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Renzi A, Mariani R, Fedele F, Maniaci VG, Petrovska E, D’Amelio R, Mazzoni G, Di Trani M. Women's Narratives on Infertility as a Traumatic Event: An Exploration of Emotional Processing through the Referential Activity Linguistic Program. Healthcare (Basel) 2023; 11:2919. [PMID: 37998411 PMCID: PMC10671616 DOI: 10.3390/healthcare11222919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/25/2023] [Accepted: 11/06/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND the diagnosis of infertility and its related treatment can be traumatic, leading to profound psychological distress and a variety of psychopathological symptoms. The primary objective of this study is to contrast the linguistic features of narratives from women undergoing Assisted Reproductive Treatment with those of women not undergoing any fertility treatment. This study examines the speech of both groups of individuals as an indicator of their capacity to cope with current and past distressing experiences. METHOD 44 women (mean age 36.05; SD = 4.66) enrolled in a fertility medical center in Rome, and 43 control women (mean age 36.07; SD = 3.47) completed a socio-demographic questionnaire and a semi-structured interview designed to collect their memories of a neutral, a positive, and a negative event. This interview also aimed to investigate: (a) (for women with fertility difficulties) how they realized they and their partner had fertility problems and a description of an event when they talked about these difficulties with their partner; and (b) (for control group participants) the most difficult moment of their pregnancy and an event when they talked about it with their partner. The interviews were audio recorded and transcribed, and the text was analyzed using the referential process (RP) linguistic measures software. RESULTS Mann-Whitney non-parametric U tests for the independent samples showed several significant differences regarding the linguistic measures applied to the narratives of neutral, positive, negative, and difficult experiences in the form of a linguistic style, with more intellectualization and defenses in all the narratives associated with the women with fertility problems compared to the women in the control group. CONCLUSIONS the traumatic and painful experience of infertility and ART seems to characterize the whole mode of narrating life experiences. Present findings sustain the importance of helping women to elaborate on their experience and to understand and recognize the difficult feelings that are activated in relation to the difficulties of having a child.
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Affiliation(s)
- Alessia Renzi
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, Via degli Apuli 1, 00185 Rome, Italy; (R.M.); (V.G.M.); (G.M.); (M.D.T.)
| | - Rachele Mariani
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, Via degli Apuli 1, 00185 Rome, Italy; (R.M.); (V.G.M.); (G.M.); (M.D.T.)
| | - Fabiola Fedele
- ART Italian National Register, National Centre for Diseases Prevention and Health Promotion, Italian National Health Institute, Viale Regina Elena 299, 00161 Rome, Italy;
| | - Vito Giuseppe Maniaci
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, Via degli Apuli 1, 00185 Rome, Italy; (R.M.); (V.G.M.); (G.M.); (M.D.T.)
| | - Elena Petrovska
- Derner School of Psychology, Adelphi University, Garden City, NY 11530-0701, USA;
| | - Renzo D’Amelio
- Department of Gynecologic-Obstetrical and Urologic Sciences, Umberto I Hospital, Sapienza University of Rome, 00185 Rome, Italy;
| | - Giuliana Mazzoni
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, Via degli Apuli 1, 00185 Rome, Italy; (R.M.); (V.G.M.); (G.M.); (M.D.T.)
| | - Michela Di Trani
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, Via degli Apuli 1, 00185 Rome, Italy; (R.M.); (V.G.M.); (G.M.); (M.D.T.)
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Pellerone M, Martinez-Torvisco J, Razza SG, Commodari E, Miccichè S. Precursors of Prenatal Attachment and Anxiety during Pregnancy in Women Who Procreate Naturally and Pregnant Women following Assisted Reproduction Technology. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6945. [PMID: 37887682 PMCID: PMC10606198 DOI: 10.3390/ijerph20206945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/21/2023] [Accepted: 10/17/2023] [Indexed: 10/28/2023]
Abstract
The process of adaptation of the woman to pregnancy seems to be influenced by many factors, such as the type of conception, the mother's age, the possible presence of other children, and socio-cultural factors. Women who conceived with an assisted reproductive technique are emotionally vulnerable; compared with pregnant women who procreated naturally, they manifest elevated anxiety, which seems to be correlated to the fright of being separated from their child. Objectives of the present research are as follows: (1) to analyze the relationship between age, gestational age, time expectancy, previous failed attempts, perception of a high-risk pregnancy, and presence of other children, with the level of maternal-fetal attachment (MFA); (2) explore the level of maternal-infant attachment and anxiety by comparing the control and experimental group; (3) to measure a possible relationship between anxiety levels and MFA in ART pregnant women; (4) to identify variables predictive of prenatal attachment. The study group is formed by ninety-five women aged between 18-42 years (M = 30.57; S.D. = 5.47), pregnant from the 23rd to the 37th week (M = 28.95; S.D. = 3.99); on which 50 women who procreate naturally and 45 pregnant women following assisted reproductive technology. They completed: Maternal-Fetal Attachment Scale (MFAS), State-Trait Anxiety Inventory (STAI), and ad hoc questionnaire to collect anamnestic data. The results show the presence of a correlation between gestational age and waiting period, between the number of assisted fertilization attempts with the worry about their ability to become pregnant, but a negative correlation between pregnancy weeks and the level of maternal-fetal attachment. The study shows the predictive role of anxiety on the MFA. The applications and indications for future research are analyzed.
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Affiliation(s)
- Monica Pellerone
- Faculty of Human and Social Sciences, Kore University of Enna, 94100 Enna, Italy; (S.G.R.); (S.M.)
| | - Juan Martinez-Torvisco
- Department of Cognitive, Social and Organizational Psychology, La Laguna University, 38200 Santa Cruz de Tenerife, Spain;
| | - Stesy Giuseppa Razza
- Faculty of Human and Social Sciences, Kore University of Enna, 94100 Enna, Italy; (S.G.R.); (S.M.)
| | - Elena Commodari
- Department of Educational Sciences, University of Catania, 95126 Catania, Italy;
| | - Sandra Miccichè
- Faculty of Human and Social Sciences, Kore University of Enna, 94100 Enna, Italy; (S.G.R.); (S.M.)
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Rajati R, Khadivzade T, Esmaeili H, Danesh F. Female or Male Fertility Motivation? Which One Determines the Number of Children? (A Comparative Study). IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2023; 28:144-149. [PMID: 37332381 PMCID: PMC10275472 DOI: 10.4103/ijnmr.ijnmr_189_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 09/11/2022] [Accepted: 09/13/2022] [Indexed: 06/20/2023]
Abstract
Background In the last three decades, childbearing in Iran has decreased more than many countries in the world. The aim of this study was to explore the fertility motivation of Working women and their husbands and discover which one determines the number of children. Materials and Methods This correlational study was conducted on 540 employed, married women and their husbands (270 couples) living in Mashhad, Iran, during 2017-2018. The participants were selected through multistage cluster sampling. Then, a random number table was used. Subsequently, questionnaires were distributed and completed at home, and collected after 24 h. Data were collected using a demographic characteristics form and the Childbearing Questionnaire (CBQ). Results The mean(SD) positive motivation scores of men and women differed significantly [92.77 (13.04) Vs. 92.22 (13.51) df = 4; p = 0.001;]. The mean (SD) negative motivation scores of men and women also differed significantly 55.42 (10.94) Vs. 56.78 (10.57) df = 4; p = 0.001;]. Conclusions According to the scores obtained for the positive and negative fertility motivations of working women and their husbands, women were more in favor of having children and had an ambivalent motivation to bear children. Moreover, the working women's spouses were more indifferent to fertility. The results of this study can help reproductive health policymakers in childbearing.
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Affiliation(s)
- Reihane Rajati
- MSc Student of Counseling in Midwifery, Department of Midwifery, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Talat Khadivzade
- Department of Midwifery, Faculty of Nursing and Midwifery, Mashhad University Medical of Medical Sciences, Mashhad, Iran
| | - Habibollah Esmaeili
- Social Determinants of Health Research Center, Mashhad University of Medical Science, Mashhad, Iran
| | - Fereshte Danesh
- MSc in Clinical Psychology, Mashhad University of Medical Sciences, Mashhad, Iran
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Fusco C, Masaro C, Calvo V. 'I feel like I was born for something that my body can't do': a qualitative study on women's bodies within medicalized infertility in Italy. Psychol Health 2023:1-20. [PMID: 36799345 DOI: 10.1080/08870446.2023.2180148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 02/08/2023] [Accepted: 02/08/2023] [Indexed: 02/18/2023]
Abstract
OBJECTIVE In the context of infertility, women's bodies have a central physical, psychological, and social role. Medically assisted reproduction (MAR) treatment includes highly intrusive procedures targeting women's bodies. This study aimed to develop a preliminary understanding of women's core meanings around their bodies within their experiences of medicalized infertility in Italy. DESIGN 104 Italian women dealing with infertility and MAR treatments answered open-ended questions, which were part of a broader online survey. A reflexive thematic analysis was performed. RESULTS Three themes were identified: (a) the paradox of the body: 'I feel like I was born for something that my body can't do'; (b) 'Something only mothers can do': meanings attributed to the physical body; (c) Internalized 'clinical gaze': medicalized body representations. CONCLUSIONS This work provides insights into the meanings assigned to their bodies by Italian women dealing with MAR. This study outlined women's ambivalence towards their bodies, describing them as 'fragmented' into parts and as 'deposits' of their reproductive hopes. Results suggest that Italian pronatalist culture may have potential fallouts for women's gendered sense of self and the integration between their biological and psychosocial body experiences. Study limitations, future research directions, and clinical implications are presented.
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Affiliation(s)
- Chiara Fusco
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Chiara Masaro
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padua, Padova, Italy
| | - Vincenzo Calvo
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padua, Padova, Italy
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Scaravelli G, Fedele F, Spoletini R, Monaco S, Renzi A, Di Trani M. Toward a Personalized Psychological Counseling Service in Assisted Reproductive Technology Centers: A Qualitative Analysis of Couples' Needs. J Pers Med 2022; 13:jpm13010073. [PMID: 36675734 PMCID: PMC9867277 DOI: 10.3390/jpm13010073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/22/2022] [Accepted: 12/26/2022] [Indexed: 12/30/2022] Open
Abstract
Infertility may have a very strong emotional impact on individuals, requiring adequate support, but few studies on patients' demands toward psychological support have been conducted. This study aims to explore the emotions related to the infertility and to the Assisted Reproductive Technology (ART) procedure for which patients consider useful a psychological support. A total of 324 women completed a sociodemographic and clinical questionnaire and an open-ended questionnaire on emotional needs for psychological support. The written texts were explored by the Linguistic Inquiry and Word Count (LIWC) programme and linguistic characteristics were related to sociodemographic and anamnestic variables. Specific linguistic features were connected to several individual characteristics. More specifically, differences in linguistic processes emerged comparing women with an age over or under 40 years, women undergoing their first attempts versus more attempts, women undergoing ART with or without gamete donation, and women undergoing ART for male or unknown causes, as well as those undergoing ART for female or both partners' problems. These differences seem to confirm that older age, more attempts, gamete donation, and ART for unknown or male causes are risk factors that may worsen women's psychological well-being. This study contributes to increase the knowledge about the emotional needs of patients undergoing an ART procedure to develop specific psychological intervention programs.
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Affiliation(s)
- Giulia Scaravelli
- ART Italian National Register, National Centre for Diseases Prevention and Health Promotion, Italian National Health Institute, Viale Regina Elena 299, 00161 Rome, Italy
| | - Fabiola Fedele
- ART Italian National Register, National Centre for Diseases Prevention and Health Promotion, Italian National Health Institute, Viale Regina Elena 299, 00161 Rome, Italy
| | - Roberta Spoletini
- ART Italian National Register, National Centre for Diseases Prevention and Health Promotion, Italian National Health Institute, Viale Regina Elena 299, 00161 Rome, Italy
| | - Silvia Monaco
- Department of Dynamic and Clinical Psychology and Health Studies, “Sapienza” University of Rome, Via degli Apuli 1, 00185 Rome, Italy
- Correspondence:
| | - Alessia Renzi
- Department of Dynamic and Clinical Psychology and Health Studies, “Sapienza” University of Rome, Via degli Apuli 1, 00185 Rome, Italy
| | - Michela Di Trani
- Department of Dynamic and Clinical Psychology and Health Studies, “Sapienza” University of Rome, Via degli Apuli 1, 00185 Rome, Italy
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Zhu H, Shi L, Wang R, Cui L, Wang J, Tang M, Qian H, Wei M, Wang L, Zhou H, Xu W. Global Research Trends on Infertility and Psychology From the Past Two Decades: A Bibliometric and Visualized Study. Front Endocrinol (Lausanne) 2022; 13:889845. [PMID: 35903282 PMCID: PMC9317298 DOI: 10.3389/fendo.2022.889845] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 06/13/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives The aim of this study was to evaluate the global scientific output of research on infertility and psychology; explore the current status and trends in this field through the cooperation of authors, countries, and institutions; shed light on the direction of clinical infertility research in the future, and provide inspiration for targeted diagnosis and treatment of infertility. Methods Research publications on infertility and psychology from the past two decades were retrieved from the Web of Science Core Collection (WoSCC). Bibliometric analyses were performed using VOSviewer software and the bibliometrix R package. Network maps were generated to evaluate the collaborations between different authors, countries, institutions, and keywords. Results A total of 151 articles related to the study of infertility and psychology were identified. We observed a gradual increase in the number of publications from 2001 to 2021, and the trend has been relatively stable in the past eight years. Human Reproduction (England), as the leading journal publishing the most papers (29 articles), was cited in the most journals (1208 times). Boivin J was the most prolific author (16 articles), with the largest number of citations (890 times) and the highest h-index (14) during the past decades. Boivin J was also the leader with the highest publication frequency and more active cooperation with other top authors. The United Kingdom (34 papers) and Cardiff University (25 articles) contributed the most publications and were the leading contributors in this field. Active cooperation between countries and between institutions was observed, and analyses of articles and references were also shown. The main hot topics included matters related to women (39 times), in-vitro salt (31 times), infertility (30 times), couples (25 times), and impact (24 times). Conclusion Our study results provide a comprehensive overview of the development of scientific literature, allowing relevant authors and research teams to recognize the current research status in this field. At the same time, infertility and psychology may soon become hotspots and should be closely monitored.
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Affiliation(s)
- Hongkun Zhu
- Nanjing University of Chinese Medicine, Nanjing, China
| | - Lingli Shi
- Department of Reproduction, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Rong Wang
- Department of Laboratory Medicine, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Lijuan Cui
- Department of Pathology, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Jiahui Wang
- Department of Reproduction, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Mengyu Tang
- Department of Reproduction, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Haiqing Qian
- Department of Reproduction, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Minggang Wei
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Lihong Wang
- Department of Reproduction, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Huifang Zhou
- Department of Gynaecology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Wenting Xu
- Nanjing University of Chinese Medicine, Nanjing, China
- Department of Reproduction, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
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Marchini F, Caputo A, Langher V, Giuliani C, Convertino A, Mazzilli R, Faggiano A, Napoli A. Understanding care relationships in diabetes practice: A psychodynamic interview-based exploratory study. PLoS One 2022; 17:e0263226. [PMID: 35176064 PMCID: PMC8853562 DOI: 10.1371/journal.pone.0263226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 01/17/2022] [Indexed: 11/19/2022] Open
Abstract
Objective To explore the subjective experience of physicians working in diabetic settings about their care relationships in order to find some unique clues contributing to physician professional health and capacity to manage patients’ adherence. Research design and methods An interview-based exploratory study has been carried out involving 18 physicians (77.8% female) with at least 3 years of clinical practice in diabetes care. In-depth interviews about the emotional experience with patients with diabetes were conducted and audio recorded. Interviews transcripts were analyzed through a computer-based text analysis which allowed the identification of thematic domains (Cluster Analysis) and latent factors (Correspondence Analysis) viewed through a psychodynamic and constructivist lens. Results Six thematic domains emerged respectively referring to: Concern (8.43%), Control (14.42%), Ambivalence (22.08%), Devotion (22.49%), Guilt (19.29%) and Strive for Achievement (13.30%). Moreover, three latent dimensions were taken into account, which explained 69.20% of data variance: Affect Repression (28.50%), Tendency to Repair (22.70%) and Anxiety Pattern (18.00%). Conclusions Overall, the results of the present study confirm the challenging nature of diabetes care. In particular, physicians ongoing effort to restore patients’ psychological integrity in chronic condition constitute the most novel finding above all. In this regard, the need for emotional labor in physicians’ education and training is suggested in order to both prevent burnout symptoms (e.g. depersonalization) and promote shared decision making in care relationships. However, findings should be treated as preliminary given the convenience nature of the sample and its reduced size.
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Affiliation(s)
- Francesco Marchini
- Department of Dynamic and Clinical Psychology, “Sapienza” University of Rome, Rome, Italy
- Italian Center of Analytical Psychology, CIPA, Roma, Italy
- * E-mail:
| | - Andrea Caputo
- Department of Dynamic and Clinical Psychology, “Sapienza” University of Rome, Rome, Italy
| | - Viviana Langher
- Department of Dynamic and Clinical Psychology, “Sapienza” University of Rome, Rome, Italy
| | - Chiara Giuliani
- Endocrinology Unit, Department of Clinical and Molecular Medicine, “Sapienza” University” of Rome, Rome, Italy
| | - Alessio Convertino
- Endocrinology Unit, Department of Clinical and Molecular Medicine, “Sapienza” University” of Rome, Rome, Italy
| | - Rossella Mazzilli
- Endocrinology Unit, Department of Clinical and Molecular Medicine, “Sapienza” University” of Rome, Rome, Italy
| | - Antongiulio Faggiano
- Endocrinology Unit, Department of Clinical and Molecular Medicine, “Sapienza” University” of Rome, Rome, Italy
| | - Angela Napoli
- Endocrinology Unit, Department of Clinical and Molecular Medicine, “Sapienza” University” of Rome, Rome, Italy
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Caputo A, Langher V, Capri O, Muzii L, Fedele F. The need to restore generative identity in women undergoing assisted reproductive technology: Development and psychometric validation of the fertility reparation inventory. J Clin Psychol 2021; 78:1151-1169. [PMID: 34735723 PMCID: PMC9298421 DOI: 10.1002/jclp.23273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 10/17/2021] [Indexed: 11/29/2022]
Abstract
Objective This study described the development and psychometric evaluation of the fertility reparation inventory, providing measures of manic and expiatory reparation as symbolic dynamics of restoring one's procreative and generative identity through Assisted Reproductive Technology (ART). Methods Two cross‐sectional studies were conducted on female patients undergoing ART (N = 150) and women from the general population (N = 250), respectively. Exploratory factor analysis and confirmatory factor analysis assessed construct validity and reliability. Pearson's bivariate correlations were used to provide convergent evidence of validity with omnipotence, perceived infertility‐related stress, anxiety, depression, need for reparation, fear of punishment, and hope. Results The results confirmed a two‐factor solution of the 12‐item instrument, with adequate fit, a very good internal consistency, and well‐supported forms of convergent validity. Conclusion This study provides a meaningful psychodynamic contribution, in both theoretical and empirical terms, for the understanding of emotional dynamics and psychological issues underlying the demand for ART.
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Affiliation(s)
- Andrea Caputo
- Department of Dynamic, Clinical and Health Psychology, "Sapienza" University of Rome, Rome, Italy
| | - Viviana Langher
- Department of Dynamic, Clinical and Health Psychology, "Sapienza" University of Rome, Rome, Italy
| | - Oriana Capri
- Sterility and Assisted Reproduction Unit, Department of Gynecologic-Obstetrical and Urologic Sciences, "Sapienza" University of Rome, Umberto I Hospital, Rome, Italy
| | - Ludovico Muzii
- Sterility and Assisted Reproduction Unit, Department of Gynecologic-Obstetrical and Urologic Sciences, "Sapienza" University of Rome, Umberto I Hospital, Rome, Italy
| | - Fabiola Fedele
- Department of Dynamic, Clinical and Health Psychology, "Sapienza" University of Rome, Rome, Italy
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Caputo A. Telling a Complicated Grief: A Psychodynamic Study on Mental Health Nurses' Countertransference Reactions to Patients' Suicidal Behavior. Arch Suicide Res 2021; 25:862-875. [PMID: 32686613 DOI: 10.1080/13811118.2020.1768990] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
A key element of suicide education, training and clinical supervision is enhancing emotional awareness about mental health professionals' countertransference reactions, as emotional responses to patients' suicidal behavior (SB) that may be unbeneficial to care. This study aimed to explore emotional responses to patients' SB in mental health nurses (MHNs) according to a psychodynamic perspective. Twenty-eight Italian MHNs (61% females, Mage = 52 years) were interviewed to examine their deep feelings about attempted suicides or deaths by suicide of patients with mental illness. Computer-aided thematic analysis was performed on the verbatim transcribed interviews, adopting Emotional Text Analysis (ETA) as a research framework to explore affective symbolizations underlying narratives, beyond intentional and explicitly reported contents. Some statistical multidimensional techniques were carried out, allowing th.e detection of shared symbolic domains (Cluster Analysis) and latent factors organizing the contraposition between them (Multiple Correspondence Analysis). Five symbolic domains emerged which were respectively referred to as: hyper-vigilance (21.97% of the overall textual corpus), resentment (17.86%), rationalization (34.50%), resignation (5.54%) and mourning (20.12%). Four latent factors explained the overall data variance: strive for reparation (F1), lack of control (F2), ambivalence toward care (F3) and complicated grief (F4). Some clinical recommendations were derived suggesting to balance issues of risk assessment/management and staff's reflective practice, to work on the subjective sense of hopelessness resulting from turning against oneself the hostility evoked by patients, to consider rationalization processes and implicit beliefs leading to risk underestimation and to address some basic conflicts contributing to a complicated grief in mourning suicidal events.
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Domar A, Vassena R, Dixon M, Costa M, Vegni E, Collura B, Markert M, Samuelsen C, Guiglotto J, Roitmann E, Boivin J. Barriers and factors associated with significant delays to initial consultation and treatment for infertile patients and partners of infertile patients. Reprod Biomed Online 2021; 43:1126-1136. [PMID: 34756644 DOI: 10.1016/j.rbmo.2021.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 08/09/2021] [Accepted: 09/02/2021] [Indexed: 11/28/2022]
Abstract
RESEARCH QUESTION What are the key drivers and barriers for infertile patients and their partners to see an infertility specialist and initiate treatment? DESIGN An online, international, 30-minute quantitative survey collected data from 1944 respondents from nine countries. Respondents were infertile patients (n = 1037) or partners of infertile patients (n = 907; but not necessarily partners of the patient sample), at different stages of the treatment journey. RESULTS The overall average times were 3.2 years to receiving a medical infertility diagnosis, 2.0 years attempting to achieve pregnancy without assistance before treatment, and 1.6 years of treatment before successful respondents achieved pregnancy. The most common driver for considering treatment after a consultation (n = 1025) was an equal desire within the couple to have a child (40.8%). Of the partners (n = 356), 29.8% reported that transparency of information from healthcare professionals about treatment expectations was important. A significantly higher proportion of respondents seeking treatment reported that healthcare professionals offered supportive services (61.2%) and mental health services (62.0%), than of the 207 respondents who did not seek treatment (32.4% and 36.7%, respectively; P < 0.001). Perceived cost was the most commonly reported barrier for respondents not seeking a consultation (37.5% of n = 352) or treatment (42.0% of n = 207). Of the 95 respondents who discontinued treatment, 34.7% discontinued due to the financial impact. CONCLUSIONS Respondents reported significant delays to seeking treatment, probably negatively impacting the chances of achieving pregnancy. Motivational coherence within couples was a key driver and cost of treatment was the main barrier. Reported supportive service offerings by healthcare professionals were significantly associated with continuation of the treatment journey.
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Affiliation(s)
- Alice Domar
- Boston IVF, Domar Center for Mind/Body Health, Waltham, MA and Harvard Medical School, Boston MA, USA.
| | | | - Marjorie Dixon
- ANOVA Fertility and Reproductive Health, University of Toronto, Toronto ON, Canada
| | - Mauro Costa
- Reproductive Medicine, International Evangelical Hospital, Genova, Italy
| | - Elena Vegni
- Department of Health Sciences, Università Statale di Milano, Milan, Italy
| | - Barbara Collura
- RESOLVE: The National Infertility Association, McClean, Virginia, USA
| | - Marie Markert
- Ferring Pharmaceuticals, Health Economics & Outcomes Research, Copenhagen, Denmark
| | - Carl Samuelsen
- Ferring Pharmaceuticals, Health Economics & Outcomes Research, Copenhagen, Denmark
| | | | | | - Jacky Boivin
- School of Psychology, Cardiff University, Cardiff, UK
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Boz İ, Teskereci G, Akgün M. The experience of becoming a mother following successful in vitro fertilization: A grounded theory. J Adv Nurs 2021; 77:4170-4183. [PMID: 34227135 DOI: 10.1111/jan.14958] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 05/28/2021] [Accepted: 06/15/2021] [Indexed: 11/30/2022]
Abstract
AIM To develop a theory to explain women's experiences about becoming a mother following successful in vitro fertilization treatment. DESIGN This study is a qualitative study based on a constructivist grounded theory approach. METHODS Data were collected using a semi-structured interview guide initially that was later to be changed to a flexible interview guide between June 2018 and 2019. Interviews were conducted with 18 women, who became pregnant and mothers following successful in vitro fertilization treatment. Data collection and analysis were performed in a cyclic manner using open, axial and selective coding. This study was reported based on consolidated criteria and was used to report qualitative research data. FINDINGS The core category, 'non-spontaneous path to motherhood', involved the following four categories: 'the treatment process is exhausting', 'leaving the infertility world', 'pregnancy under the shadow of fear' and 'getting stuck between fertile and infertile worlds' with 10 sub-categories. CONCLUSION This study provides valuable insight into experiences of these women about becoming a mother. Unlike the Becoming a Mother Theory, it can be said that the anticipation stage, the first stage in the Becoming a Mother Theory, begins at the moment of embryo transfer in these women. Furthermore, the personal stage, the final stage in the Becoming a Mother Theory, is not completed within the first year after birth, even women were found to conceal experiences of in vitro fertilization treatment from the social environment even after birth. IMPACT This study will provide potential support for obstetric healthcare professionals in better understanding women's experiences about becoming a mother following successful in vitro fertilization treatment.
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Affiliation(s)
- İlkay Boz
- Department of Maternity and Gynecological Nursing, Akdeniz University Nursing Faculty, Antalya, Turkey
| | - Gamze Teskereci
- Department of Maternity and Gynecological Nursing, Akdeniz University Kumluca Health Science Faculty, Antalya, Turkey
| | - Mehtap Akgün
- Department of Maternity and Gynecological Nursing, Akdeniz University Nursing Faculty, Antalya, Turkey
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Paterlini M, Andrei F, Neri E, Trombini E, Santi S, Villani MT, Aguzzoli L, Agostini F. Maternal and Paternal Representations in Assisted Reproductive Technology and Spontaneous Conceiving Parents: A Longitudinal Study. Front Psychol 2021; 12:635630. [PMID: 33815221 PMCID: PMC8010127 DOI: 10.3389/fpsyg.2021.635630] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/22/2021] [Indexed: 11/21/2022] Open
Abstract
Aim of this study was to investigate whether parental mental representations during pregnancy and after delivery differed between parents who conceived after Assisted Reproductive Treatments (ART) and spontaneous conceiving (SC) parents. Effects of specific ART variables (previous ART attempts, treatment type and cause of infertility) were also taken into account. Seventeen ART couples and 25 SC couples were recruited at Santa Maria Nuova Hospital (Reggio Emilia, Italy). At both 32 weeks of gestation (T1) and 3 months postpartum (T2) participants completed the Semantic Differential of the IRMAG, a self-report tool which measures specific domains of mental representations pertaining either individual (Child, Self-as-woman/man, and Partner) or parental (Self-as-parent, Own parent) characteristics. Results showed that ART parents had significantly more positive representations of the child compared to SC parents, while the scores at Partner dimension improved from T1 to T2 for SC parents only. With regards to ART history, scores at the Self-as-woman/man dimension were significantly less positive for ICSI than IVF parents and improved substantially from T1 to T2 only in case of mothers with previous ART attempts and of fathers at the first ART cycle. The representation of own parents increased from T1 to T2 in case of infertility diagnosis due to male factors, while a decrease emerged when infertility was due to female factors. Findings suggest the need to investigate parental mental representations after ART, in order to improve the understanding on the transition to parenthood of infertile couples and to target more specific intervention for parenting support.
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Affiliation(s)
- Marcella Paterlini
- Department of Obstetrics and Pediatrics, AUSL-IRCCS, Reggio Emilia, Italy
| | - Federica Andrei
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Erica Neri
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Elena Trombini
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Sara Santi
- Department of Obstetrics and Gynecology, Fertility Center, AUSL-IRCCS, Reggio Emilia, Italy
| | - Maria Teresa Villani
- Department of Obstetrics and Gynecology, Fertility Center, AUSL-IRCCS, Reggio Emilia, Italy
| | - Lorenzo Aguzzoli
- Department of Obstetrics and Gynecology, Fertility Center, AUSL-IRCCS, Reggio Emilia, Italy
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13
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Caputo A. The emotional experience of caregiving in dementia: Feelings of guilt and ambivalence underlying narratives of family caregivers. DEMENTIA 2021; 20:2248-2260. [DOI: 10.1177/1471301221989604] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Objective The aim of this study was to explore narrative domains of family caregivers’ emotional experiences, beyond intentional and explicitly reported contents, and to examine their associations with subjects defining characteristics, such as gender, kinship, duration of caregiving, and burden levels. Methods The study participants were 17 Italian family caregivers (88.23% women) with a mean age of 59.14 years ( SD = 7.76), who provided their loved ones affected by dementia with in-home care. Structured interviews and Caregiver Burden Inventory were administered according to a mixed method design. A computer-aided text analysis was used which allowed the detection of shared narrative domains (cluster analysis) and latent factors organizing the contraposition between them (multiple correspondence analysis). Findings Five narrative domains emerged which were respectively referred to as perceived formal support (14.38% of the overall textual corpus), devotion (33.56%), anger (13.70%), sense of loss (18.49%), and feeling of uncertainty (19.86%). Kinship, duration of caregiving, and burden levels were differently associated with such domains. Two latent factors dealing with feelings of guilt and ambivalence explained 62.92% of overall data variance. Conclusion Guilt feelings should be carefully taken into account in support intervention with caregivers, with specific regard to stress and anger management. As well, a greater focus on caregivers’ emotion regulation and on the promotion of their problem-solving skills is needed when faced with contrasting beliefs about care decisions or role conflicts.
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Affiliation(s)
- Andrea Caputo
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
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Fedele F, Caputo A, Cordella B, Muzii L, Pietrangeli D, Aragona C, Langher V. What About Fertility Staff Emotions? An Explorative Analysis of Healthcare Professionals' Subjective Perspective. EUROPES JOURNAL OF PSYCHOLOGY 2020; 16:619-638. [PMID: 33680202 PMCID: PMC7909494 DOI: 10.5964/ejop.v16i4.2245] [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: 11/05/2019] [Accepted: 02/24/2020] [Indexed: 11/29/2022]
Abstract
Infertility-related psychological research is traditionally oriented to analyze the wellbeing of couples undergoing Assisted Reproductive Technologies (ART), than to study the job-related effects on the healthcare fertility staff. This piece of research aims at understanding the subjective perspective of the fertility professionals and contribute to identify their emotional dynamics in their work environment. An in-depth explorative research study was conducted on 12 healthcare professionals of an Italian ART hospital clinic. Structured interviews with open-ended questions were administered to explore their deep feelings about their professional experience. Emotional text analysis was then conducted to analyze the textual corpus of their narratives to grasp their affective symbolizations. Statistical multidimensional techniques were used to detect some thematic domains (cluster analysis) and latent factors organizing the contraposition between them (multiple correspondence analysis). Five thematic domains were detected which refer to different emotional dimensions, as follows: performance anxiety (Cluster 1), ambivalence between omnipotence and powerlessness (Cluster 2), care burden (Cluster 3), feeling of duty (Cluster 4), and sense of interdependence (Cluster 5). Then, four latent factors were identified dealing with the laborious attempt to remedy, the realistic sense of limitation, the incumbent feeling of pressure and the restorative sense of justice, respectively. The results are discussed based on the existing literature and some useful recommendations for staff education, training and clinical supervision are provided accordingly.
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Affiliation(s)
- Fabiola Fedele
- Department of Dynamic and Clinical Psychology, "Sapienza" University of Rome, Rome, Italy
| | - Andrea Caputo
- Department of Dynamic and Clinical Psychology, "Sapienza" University of Rome, Rome, Italy
| | - Barbara Cordella
- Department of Dynamic and Clinical Psychology, "Sapienza" University of Rome, Rome, Italy
| | - Ludovico Muzii
- Department of Gynecologic-Obstetrical and Urologic Sciences, "Sapienza" University of Rome, Umberto I Hospital, Rome, Italy
| | - Daniela Pietrangeli
- Department of Gynecologic-Obstetrical and Urologic Sciences, "Sapienza" University of Rome, Umberto I Hospital, Rome, Italy
| | - Cesare Aragona
- Department of Gynecologic-Obstetrical and Urologic Sciences, "Sapienza" University of Rome, Umberto I Hospital, Rome, Italy
| | - Viviana Langher
- Department of Dynamic and Clinical Psychology, "Sapienza" University of Rome, Rome, Italy
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