Assessment of a telephone helpline on infertility provided by a patient association

Implications of psychosocial support in infertility--a critical appraisal

OBJECTIVE

Various psychosocial interventions have been recommended for infertile persons, but it remains unclear what their implications are, and if some of them might even be harmful under certain circumstances.

METHODS

A survey is given of papers concerning the usefulness of psychosocial support in infertility.

RESULTS

Providing procedural information concerning the technical aspects of infertility investigation probably facilitates coping with infertility and with assisted reproductive techniques. This information can be given in the form of booklets or educational films. Using the Internet is a fast and easy way to obtain information on infertility and its treatment, but with the risk of getting wrong or misleading information. Telephone counseling can be helpful in providing specific information about the infertility workup but it cannot replace face-to-face counseling on distressing psychosocial issues. Attendance at support groups can be recommended to strengthen coping abilities. Psychosocial counseling and psychotherapy are definitely effective in reducing negative affect, mostly within a short period of time (less than 10 sessions). Pregnancy rates are unlikely to be affected by psychosocial interventions.

CONCLUSION

Infertility counseling and support groups seem to be the most efficient psychosocial interventions in infertility. Therefore, infertility counseling should be available at all stages of medical therapy, and it should be free of charge for the persons attending it. Course, content and goals of the infertility counseling should be made transparent. The efficacy of support groups has to be evaluated more systematically. Several methodological questions have to be solved yet, and the generalizability of these results is still restricted.

Erectile dysfunction and premature ejaculation are the most frequently self-reported sexual concerns: profiles of 9,536 men calling a helpline

OBJECTIVES

To describe the range of sexual problems, as reported by men calling a help-line and to investigate factors associated with help seeking behaviour.

METHODS

The study included all calls between 1999 and 2004. The information used for analysis comprised caller's demographic characteristics, the sexual problem reported, previous doctor contacts, coexisting physical and mental health problems.

RESULTS

Erectile dysfunction (ED) and premature ejaculation (PE) were the most frequently reported problems (57 and 19.2% respectively). ED-reporting callers were older (OR 0.63 for the ages of 50-59 yrs), with co-morbidities (OR 1.75) and in stable relationship (OR 0.46), while PE-reporting callers were younger (OR 5.83 for the ages of 20-29 yrs), relatively healthy and more likely single (OR 2.62 and OR 2.92 respectively). Type and duration of sexual concern, age, coexisting health problems and marital status relate significantly (p<0.01) with willingness to seek medical help.

CONCLUSIONS

The study demonstrates that ED and PE are men's major sexual concerns with personal and interpersonal factors influencing their help-seeking behaviour. Help-lines can serve as a link between health services and callers, while provide useful information for policy formation and improvement of support services.

Evaluation of the Dutch AIDS information helpline: an investigation of information needs and satisfaction of callers

AIDS telephone hotlines have an important function in AIDS education, HIV prevention and counselling. In this study, consults of the Dutch AIDS information helpline were evaluated to determine the AIDS information needs of the callers and callers' satisfaction with the telephone-delivered information and consultation. Immediately after their telephone consult, callers (N = 309) were redirected to co-workers of an independent telephone survey. They participated in an interview on content and evaluation of the telephone consult. This study shows that most telephone calls concerned questions about personal risk of HIV transmission, HIV transmission in general and HIV testing. Callers were very satisfied with the services of the helpline. Furthermore, helpline employees' counselling and conversation skills were evaluated very positively. These results are discussed within the scope of the professional organization of the Dutch AIDS information helpline.

A review of psychosocial interventions in infertility

Counselling has been strongly recommended by numerous governmental, medical and community associations to help infertile people. The purpose of this review was to determine whether psychosocial interventions improved well-being and pregnancy rates, and to identify the kinds of interventions that were most effective. A systematic search identified all published and unpublished papers in any language and any source that (1) described a psychosocial intervention and (2) evaluated its effect on at least one outcome measure in an infertile population. A total of 380 studies met the first criteria but only 6.6% (n=25) of these were independent evaluation studies. Analysis of these studies showed that psychosocial interventions were more effective in reducing negative affect than in changing interpersonal functioning (e.g., marital and social functioning). Pregnancy rates were unlikely to be affected by psychosocial interventions. It was also found that group interventions which had emphasised education and skills training (e.g., relaxation training) were significantly more effective in producing positive change across a range of outcomes than counselling interventions which emphasised emotional expression and support and/or discussion about thoughts and feelings related to infertility. Men and women were found to benefit equally from psychosocial interventions. Directions for future research on the evaluation of psychosocial interventions are discussed.