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Warmelink JC, Marissink L, Kroes L, Ranjbar F, Henrichs J. What are antenatal maternity care needs of women who conceived through fertility treatment?: a mixed methods systematic review. J Psychosom Obstet Gynaecol 2023; 44:2148099. [PMID: 36508566 DOI: 10.1080/0167482x.2022.2148099] [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] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Existing research indicates that pregnant women who conceived through fertility treatment might experience more stress and anxiety compared to women who conceived spontaneously. Therefore, these women might have additional antenatal care needs. METHODS A search for both quantitative and qualitative studies was performed in PubMed, PsycINFO, CINAHL and MEDLINE through May 2021, guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. 21 articles met the inclusion criteria. After methodological quality appraisal using the Mixed Methods Appraising Tool, 15 studies were included in the review. RESULTS Analysis of the studies identified behavioral, relational/social, emotional, and cognitive needs and women's preference about maternity care. Women who conceived through fertility treatment reported lower social and physical functioning scores and elevated levels of anxiety and depression compared to women who conceived spontaneously. They reported difficulties adjusting to pregnancy and experienced a care gap between discharge from the fertility clinic and going to local maternity care services for their first consultation, and a care gap postpartum. CONCLUSIONS Women who conceived through fertility treatment have additional antenatal care needs. We recommend to offer these women more frequent check-ins, and to pay attention to the impact of their infertility and treatment on their pregnancy.
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Affiliation(s)
- J Catja Warmelink
- Department of General Practice and Elderly Care Medicine, Section Midwifery Science AVAG, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Department of Midwifery Science, VU University Medical Center, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,Midwifery Academy Amsterdam/Groningen, Groningen, The Netherlands
| | - Lisa Marissink
- Midwifery Academy Amsterdam/Groningen, Groningen, The Netherlands.,Midwifery Practice Liberis Libenter, Enschede, The Netherlands
| | - Linda Kroes
- Midwifery Academy Amsterdam/Groningen, Groningen, The Netherlands.,Midwifery Practice De vroedschap, Oosterwolde, The Netherlands.,Midwifery Practice De morgen, Dalfsen, The Netherlands
| | - Fahimeh Ranjbar
- Nursing and Midwifery Care Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Jens Henrichs
- Department of Midwifery Science, VU University Medical Center, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Foyston Z, Higgins L, Smith DM, Wittkowski A. Parents' experiences of life after medicalised conception: a thematic meta-synthesis of the qualitative literature. BMC Pregnancy Childbirth 2023; 23:520. [PMID: 37460955 DOI: 10.1186/s12884-023-05727-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 05/22/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Medicalised Conception (MAC) assists many couples to achieve pregnancy worldwide. As the impact of MAC has been linked to increased pregnancy-specific anxiety and parenting difficulties, this review aimed to explore parental experiences of pregnancy and early parenting following MAC, identifying parents' psychological, social and health needs. METHOD Five databases were searched systematically from inception to March 2023. Identified articles were screened for eligibility against the inclusion criteria and the results were analysed using thematic synthesis. The Critical Appraisal Skills checklist was employed to appraise methodological quality. RESULTS Twenty qualitative studies, drawing on a total of 19 participant samples, were included in this review, most with samples with history of subfertility. The findings were synthesised into three main themes (consisting of seven subthemes): 1) The vulnerable parent: fear, doubt, uncertainty, 2) the stark realisation of the parental dream, 3) psychosocial needs and support. Parents lacked a sense of safety during pregnancy and reported acting protectively both antenatally and postnatally. Furthermore, their identity transition was complex and non-linear, influenced by sociocultural context. CONCLUSIONS Considerable unmet psychosocial needs were identified including the potential for anxiety in pregnancy, the possibility of feeling excluded and marginalised, and a reluctance to share distress and experiences with healthcare professionals. These findings suggest a need for consistent, holistic care, integrating psychological services.
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Affiliation(s)
- Z Foyston
- School of Health Sciences, The University of Manchester, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - L Higgins
- Maternal and Fetal Health Research Centre, University of Manchester, Manchester, UK
- St. Mary's Hospital, Manchester University Hospital NHS Foundation Trust, Manchester, UK
| | - D M Smith
- School of Health Sciences, The University of Manchester, Manchester, UK
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, the University of Manchester, Manchester Academic Health Science Centre, 2nd Floor Zochonis Building, Manchester, UK
- Manchester Academic Health Science Centre, Manchester, UK
| | - A Wittkowski
- School of Health Sciences, The University of Manchester, Manchester, UK.
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK.
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, the University of Manchester, Manchester Academic Health Science Centre, 2nd Floor Zochonis Building, Manchester, UK.
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Skvirsky V, Taubman – Ben-Ari O, Azuri J, Weissman A, Horowitz E. Mental health of pregnant women with a background of fertility problems: the contribution of meaning in life and cognitive appraisal. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03565-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Facchin F, Leone D, Tamanza G, Costa M, Sulpizio P, Canzi E, Vegni E. Working With Infertile Couples Seeking Assisted Reproduction: An Interpretative Phenomenological Study With Infertility Care Providers. Front Psychol 2020; 11:586873. [PMID: 33391106 PMCID: PMC7773748 DOI: 10.3389/fpsyg.2020.586873] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 11/26/2020] [Indexed: 11/13/2022] Open
Abstract
Although most studies investigated the impact of infertility and its treatment on the couple, a small body of evidence suggested that infertility care providers may experience different sources of stress related for instance to excessive workload, the complexity of the technique, and relational difficulties with patients. The current study aimed at providing further insight into the understanding of the subjective experience of infertility care providers by highlighting their feelings and emotions, personal meanings, challenges, and opportunities. Following the methodological guidelines of Interpretative Phenomenological Analysis, we conducted individual semi-structured interviews with 23 members of two different fertility units. Interviews were audiotaped and transcribed verbatim. Textual analysis was then conducted to identify emerging dominant themes and subthemes. Three main themes were extracted: (i) dealing with infertile patients and their specificities, (ii) performing assisted reproductive technology (ART), (iii) being part of a team. These themes related to participants experiencing: (i) difficulties in establishing an empathic connection and communicating with couples, such that women were sometimes perceived as "particular patients" and men as poorly involved in the process; (ii) difficulties in dealing with a complex procedure in which errors are not allowed (as reported by embryologists), with a growing number of women aged > 40 seeking assisted reproduction, despite the risks for their health; (iii) being part of a team as a resource, although the huge amount of time spent together can involve conflicts and organizational problems. These findings suggested that patients' overpersistence (rather than just dropout) represents an important source of stress for infertility care providers. At the same time, the concept of particular or difficult patient derives from the combination of multiple factors, including providers' own history and subjective experience. The presence of mental health professionals in fertility units is essential to help providers improve the quality of doctor-patient communication and relieve the stress related to organizational issues and conflicts.
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Affiliation(s)
- Federica Facchin
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Daniela Leone
- Unit of Clinical Psychology, San Paolo University Hospital, Asst-Santi Paolo e Carlo, Milan, Italy
| | - Giancarlo Tamanza
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Mauro Costa
- Reproductive Medicine Unit, Ospedale Evangelico Internazionale, Genoa, Italy
| | - Patrizia Sulpizio
- Reproductive Medicine Unit, San Paolo University Hospital, Asst-Santi Paolo e Carlo, Milan, Italy
| | - Elena Canzi
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Elena Vegni
- Unit of Clinical Psychology, San Paolo University Hospital, Asst-Santi Paolo e Carlo, Milan, Italy.,Department of Health Sciences, University of Milan, Milan, Italy
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Fioretti C, Mazzocco K, Riva S, Oliveri S, Masiero M, Pravettoni G. Research studies on patients' illness experience using the Narrative Medicine approach: a systematic review. BMJ Open 2016; 6:e011220. [PMID: 27417197 PMCID: PMC4947803 DOI: 10.1136/bmjopen-2016-011220] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Since its birth about 30 years ago, Narrative Medicine approach has increased in popularity in the medical context as well as in other disciplines. This paper aims to review Narrative Medicine research studies on patients' and their caregivers' illness experience. SETTING AND PARTICIPANTS MEDLINE, Psycinfo, EBSCO Psychological and Behavioural Science, The Cochrane Library and CINAHL databases were searched to identify all the research studies which focused on the Narrative Medicine approach reported in the title, in the abstract and in the keywords the words 'Narrative Medicine' or 'Narrative-based Medicine'. PRIMARY AND SECONDARY OUTCOME MEASURES number of participants, type of disease, race and age of participants, type of study, dependent variables, intervention methods, assessment. RESULTS Of the 325 titles screened, we identified 10 research articles fitting the inclusion criteria. Our systematic review showed that research on Narrative Medicine has no common specific methodology: narrative in Medicine is used as an intervention protocol as well as an assessment tool. Patients' characteristics, types of disease and data analysis procedures differ among the screened studies. CONCLUSIONS Narrative Medicine research in medical practice needs to find clear and specific protocols to deepen the impact of narrative on medical practice and on patients' lives.
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Affiliation(s)
- Chiara Fioretti
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Milan, Italy
| | - Ketti Mazzocco
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milano, Lombardia, Italy
| | - Silvia Riva
- Department of Oncology and Hemato-Oncology, University of Milan, Milano, Lombardia, Italy
| | - Serena Oliveri
- Department of Oncology and Hemato-Oncology, University of Milan, Milano, Lombardia, Italy
| | - Marianna Masiero
- Department of Oncology and Hemato-Oncology, University of Milan, Milano, Lombardia, Italy
| | - Gabriella Pravettoni
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milano, Lombardia, Italy
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Donzelli G, McGreevy KS. Perinatal care at the confluence of narrative medicine and personalized medicine: what lies downstream? J Matern Fetal Neonatal Med 2016; 29:2807-9. [PMID: 26794262 DOI: 10.3109/14767058.2015.1105210] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Gianpaolo Donzelli
- a Fetal-Neonatal Department , Meyer Children's Hospital, University of Florence , Florence , Italy and
| | - Kathleen S McGreevy
- b Research, Innovation and International Relations Office, Meyer Children's Hospital , Florence , Italy
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Donzelli G, Paddeu EM, D’Alessandro F, Nanni Costa A. The role of narrative medicine in pregnancy after liver transplantation. J Matern Fetal Neonatal Med 2014; 28:158-61. [DOI: 10.3109/14767058.2014.906578] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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