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Karakaş S, Akarsu RH, Tandoğan Ö, Şahan Ö. "The biggest disappointment": women's expectations from sex are ignored, from the perspective of infertile women. J Reprod Infant Psychol 2024; 42:842-854. [PMID: 37565411 DOI: 10.1080/02646838.2023.2243296] [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: 01/30/2023] [Accepted: 07/27/2023] [Indexed: 08/12/2023]
Abstract
OBJECTIVE The aim of this study is to determine the attitudes, behaviours and experiences of infertile women towards sexuality. METHODS This study was carried out in the infertility outpatient clinic of a state hospital in Istanbul of Turkey. Fifteen infertile women who had been receiving primary infertility treatment for at least two years and were actively continuing infertility treatment were included in the study. Data were collected by means of an detailed information form and a semi-structured interview. Content analysis was applied to the data obtained from semi-structured interviews. Consistency percentage calculation was made between the codes and themes determined by 4 researchers who are experts in their fields. RESULTS Results based on the interviews with the participants, 2 main themes, 6 sub-themes and 27 codes related to sub-themes were determined as 'Factors Affecting Sexual Life' and 'Overview of Sexual Health and Sexuality'. 'Disappointment' was determined as the most commonly defined code in the determined main theme and sub-themes. CONCLUSION It was determined that the majority of infertile women base their sexual lives on reproductive functions, experience serious sexual health problems, feel worthless, and describe their sexual life as a great disappointment.
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Affiliation(s)
- Sevda Karakaş
- Department of Nursing, Istanbul Arel University Faculty of Health Sciences, Istanbul, Turkey
| | - Rukiye Höbek Akarsu
- Faculty of Health Sciences, Department of Nursing, Yozgat Bozok University, Yozgat, Turkey
| | - Özden Tandoğan
- Department of Nursing, Istanbul Arel University Faculty of Health Sciences, Istanbul, Turkey
| | - Özlem Şahan
- Faculty of Health Sciences, Department of Midwifery, Antalya Bilim University, Antalya, Turkey
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Abdelnabi SJ. Muslim Women's Experiences with Infertility: A Literature Review. MCN Am J Matern Child Nurs 2024; 49:211-218. [PMID: 38512137 DOI: 10.1097/nmc.0000000000001022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
OBJECTIVE Infertility affects one in six women worldwide, playing a large role on an individual's psychosocial wellbeing and quality of life. The purpose of this review was to examine the experiences of Muslim women with infertility. METHODS A Prisma-guided literature review was conducted in Scopus, CINAHL, PubMed, Embase, PsychInfo, and Google Scholar. Sample inclusion criteria included research that examined the psychosocial consequences of infertility in women, used a qualitative design, were from a Muslim majority country or specified participants were Muslim, and were published in the English-language since 2013. Thematic analysis was used to synthesize the findings into themes. RESULTS Fourteen qualitative studies that explored the experiences of Muslim women with infertility were included for analysis. Women's responses were categorized into three focus areas: (1) emotional responses, (2) interpersonal relationships, and (3) social relationships. From these focus points, six overarching themes were identified that illustrated the challenges faced by Muslim women experiencing infertility: (1) identity crisis, (2) low self-esteem and depression, (3) abuse and harassment, (4) a weakened marital bond, (5) stigma, and (6) social exclusion and isolation . CLINICAL IMPLICATIONS Review of the literature provided an initial entrée into understanding the experiences of Muslim women with infertility. Understanding the unique role of infertility within a religious community equips nurses and other providers with the knowledge that discussions surrounding infertility must be conducted with cultural sensitivity. Further research should be conducted to explore and offer culturally tailored educational materials that align with the religious preferences of Muslim women.
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Affiliation(s)
- Samia Jamal Abdelnabi
- Samia Jamal Abdelnabi is a Research Fellow, National Clinician Scholars Program, Department of Health Behavior and Biological Sciences, University of Michigan, School of Nursing, Ann Arbor, MI. Dr. Abdelnabi can be reached at
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Luo D, Zhouchen YB, Li L, Jiang YL, Liu Y, Redding SR, Wang R, Ouyang YQ. The Stigma and Infertility-Related Stress of Chinese Infertile Women: A Cross-Sectional Study. Healthcare (Basel) 2024; 12:1053. [PMID: 38891128 PMCID: PMC11171736 DOI: 10.3390/healthcare12111053] [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: 03/22/2024] [Revised: 05/05/2024] [Accepted: 05/20/2024] [Indexed: 06/21/2024] Open
Abstract
OBJECTIVES This study was conducted to investigate the stigma status of infertile women in China and to determine the influencing factors. METHODS 366 infertile women from the gynecological and reproductive departments of two tertiary hospitals completed socio-demographic questionnaires, the Infertility Stigma Scale (ISS) and the Mandarin Fertility Problem Inventory (M-FPI). RESULTS The scores of stigma and infertility-related stress in infertile women were (52.51 ± 17.74) and (150.03 ± 17.51), respectively. Multiple regression analysis found that location of residence, regarding children as the most important thing in life, talking to others about infertility and infertility-related stress were the main influencing factors of stigma in infertile women, which explained 17.3% of the total variance. CONCLUSIONS In the current study, the level of stigma in women with infertility was at the middle range. Location of residence, regarding children as the most important thing in life, whether to talk with others about infertility and infertility-related stress were the four main influencing factors of stigma.
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Affiliation(s)
- Dan Luo
- School of Nursing, Wuhan University, Wuhan 430071, China; (D.L.); (Y.-B.Z.); (Y.-L.J.)
| | - Yi-Bei Zhouchen
- School of Nursing, Wuhan University, Wuhan 430071, China; (D.L.); (Y.-B.Z.); (Y.-L.J.)
| | - Lu Li
- The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China;
| | - Yu-Lei Jiang
- School of Nursing, Wuhan University, Wuhan 430071, China; (D.L.); (Y.-B.Z.); (Y.-L.J.)
| | - Yi Liu
- Zhongnan Hospital of Wuhan University, Wuhan 430071, China;
| | | | - Rong Wang
- Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Yan-Qiong Ouyang
- School of Nursing, Wuhan University, Wuhan 430071, China; (D.L.); (Y.-B.Z.); (Y.-L.J.)
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Bawadi H, Al-Hamdan ZM, Clark CJ, Hall-Clifford R, Hamadneh JM, Al-Sharu EE. Infertile Jordanian Women's Self-Perception About Societal Violence: An Interpretative Phenomenological Study. Int J Womens Health 2024; 16:593-603. [PMID: 38633886 PMCID: PMC11022872 DOI: 10.2147/ijwh.s451950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 04/02/2024] [Indexed: 04/19/2024] Open
Abstract
Background Infertility affects one in six couples globally and is compounded by stigma and violence, particularly for women, in Jordan's culture. While existing research has illuminated societal pressures faced by infertile women, there is, yet no comprehensive understanding of the violence they encounter in their daily lives. Objective This Interpretative Phenomenological study seeks to unravel the experiences of infertile women regarding societal violence in Jordan. By focusing on different types of community violence - physical, psychological, and emotional - The study aims to provide nuanced insights into the challenges these women confront. It also endeavors to identify contributing factors, including societal attitudes, cultural beliefs, and individual encounters, while informing policy and practice to mitigate this issue. Methods Employing a qualitative approach, this study conducted semi-structured interviews with purposively sampled infertile women. Thematic analysis was utilized to uncover recurring patterns and themes, facilitating a comprehensive exploration of their experiences. Results Five main themes were identified: How the surrounding people view me as an infertile woman; I am suffocated by their questions; they interfere in the smallest details; I got burned and turned to ashes, and I have no right to complain; The problem of childbearing and the treatment plan is a matter for me and my husband only; and who supports me and what do I want from those around me? Implications This study's implications are significant for policy and practice. By foregrounding the prevalent violence faced by infertile women, it underscores the urgency of interventions. Raising awareness, providing education, and extending support can counteract societal stigma and violence. Creating a more compassionate societal fabric can ensure a safer, more inclusive environment for these women.
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Affiliation(s)
- Hala Bawadi
- Maternal and Child Health Nursing Department, the University of Jordan, Amman, Jordan
| | - Zaid M Al-Hamdan
- Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Cari Jo Clark
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Rachel Hall-Clifford
- Center for the Study of Human Health and Department of Sociology, Emory University, Atlanta, GA, USA
| | - Jehan Mahmoud Hamadneh
- IVF Center/ King Abdullah University Hospital, Jordan University of Science and Technology, Ar-Ramtha, Jordan
| | - Emad Elddeen Al-Sharu
- OB-GYN Senior Specialist Reproductive Medicine(IVF), Royal Medical Services, Amman, Jordan
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Mohammadi F, Javanmardifard S, Bijani M. Women living with infertility in Iran: A qualitative content analysis of perception of dignity. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241260027. [PMID: 38836384 PMCID: PMC11155321 DOI: 10.1177/17455057241260027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 05/07/2024] [Accepted: 05/21/2024] [Indexed: 06/06/2024]
Abstract
BACKGROUND Globally, infertility is known as a major problem which can ruin a couple's relationship. In recent years, many studies have addressed the causes of infertility, the outcomes of treatments for infertility, and the effects of infertility on couples' mental health; however, the concept of dignity of women living with infertility has never been examined in depth. OBJECTIVE This study aimed to explore the dignity of women living with infertility in Iran. DESIGN This qualitative research was conducted via conventional content analysis approach. METHODS This qualitative study was conducted in Iran from February to December 2022. In this research, the data were collected through face-to-face semi-structured in-depth interviews with 23 women living with infertility selected via purposive sampling. The interviews were continued until reaching the data saturation point. Data analysis was performed simultaneously with data collection. The interviews were recorded, transcribed, and analyzed through Graneheim and Lundman style content analysis, with data management done using the MAXQDA software. To achieve the accuracy and validity of the study, the four-dimension criteria by Lincoln and Guba, namely credibility, dependability, conformability, and transformability, were considered and used. RESULTS Analysis of the qualitative data yielded three themes and eight subthemes. The three main themes were (1) overcoming identity crises (overcoming dysthymia, coping with unaccomplished motherhood), (2) respect for personal identity (respect for confidentiality; respect for beliefs, values, and attitudes; avoidance of stigma and pity), and (3) compassion-focused therapy (sympathizing, mental and spiritual support, and enhancement of life skills). CONCLUSION Dignity of women living with infertility encompasses overcoming identity crises, respect for personal identity, and compassion therapy. The policymakers and administrators in the healthcare system can use the findings of this study to create a proper clinical environment toward preserving the dignity of women living with infertility.
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Affiliation(s)
- Fateme Mohammadi
- Chronic Diseases (Home Care) Research Center and Autism Spectrum Disorders Research Center, Department of Nursing, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Sorur Javanmardifard
- Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mostafa Bijani
- Department of Medical Surgical Nursing, School of Nursing, Fasa University of Medical Sciences, Fasa, Iran
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Ozcan S, Kirca N. Effects of care given in line with Levine's Conservation Model on the quality of life of women receiving infertility treatment: A single blind randomized controlled trial. Health Care Women Int 2023; 44:418-439. [PMID: 34846278 DOI: 10.1080/07399332.2021.2007927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Although infertility is not a life-threatening condition, it decreases the quality of life of people. This single blind randomized controlled trial was conducted with 80 women who received infertility treatment in an IVF Center located in a city center in the west of Turkey between May 2020 and February 2021. It was determined that thanks to the holistic care given in line with Levine's Conservation Model (LCM), fatigue levels of the women in the experimental group decreased, their energy levels increased, their structural, personal and social integrity was conserved and thus their quality of life improved compared to the women in the control group (all p < 0.001).
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Affiliation(s)
- Sadiye Ozcan
- Department of Obstetrics & Gynecological Nursing, Yalova University Faculty of Health Sciences, Yalova, Turkey
| | - Nurcan Kirca
- Department of Obstetrics & Gynecological Nursing, Akdeniz University Faculty of Nursing, Antalya, Turkey
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El-Dirani Z, Akik C, Attel L, Kamhawi R, Nawafleh M, Essaid A, DeJong J. Interactive community-based theatre to address social barriers to accessing reproductive health services in patriarchal societies: the case of Jordan. CULTURE, HEALTH & SEXUALITY 2023; 25:176-191. [PMID: 35156538 DOI: 10.1080/13691058.2022.2029572] [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: 05/28/2021] [Accepted: 01/11/2022] [Indexed: 06/14/2023]
Abstract
Interactive community-based theatre is used to engage with audience members and allow for free exchange of ideas relevant to context. It aims to bring about a new understanding of an issue while challenging people's attitudes and perceptions. Its application within the field of sexual and reproductive health has been limited, particularly in low and middle-income contexts. This paper presents the rationale for a research-arts partnership in Jordan and describes the process and some lessons learned from the development and country-wide performances of a research-informed interactive play. The play, Mish 'Ayb (Not a Shame) was designed to address social barriers to accessing sexual and reproductive services in a patriarchal society. The sensitive portrayal by Jordanian actors of real-life scenarios pertaining to specific health issues encouraged identification of the audience with the actors, thereby building trust. This process helped to uncover cultural norms that facilitate and impede people's access to health services and information. Qualitative research designs that incorporate interactive theatre present a strong potential avenue to explore sensitive topics related to sexuality, particularly in patriarchal contexts.
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Affiliation(s)
- Zeinab El-Dirani
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Chaza Akik
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Lina Attel
- National Centre for Culture and Arts, King Hussein Foundation, Amman, Jordan
| | - Rania Kamhawi
- National Centre for Culture and Arts, King Hussein Foundation, Amman, Jordan
| | - Muhannad Nawafleh
- National Centre for Culture and Arts, King Hussein Foundation, Amman, Jordan
| | - Aida Essaid
- Information and Research Center, King Hussein Foundation, Amman, Jordan
| | - Jocelyn DeJong
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
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8
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Abu-Sharkia S, Taubman - Ben-Ari O, Mofareh A. Personal Growth and Life Satisfaction during Fertility Treatment-A Comparison between Arab and Jewish Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2187. [PMID: 36767553 PMCID: PMC9915886 DOI: 10.3390/ijerph20032187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/20/2023] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
Coping with difficulty conceiving and the ensuing fertility treatments is a stressful experience that impacts many aspects of women's lives. On the basis of Lazarus and Folkman's model of stress and coping and Schaefer and Moos's model of personal growth, and in view of the sparse literature on cultural aspects of infertility and personal growth, this study examined the relationship between stress on the one hand and personal growth and life satisfaction on the other among Arab and Jewish Israeli women. Furthermore, it investigated the moderating role played by perceived stigma, coping flexibility, cultural orientation (individualism and collectivism), and ethnicity. Two hundred five Arab and Jewish Israeli women undergoing fertility treatment completed self-report questionnaires. The results show that Arab women reported higher levels of personal growth and individualism than Jewish women. In the whole sample, a linear negative relationship was found between stress and life satisfaction, and a curvilinear relationship was found between stress and personal growth. In addition, perceived stigma, collectivism, individualism, and coping flexibility were found to moderate the association between perceived stress and personal growth. The findings provide further understanding of personal growth in the context of infertility, showing that personal resources and perceptions are more important than cultural differences in this regard.
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Affiliation(s)
- Salam Abu-Sharkia
- The Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat Gan 5290002, Israel
| | - Orit Taubman - Ben-Ari
- The Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat Gan 5290002, Israel
| | - Ali Mofareh
- Clalit Health Services (Kupat Holim Clalit), Jerusalem 9112102, Israel
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Xie Y, Ren Y, Niu C, Zheng Y, Yu P, Li L. The impact of stigma on mental health and quality of life of infertile women: A systematic review. Front Psychol 2023; 13:1093459. [PMID: 36698573 PMCID: PMC9869765 DOI: 10.3389/fpsyg.2022.1093459] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 11/30/2022] [Indexed: 01/11/2023] Open
Abstract
Introduction The stigma of not giving birth to children affects approximately 53. 08~64% of female infertility patients worldwide. This stigma not only causes harm to the mental health of these infertility patients, but also affects their quality of life, making them bear the adverse social consequences such as domestic violence, marriage breakdown, or even delay in receiving the treatment. Therefore, it is crucial to have a deep understanding of the patients' stigma and effective intervention in alleviating it. Aims/Question This study aims to discuss and summarize the stigma in infertile women and its impact on patients, and to provide a theoretical basis for the clinical treatment and nursing intervention of disease stigma in infertile female patients. Methods The literature search used four English databases (Cochrane Library, EMBASE, Web of Science, and PubMed) and two Chinese databases (CNKI and Wanfang). The search time of the literature ranges from the establishment of the library to 2022, with no language restriction. Results The review included 28 studies, with 20 cross-sectional studies and 8 qualitative studies. This study found that social support, living environment, education level, occupation, and fertility awareness were the major influencing factors of infertility stigma. Conclusions Infertility stigma can bring heavy mental pressure and psychological burden to female infertility patients and affect their quality of life. Therefore, effective and targeted psychological interventions should be developed to reduce the patients' stigma and improve their quality of life. Implications for practice Healthcare workers must develop targeted nursing interventions, provide professional counseling services to reduce the level of stigma in female infertility patients, alleviate fertility stress, and improve their quality of life.
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Affiliation(s)
- Yue Xie
- School of Nursing and Public Health, Yangzhou University, Yangzhou, China
| | - Yue Ren
- School of Nursing and Public Health, Yangzhou University, Yangzhou, China
| | - Changmin Niu
- School of Nursing and Public Health, Yangzhou University, Yangzhou, China
| | - Ying Zheng
- School of Nursing and Public Health, Yangzhou University, Yangzhou, China
| | - Ping Yu
- Affiliated Hospital of Yangzhou University, Yangzhou, China
| | - Lin Li
- Affiliated Hospital of Yangzhou University, Yangzhou, China
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Crooks R, Bedwell C, Lavender T. Adolescent experiences of pregnancy in low-and middle-income countries: a meta-synthesis of qualitative studies. BMC Pregnancy Childbirth 2022; 22:702. [PMID: 36096763 PMCID: PMC9469636 DOI: 10.1186/s12884-022-05022-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 09/01/2022] [Indexed: 11/17/2022] Open
Abstract
Background Fertility rates among adolescents have fallen globally, yet the greatest incidence remains in low-and middle-income countries (LMICs). Gaining insight into adolescents needs and experiences of pregnancy will help identify if context specific services meet their needs and how to optimise pregnancy experiences. A meta-synthesis of qualitative studies considering adolescent experiences of pregnancy in LMICs has not yet been published. Aim To synthesise available qualitative evidence to provide greater understanding of the needs and experiences of adolescents who become pregnant in low-and middle-income countries. Methods An extensive search utilised six databases and citations searching. Studies were included if they were of a qualitative or mixed methods design. Participants lived in LMICs and were adolescents who were pregnant, had experienced pregnancy during adolescence or were an adolescent male partner. Relevant studies were assessed for quality to determine suitability for inclusion. A meta-ethnography approach was used to generate themes and a final line of argument. Results After screening and quality assessment 21 studies were included. The meta-ethnography generated four themes, A wealth of emotions, I am not ready, Impactful relationships and Respectful and disrespectful care. Unplanned, unwanted and unacceptable pregnancies were a source of shame, with subsequent challenging personal relationships and frequently a lack of needed support. Even when pregnancy was wanted, adolescents faced the internal conflict of their desires not always aligning with socio-cultural, religious and family expectations. Access, utilisation and experiences of care were significantly impacted by adolescents’ relationships with others, the level of respectful care experienced, and engagement with adolescent friendly services. Conclusions Adolescents who experience pregnancy in LMICs deserve support to meet their personal and pregnancy needs; efforts are needed to tailor the support provided. A lack of a health care provider knowledge and skills is an obstacle to optimal support, with more and better training integral to increasing the availability of adolescent friendly and respectful care. Adolescents should be involved in the planning of health care services and supported to make decisions about their care. The diversity across countries mean policy makers and other stakeholders need to consider how these implications can be realised in each context. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-05022-1.
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Affiliation(s)
- Rachel Crooks
- Liverpool School of Tropical Medicine, Liverpool, UK.
| | - Carol Bedwell
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Tina Lavender
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
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Romeiro J, Caldeira S, Venicios Lopes M. "Impaired Resilience (00210)" in patients under fertility treatment: Clinical validation study. Int J Nurs Knowl 2022. [PMID: 36031947 DOI: 10.1111/2047-3095.12391] [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: 03/26/2022] [Accepted: 07/21/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE The aim of this study was a clinical validation of the NANDA-I nursing diagnosis "Impaired Resilience (00210)" in people under fertility treatment and determination of the sensitivity, specificity, and predictive value of the defining characteristics. METHODS A cross-sectional study was conducted between September 2019 and June 2020. A total of 104 patients were recruited through fertility-related websites, and they answered an online questionnaire after giving informed consent. The Rasch model was used for statistical analysis. The study was approved by the Ethics Committee. FINDINGS The "Impaired Resilience (00210)" had a prevalence of 15.4% in the sample, and seven defining characteristics confirmed as representative are "decreased interest in vocational activities," "depression," "impaired health status," "ineffective coping strategies," "low self-esteem," "renewed elevation of distress," and "social isolation." No item showed differential item functioning. "Renewed elevation of distress" and "low self-esteem" were the most sensitive defining characteristics and had the highest negative predictive value. "Shame" was the most specific one. CONCLUSIONS The nursing diagnosis "Impaired Resilience (00210)" was validated, and results may improve its accuracy in people going through fertility treatment. IMPLICATIONS FOR NURSING PRACTICE This paper contributes by raising knowledge regarding NANDA-I nursing diagnosis and enhancing the quality of nurses' critical judgment and clinical reasoning. A more effective assessment will allow early recognition of patients struggling with adversity during fertility treatment and enhance a nursing resilience approach in the reproductive field.
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Affiliation(s)
- Joana Romeiro
- Centre for Interdisciplinary Research in Health, Institute of Health Sciences, Universidade Católica Portuguesa, Palma de Cima, Lisbon, Portugal
| | - Sílvia Caldeira
- Centre for Interdisciplinary Research in Health, Institute of Health Sciences, Universidade Católica Portuguesa, Palma de Cima, Lisbon, Portugal
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12
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Romeiro J, Caldeira S, Lopes MV. “Spiritual distress (00060)” in patients under fertility treatment: Clinical validation study. Int J Nurs Knowl 2022; 34:97-107. [PMID: 35792716 DOI: 10.1111/2047-3095.12383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 06/01/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE This study aimed to clinically validate the NANDA-I nursing diagnosis of "Spiritual distress (00066)" in people under assisted reproductive technologies, and to determine the sensitivity, specificity, and predictive value of the defining characteristics. METHODS Cross-sectional study that was conducted between September 2019 and June 2020. Recruitment happened by invitation posted in fertility-related websites. Those who accepted to participate were asked to fill the consent form and the online questionnaire. Statistical analysis was based on Rasch's model. The study was approved by the Ethics Committee. FINDINGS The sample comprised 104 Portuguese individuals undergoing assisted reproductive techniques. The "Spiritual distress (00066)" was validated and 22 defining characteristics were confirmed as representative. No item showed differential item functioning. "Perceived suffering" was the most sensitive defining characteristic and had the highest negative predictive value. "Insufficient courage" had the highest positive predictive value, and "Anger toward power greater than self" was the most specific. CONCLUSIONS Results validated the presence of the NANDA-I nursing diagnosis of "Spiritual distress (00066)" in a sample going through assisted reproductive technologies, improving accuracy of this nursing diagnosis in such population. IMPLICATIONS FOR NURSING PRACTICE This is a crucial step to raise the level of evidence of such nursing diagnosis and to increase the level of evidence on NANDA-I terminology. Furthermore, this study has contributed to raising the quality of nurse's critical judgement and clinical reasoning and allow an early spiritual and a more holistic and personalized patient-centered intervention in the reproductive field.
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Affiliation(s)
- Joana Romeiro
- Universidade Católica Portuguesa, Institute of Health Sciences, Centre for Interdisciplinary Research in Health Palma de Cima, Lisbon Portugal
| | - Sílvia Caldeira
- Universidade Católica Portuguesa, Institute of Health Sciences, Centre for Interdisciplinary Research in Health Palma de Cima, Lisbon Portugal
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Ebrahimzadeh Zagami S, Latifnejad Roudsari R, Janghorban R, Allan HT. Trying for a second chance: Iranian infertile couples' experiences after failed ART. J Psychosom Obstet Gynaecol 2022; 43:165-170. [PMID: 34388051 DOI: 10.1080/0167482x.2021.1961733] [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: 10/20/2022] Open
Abstract
INTRODUCTION Despite significant advances, only 35% infertile couples conceive after ART. If IVF is unsuccessful, couples will need to decide whether to proceed again with assisted conception. The aim of this study was to explore Iranian infertile couples' experiences after failed ART to continue treatment. METHODS In this qualitative study participants were selected using purposeful sampling method. Data were collected using 29 semi-structured face-to-face in-depth interviews at a regional Infertility Center from April 2016 to June 2017. All interviews were recorded, transcribed verbatim, and analyzed with conventional content analysis method using MAXQDA software. RESULTS Our findings suggest that couples' decisions to continue treatment after unsuccessful ART is shaped by their social, emotional and financial circumstances. We have constructed two themes to describe their experiences: support to continue and trying for a second chance. CONCLUSION Our findings suggest that good marital and family support networks can support infertile couples during this period of decision making. Considering the depression and anxiety caused by failed ARTs, which itself could affect the success rate of any further ARTs, the clinical team should effectively assess psychological readiness of couples who decide to continue with another ART after unsuccessful treatment.
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Affiliation(s)
| | | | - Roksana Janghorban
- Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Helen T Allan
- Department of Adult Child and Midwifery, School of Health and Education, Middlesex University, London, UK
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Jing X, Gu W, Xu X, Yan C, Jiao P, Zhang L, Li X, Wang X, Wang W. Stigma predicting fertility quality of life among Chinese infertile women undergoing in vitro fertilization-embryo transfer. J Psychosom Obstet Gynaecol 2022; 43:35-41. [PMID: 32633181 DOI: 10.1080/0167482x.2020.1778665] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE To investigate stigma and fertility quality of life (FertiQoL) and identify predictors of FertiQoL in Chinese infertile women undergoing in vitro fertilization-embryo transfer (IVF-ET). METHODS A descriptive correlational design was adopted to investigate the association between stigma and FertiQoL in 588 infertile women undergoing IVF-ET. The personal information questionnaire, Infertility Stigma Scale (ISS) and FertiQoL tool were used to measure study variables. RESULTS The mean scores of ISS and FertiQoL were 62.59 (SD = 21.58) and 63.64 (SD = 13.72), respectively. There were significant differences of ISS scores among participants with different educational level, residence, occupation, religious belief, financial condition, age group, duration of infertility and infertility treatment, while significant differences of the FertiQoL scores were found in participants with different insurance status, determinism of etiology, infertile type, duration of infertility treatment and cycles of IVF-ET. Pearson's correlation analysis showed stigma was negatively correlated with FertiQoL (r = -0.081 to -0.669, p < .05). The self-devaluation (β = -0.290, p < .001), social withdrawal (β = -0.237, p < .001), family stigma (β = -0.217, p < .001) and insurance status (β = 0.066, p=.035) were identified as the significant predictor of FertiQoL accounting for 43.5% of variance. CONCLUSIONS The stigma was significantly associated with FertiQoL in infertile women undergoing IVF-ET with higher level of stigma predicting poorer FertiQoL. More psychological support should be provided to infertile women to reduce stigma and improve FertiQoL.
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Affiliation(s)
- Xiaoyu Jing
- School of Nursing, Xi'an Jiaotong University, Xi'an, PR China
| | - Wei Gu
- School of Nursing, Xi'an Jiaotong University, Xi'an, PR China
| | - Xiuli Xu
- Northwest Women's and Children's Hospital, Xi'an, PR China
| | | | - Peijuan Jiao
- School of Nursing, Xi'an Jiaotong University, Xi'an, PR China
| | - Lu Zhang
- School of Nursing, Xi'an Jiaotong University, Xi'an, PR China
| | - Xiaomei Li
- School of Nursing, Xi'an Jiaotong University, Xi'an, PR China
| | - Xiaoqin Wang
- School of Nursing, Xi'an Jiaotong University, Xi'an, PR China
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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15
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Zhao Q, Huangfu C, Li J, Liu H, Tang N. Psychological Resilience as the Mediating Factor Between Stigma and Social Avoidance and Distress of Infertility Patients in China: A Structural Equation Modeling Analysis. Psychol Res Behav Manag 2022; 15:391-403. [PMID: 35228821 PMCID: PMC8882026 DOI: 10.2147/prbm.s354803] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 02/10/2022] [Indexed: 12/12/2022] Open
Abstract
Background Stigma, social avoidance and distress may seriously affect the quality of life of infertility patients. Psychological resilience has been proved to effectively combat psychological stress. This study aimed to explore the mediating role of psychological resilience between stigma and social avoidance and distress (SAD) in females with an unfulfilled wish for a child. Methods Stigma Scale, Social Avoidance and Distress Scale (SADS), and Psychological Resilience Scale were used to evaluate 266 females with infertility. Structural equation model was used to test the mediating effect of psychological resilience on the relationship between stigma and SAD. Results The SADS, stigma scores, and psychological resilience scores of 266 females with infertility were 13.36 ± 5.77, 77.84 ± 16.91, and 58.84 ± 12.24 points, respectively. The stigma scores were positively correlated with SADS, and negatively correlated with psychological resilience scores. The psychological resilience scores were negatively correlated with SADS. Psychological resilience played a partially mediating role between the stigma and SAD of infertility patients, and the mediating effect accounted for 25.5% of the total effect. Conclusion Psychological resilience had a partial mediating effect on the relationship between stigma and SAD, and could reduce the negative effect of stigma on the development of SADS. Therefore, positive psychological interventions improving psychological resilience might help to reduce stigma and improve SAD in infertility patients.
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Affiliation(s)
- Qing Zhao
- School of Nursing, Lanzhou University, Lanzhou, Gansu, 730010, People’s Republic of China
| | - Chaoji Huangfu
- Department of Infectious Disease Prevention and Control, Center for Disease Control and Prevention, Western Theater Command, Lanzhou, Gansu, 730020, People’s Republic of China
| | - Junzheng Li
- Department of Infectious Disease Prevention and Control, Center for Disease Control and Prevention, Western Theater Command, Lanzhou, Gansu, 730020, People’s Republic of China
| | - Huihui Liu
- School of Nursing, Lanzhou University, Lanzhou, Gansu, 730010, People’s Republic of China
| | - Nan Tang
- School of Nursing, Lanzhou University, Lanzhou, Gansu, 730010, People’s Republic of China
- Correspondence: Nan Tang, Tel +86-18793111027, Email
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Dierickx S. 'With the kanyaleng and the help of god, you don't feel ashamed': women experiencing infertility in Casamance, Senegal. CULTURE, HEALTH & SEXUALITY 2022; 24:268-283. [PMID: 33135970 DOI: 10.1080/13691058.2020.1833366] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 10/04/2020] [Indexed: 06/11/2023]
Abstract
While the precarious situation of women with infertility in Sub-Saharan Africa is well documented, little is known about the ways in which such women show agency despite the challenges that infertility brings to their lives. This study provided a holistic understanding of the experiences of women with infertility living in a rural community in Casamance (Senegal), drawing attention towards both suffering as well as agency. Qualitative research methods were used, triangulating life-story interviews, participant observation and informal conversations. Findings showed that all women with infertility experienced emotional challenges. These emotional challenges were intertwined with social stigmatisation and troubled relationships with their families-in-law and within their marriages. However, women with infertility were not passive victims in these circumstances. The study identified several strategies used by women to cope with the challenges of infertility, including organising in kanyaleng groups, treatment seeking, fosterage, looking for religious and social support, becoming (financially) independent, avoidance and ignorance. These findings highlight the complexity of agency within a context of structural violence. Concrete measures to improve the lives of women with infertility should acknowledge the agency of women with infertility and involve such women while developing multi-component approaches addressing inequalities.
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Affiliation(s)
- Susan Dierickx
- Centre of Expertise on Gender, Diversity and Intersectionality (RHEA), Vrije Universiteit Brussel, Brussels, Belgium
- Centre for Research on Culture and Gender, Ghent University, Ghent, Belgium
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17
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Kucuk S, Koruk F. Being An Infertile Woman in A Highly Fertile Region of Turkey: Stigmatisation and Coping Experiences. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2022. [DOI: 10.29333/ejgm/11545] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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18
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Jing X, Gu W, Zhang L, Miao R, Xu X, Wang M, Ramachandran HJ, Wang W. Coping strategies mediate the association between stigma and fertility quality of life in infertile women undergoing in vitro fertilization-embryo transfer. BMC WOMENS HEALTH 2021; 21:386. [PMID: 34727911 PMCID: PMC8561985 DOI: 10.1186/s12905-021-01525-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 10/25/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND The mediating role of coping strategies and its relationship with psychological well-being and quality of life has been considered in the literature. However, there is little research to explore the mechanism of coping strategies on stigma and fertility quality of life (FertiQoL) in infertile women undergoing In Vitro Fertilization Embryo Transfer (IVF-ET). The aim of this study was to examine the mediating effect of coping strategies on the relationship between stigma and fertility quality of life (FertiQoL) in Chinese infertile women undergoing In Vitro Fertilization Embryo Transfer (IVF-ET). METHODS In this cross-sectional study, a total of 768 infertile women undergoing IVF-ET were recruited from Assisted Reproductive Center of Shaanxi Province, China. The personal information, infertility stigma scale, coping strategy scale and FertiQoL scale were measured using a set of questionnaires. The multiple mediator model was performed using AMOS 21.0. RESULTS The model showed a significant negative direct effect between stigma on FertiQoL. There were significantly negative indirect effects of stigma on FertiQoL through active-avoidance, active-confronting and passive-avoidance, respectively. The meaning-based coping played a positive intermediary role. The model explained 69.4% of the variance in FertiQoL. CONCLUSION Active-avoidance coping strategy is the most important mediator factor between stigma and FertiQoL in infertile women undergoing IVF-ET treatment. Meaning-based coping strategy plays a positive mediating role between stigma and FertiQoL.
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Affiliation(s)
- Xiaoyu Jing
- Northwest Women's and Children's Hospital, No. 73 Houzaimen, Xi'an, 710003, Shaanxi, China
| | - Wei Gu
- School of Nursing, Xi'an Jiaotong University Health Science Centre, No. 76 Yantaxi Road, Xi'an, 710061, Shaanxi, China.
| | - Lu Zhang
- School of Nursing, Xi'an Jiaotong University Health Science Centre, No. 76 Yantaxi Road, Xi'an, 710061, Shaanxi, China
| | - Runna Miao
- School of Nursing, Xi'an Jiaotong University Health Science Centre, No. 76 Yantaxi Road, Xi'an, 710061, Shaanxi, China
| | - Xiuli Xu
- Northwest Women's and Children's Hospital, No. 73 Houzaimen, Xi'an, 710003, Shaanxi, China
| | - Min Wang
- Northwest Women's and Children's Hospital, No. 73 Houzaimen, Xi'an, 710003, Shaanxi, China
| | - Hadassah Joann Ramachandran
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Block MD11, level 2 10 Medical Drive, Singapore, 117597, Singapore
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Block MD11, level 2 10 Medical Drive, Singapore, 117597, Singapore
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Simionescu G, Doroftei B, Maftei R, Obreja BE, Anton E, Grab D, Ilea C, Anton C. The complex relationship between infertility and psychological distress (Review). Exp Ther Med 2021; 21:306. [PMID: 33717249 PMCID: PMC7885086 DOI: 10.3892/etm.2021.9737] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 12/18/2020] [Indexed: 12/11/2022] Open
Abstract
Infertility is defined as the inability to procreate, or carry or deliver a baby naturally. The majority of specialists describe infertility as being unable to get pregnant after having tried for at least one year. The relationship between infertility and psychological stress is complex. On the one hand, infertile couples are subject to greater stress and have a greater risk of developing psychological disorders compared with normal, healthy couples. On the other hand, high levels of psychological distress have been indicated to increase infertility. Therefore, in the present review, the main factors that may lead to increased stress in couples who try to conceive, psychological stress as the reason for infertility, and the therapies that can help decrease psychological distress and increase chances of pregnancy are underlined. In addition to the psychological side effects that may occur from infertility itself, a range of other side effects can be caused by hormones and drugs used to treat infertility. Additionally, problem during erection and ejaculation can cause of psychological distress, which can lead to infertility among men. Psychotherapy is the main intervention recommended for couples who suffer from any form of infertility. Ideally, counselling should begin before patients start any medical intervention to help with their infertility.
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Affiliation(s)
- Gabriela Simionescu
- Department of Mother and Child Medicine, University of Medicine and Pharmacy ‘Gr. T. Popa’ Iasi, Faculty of Medicine, 700115 Iasi, Romania
- Clinical Department, Clinical Hospital of Obstetrics and Gynecology ‘Cuza Voda’, 700038 Iasi, Romania
- Origyn Fertility Center, 700032 Iasi, Romania
| | - Bogdan Doroftei
- Department of Mother and Child Medicine, University of Medicine and Pharmacy ‘Gr. T. Popa’ Iasi, Faculty of Medicine, 700115 Iasi, Romania
- Clinical Department, Clinical Hospital of Obstetrics and Gynecology ‘Cuza Voda’, 700038 Iasi, Romania
| | - Radu Maftei
- Clinical Department, Clinical Hospital of Obstetrics and Gynecology ‘Cuza Voda’, 700038 Iasi, Romania
- Origyn Fertility Center, 700032 Iasi, Romania
- Department of Morphostructural Sciences, University of Medicine and Pharmacy ‘Gr. T. Popa’ Iasi, Faculty of Medicine, 700115 Iasi, Romania
| | | | - Emil Anton
- Department of Mother and Child Medicine, University of Medicine and Pharmacy ‘Gr. T. Popa’ Iasi, Faculty of Medicine, 700115 Iasi, Romania
- Clinical Department, Clinical Hospital of Obstetrics and Gynecology ‘Cuza Voda’, 700038 Iasi, Romania
| | - Delia Grab
- Department of Mother and Child Medicine, University of Medicine and Pharmacy ‘Gr. T. Popa’ Iasi, Faculty of Medicine, 700115 Iasi, Romania
- Clinical Department, Clinical Hospital of Obstetrics and Gynecology ‘Cuza Voda’, 700038 Iasi, Romania
| | - Ciprian Ilea
- Department of Mother and Child Medicine, University of Medicine and Pharmacy ‘Gr. T. Popa’ Iasi, Faculty of Medicine, 700115 Iasi, Romania
- Clinical Department, Clinical Hospital of Obstetrics and Gynecology ‘Cuza Voda’, 700038 Iasi, Romania
| | - Carmen Anton
- Department of Mother and Child Medicine, University of Medicine and Pharmacy ‘Gr. T. Popa’ Iasi, Faculty of Medicine, 700115 Iasi, Romania
- Clinical Department, Sf. Spiridon Clinical Hospital, 700111 Iasi, Romania
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Kyei JM, Manu A, Kotoh AM, Adjei CA, Ankomah A. Beliefs about children and the psychosocial implications of infertility on individuals seeking assisted fertilization in Ghana. REPRODUCTIVE BIOMEDICINE & SOCIETY ONLINE 2021; 12:88-95. [PMID: 33898794 PMCID: PMC8053779 DOI: 10.1016/j.rbms.2021.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 02/06/2021] [Accepted: 02/11/2021] [Indexed: 05/02/2023]
Abstract
Infertility presents challenges to individuals and couples, particularly in Sub-Saharan Africa. This study aimed to document beliefs about childbearing/children and the psychosocial implications of infertility in individuals seeking assisted fertilization in the Ghanaian context. The study had an exploratory descriptive qualitative design. Six males and 12 females were recruited purposefully from five private fertility centres in the Greater Accra Region. Face-to-face interviews were performed. In Ghanaian society, couples and individuals with infertility who are seeking assisted fertilization consider having biological children to be important. The quest to have children was broadly centred on the associated benefits of being a parent, including societal recognition, the role of family inheritance, and support. The inability of participants to have biological children was found to have a negative effect on their psychological and social well-being. Anxiety, worry, hopelessness, stigma and suicidal ideations were some of the effects identified. It is recommended that those seeking assisted fertilization should be supported through counselling to minimize the potential negative effects of childlessness.
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Affiliation(s)
| | - Adom Manu
- Department of Population, Family and Reproductive Health, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Agnes M. Kotoh
- Department of Population, Family and Reproductive Health, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | | | - Augustine Ankomah
- Department of Population, Family and Reproductive Health, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
- Population Council, Accra, Ghana
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21
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Olamijuwon E, Odimegwu C, Chemhaka G. Involuntary Childlessness and Marital Infidelity Among Women in Sub-Saharan African Countries: An Assessment of the Moderating Role of Women's Education. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:601-614. [PMID: 32621140 DOI: 10.1007/s10508-020-01770-3] [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: 11/11/2018] [Revised: 05/31/2020] [Accepted: 06/10/2020] [Indexed: 06/11/2023]
Abstract
A considerable number of married women in sub-Saharan African countries are childless and may be likely to engage in marital infidelity to avoid social stigma, economic insecurities, and other debilitating experience associated with being involuntarily childless. This study sought to investigate the relationship between involuntary childlessness and marital infidelity and how it may be moderated by women's educational attainment. Data were obtained from 23,847 women in their first union for at least 2 years and participated in the demographic and health surveys of five sub-Saharan African countries comprising Cameroon, Gabon, Lesotho, Liberia, and Sierra Leone. Data were analyzed using multivariate logistic regression, adjusted for socioeconomic, union, and partner characteristics. Involuntarily childless women in Cameroon (AOR: 2.34, 95% CI 1.62-3.39) and Sierra Leone (AOR: 2.22, 95% CI 1.42-3.49) were about two times more likely to engage in marital infidelity compared to non-childless married women. In Gabon, Lesotho, and Liberia, the odds of marital infidelity did not significantly differ between involuntarily childless and non-childless married women. Although involuntarily childless women with secondary or higher education reported higher levels of marital infidelity than non-childless women with a similar level of education, we found no statistical evidence in all the countries that the relationship between involuntary childlessness and marital infidelity was moderated by women's educational attainment. These findings suggest that involuntary childlessness is a critical factor potentially related to marital infidelity and may be an important target for intervention and prevention, particularly in settings with high levels of sexually transmitted infections.
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Affiliation(s)
- Emmanuel Olamijuwon
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, 1 Jan Smuts Avenue, Braamfontein, Johannesburg, 2000, South Africa.
- Department of Statistics and Demography, Faculty of Social Sciences, University of Eswatini, Kwaluseni Campus, Kwaluseni, Eswatini.
| | - Clifford Odimegwu
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, 1 Jan Smuts Avenue, Braamfontein, Johannesburg, 2000, South Africa
| | - Garikayi Chemhaka
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, 1 Jan Smuts Avenue, Braamfontein, Johannesburg, 2000, South Africa
- Department of Statistics and Demography, Faculty of Social Sciences, University of Eswatini, Kwaluseni Campus, Kwaluseni, Eswatini
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22
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Mahadeen AI, Hamdan-Mansour AM, Habashneh SA, Dardas LA. Sexual Satisfaction Among Infertile Couples: Demographics and Psychosocial Health Factors. J Psychosoc Nurs Ment Health Serv 2020; 58:40-47. [PMID: 32853392 DOI: 10.3928/02793695-20200812-01] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 05/26/2020] [Indexed: 11/20/2022]
Abstract
The purpose of the current study was to explore sexual satisfaction among infertile couples in Jordan and its associations with psychosocial and sociodemographic factors. Using a descriptive correlational design, 248 infertile couples from outpatient clinics were recruited and filled out a questionnaire on sexual satisfaction, in addition to perceived social support, depressive symptoms, psychological stress, coping skills, optimism, life satisfaction, and sociodemographics. Sexual satisfaction was significantly and positively correlated with perceived social support, optimism, life satisfaction, and coping. Stronger association was observed between sexual satisfaction and optimism. No difference was found in sexual satisfaction in relation to participants' gender, age, working status, or education. This study highlights the importance of building mental health nurses' competence to provide education and counseling on sexuality to improve the quality of life of infertile couples and optimize their sexual wellness. The most recent guidelines for psychosocial care for infertile couples are discussed. [Journal of Psychosocial Nursing and Mental Health Services, 58(9), 40-47.].
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Zarif Golbar Yazdi H, Aghamohammadian Sharbaf H, Kareshki H, Amirian M. Psychosocial Consequences of Female Infertility in Iran: A Meta-Analysis. Front Psychiatry 2020; 11:518961. [PMID: 33250787 PMCID: PMC7674496 DOI: 10.3389/fpsyt.2020.518961] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 09/16/2020] [Indexed: 12/29/2022] Open
Abstract
Background: Although not a life-threatening condition, infertility does influence various aspects of life. Based on a meta-analysis of the relevant literature, the aim of this study is to identify the psychosocial consequences of infertility in Iranian women. Methods: Comprehensive Portal of Human Sciences, Magiran, Scientific Information Database, Noormags, MEDLIB, ScienceDirect, Google Scholar, Medline, and ProQuest were the databases searched from inception (1999) to 2018. To maximize the comprehensiveness of the search, the reference lists of all the relevant papers identified were manually examined. The evaluation of the content was based on PRISMA guidelines, and Comprehensive Meta-Analysis software was used for data analysis. Results: Based on the analysis of 124 quantitative papers, the psychosocial consequences of infertility in women in Iran can be classified into 14 categories: psychological well-being (effect size = 3.10), adaptation to infertility (effect size = 2.71), quality of life (effect size = 1.83), depression (effect size = 1.80), anxiety (effect size = 1.72), marital relationships (effect size = 1.37), personality disorders (effect size = 1.37), violence (effect size = 1.31), social support (effect size = 0.90), self-efficacy (effect size = 0.90), coping strategies (effect size = 0.84), irrational thoughts (effect size = 0.77), somatization disorders (effect size = 0.65), and sexual dysfunction (effect size = 0.55). Conclusion: Considering the wide-ranging psychosocial consequences of infertility in women, it is necessary for treatment to account for psychological factors.
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Affiliation(s)
| | | | - Hossein Kareshki
- Department of Psychology, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Malihe Amirian
- Department of Reproductive Medicine and Gynecology, Milad (Mashhad) Infertility Center, Mashhad, Iran
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Ebrahimzadeh Zagami S, Latifnejad Roudsari R, Janghorban R, Mousavi Bazaz SM, Amirian M, Allan HT. Iranian infertile couples' strategies to manage social interactions after unsuccessful treatment with assisted reproductive technologies. HUM FERTIL 2019; 24:341-352. [PMID: 31621448 DOI: 10.1080/14647273.2019.1677950] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Many infertile couples feel vulnerable after failed treatment cycles and find insensitive remarks or inappropriate support distressing. They fear that the stress of failed treatment cycles may affect their marriage and lead to marriage breakdown. This study explored the strategies a sample of infertile couples used to manage social interactions after unsuccessful treatment with assisted reproductive technologies. A descriptive qualitative study was conducted with 34 participants including nine infertile couples, nine infertile women and two infertile men with primary infertility, two relatives, and three fertility clinic staff. The participants were selected through purposive sampling at an infertility centre in Iran, between 2016 and 2017. Data were collected using semi-structured face-to-face interviews and analysed by qualitative content analysis approach. Participants found some social interactions after failed assisted reproductive treatment cycles to be distressing and painful. They described tolerating painful emotions which cause them sadness and sorrow as well as feeling embarrassed. As a result, they found they needed to maintain their adopting concealment strategies with their families through not permitting speculation, selective disclosure, not giving details and hiding the truth. This study showed that social interactions following failed assisted reproductive cycles can be upsetting for infertile couples. Couples use different strategies to manage potentially distressing social interactions. Healthcare providers and psychologists may provide a space for safe social interactions in order to help couples to use appropriate strategies in these circumstances.
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Affiliation(s)
| | | | - Roksana Janghorban
- Maternal-Fetal Medicine Research Centre, Shiraz University of Medical Sciences , Shiraz , Iran
| | | | - Maliheh Amirian
- Department of Obstetrics and Gynecology, School of Medicine, Mashhad University of Medical Sciences , Mashhad , Iran
| | - Helen T Allan
- Department of Adult Child and Midwifery, School of Health and Education, Middlesex University , London , UK
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Grootenhuis A, van den Hoogen A, Broekmans F, Torrance H, van Os-Medendorp H, Ockhuijsen H. Young women's opinions on the use of a blood test to predict the possibility of premature ovarian failure: a qualitative study. HUM FERTIL 2019; 24:304-314. [PMID: 31530237 DOI: 10.1080/14647273.2019.1665198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The anti-Müllerian hormone (AMH) test is increasingly being used to predict the age when women will enter menopause, signalling the end of their reproductive life. However, the accuracy of the AMH test varies widely. In this qualitative study, we asked young women of three differing education levels about the possibility of predicting premature ovarian failure (POF), defined as menopause that occurs before the age of 40. A total of 15 face-to-face semi-structured interviews were conducted. The overarching theme was 'considering the possibility of predicting POF', and the three interpretive themes were (i) limited fertility knowledge, (ii) preconditions for pregnancy and (iii) desire to have children. The interview was their first awareness of the concept of POF. All the women who participated in this study wished to have children at some point later in life and tended to think more about fulfilling preconditions before getting pregnant than about their actual fertility. Most participants (n = 8) were interested in the AMH test regardless of their education level. Five participants wanted to take the test in the future. This research provides some insight into young women's current thoughts about the possibility of predicting POF with an AMH test.
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Affiliation(s)
- Anouk Grootenhuis
- Clinical Health Sciences at the University Utrecht, Utrecht, The Netherlands
| | - Agnes van den Hoogen
- Department Women and Baby, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Frank Broekmans
- Department Women and Baby, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Helen Torrance
- Department Women and Baby, University Medical Centre Utrecht, Utrecht, The Netherlands
| | | | - Henrietta Ockhuijsen
- Department Women and Baby, University Medical Centre Utrecht, Utrecht, The Netherlands
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Kaya Z, Oskay U. Stigma, hopelessness and coping experiences of Turkish women with infertility. J Reprod Infant Psychol 2019; 38:485-496. [DOI: 10.1080/02646838.2019.1650904] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Zehra Kaya
- Department of Gynecologic and Obstetrics Nursing, Istanbul University-Cerrahpaşa Florence Nightingale Nursing Faculty, Istanbul, Turkey
| | - Umran Oskay
- Department of Gynecologic and Obstetrics Nursing, Istanbul University-Cerrahpaşa Florence Nightingale Nursing Faculty, Istanbul, Turkey
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Women with infertility complying with and resisting polygyny: an explorative qualitative study in urban Gambia. Reprod Health 2019; 16:103. [PMID: 31307488 PMCID: PMC6633655 DOI: 10.1186/s12978-019-0762-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 06/26/2019] [Indexed: 12/04/2022] Open
Abstract
Background In many low-and middle-income countries women with infertility are often in polygynous marriages. From a human and women’s rights perspective, the practice of polygyny is commonly understood as harmful. Studies indicate that polygyny aggravates negative life circumstances of women with infertility with respect to their health and social well-being. The purpose of this qualitative study is to explore how women with infertility experience polygyny and to understand their decision-making regarding these marriages. Methods An explorative qualitative study was conducted among women with infertility in the urban communities of the West Coast region of The Gambia using in-depth interviews (30). Data analysis involved an emergent and partially inductive thematic framework and was carried out using NVivo 11. Results With the exception of some women with infertility who described positive experiences within polygynous marriages, most women emphasised conflicts that exist within polygynous households and reported financial and emotional difficulties. Thematic analysis identified several strategies of women with infertility to cope with and resist polygynous marriages, including overcoming childlessness, addressing conflict, spending time outside the compound, looking for social support, kanyaleng kafoolu, living separately and initiating divorce. Moreover, the experiences and decision-making power of women with infertility when it comes to polygynous marriages was found to be closely related to their socio-demographic background. Conclusion This work highlights how women with infertility in polygynous marriages are in a precarious situation in urban Gambia. Women utilize a mix of compliance, coping and resistance strategies to navigate the challenges of polygynous marriages in a structurally constraining context.
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Al-Kloub MI, Al-Zein HJ, Abdalrahim MS, Abed MA. Young women's experience of adolescent marriage and motherhood in Jordan. CULTURE, HEALTH & SEXUALITY 2019; 21:462-477. [PMID: 30355056 DOI: 10.1080/13691058.2018.1489067] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Accepted: 06/11/2018] [Indexed: 06/08/2023]
Abstract
Adolescent pregnancy and early motherhood are associated with poor social and physical outcomes. This study explored the experiences of marriage and motherhood among Jordanian young women. A descriptive qualitative design was employed. Participants (n = 15, age 15-37 years) who had experienced adolescent marriage and motherhood and who lived in eastern Amman, the capital of Jordan, were selected via snowball sampling. Data were collected by tape-recorded face-to-face interviews and analysed thematically. Five themes were identified: lost opportunities for personal development, learning to be submissive and indecisive, uncertainty toward cultural norms, ambivalent feelings toward a maternal role and empowering oneself to face life demands. The findings indicate that the experience of marriage and motherhood among Jordanian adolescents was mostly negative; they felt that they had been deprived of their rights, respect and the experience of being a young person. Additionally, they felt that the transition into motherhood was very difficult, and that they were prematurely forced into adult social roles and responsibilities, which caused them to experience numerous challenges. Adolescent mothers are a vulnerable group that should be better targeted by prevention and intervention measures.
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Affiliation(s)
- Manal Ibrahim Al-Kloub
- a Department of Maternal, Child and Family Health Nursing , The Hashemite University , Zarqa , Jordan
| | - Hanan J Al-Zein
- b Faculty of Nursing , Al-Ahliyya Amman University , Amman , Jordan
| | | | - Mona Abdallah Abed
- d Department of Adult Health Nursing , The Hashemite University , Zarqa , Jordan
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Banihani SA, Khabour OF, Alzoubi KH. Fertility testing for men before marriage: Is it acceptable? Andrologia 2018; 51:e13212. [PMID: 30523631 DOI: 10.1111/and.13212] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 11/05/2018] [Accepted: 11/06/2018] [Indexed: 02/01/2023] Open
Abstract
Addressing male infertility issue before marriage, at least to the mate and her family, seems reasonable to avoid several psychosocial, economic and biological consequences. Here, we intended to comprehend whether fertility testing (i.e. semen analysis) for men before marriage is acceptable and can be applied in Jordanian society. To achieve this contribution, we designed a questionnaire that shows the opinion of a sample of the Jordanian population in applying fertility testing for men before marriage. A total of 740 adult individuals (>18 years old, 364 males, 382 females) were selected randomly from different martial, economic, social, ethnic, religious and education statuses to fill the questionnaire. A total of 523 (70.11%) participants had a positive attitude towards applying fertility testing for men before marriage. This opinion was found not to be affected by gender (p = 0.305), age (p = 0.329), body mass index (p = 0.061), smoking (p = 0.059), monthly income (p = 0.094), education level (p = 0.131) and family members with infertility (p = 0.074); while, it is found to be affected by the social status of the participant (p = 0.004). In conclusion, applying fertility testing for men before marriage appears to be acceptable in Jordanian society.
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Affiliation(s)
- Saleem Ali Banihani
- Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Omar F Khabour
- Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Karem H Alzoubi
- Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
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Mollayeva T, Mollayeva S, Colantonio A. Traumatic brain injury: sex, gender and intersecting vulnerabilities. Nat Rev Neurol 2018; 14:711-722. [DOI: 10.1038/s41582-018-0091-y] [Citation(s) in RCA: 109] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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'I am always crying on the inside': a qualitative study on the implications of infertility on women's lives in urban Gambia. Reprod Health 2018; 15:151. [PMID: 30208896 PMCID: PMC6134751 DOI: 10.1186/s12978-018-0596-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 08/24/2018] [Indexed: 11/10/2022] Open
Abstract
Background There is an increasing awareness that infertility in Sub-Saharan Africa constitutes a severe social and public health problem. Few of the existing studies on infertility explicitly take into account the differences between women. However, how women experience infertility is formed by their various social positions. This research explores the implications of infertility on women’s lives in urban Gambia and aims to provide an in-depth understanding of how this relates to gender and cultural norms as well as different social positions. Methods Qualitative data were collected through interviews (33), group discussions (13), participatory observations (14) and informal conversations (31). Purposive and snowball sampling techniques were used to identify participants. The data was analysed thematically using NVivo 11. Results Results showed that there was strong social pressure on urban women in The Gambia to procreate. Unable to conform to their gender role, women with infertility were confronted with financial problems, social stigma, as well as emotional and physical violence in their marriage. All women expressed feelings of trauma, stress and sadness. The intersectional approach used in this study highlighted how different positions influenced women’s experiences of infertility. Urban women with a high socio-economic status had a more powerful position within their marriages and the broader community, due to their financial position, professional career and, sometimes, their educational background. In contrast, women from a lower socio-economic background were more likely to be harshly confronted with the social stigma of infertility. Conclusion The lives of most women with infertility in The Gambia are characterized by social suffering resulting from gender and pro-natal norms, cultural beliefs and moral concerns, cultural practices and limited access to health care. An intersectional approach is an effective tool to inform public health and social policy since it highlights how, in specific situations, certain groups are more vulnerable than others.
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