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Limin Huang
- Department of Gynecology and Obstetrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Xian Wu
- Department of Gynecology and Obstetrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Qing Feng
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
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Evaluating health-related quality of life and subjective wellbeing among infertility patients: a cross-sectional study in mainland China. Qual Life Res 2023; 32:1469-1480. [PMID: 36617607 DOI: 10.1007/s11136-022-03330-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2022] [Indexed: 01/10/2023]
Abstract
PURPOSE This study aimed to explore the health-related quality of life (HRQoL) and subjective wellbeing (SWB) of infertility patients in mainland China and to investigate the relationships between HRQoL and SWB instruments in infertility patients. METHODS We conducted this cross-sectional study in the Hospital for Reproductive Medicine Affiliated of Shandong University between April 2019 and November 2019. Participants self-completed the five-level EQ-5D (EQ-5D-5L) questionnaire, the Assessment of Quality of Life (AQoL)-8D, and the WHO-5 wellbeing index (WHO-5). The agreements between EQ-5D-5L and AQoL-8D were assessed employing intraclass correlation coefficient (ICC) and Bland-Altman plots. Exploratory factor analysis (EFA) was conducted to examine the difference in descriptive systems among the three instruments. RESULTS We analyzed a valid sample of 618 infertility patients (84.4%). The mean scores of the total EQ-5D-5L, AQoL-8D, and WHO-5 were 0.96 (95%CI 0.96, 0.96), 0.80 (95%CI 0.79, 0.81), and 16.92 (95%CI 16.52, 17.31), respectively. Patients diagnosed with primary infertility had significantly lower HRQoL and SWB than those with secondary infertility. The ICC of EQ-5D-5L and AQoL-8D was 0.14. The AQoL-8D (r = 0.625) was more strongly correlated with WHO-5 than with the EQ-5D-5L (r = 0.262). The EFA results indicated that HRQoL instruments and the WHO-5 instruments were complementary rather than substitutable. CONCLUSIONS Poorer HRQoL and SWB were found that primary than secondary infertility patients. There exists a poor agreement between EQ-5D-5L and AQoL-8D and the difference in the psychosocial components may explain the difference. Measuring both HRQoL and SWB could provide complementary information for infertility patients.
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Calvo V, Fusco C, Pellicelli C, Masaro C. Romantic attachment, infertility-related stress, and positive body image of women dealing with infertility. Front Psychol 2023; 13:1067970. [PMID: 36687918 PMCID: PMC9852893 DOI: 10.3389/fpsyg.2022.1067970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 12/12/2022] [Indexed: 01/07/2023] Open
Abstract
Introduction Infertility is a condition that can affect the physical, emotional, social, and relational well-being of women. Women's bodies seem to assume a crucial relevance as part of the experience of infertility and its treatments. An extended body of literature supports the role of romantic attachment orientations in facing infertility-related stress. However, the association between romantic attachment orientations, infertility-related stress, and women's body image has not been explored. Methods This cross-sectional study aimed to investigate the role of romantic attachment and infertility-related stress concerning positive body image in 113 women dealing with infertility. Data were analyzed with correlation and mediation path analyses. Results Results showed that high levels of attachment anxiety, attachment avoidance, and infertility-related stress were negatively associated with positive body image. Path analyses indicated that positive body image may be directly associated with romantic attachment anxiety. The negative association of attachment avoidance with body image appeared to be mediated by infertility-related stress. Discussion Findings suggest that romantic attachment insecurities and infertility-related stress are significantly associated with a worsened body image in infertile women. Implications for future research are discussed.
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Affiliation(s)
- Vincenzo Calvo
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padua, Padua, Italy,*Correspondence: Vincenzo Calvo,
| | - Chiara Fusco
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Camilla Pellicelli
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padua, Padua, Italy
| | - Chiara Masaro
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padua, Padua, Italy
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Liu X, Ding J, Li Y, Hua K, Zhang X. An Investigation of Depressive Symptoms in Patients with Congenital Cervical and Vaginal Aplasia: A Cross-Sectional Study. Int J Womens Health 2022; 14:1621-1627. [DOI: 10.2147/ijwh.s384339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 11/04/2022] [Indexed: 11/18/2022] Open
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Zhang L, Shao H, Huo M, Chen J, Tao M, Liu Z. Prevalence and associated risk factors for anxiety and depression in infertile couples of ART treatment: a cross-sectional study. BMC Psychiatry 2022; 22:616. [PMID: 36123644 PMCID: PMC9483863 DOI: 10.1186/s12888-022-04256-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 09/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Infertility now is a public health concern and is associated with increased psychological distress. METHODS We enrolled 1247 infertile couples and assessed their anxiety and depression status before and during assisted reproductive technology (ART) treatment using the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS). The Chi-square or fisher's exact test was used to analyze the prevalence of anxiety and depression in infertile couples. Multivariate logistical regression was performed to analyze the risk factors for anxiety and depression. RESULTS The prevalence of anxiety was 13.5% and 8.7% (p < 0.05), and that of depression was 9.4% and 7.9% (p = 0.2) in female and male partners, respectively. Female SAS and SDS scores were positively associated with male SAS and SDS scores, respectively (r = 0.52 and r = 0.50, respectively, both p < 0.0001), and were positively associated with their own SDS and SAS scores, respectively (r = 0.63 and r = 0.62, respectively, both p < 0.0001). Their own depression or partners' anxiety was associated with the anxiety, and their own anxiety or partners' depression was associated with the depression in infertile couples. No children, unemployment, and low education level were also associated with female anxiety. SAS and SDS scores were significantly decreased during ART treatment. CONCLUSIONS Females were more vulnerable to having anxiety than males in infertile couples. Anxiety and depression in infertile couples could interact, therefore, anxiety and depression would be simultaneously counseled, and their partners also should be given supportive psychotherapy. TRIAL REGISTRATION It was an observational study and had no health care interventions on participants. So it was not registrated.
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Affiliation(s)
- Li Zhang
- grid.412528.80000 0004 1798 5117Department of Reproductive Medicine Center, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, 200233 People’s Republic of China
| | - Hongfang Shao
- grid.412528.80000 0004 1798 5117Department of Reproductive Medicine Center, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, 200233 People’s Republic of China
| | - Mian Huo
- grid.412528.80000 0004 1798 5117Department of Reproductive Medicine Center, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, 200233 People’s Republic of China
| | - Jie Chen
- grid.412528.80000 0004 1798 5117Department of Reproductive Medicine Center, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, 200233 People’s Republic of China
| | - Minfang Tao
- grid.412528.80000 0004 1798 5117Department of Reproductive Medicine Center, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, 200233 People’s Republic of China
| | - Zhangshun Liu
- Department of Reproductive Medicine Center, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, People's Republic of China.
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Yang T, Wongpakaran N, Wongpakaran T, Saeng-Anan U, Singhapreecha C, Jenraumjit R, Peisah C. Factors Associated with Anxiety and Depression in Infertile Couples—Study Protocol. Healthcare (Basel) 2022; 10:healthcare10071352. [PMID: 35885878 PMCID: PMC9321015 DOI: 10.3390/healthcare10071352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/14/2022] [Accepted: 07/19/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Infertility refers to the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse. Infertility is an important medical and social problem that causes individual distress, family conflict and emotional impact experienced by about 15% of couples worldwide. Anxiety and depression are the main psychological problems associated with infertility with many potential contributing factors which are yet to be fully elucidated. This study aims to investigate factors related to anxiety and depression among infertile couples. (2) Methods/Design: This study will employ an analytical cross-sectional survey. Sociodemographic information will be collected. Validated tools will be used to assess anxiety and depression (Outcome Inventory-21(OI-21), marital satisfaction (ENRICH Marital Satisfaction Scale, sufficiency economy (Sufficiency Economy Scale (SES) and personality traits (Zuckerman-Kuhlman-Aluja Personality Questionnaire (ZKA-PQ). The Actor-Partner Interdependence Model estimated by multilevel modeling will be used for dyadic analysis. (3) Discussion: This study will provide evidence about factors associated with anxiety and depression in infertile couples. Outcomes will raise awareness about mental health problems among infertile couples and guide future research for interventions.
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Affiliation(s)
- Tong Yang
- Master of Science (Mental Health), Graduate School, Chiang Mai University, Chiang Mai 50200, Thailand; (T.Y.); (T.W.); (C.S.); (R.J.); (C.P.)
| | - Nahathai Wongpakaran
- Master of Science (Mental Health), Graduate School, Chiang Mai University, Chiang Mai 50200, Thailand; (T.Y.); (T.W.); (C.S.); (R.J.); (C.P.)
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Correspondence: ; Tel.: +66-(53)-935422 (ext. 320); Fax: +66-(53)-935426
| | - Tinakon Wongpakaran
- Master of Science (Mental Health), Graduate School, Chiang Mai University, Chiang Mai 50200, Thailand; (T.Y.); (T.W.); (C.S.); (R.J.); (C.P.)
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Ubol Saeng-Anan
- Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand;
| | - Charuk Singhapreecha
- Master of Science (Mental Health), Graduate School, Chiang Mai University, Chiang Mai 50200, Thailand; (T.Y.); (T.W.); (C.S.); (R.J.); (C.P.)
- Faculty of Economics, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Rewadee Jenraumjit
- Master of Science (Mental Health), Graduate School, Chiang Mai University, Chiang Mai 50200, Thailand; (T.Y.); (T.W.); (C.S.); (R.J.); (C.P.)
- Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Carmelle Peisah
- Master of Science (Mental Health), Graduate School, Chiang Mai University, Chiang Mai 50200, Thailand; (T.Y.); (T.W.); (C.S.); (R.J.); (C.P.)
- Discipline of Psychiatry and Mental Health, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
- Specialty of Psychiatry, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
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Cao D, Bai C, Zhang G. Psychological Distress Among Infertility Patients: A Network Analysis. Front Psychol 2022; 13:906226. [PMID: 35837642 PMCID: PMC9274242 DOI: 10.3389/fpsyg.2022.906226] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundPsychological distress is common among infertility patients. Total scale scores are often used to represent the severity of anxiety, depression, or stress, which ignores important differences between specific symptoms, and relationships between symptoms. This study aimed to identify patterns of psychological distress experienced by infertility patients and to identify the most central symptoms of anxiety, depression, and stress.MethodFrom June to September 2016, 740 infertility patients were included in this cross-sectional study. Infertility patients were asked to complete the Generalized Anxiety Disorder-7, Patients Health Questionnaire-9 (PHQ-9), and Fertility Problem Inventory. Network analysis was used to examine the patterns of psychological distress in infertility patients and to test the most central symptoms of anxiety, depression, and stress.ResultsRestlessness was the most central symptom in infertility patients. “Feelings of guilt” had the highest strength among PHQ-9 symptoms. “Relationship concern stress” and “sexual concern stress” had the strongest connections in the network. Stability estimation indicated that the order of node strength centrality was more stable than the order of closeness and betweenness (the CS-coefficients were 0.75, 0.13, and 0.67, respectively). In addition, network structure and global strength were invariant across gender.LimitationsThe cross-sectional design did not permit identification of causal relationships. Patients in this study were recruited from one reproductive hospital; especially, most patients had low socioeconomic status, which limits generalizability of the findings.ConclusionThis study reinforces the need to better understand the underlying causes of psychological distress in infertile patients. A more detailed investigation of the relationship between these symptoms could provide information for psychosocial interventions aimed beyond “alleviating psychological distress.” We should consider the individual psychological symptom pattern and its potential causes in infertility patients instead of assuming a consistent psychological distress structure.
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Affiliation(s)
- Danfeng Cao
- Department of Obstetrics, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Jinan, China
| | - Caifeng Bai
- School of Nursing, Ningxia Medical University, Yinchuan, China
| | - Guoxiang Zhang
- Department of Obstetrics, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Jinan, China
- *Correspondence: Guoxiang Zhang,
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Ni Y, Huang L, Zhang E, Xu L, Tong C, Qian W, Zhang A, Fang Q. Psychosocial correlates of fertility-related quality of life among infertile women with repeated implantation failure: The mediating role of resilience. Front Psychiatry 2022; 13:1019922. [PMID: 36440419 PMCID: PMC9691643 DOI: 10.3389/fpsyt.2022.1019922] [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: 08/15/2022] [Accepted: 10/31/2022] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE This study aimed to examine associations between psychosocial factors and fertility-related quality of life (FertiQoL) among infertile women with repeated implantation failure (RIF), and to identify the possible role of resilience in mediating the effect of social support on FertiQoL. MATERIALS AND METHODS A cross-sectional study was conducted with 234 infertile women with RIF in total. Fertility quality of life scale (FertiQoL), perceived social support scale (PSSS), and Connor-Davidson Resilience Scale (CD-RISC) were used to evaluate the patients. Data were described by univariate and multivariate analyses. Stepwise regression method was performed to analyse the mediating effect of resilience. RESULTS Social support had a positive predictive effect on FertiQoL (β = 0.757, P < 0.001), also positive on resilience (β = 0.847, P < 0.001). After both variables were added to the regression equation, resilience was found to have a significant positive predictive effect on FertiQoL (β = 0.798, P < 0.001), while the predictive effect of social support on FertiQoL was no longer significant (β = 0.081, P > 0.05). The results indicated that resilience played a complete mediating role between social support and FertiQoL. CONCLUSION This study preliminarily verified the mediating role of resilience between social support and FertiQoL among infertile women with RIF. Interventions that consider enhancing resilience and building social support will likely improve their FertiQoL.
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Affiliation(s)
- Ying Ni
- Department of Gynecology and Obstetrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Reproductive Medical Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Limin Huang
- Department of Gynecology and Obstetrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Reproductive Medical Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Enming Zhang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Lianying Xu
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chenye Tong
- Reproductive Medical Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wen Qian
- Reproductive Medical Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Aijun Zhang
- Department of Gynecology and Obstetrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Reproductive Medical Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiong Fang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
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Aljurbua FI, Selaihem A, Alomari NA, Alrashoud AM. A cross-sectional study on generalized anxiety disorder and its socio-demographic correlates among the general population in Saudi Arabia. J Family Med Prim Care 2021; 10:3644-3649. [PMID: 34934660 PMCID: PMC8653481 DOI: 10.4103/jfmpc.jfmpc_847_21] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 06/20/2021] [Accepted: 07/04/2021] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Generalized anxiety disorder (GAD) is often described than define as a psychological illness that is characterized by excessive worry. Little attention has been given to anxiety disorders by the medical community in Saudi Arabia. This study was carried out to screen for GAD among adults and determine the correlation of anxiety disorder with other comorbidities. METHODOLOGY This study was a cross-sectional observational study carried out among adults aged 18 years and above in the general population in Saudi Arabia. The people were screened by using an Arabic validated version of General Anxiety Disorder-7 (GAD-7) questionnaire that was sent as a Google link via emails or different social media (Twitter, Facebook, WhatsApp, and Telegram groups) of the general population. The study was approved by the hospital research committee and the Institutional Review Board (HlRI-05-Apr21-01). RESULTS We collected 338 participants in response to our questionnaire where 60.7% of them were females and 54.5% were aged between 25 and 34 years old. hypersensitivity, rheumatoid arthritis (RA), hypertension and diabetes mellitus (DM) were the main medical conditions represented by 7.6%, 4.8%, 3.7%, and 3.4%. According to GAD-7 questionnaire, prevalence of any degree of anxiety was 62.1% where 33.1% of the total sample had mild anxiety, 15.7% had a moderate degree of anxiety and 13.3% had severe anxiety. Anxiety was related to age, residency, occupation, and some medical conditions. CONCLUSION We found high prevalence of anxiety among our population which was the highest among younger participants, and students. Moreover, we found that prevalence and severity of anxiety were higher in patients with chronic conditions and depressed patients.
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Affiliation(s)
- Faisal I. Aljurbua
- Family Medicine Resident, Family Medicine Academy, King Saud Medical City, Riyadh, Saudi Arabia
| | - Ahmed Selaihem
- Family Medicine Resident, Family Medicine Academy, King Saud Medical City, Riyadh, Saudi Arabia
| | - Naif A. Alomari
- Family Medicine Resident, Family Medicine Academy, King Saud Medical City, Riyadh, Saudi Arabia
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Gui W, Yang X, Jiang H, Wu H, Zeng M, Wen Y, Qiu T, Zhang Y, Ma Z, Tong C, Luo L, Zhao Y, Wang L. Prevalence of anxiety and its associated factors among infertile patients after 'two-child' policy in Chongqing, China: a cross-sectional study. Reprod Health 2021; 18:193. [PMID: 34593017 PMCID: PMC8482576 DOI: 10.1186/s12978-021-01140-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 04/14/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND With the prevalence of infertility increasing every year around the world, it has seriously impacted the individual quality of family and social life. Anxiety is one of the most prevalent anxiety disorders among infertile patients. After the two-child policy, whether it affected the prevalence of anxiety is controversial. This study aimed to determine the prevalence of anxiety and its potential risk factors among Chinese infertile women after the enforcement of 'two-child policy'. METHODS This cross-sectional study included 693 infertile patients in a reproductive medical center in Chongqing, China, between February 2016 and December 2018. Data was collected by Self-filling questionnaires including basic demographic information and the Generalized Anxiety Disorder-7 (GAD-7). SPSS statistical software (IBM SPSS version 25) was used to analyse the obtained data. Descriptive analysis was used to describe basic information and anxiety scores, the chi-square test and binary logistic regression were used to analyse the relationship between anxiety and other variables. RESULTS The prevalence of anxiety among total infertile patients was 21.8%, and its 23.5% among first-child infertile patients (FI), and 18.4% among second-child infertile patients (SI) respectively (P > 0.05). Binary logistic regression showed that patients with lower education levels were more likely to have anxiety (P < 0.01). Patients with middle salary incomes were more likely to have anxiety (OR = 1.860, 95% CI: 1.068-3.238). Oral contraception taking history (OR = 1.778, 95% CI: 1.186-2.667), and history of allergy (OR = 2.098, 95% CI: 1.219-3.612) were associated with anxiety. CONCLUSIONS Under the full liberalization of the "two-child policy", the total prevalence of anxiety among Chinese infertile female is comparatively high. Low education levels, middle incomes, oral contraception taking and allergy history can be the related risk factors of anxiety. We promote that all infertile patients should be evaluated for the prevalence of anxiety, especially those with potential risks, and receive consultant or targeted treatment when needed.
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Affiliation(s)
- Wenwu Gui
- Department of Reproductive Center, The First Affiliated Hospital of Chongqing Medical University, Youyi Road, Yuzhong, Chongqing, China
| | - Xi Yang
- Department of Reproductive Center, The First Affiliated Hospital of Chongqing Medical University, Youyi Road, Yuzhong, Chongqing, China
| | - Huimin Jiang
- Department of Reproductive Center, The First Affiliated Hospital of Chongqing Medical University, Youyi Road, Yuzhong, Chongqing, China
| | - Hongwen Wu
- Department of Reproductive Center, The First Affiliated Hospital of Chongqing Medical University, Youyi Road, Yuzhong, Chongqing, China
| | - Mao Zeng
- School of Public Health and Management, Chongqing Medical University, Yixueyuan Road, Yuzhong, Chongqing, 400016, China.,Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, 400016, China.,The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, 400016, China
| | - Yidi Wen
- Department of Reproductive Center, The First Affiliated Hospital of Chongqing Medical University, Youyi Road, Yuzhong, Chongqing, China
| | - Tian Qiu
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Yong Zhang
- School of Public Health and Management, Chongqing Medical University, Yixueyuan Road, Yuzhong, Chongqing, 400016, China.,Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, 400016, China.,The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, 400016, China
| | - Zhi Ma
- Department of Reproductive Center, The First Affiliated Hospital of Chongqing Medical University, Youyi Road, Yuzhong, Chongqing, China
| | - Chao Tong
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.,Canada-China-New Zealand Joint Laboratory of Maternal and Fetal Medicine, Chongqing Medical University, Chongqing, 400016, China
| | - Li Luo
- School of Public Health and Management, Chongqing Medical University, Yixueyuan Road, Yuzhong, Chongqing, 400016, China.,Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, 400016, China.,The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, 400016, China
| | - Yong Zhao
- School of Public Health and Management, Chongqing Medical University, Yixueyuan Road, Yuzhong, Chongqing, 400016, China. .,Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, 400016, China. .,The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, 400016, China.
| | - Lianlian Wang
- Department of Reproductive Center, The First Affiliated Hospital of Chongqing Medical University, Youyi Road, Yuzhong, Chongqing, China. .,Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
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Hosseini M, Sepidarkish M, Omani-Samani R, Maroufizadeh S. Gender Differences in Self-Efficacy, Resilience, and Social Support among Infertile Iranian Couples: A Dyadic Approach. IRANIAN JOURNAL OF PUBLIC HEALTH 2021; 50:1295-1297. [PMID: 34540756 PMCID: PMC8410963 DOI: 10.18502/ijph.v50i6.6436] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 10/15/2019] [Indexed: 11/24/2022]
Abstract
The article's abstract is not available.
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Affiliation(s)
- Mostafa Hosseini
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdi Sepidarkish
- Department of Biostatistics and Epidemiology, School of Public Health, Babol University of Medical Sciences, Babol, Iran
| | - Reza Omani-Samani
- Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, The Academic Center for Education, Culture, and Research, Tehran, Iran
| | - Saman Maroufizadeh
- Department of Biostatistics, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
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16
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Ni Y, Tong C, Huang L, Zhou W, Zhang A. The analysis of fertility quality of life and the influencing factors of patients with repeated implantation failure. Health Qual Life Outcomes 2021; 19:32. [PMID: 33494768 PMCID: PMC7831164 DOI: 10.1186/s12955-021-01666-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 01/01/2021] [Indexed: 01/29/2023] Open
Abstract
Background The objective of this study was to investigate the current status of fertility quality of life (QoL) and explore the influencing factors for infertile women with repeated implantation failure (RIF). Methods The sample consisted of 137 infertile women with RIF who were under treatment from January 2019 to December 2019 in the Reproductive Medical Center of Ruijin Hospital, affiliated with Shanghai Jiaotong University School of Medicine in China. A general information questionnaire, FertiQoL scale, perceived social support scale (PSSS), self-rating anxiety scale (SAS), and self-rating depression scale (SDS) were used to analyse the fertility QoL and related factors of RIF patients.
Results The total fertility QoL score of RIF patients was 60.44 ± 11.60. The results of multivariate regression analysis showed that residence, financial difficulties, male infertility, BMI index, depression, and family social support were the main factors that influenced the fertility QoL of RIF patients (adjusted R2 = 0.762). Conclusion Based on the results of this study, RIF patients’ psychological status must be addressed. Corresponding interventions such as building a sound family and social support system, creating a good medical environment and offering diverse health education should be provided to improve the fertility QoL of RIF patients.
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Affiliation(s)
- Ying Ni
- Nursing Department of Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China
| | - Chenye Tong
- Nursing Department of Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China
| | - Limin Huang
- Nursing Department of Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China
| | - Wenjie Zhou
- Reproductive Medical Center of Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China
| | - Aijun Zhang
- Reproductive Medical Center of Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, China.
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Lawson AK, McQueen DB, Swanson AC, Confino R, Feinberg EC, Pavone ME. Psychological distress and postponed fertility care during the COVID-19 pandemic. J Assist Reprod Genet 2021; 38:333-341. [PMID: 33400078 PMCID: PMC7783482 DOI: 10.1007/s10815-020-02023-x] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 11/24/2020] [Indexed: 02/02/2023] Open
Abstract
Purpose To evaluate perceptions of delayed fertility care secondary to the COVID-19 pandemic. Methods This was a cross-sectional anonymous survey of N = 787/2,287 patients (response rate = 42.6%) from a single academic fertility center. Participants were randomized 1:1 to receive supplemental educational explaining the rationale behind recommendations to delay fertility treatments due to the COVID-19 pandemic. Assessment of well-being was conducted via the Personal Health Questionnaire Depression Scale, the Generalized Anxiety Disorder-7, the Ways of Coping-Revised, the Appraisal of Life Events Scale, and influence of supplemental education on agreement with ASRM COVID-19 Taskforce recommendations and associated distress. Results Participants in the education v. no education groups were 35.51 (SD = 4.06) and 37.24 (SD = 5.34) years old, married (90.8% v. 89.8%), had a graduate degree (53.9% v. 55.4%), > 1 year of infertility (73.4% v. 74.4%), and were nulliparous (69.0% v. 72.6%), with moderate to high distress (64.9% v. 64.2%) (ns). Distress was related to age, duration of infertility, and engagement in social support seeking and avoidant coping strategies (P < 0.001). Agreement with recommendations was related to receipt of supplemental education, history of pregnancy loss, and use of cognitive coping (P = 0.001). Conclusion Most participants were distressed by the delay of treatments. Supplemental education increased acceptance of recommendations but did not decrease distress. Future treatment delays should include education related to and assessment of understanding of recommendations, and inclusion of mental health professionals in patient care. Supplementary Information The online version contains supplementary material available at 10.1007/s10815-020-02023-x.
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Affiliation(s)
- Angela K Lawson
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Dana B McQueen
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Amelia C Swanson
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Rafael Confino
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Eve C Feinberg
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Mary Ellen Pavone
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA.
- , Chicago, USA.
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Liu YF, Fu Z, Chen SW, He XP, Fan LY. The Analysis of Anxiety and Depression in Different Stages of in vitro Fertilization-Embryo Transfer in Couples in China. Neuropsychiatr Dis Treat 2021; 17:649-657. [PMID: 33658786 PMCID: PMC7920591 DOI: 10.2147/ndt.s287198] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 01/05/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND This study aimed to examine the differences in anxiety and depression between infertile Chinese couples in diverse stages of in vitro fertilization-embryo transfer (IVF-ET) and their relationship with the IVF-ET outcomes. METHODS From February 2016 to December 2018, a total of 247 couples that were undergoing IVF-ET were randomly selected for this study. On the day they started their treatment (T1), the day human chorionic gonadotropin was administered (T2), and 4 days after the embryo transfer (T3), self-designed questionnaires, the Self-Rating Anxiety Scale, and the Self-Rating Depression Scale were completed to investigate anxiety and depression in different stages. RESULTS Age had an effect on the anxiety and depression in women. Male infertility type and the cause of infertility had an effect on the anxiety and depression in men. The incidence of anxiety in women in the T1, T2, and T3 stages was 29.96%, 44.94%, and 17.81%, respectively. The anxiety scores of women were 46.14 ± 8.37, 50.83 ± 8.50, and 44.09 ± 8.17, respectively, which were significantly higher than those of men (p < 0.05). The anxiety score in stage T2 was the highest in women, and the depression score of women in stage T1 was the highest. The incidence of anxiety in men in the T1, T2, and T3 stages was 20.65%, 8.50%, and 6.07%, respectively. The incidence of anxiety was not significantly different in diverse stages (p > 0.05), and the same result was obtained for the incidence of depression. The anxiety and depression scores of the infertile couples in different stages were not related to the outcome of IVF-ET. CONCLUSION The incidence of anxiety and depression in infertile couples in diverse stages of IVF-ET is different, especially in women, and the anxiety and depression of infertile couples in the process of IVF-ET may not be related to the outcome of assisted pregnancy.
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Affiliation(s)
- Yao-Fang Liu
- Department of Reproductive Technology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, People's Republic of China
| | - Zheng Fu
- Department of Reproductive Technology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, People's Republic of China
| | - Shao-Wei Chen
- Department of Reproductive Technology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, People's Republic of China
| | - Xiao-Ping He
- Department of Prosthodontics, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou, 646000, People's Republic of China
| | - Ling-Ye Fan
- Department of Reproductive Technology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, People's Republic of China
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Anxiety symptoms in patients with Mayer-Rokitansky-Küster-Hauser syndrome: a cross-sectional study. Chin Med J (Engl) 2020; 133:388-394. [PMID: 31977552 PMCID: PMC7046242 DOI: 10.1097/cm9.0000000000000648] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background: As a congenital malformation that results in infertility and an inability to have vaginal intercourse, Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome places a considerable psychological burden on patients, which results in anxiety symptoms. However, only single case studies or a few small to medium-sized cross-sectional studies were identified to focus on anxiety symptoms in MRKH patients. Thus, the aim of this study was to explore the status of anxiety symptoms and the related factors in patients with MRKH syndrome. Methods: This cross-sectional study involving 141 patients with MRKH syndrome and 178 healthy women was conducted from January 2018 to December 2018. All participants were required to complete a demographic questionnaire and the Generalized Anxiety Disorder 7-item scale (GAD-7), Patient Health Questionnaire-9, Eysenck Personality Questionnaire-Revised, Short Scale for Chinese, and Chinese Version of the Female Sexual Function Index. The main outcome was the anxiety symptoms measured by the GAD-7. Main outcome was compared between the MRKH syndrome group and the healthy control group. Then, we explored the related factors by comparing patients with and without anxiety symptoms. Results: Of the respondents, 24.1% experienced moderate to severe anxiety symptoms. Patients with MRKH syndrome manifested more severe anxiety symptoms than healthy women. Negative self-evaluation of femininity (odds ratio [OR] 2.706, 95% confidence interval [CI] 1.010–7.247), neurotic personality traits (OR 1.100, 95% CI 1.029–1.175), and coexisting depressive symptoms (OR 4.422, 95% CI 1.498–13.049) were more prevalent in anxious patients. Conclusion: The findings stress the importance of anxiety symptom screening in MRKH patients and identify patients at risk of anxiety symptoms, providing a possible basis for future intervention.
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Ghaheri A, Omani-Samani R, Sepidarkish M, Hosseini M, Maroufizadeh S. The Four-item Patient Health Questionnaire for Anxiety and Depression: A Validation Study in Infertile Patients. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2020; 14:234-239. [PMID: 33098392 PMCID: PMC7604697 DOI: 10.22074/ijfs.2020.44412] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 05/20/2020] [Indexed: 12/02/2022]
Abstract
Background The most common mental disorders in infertile patients are depression and anxiety. The four-item
Patient Health Questionnaire-4 (PHQ-4) is a widely used tool that consists of the PHQ-2 depression and Generalized
Anxiety Disorder-2 (GAD-2) scales. Given that PHQ-4 has not been validated in infertile patients, this study aimed to
examine its reliability and validity in this population. Materials and Methods Participants in this cross-sectional study consisted of 539 infertile patients from a referral
fertility centre in Tehran, Iran. The PHQ-4, Hospital Anxiety and Depression Scale (HADS), World Health Organi-
sation-Five Well-Being Index (WHO-5), Penn State Worry Questionnaire (PSWQ) and demographic/infertility ques-
tionnaires were administered to all participants. Factor structure and internal consistency of PHQ-4 were evaluated
via confirmatory factor analysis (CFA) and Cronbach’s alpha, respectively. The convergent validity of this scale was
examined by its relationship with HADS, WHO-5 and PSWQ. Results CFA results provided support for a two-factor model of PHQ-4. Internal consistency of the PHQ-4 and its subscales
both were elevated with Cronbach’s alpha coefficients of 0.767 (PHQ-4), 0.780 (PHQ-2) and 0.814 (GAD-2). Inter-item
correlations were between 0.386 and 0.639, and corrected item-total correlations were between 0.576 and 0.687. PHQ-4,
PHQ-2 and GAD-2 showed positive correlations with measures of HADS-anxiety, HADS-depression, and PSWQ and neg-
ative correlations with WHO-5, which confirmed convergent validity. Among demographic/fertility variables, we observed
that gender, infertility duration, and failure in previous treatment were correlated with PHQ-4 and its subscales scores. Conclusion The PHQ-4 is a reliable and valid ultra-brief screening instrument for measuring both anxiety and depres-
sive symptoms in infertile patients.
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Affiliation(s)
- Azadeh Ghaheri
- Department of Diabetes, Obesity and Metabolism, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Reza Omani-Samani
- Department of Medical Ethics and Law, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Mahdi Sepidarkish
- Department of Biostatistics and Epidemiology, School of Public Health, Babol University of Medical Sciences, Babol, Iran
| | - Mostafa Hosseini
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Saman Maroufizadeh
- Department of Biostatistics, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran. Electronic Address:
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Evaluation of the Psychological Status, Infertility-Associated Factors, and Erectile Function in Patients with Timely Ovulatory Intercourse Failure in China: Evidence from a Cross-Sectional Study. BIOMED RESEARCH INTERNATIONAL 2020; 2020:2850507. [PMID: 33015159 PMCID: PMC7525294 DOI: 10.1155/2020/2850507] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 08/26/2020] [Accepted: 09/03/2020] [Indexed: 01/11/2023]
Abstract
Results A total of 1128 patients were enrolled, and 264 of them (23.40%) suffered from TOIF. TOIF was positively associated with smoking, drinking, hypertension, diabetes, anxiety, unknown cause of infertility, lower semen concentration, lower frequency of intercourse, and decreased erectile function. The total IIEF-15 scores, erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction were significantly decreased in patients with TOIF. Conclusion TOIF is associated with lower semen concentration, anxiety, and other comorbidities such as hypertension and diabetes. Clinicians are required to focus on these associated factors in addition to improve the erectile function.
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Foroudifard F, Amini P, Navid B, Omani-Samani R, Sepidarkish M, Maroufizadeh S. Cognitive emotion regulation, anxiety, and depression in infertile women: a cross-sectional study. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2020. [DOI: 10.1186/s43043-020-00035-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Simionescu G, Ilie OD, Ciobica A, Doroftei B, Maftei R, Grab D, McKenna J, Dhunna N, Mavroudis I, Anton E. Mini-Review on the Possible Interconnections between the Gut-Brain Axis and the Infertility-Related Neuropsychiatric Comorbidities. Brain Sci 2020; 10:brainsci10060384. [PMID: 32560488 PMCID: PMC7349587 DOI: 10.3390/brainsci10060384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/09/2020] [Accepted: 06/15/2020] [Indexed: 12/26/2022] Open
Abstract
Both the gut-brain axis (GBA) and the hypothalamic–pituitary–adrenal (HPA) axis remain an intriguing yet obscure network with a strong influence over other systems of organs. Recent reports have sought to describe the multitude of harmful stressors that may impact the HPA axis along with the interconnections between these. This has improved our knowledge of how the underlying mechanisms working to establish homeostasis are affected. A disruption to the HPA axis can amplify the chances of gastrointestinal deficiencies, whilst also increasing the risk of a wide spectrum of neuropsychiatric disorders. Thus, the influence of microorganisms found throughout the digestive tract possess the ability to affect both physiology and behaviour by triggering responses, which may be unfavourable. This is sometimes the case in of infertility. Numerous supplements have been formulated with the intention of rebalancing the gut microflora. Accordingly, the gut flora may alter the pharmacokinetics of drugs used as part of fertility treatments, potentially exacerbating the predisposition for various neurological disorders, regardless of the age and gender.
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Affiliation(s)
- Gabriela Simionescu
- Department of Mother and Child Medicine, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street, No 16, 700115 Iasi, Romania; (G.S.); (D.G.); (E.A.)
- Clinical Hospital of Obstetrics and Gynecology “Cuza Voda”, Cuza Voda Street, No 34, 700038 Iasi, Romania;
- Origyn Fertility Center, Palace Street, No 3C, 700032 Iasi, Romania
| | - Ovidiu-Dumitru Ilie
- Department of Research, Faculty of Biology, “Alexandru Ioan Cuza” University, Carol I Avenue, No 11, 700505 Iasi, Romania; (O.-D.I.); (A.C.)
| | - Alin Ciobica
- Department of Research, Faculty of Biology, “Alexandru Ioan Cuza” University, Carol I Avenue, No 11, 700505 Iasi, Romania; (O.-D.I.); (A.C.)
| | - Bogdan Doroftei
- Department of Mother and Child Medicine, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street, No 16, 700115 Iasi, Romania; (G.S.); (D.G.); (E.A.)
- Clinical Hospital of Obstetrics and Gynecology “Cuza Voda”, Cuza Voda Street, No 34, 700038 Iasi, Romania;
- Origyn Fertility Center, Palace Street, No 3C, 700032 Iasi, Romania
- Correspondence:
| | - Radu Maftei
- Clinical Hospital of Obstetrics and Gynecology “Cuza Voda”, Cuza Voda Street, No 34, 700038 Iasi, Romania;
- Origyn Fertility Center, Palace Street, No 3C, 700032 Iasi, Romania
- Department of Morphostructural Sciences, Faculty of Medicine, University of Medicine and Pharmacy “Grigore. T. Popa” Iasi, University Street, No 16, 700115 Iasi, Romania
| | - Delia Grab
- Department of Mother and Child Medicine, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street, No 16, 700115 Iasi, Romania; (G.S.); (D.G.); (E.A.)
- Clinical Hospital of Obstetrics and Gynecology “Cuza Voda”, Cuza Voda Street, No 34, 700038 Iasi, Romania;
| | - Jack McKenna
- York Hospital, Wigginton Road Clifton, York YO31 8HE, UK;
| | - Nitasha Dhunna
- Mid Yorkshrie Hospitals NHS Trust, Pinderfields Hospital, Wakefield WF1 4DG, UK;
| | - Ioannis Mavroudis
- Leeds Teaching Hospitals NHS Trust, Great George St, Leeds LS1 3EX, UK;
- Laboratory of Neuropathology and Electron Microscopy, School of Medicine, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Emil Anton
- Department of Mother and Child Medicine, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, University Street, No 16, 700115 Iasi, Romania; (G.S.); (D.G.); (E.A.)
- Clinical Hospital of Obstetrics and Gynecology “Cuza Voda”, Cuza Voda Street, No 34, 700038 Iasi, Romania;
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Öztekin Ü, Hacimusalar Y, Gürel A, Karaaslan O. The Relationship of Male Infertility with Somatosensory Amplification, Health Anxiety and Depression Levels. Psychiatry Investig 2020; 17:350-355. [PMID: 32252512 PMCID: PMC7176565 DOI: 10.30773/pi.2019.0248] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 02/07/2020] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE The purpose of this study was to investigate the relationship between infertility and factors such as anxiety, health anxiety, depression, and somatosensory amplification in male patients presenting with infertility. METHODS In this study, we evaluated 198 patients (infertile group: 130, control group: 68). Patients that fit the inclusion criteria were informed about the aim and method of the study and filled out sociodemographic data collection form, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), The Somatosensory Amplification Scale (SSAS), and Health Anxiety Inventory (HAI) questionnaires. RESULTS The mean scores for SSAS, HAI, BAI, and BDI were significantly higher in the infertility group compared to the control group (p<0.001 for all comparisons). Moreover, the mean scores of the patients in the primary infertile group (n=107) were significantly higher than in the secondary infertile group (n=23) (p<0.05 for all comparisons). Logistic regression analysis revealed that infertility had a significant effect on age, HAI and BDI. CONCLUSION Psychiatric evaluation of infertile patients may contribute to more efficient use of health services, may reduce the negative effects of anxiety and depression on fertility, and in turn, increase the success of infertility treatment. Therefore, we recommend that each patient presenting with infertility undergoes psychiatric evaluation as part of their treatment.
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Affiliation(s)
- Ünal Öztekin
- Department of Urology, Bozok Unıversıty Faculty of Medicine, Yozgat, Turkey
| | - Yunus Hacimusalar
- Department of Psychiatry, Bozok Unıversıty Faculty of Medicine, Yozgat, Turkey
| | - Abdullah Gürel
- Department of Urology, Bozok Unıversıty Faculty of Medicine, Yozgat, Turkey
| | - Ozgul Karaaslan
- Department of Psychiatry, Bozok Unıversıty Faculty of Medicine, Yozgat, Turkey
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Abdishahshahani M, Torabi M, Kazemi A. Investigating related factors to psychological symptoms of infertile couples undergoing assisted reproductive treatment. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2020; 9:21. [PMID: 32154316 PMCID: PMC7034165 DOI: 10.4103/jehp.jehp_412_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 11/24/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND The impact of infertility and assisted reproductive treatment on the mental health of infertile couples is documented, and the identification of its predictor factors can be helpful in identifying susceptible individuals. Therefore, the aim of this study was to identify the factors associated with psychological symptoms of infertile couples undergoing assisted reproductive treatment. MATERIALS AND METHODS Using convenience sampling method, this cross-sectional study was conducted on 212 couples undergoing assisted reproductive treatments. The levels of mental disorders (depression, anxiety, and stress) of the couples undergoing assisted reproductive treatments were assessed via self-report questionnaire of Depression, Anxiety, and Stress Scales. Data analysis was performed using paired t-test, independent t-test, Wilcoxon signed-rank test, Pearson correlation coefficient, Spearman correlation, and multivariate linear regression. RESULTS The mean scores of stress, anxiety, and depression in women (14, 9.93, and 10.7) were significantly higher than that in men (9, 5.51, and 6.6). Correlation coefficient of stress, anxiety, and depression scores in women was inversely correlated with their age. Moreover, stress, anxiety, and depression scores in men were significantly correlated with the duration of infertility. In both men and women, stress, anxiety, and depression scores were inversely correlated with the level of education and economic situation. CONCLUSION The results showed that during assisted reproductive treatment, women are more likely to experience psychological problems than their spouses. In addition, underlying factors such as age, duration of infertility, and educational level do not similarly cause of lower mental health in men and women.
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Affiliation(s)
- Mahshid Abdishahshahani
- Department of Midwifery, Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Marjan Torabi
- Department of Midwifery and Reproductive Health, Student Research Committee, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ashraf Kazemi
- Department of Reproductive Health, Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Maroufizadeh S, Omani-Samani R, Hosseini M, Almasi-Hashiani A, Sepidarkish M, Amini P. The Persian version of the revised dyadic adjustment scale (RDAS): a validation study in infertile patients. BMC Psychol 2020; 8:6. [PMID: 31996245 PMCID: PMC6988239 DOI: 10.1186/s40359-020-0375-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Accepted: 01/19/2020] [Indexed: 01/13/2023] Open
Abstract
Background Infertility can have a powerful impact on marital quality. The Revised Dyadic Adjustment Scale (RDAS) is a widely used measure of marital quality. This scale has not been validated in infertile patients. Therefore, this study aimed to evaluate the reliability and validity of the RDAS in a sample of infertile patients. Methods The sample of this methodological study consisted of 254 infertile patients referring to a referral infertility clinic in Tehran, Iran. A battery of questionnaires was administered to the participants, including a demographic/fertility questionnaire, the RDAS, the Relationship Assessment Scale (RAS), the Kansas Marital Satisfaction Scale (KMSS), the Couples Satisfaction Index- 4 Item (CSI-4), the Hospital Anxiety and Depression Scale (HADS), and the Perceived Stress Scale-4 Item (PSS-4). Internal consistency of the scale was assessed with Cronbach’s alpha, construct validity was investigated using confirmatory factor analysis (CFA), and convergent validity was examined by correlating the RDAS with RAS, KMSS, CSI-4, HADS, and PSS-4 instruments. Results The mean total RDAS score was 49.26 ± 9.34, and 100 patients (39.4%) had marital distress based on the cut-off value of < 48. The second-order three-factor model of the RDAS exhibited an excellent fit to the data, as indicated by χ2/df = 2.26; CFI = 0.96; GFI = 0.91; NFI = 0.93; IFI = 0.96; RMSEA = 0.071 and SRMR = 0.050. The RDAS and its subscales revealed satisfactory internal consistency that ranged from 0.664 to 0.847. Convergent validity was confirmed by strong correlations between RDAS scores and scores on the RAS, KMSS, and CSI-4. These correlations also tended to be larger than correlations with measures of HADS-anxiety, HADS-depression, and PSS-4. Among demographic/fertility variables, only infertility duration was found to be correlated to the RDAS. Conclusion The RDAS is a reliable and valid inventory for measuring marital quality in infertile patients. Further validation studies are needed to generalize the underlying structure of the scale in various populations.
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Affiliation(s)
- Saman Maroufizadeh
- School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Reza Omani-Samani
- Department of Medical Ethics and Law, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Mostafa Hosseini
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Almasi-Hashiani
- Department of Epidemiology, School of Health, Arak University of Medical Sciences, Arak, Iran
| | - Mahdi Sepidarkish
- Department of Biostatistics and Epidemiology, Babol University of Medical Sciences, Babol, Iran
| | - Payam Amini
- Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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Maroufizadeh S, Riazi H, Lotfollahi H, Omani-Samani R, Amini P. The 6-item Female Sexual Function Index (FSFI-6): factor structure, reliability, and demographic correlates among infertile women in Iran. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2019. [DOI: 10.1186/s43043-019-0008-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The 6-item Female Sexual Function Index (FSFI) is a short form of the original 19-item FSFI that measures sexual function in women. The aim of this study was to examine the factor structure and reliability of the FSFI-6 and to determine the demographic correlates of sexual dysfunction among infertile women in Iran.
Results
In total, 250 infertile women participated in this study. The mean total FSFI-6 score was 20.71 ± 5.09. Internal consistency of the FSFI-6 was high (Cronbach’s alpha = 0.856). All inter-item correlations and item-total correlations were in acceptable range. The results of confirmatory factor analysis provided support for a unidimensional model of the FSFI-6. Among demographic and infertility variables, higher women’s age, low education, unwanted marriage, short infertility duration, and low frequency of intercourse were associated with sexual dysfunction.
Conclusions
The FSFI-6 demonstrated sound reliability and validity in this study, supporting its continued use for measuring sexual disfunction among infertile women. Its brevity and comprehensiveness allow a quick assessment both in clinical and research settings.
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Maroufizadeh S, Omani-Samani R, Almasi-Hashiani A, Amini P, Sepidarkish M. The reliability and validity of the Patient Health Questionnaire-9 (PHQ-9) and PHQ-2 in patients with infertility. Reprod Health 2019; 16:137. [PMID: 31500644 PMCID: PMC6734346 DOI: 10.1186/s12978-019-0802-x] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 09/02/2019] [Indexed: 01/17/2023] Open
Abstract
Background Depression in patients with infertility often goes undiagnosed and untreated. The Patient Health Questionnaire-9 (PHQ-9) and its ultra-brief version (i.e. PHQ-2) are widely used measures of depressive symptoms. These scales have not been validated in patients with infertility. The aim of the present study was to examine the reliability and validity of the PHQ-9 and PHQ-2 in patients with infertility. Methods In this cross-sectional study, a total of 539 patients with infertility from a referral infertility clinic in Tehran, Iran completed the PHQ-9, along with other relevant scales: the WHO-five Well-being Index (WHO-5), the Hospital Anxiety and Depression Scale (HADS), and the Generalized Anxiety Disorder-7 (GAD-7). Factor structure and internal consistency of PHQ-9 were examined via confirmatory factor analysis (CFA) and Cronbach’s alpha, respectively. Convergent validity was evaluated by relationship with WHO-5, HADS and GAD-7. Results The mean total PHQ-9 and PHQ-2 scores were 8.47 ± 6.17 and 2.42 ± 1.86, respectively, and using a cut-off value of 10 (for PHQ-9) and 3 (for PHQ-2), the prevalence of depressive symptoms was 38.6 and 43.6%, respectively. The Cronbach’s alphas for PHQ-9 and PHQ-2 were, respectively, 0.851 and 0.767, indicating good internal consistency. The CFA results confirmed the one-factor model of the PHQ-9 (χ2/df = 4.29; CFI = 0.98; RMSEA = 0.078 and SRMR = 0.044). Both PHQ-9 and PHQ-2 showed moderate to strong correlation with the measures of WHO-5, HADS-depression, HADS-anxiety, and the GAD-7, confirming convergent validity. In univariate analysis, female sex, long infertility duration, and unsuccessful treatment were significantly associated with depression symptoms. Conclusion Both PHQ-9 and PHQ-2 are brief and easy to use measures of depressive symptoms with good psychometric properties that appear suitable for routine use in patients with infertility.
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Affiliation(s)
- Saman Maroufizadeh
- School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Reza Omani-Samani
- Department of Medical Ethics and Law, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Amir Almasi-Hashiani
- Department of Epidemiology, School of Health, Arak University of Medical Sciences, Arak, Iran
| | - Payam Amini
- Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Mahdi Sepidarkish
- Department of Biostatistics and Epidemiology, Babol University of Medical Sciences, Babol, Iran
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Maroufizadeh S, Almasi-Hashiani A, Amini P, Sepidarkish M, Omani-Samani R. The Quality of Marriage Index (QMI): a validation study in infertile patients. BMC Res Notes 2019; 12:507. [PMID: 31412948 PMCID: PMC6693237 DOI: 10.1186/s13104-019-4438-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 07/05/2019] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Infertility can have a considerable effect on a person's marital satisfaction. The Quality of Marriage Index (QMI) is a self-report inventory to measure global perceptions of marital satisfaction. The current study examined the reliability and validity of the Persian language version of QMI in a sample of infertile patients. RESULTS The mean QMI total score was 36.54 ± 6.87. The internal consistency of the scale was good, with a Cronbach's alpha of 0.922. All inter-item correlations and item-total correlations were also in acceptable range. The confirmatory factor analysis results provided evidence for unidimensionality of the scale (χ2/df = 3.10; GFI = 0.97; CFI = 0.99; NFI = 0.99; RMSEA = 0.091 and SRMR = 0.020). The convergent validity of the QMI was demonstrated via significant correlations with measures of the Relationship Assessment Scale, Kansas Marital Satisfaction Scale, and Couples Satisfaction Index-4 Item. These correlations also tended to be larger than correlations with measures of Hospital Anxiety and Depression Scale and Perceived Stress Scale-4 Item. Among demographic/fertility variables, only infertility duration was negatively correlated to QMI scores. In sum, the QMI is a reliable and valid brief inventory for measuring overall marital satisfaction in infertile patients. Trial registration This was a cross-sectional study (NOT clinical trial); thus, the trail registration number is not required for the present study.
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Affiliation(s)
- Saman Maroufizadeh
- School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Amir Almasi-Hashiani
- Department of Epidemiology, School of Health, Arak University of Medical Sciences, Arak, Iran
| | - Payam Amini
- Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mahdi Sepidarkish
- Department of Biostatistics and Epidemiology, Babol University of Medical Sciences, Babol, Iran
| | - Reza Omani-Samani
- Department of Medical Ethics and Law, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
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Maroufizadeh S, Navid B, Omani-Samani R, Amini P. The effects of depression, anxiety and stress symptoms on the clinical pregnancy rate in women undergoing IVF treatment. BMC Res Notes 2019; 12:256. [PMID: 31072342 PMCID: PMC6507221 DOI: 10.1186/s13104-019-4294-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 05/03/2019] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Women undergoing assisted reproductive technology treatment, are often anxious and depressed because of their fertility problem and the uncertainties of the treatment with which they have to deal. On the other hand, recent studies have shown that the effects of psychological distress on the IVF treatment outcome is unclear. This study aimed to examine the effects of anxiety, depression, and stress symptoms before IVF treatment on the clinical pregnancy rate, controlling for known confounders. RESULTS In total, 142 women undergoing IVF treatment participated in this prospective study. The clinical pregnancy rate was 26.8% in this study. Controlling for age, infertility duration, and cause of infertility, there were no relationship between IVF outcome and anxiety (relative risk (RR) = 1.00; 95% CI 0.91-1.09), depression (RR = 0.96; 95% CI 0.88-1.05), and stress (RR = 1.01; 95% CI 0.96-1.07) symptoms. High woman's age and women with both cause of infertility were independent predictors of IVF clinical pregnancy rate. In sum, we found that anxiety, depression, and stress symptoms were not associated with the IVF clinical pregnancy rate.
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Affiliation(s)
- Saman Maroufizadeh
- School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Behnaz Navid
- Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, P.O. Box: 16635-148, Tehran, Iran.
| | - Reza Omani-Samani
- Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, P.O. Box: 16635-148, Tehran, Iran
| | - Payam Amini
- Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Maroufizadeh S, Hosseini M, Rahimi Foroushani A, Omani-Samani R, Amini P. Application of the dyadic data analysis in behavioral medicine research: marital satisfaction and anxiety in infertile couples. BMC Med Res Methodol 2018; 18:117. [PMID: 30367603 PMCID: PMC6203997 DOI: 10.1186/s12874-018-0582-y] [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: 09/18/2018] [Accepted: 10/18/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dyadic data analysis (DDA) is increasingly being used to better understand, analyze and model intra- and inter-personal mechanisms of health in various types of dyads such as husband-wife, caregiver-patient, doctor-patient, and parent-child. A key strength of the DDA is its flexibility to take the nonindependence available in the dyads into account. In this article, we illustrate the value of using DDA to examine how anxiety is associated with marital satisfaction in infertile couples. METHODS This cross-sectional study included 141 infertile couples from a referral infertility clinic in Tehran, Iran between February and May 2017. Anxiety and marital satisfaction were measured by the anxiety subscale of the Hospital Anxiety and Depression Scale and 10-Item ENRICH Marital Satisfaction Scale, respectively. We apply and compare tree different dyadic models to explore the effect of anxiety on marital satisfaction, including the Actor-Partner Interdependence Model (APIM), Mutual Influence Model (MIM), and Common Fate Model (CFM). RESULTS This study demonstrated a practical application of the dyadic models. These dyadic models provide results that appear to give different interpretations of the data. The APIM analysis revealed that both men's and women's anxiety excreted an actor effect on their own marital satisfaction. In addition, women's anxiety exerted a significant partner effect on their husbands' marital satisfaction. In MIM analysis, in addition to significant actor effects of anxiety on marital satisfaction, women's reports of marital satisfaction significantly predicted men's marital satisfaction. The CFM analysis revealed that higher couple anxiety scores predicted lower couple marital satisfaction scores. CONCLUSION In sum, the study highlights the usefulness of DDA to explore and test the phenomena with inherently dyadic nature. With regard to our empirical data, the findings confirmed that marital satisfaction was influenced by anxiety in infertile couples at both individual and dyadic level; thus, interventions to improve marital satisfaction should include both men and women. In addition, future studies should consider using DDA when dyadic data are available.
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Affiliation(s)
- Saman Maroufizadeh
- Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.,Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Hosseini
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Abbas Rahimi Foroushani
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Omani-Samani
- Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
| | - Payam Amini
- Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
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