Factors Influencing Infertility-related Quality of Life in Women Undergoing Assisted Reproductive Techniques: Focusing on Depression and Resilience

Research trends in the Korean Journal of Women Health Nursing from 2011 to 2021: a quantitative content analysis

PURPOSE

Topic modeling is a text mining technique that extracts concepts from textual data and uncovers semantic structures and potential knowledge frameworks within context. This study aimed to identify major keywords and network structures for each major topic to discern research trends in women's health nursing published in the Korean Journal of Women Health Nursing (KJWHN) using text network analysis and topic modeling.

METHODS

The study targeted papers with English abstracts among 373 articles published in KJWHN from January 2011 to December 2021. Text network analysis and topic modeling were employed, and the analysis consisted of five steps: (1) data collection, (2) word extraction and refinement, (3) extraction of keywords and creation of networks, (4) network centrality analysis and key topic selection, and (5) topic modeling.

RESULTS

Six major keywords, each corresponding to a topic, were extracted through topic modeling analysis: "gynecologic neoplasms," "menopausal health," "health behavior," "infertility," "women's health in transition," and "nursing education for women."

CONCLUSION

The latent topics from the target studies primarily focused on the health of women across all age groups. Research related to women's health is evolving with changing times and warrants further progress in the future. Future research on women's health nursing should explore various topics that reflect changes in social trends, and research methods should be diversified accordingly.

Types and Characteristics of Stress Coping in Women Undergoing Infertility Treatment in Korea

The purpose of this study was to identify the characteristics and predictors of types of stress coping in women undergoing infertility treatment. The cross-sectional study included 120 women who were receiving infertility treatment at infertility hospitals. Self-report questionnaires were used to measure. K-means cluster analysis and multinomial logistic regression were used to examine the characteristics and predictors of stress-coping types. Out of all the women undergoing infertility treatment who completed a self-report survey, 30.8% had a weak mixed coping type, 35.9% had a strong mixed coping type, and 33.3% had a passive coping type. The strong mixed treatment type was compared to weak mixed treatment type, with the following results: infertility adaptation (OR = 17.71, p < 0.000), spousal support (OR = 4.50, p = 0.021), infertility counseling experience (OR = 7.14, p = 0.010). Comparing the strong mixed coping type with the passive coping type, resilience (OR = 9.11, p < 0.000) was shown. It is necessary to strengthen resilience and provide a receptive attitude and spousal support to women undergoing infertility adaptation to help them relieve stress and develop functional coping.

Relationships among type-D personality, fatigue, and quality of life in infertile women

PURPOSE

The objective of the present study was to investigate the prevalence of the type D personality and identify the relationship between type D personality, fatigue and quality of life (QoL) in infertile women.

METHODS

A total of 149 infertile women were recruited between October 2020 and January 2021. The participants were assessed through self-administered questionnaires using the type- D Personality Scale-14, Fatigue Severity Scale, and Fertility QoL Instrumental Questionnaire. Data were analyzed using the independent t-test, chi-square test, Pearson's correlation coefficients, and multiple regression analysis using the SPSS/WIN 25.0 program for Windows.

RESULTS

Approximately 40.9% of infertile women were classified into the type D personality group, which showed significantly higher fatigue and lower QoL than the non-type D personality group. Fatigue was the most influential factor on the QoL of infertile women (β=-.23, p=.003), followed by the duration of infertility treatment (β=-.22, p=.003), type D personality (β=-.18, p=.025), and relationship with spouse (β=-.17, p=.024). These variables account for approximately 22% of the variance.

CONCLUSIONS

Intervention programs that consider fatigue, type D personality, relationship with spouses, and treatment duration may be useful for improving QoL in infertile women.

A qualitative study on the experience of acupuncture treatment in infertile women

BACKGROUND

This study aimed to record and analyze the experiences of infertile women who underwent acupuncture treatment.

METHODS

This is a qualitative study in which in-depth interviews were conducted with women who underwent acupuncture as a treatment for infertility from the viewpoint of phenomenology, a method of understanding human behavior in the general human and social context, and grasping the nature of the experience in depth. The study participants were 12 women who had been receiving acupuncture treatment for infertility for more than 3 months.

RESULTS

After analyzing the statements of the participants' experiences, the main concerns regarding infertility were "embarrassed by unexpected infertility," "overwhelmed with negative feelings," "blocking and defense," "sex as a duty," and "repeatition of expectations and failures." Significant statements regarding acupuncture treatments were "body warmth," "becoming a body," "care of the mind," "last trust and hope," and "difficulties of waiting." The experience with supporter was love-hate relationships, and the experience of the children's meaning was expressed as "precious beings in life."

CONCLUSION

The results of this study suggest that acupuncture treatment for infertility in women results in positive thinking through changes in the body as well as through increased hope. Participants experienced a feeling of warmth in their bodies, regular menstrual cycle, and reduced fatigue through acupuncture treatment, indicating a state of psychological stability.

Associations of Symptoms of Depression, Social Support, and Quality of Life Among Korean Women Who Experience Infertility

OBJECTIVE

To describe the quality of life (QOL) of Korean women experiencing infertility based on sociodemographic and infertility characteristics and to examine the associations among symptoms of depression, social support, and QOL.

DESIGN

Cross-sectional, descriptive study.

SETTING

Participants were recruited from July to August 2019 on one of the largest South Korean websites where individuals share pregnancy and parenthood experiences.

PARTICIPANTS

Adult women (N = 186) who received infertility treatment.

METHODS

Participants completed an online survey using the Korean version of the Patient Health Questionnaire 9 to measure symptoms of depression, the Multidimensional Scale of Perceived Support, and the Fertility Quality of Life (FertiQOL) scale. Data were analyzed using descriptive statistics, correlation, analysis of variance, and multiple regression.

RESULTS

There was a significant negative relationship between scores on the Patient Health Questionnaire 9 and FertiQOL (r = -0.557) and a significant positive relationship between scores on the Multidimensional Scale of Perceived Support and FertiQOL (r = 0.404). The length of time from diagnosis of infertility to data collection, past and current treatments, cost burden, and degree of inhibition of daily life due to infertility also significantly affected participants' FertiQOL scores. Symptoms of depression, the burden of treatment, and inhibition of daily life activities explained 46% of the variance in QOL.

CONCLUSION

Women experiencing infertility and symptoms of depression had lower FertiQOL scores. Health care providers, who are most familiar with and attentive to patients, could provide a first line of defense against poor QOL in this population. By continuously assessing the levels of psychosocial stress in women with infertility, nurses could provide timely resources and design interventions to improve women's QOL.

[Development of a Coping Scale for Infertility-Women (CSI-W)]

PURPOSE

The purpose of this study was to develop a Coping Scale for Infertility-Women (CSI-W).

METHODS

The initial items were based on an extensive literature review and in-depth interviews with seven infertile women. Forty-three items were derived from a pilot survey. Data were collected from 216 women who had experienced intrauterine insemination (IUI) and in-vitro fertilization (IVF) more than once. The data were analyzed to verify the reliability and validity of the scale.

RESULTS

Seven factors containing 28 items (four factors containing 17 items for active coping and three factors containing 11 items for passive coping) were extracted from the exploratory factor analysis to verify the construct validity. The four factors of active coping were confrontation, self-control, seeking social support (spouse), and seeking social support (colleagues and experts). The three factors of passive coping were distancing, escape, and avoidance. These items were verified through convergent, discriminant, and concurrent validity testing. The internal consistency reliability was acceptable (active coping: Cronbach's α = .78; passive coping: Cronbach's α = .81).

CONCLUSION

As its validity and reliability have been verified through various methods, the CSI-W can contribute to assessing the coping strategies of infertile women.

Factors influencing infertility-related quality of life in infertile women

Purpose: The rate of infertility in South Korea is steadily increasing. Infertile women experience various physical, psychological, and relational problems that affect their infertility–related quality of life (QoL). This study investigated infertile women’s infertility-related QoL with the goal of identifying how it is influenced by fatigue, depression, and marital intimacy.Methods: A sample of 140 infertile women was surveyed in a cross-sectional study. Data were collected from February to April 2018 using self-report structured questionnaires at three infertility clinics located in Jeonju, Korea. Data were analyzed using the independent t-test, analysis of variance, Pearson correlation coefficients, and stepwise multiple regression analysis in SPSS for Windows version 25.0. The subjects agreed to complete a face-to-face interview, including administration of the Fatigue Severity Scale, Depression Anxiety Stress Scale-21, Marital Intimacy Scale, and the Fertility Quality of Life tool.Results: The mean age of the participants was 35.6±4.3 years. Infertility-related QoL was negatively correlated with fatigue (r=–.42, p<.001) and depression (r=–.56, p<.001), and positively correlated with marital intimacy (r=.30, p<.001). Multiple regression analysis showed that depression (β=–0.44, p<.001), fatigue (β=–0.27, p<.001), and husband’s attitude (β=–0.19, p=.007) had significant effects on the QoL of infertile women, accounting for 40.5% of the variance in infertility-related QoL. Conclusion: The study provides insights into how infertile women’s infertility-related QoL was influenced by depression, fatigue, and their husbands’ attitudes regarding infertility treatment. To improve infertile women’s infertility-related QoL, healthcare providers should consider developing strategies to decrease depression and fatigue in infertile women and to address their husbands’ attitudes.

The Relationship between Fatigue, Health-Promoting Behavior, and Depression among Infertile Women

PURPOSE

As the number of infertile couples has grown, many infertile women have experienced depression during the diagnosis and treatment of their infertility. This study aimed to identify the factors related to depression in infertile women who underwent reproductive treatments.

METHODS

The study subjects were 149 infertile women who underwent reproductive treatments. The data were collected by self-administered questionnaires from August 1 to December 24, 2018. The questionnaire consisted of questions about fatigue, health-promoting behavior, and depression. Analyses of the descriptive statistics, t-tests, one-way analysis of variance, correlation, and multiple regression were conducted using the SPSS 25.0 Windows program.

RESULTS

Thirty-six of the women in the study (24.2%) were in the probably depressed group and 113 (75.8%) were in the definitely depressed group and 100% of the subjects experienced symptoms of depression. Depression was positively correlated with fatigue and negatively correlated with health-promoting behavior. Multiple regression analysis revealed that fatigue and interpersonal relationships were factors significantly related to depression in the model (p<.001), with an explanatory power of 42.6%.

CONCLUSION

The results confirmed that fatigue and interpersonal relationships, which is a subfactor of health-promoting behavior, were factors related to depression. To alleviate depression in infertile women, efforts should be made to identify and reduce psychological and physical fatigue. In addition, minimizing relational difficulties that they experience during an infertility diagnosis and treatment and strengthening positive interpersonal relationships can be positive strategies to alleviate depression.

Reproductive Health Promotion Behavior of Infertility Women and Normal Women

PURPOSE

To compare reproductive health promoting behaviors (RHPBs) of infertile women with those of normal women and identify effects of RHPB on infertility.

METHODS

A total of 148 females (73 infertile women and 75 normal women) were enrolled in this study. Measurements included their general characteristics and RHPB using self-report questionnaires. Data were analyzed with descriptive statistics, χ2 test, ANCOVA, and hierarchical logistic regression using SPSS.

RESULTS

There were significant difference in incomes, number of family, number of term deliveries, and number of abortions according to infertility diagnosis. Mean duration of infertility was 32.16 months. Only 12.32% women had known cause of infertility. The most common cause of infertility was unknown. Mean RHPB score was 3.98 for infertile women and 4.41 for normal women. In logistic regression, total RHPB (odds ratio [OR], 0.21) and safe sex of RHPB (OR, 0.66) were significant factors influencing infertility. Infertile women's total RHPB and subcategories of RHPB (safe sex behavior and sexual transmitted disease [STD] prevention) were lower than those of normal women.

CONCLUSION

For infertility women, RHPB-related intervention programs are needed, especially information about safe sex behavior and STD prevention.

Effects of Irrational Parenthood Cognition, Family Support, and Resilience on Depression of Infertile Women

PURPOSE

To determine effects of irrational parenthood cognition, family support, and resilience on depression in infertile women.

METHODS

Subjects were 118 infertile women who agreed to participate in this study. Data were collected from April 16 to July 31, 2018. Collected data were analyzed using descriptive statistics, t-test, analysis of variance (ANOVA), Pearson's correlation and multiple regression with SPSS WIN 23.0 program.

RESULTS

Depression significantly differed according to the burden of treatment cost and presence of people giving stress. Depression showed significantly positive correlation with irrational parenthood cognition and significantly negative correlations with family support and resilience. Factors affecting depression were irrational parenthood cognition, family support, and resilience. Irrational parenthood cognition had the greatest effect on depression. These three variables explained 35.8% of total variance.

CONCLUSION

Irrational parenthood cognition, family support, and resilience affected depression of infertile women, with irrational parenthood cognition having the greatest effect. Therefore, it is important to develop and implement programs that can reduce irrational parenthood cognition and increase family support and resilience in order to lower depression of infertile women. The authors declared no conflict of interest.