Application of the dyadic data analysis in behavioral medicine research: marital satisfaction and anxiety in infertile couples

Factors influencing the anxiety and depression status in patients undergoing in vitro fertilization-embryo transfer assisted pregnancy

Women undergoing in vitro fertilization-embryo transfer (IVF-ET) can suffer from anxiety and depression at various levels during the process. This study aimed to assess the anxiety and depression statuses (primary outcome) and influencing factors (secondary outcome) among patients undergoing IVF-ET. A 2019-2020 survey at Northwest Women's and Children's Hospital studied IVF-ET patients, evaluating anxiety and depression with GAD-7 and PHQ-9 alongside demographic data, using logistic regression for influencing factors. Among the 2465 women who undergoing IVF-ET, 27.18% had depression, and 18.46% had anxiety. Bachelors' degree (OR = 0.659, 95%CI: 0.503-0.864), male factor infertility (OR = 0.745, 95%CI: 0.558-0.995), and assessment on the day of starting gonadotropin stimulation (OR = 0.781, 95%CI: 0.626-0.974) were negatively independently associated with depression, while comorbidities (OR = 1.541, 95%CI: 1.281-1.854) and an extended ART strategy (OR = 1.394, 95%CI: 1.162-1.672) were independently associated with depression. High school/technical school education (OR = 0.669, 95%CI: 0.490-0.915) and bachelor's degree (OR = 0.640, 95%CI: 0.472-0.868) were negatively independently associated with anxiety, while an extended ART strategy (OR = 1.476, 95%CI: 1.197-1.820) was independently associated with anxiety. In conclusion, the prevalence of depression and anxiety was high in women undergoing IVF-ET. The study identified factors independently associated with depression and anxiety that could be used to guide the psychological management of women undergoing IVF-ET.

Impact of perceived social support on anxiety and depression in women undergoing in vitro fertilization-embryo transfer: the role of psychological resilience

PURPOSE

This study aimed to analyze the current status of women's perception of social support levels, psychological resilience, anxiety, and depression levels during IVF-ET, as well as investigate the influence of perceived social support and psychological resilience on the anxiety and depression levels of women undergoing IVF-ET and the mediating role of psychological resilience in this process.

METHODS

In this study, a convenience sampling method was used to administer a questionnaire survey among 433 women undergoing IVF-ET. Then, multivariate linear regression models were applied to identify factors influencing anxiety and depression. Lastly, mediation effect analysis was conducted to explore the mediating role of psychological resilience.

RESULTS

The incidence of anxiety and depression was 42% and 46.4%, respectively. The mean score of the Perceived Social Support Scale (PSSS) indicated a high to moderate level of support, while the mean score of the Conner-Davidson Resilience Scale (CD-RISC) suggested moderate psychological resilience. Perceived social support was positively correlated with psychological resilience, and both were negatively correlated with anxiety and depression. Perceived social support and psychological resilience were identified as influencing factors of anxiety and depression (P < 0.001). Moreover, there was a partial mediating effect of psychological resilience between perceived social support and both anxiety and depression (P < 0.01).

CONCLUSIONS

These results highlight the need for healthcare providers to assess patients' levels of psychological resilience and perceived social support when developing mental health interventions in order to mitigate the risk of anxiety and depression and concomitantly enhance fertility outcomes.

Role of Marital Relationship Quality in Emotional Disturbance and Personal Growth of Women with Infertility: A Cross-Sectional Study

BACKGROUND

Infertility is a stressful condition that can lead to either emotional disturbance or personal growth. Marital relationship is one of the factors affecting the consequences of infertility. This study aimed to explore the role of marital relationship quality in development of women's personal growth after experiencing infertility.

MATERIALS AND METHODS

In the cross-sectional study, 122 infertile women (mean age 28.79 ± 6.3) were invited to complete the survey, including ENRICH Marital Satisfaction Scale, Posttraumatic Growth, Fertility problem inventory, State-Trait Anxiety Inventory, and Beck Inventory Depression.

RESULTS

Higher scores of quality of marital relationships were a protective factor against infertility stress and state/ trait anxiety. Additionally, infertility stress was a strong negative predictor of personal growth. Furthermore, infertile women with a high level of marital relationships may have more chances to experience personal growth rather than stress in infertility treatments.

CONCLUSION

The study suggests that high quality of marital relationships may provide positive opportunities for women's personal growth after experiencing infertility.

Prevalence and associated risk factors for anxiety and depression in infertile couples of ART treatment: a cross-sectional study

BACKGROUND

Infertility now is a public health concern and is associated with increased psychological distress.

METHODS

We enrolled 1247 infertile couples and assessed their anxiety and depression status before and during assisted reproductive technology (ART) treatment using the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS). The Chi-square or fisher's exact test was used to analyze the prevalence of anxiety and depression in infertile couples. Multivariate logistical regression was performed to analyze the risk factors for anxiety and depression.

RESULTS

The prevalence of anxiety was 13.5% and 8.7% (p < 0.05), and that of depression was 9.4% and 7.9% (p = 0.2) in female and male partners, respectively. Female SAS and SDS scores were positively associated with male SAS and SDS scores, respectively (r = 0.52 and r = 0.50, respectively, both p < 0.0001), and were positively associated with their own SDS and SAS scores, respectively (r = 0.63 and r = 0.62, respectively, both p < 0.0001). Their own depression or partners' anxiety was associated with the anxiety, and their own anxiety or partners' depression was associated with the depression in infertile couples. No children, unemployment, and low education level were also associated with female anxiety. SAS and SDS scores were significantly decreased during ART treatment.

CONCLUSIONS

Females were more vulnerable to having anxiety than males in infertile couples. Anxiety and depression in infertile couples could interact, therefore, anxiety and depression would be simultaneously counseled, and their partners also should be given supportive psychotherapy.

TRIAL REGISTRATION

It was an observational study and had no health care interventions on participants. So it was not registrated.

Changes in the Sexual Behavior of Partners in Each Trimester of Pregnancy in Otwock in Polish Couples

The aim of this study was to improve knowledge regarding pregnant couples by assessing changes in their sexual behavior, the reasons for the frequency and forms of intercourse, and the self-sexuality of partners in each trimester of pregnancy. As a result, 100 couples were qualified to take part in the final study, with 100 men and 100 women examined at intervals equivalent to the trimesters of pregnancy. These women (n = 100) and men (n = 100) were partners. Each of the studied couples was assessed in the trimesters of pregnancy. A prospective examination was conducted based on the observation of the same people, which were heterosexual couples, throughout pregnancy. The data used in the study was obtained using Davies’ Sexual Satisfaction Scale (DSSS), as well as an original survey on the sexuality of people during pregnancy (SARSS). The survey allowed us to obtain sociodemographic (metrics) information along with information regarding the sexual activity, satisfaction, and sexual attraction of the partners. All questionnaire questions were answered in paper form. There was a statistically significant drop in sexual intercourse from the first trimester in the second and third trimesters. The frequency of masturbation increased in men and decreased in women. The most common cause of sexual abstinence during the pregnancy was cited as fear for the fetus by all genders. A statistical analysis indicated that the average overall scores of the DSSS for the examined women in the first trimester of pregnancy were statistically significantly higher than in the two subsequent trimesters (p < 0.05). Sexual satisfaction, measured through both DSSS and SARSS, was also strongly correlated with the level of satisfaction in the assessment of the partner relationship and with the sense of one’s own attractiveness (p < 0.05). Changes in sexual behavior and sexual problems are often exposed or worsened during a first pregnancy and can have negative impacts on a person and the future of relationships. Medical staff should be trained in the assessment of sexual difficulties in people during pregnancy, in order to conduct reliable education and increase the awareness of couples regarding sexual and reproductive health.

Using Dyadic Modeling in Nursing Research: Introduction of Theory and Application

Use of dyadic modeling in nursing has theoretical and practical importance, as the interpersonal processes related to health behaviors can be captured. Theoretical models focusing on dyadic coping with chronic illness and illness management are established in family nursing. However, few studies utilized dyadic designs in empirical research, as most studies are patient-centric or care partner-centric. With theoretical elaborations and examples, we first review how conventional health models have been extended using a dyadic perspective and then briefly review the major dyadic frameworks in nursing. Five frequently used dyadic models are described with examples from health and nursing research fields. Statistical applications and cultural considerations are reviewed. We conclude that dyadic modeling provides a useful lens for nursing research but continues to be underutilized.

Infertility Related Quality of Life and Self-Efficacy among Infertile Couples: A Dyadic Approach

The article's abstract is not available.  

Utilising dyads in medicines optimisation and illness management research

There has been much growth in the interest in and use of family-level and dyadic level theories and methodologies to explore the influence of social relationships on health and the influence of health on social relationships. Social relationships include those with romantic partners, friends, siblings, children and care professionals these individuals play a significant role in the physical health, mental health and well-being of a patient. An important part of this includes medicines optimisation and illness management. Studying health and well-being and consideration of both partners in the context of these close social relationships is clearly important in health research; as such both partners become the unit of study - also known as a dyad. The aim of this paper is to provide an introduction and overview as to how dyads might be used in medicines optimisation and illness management research. This aim will be achieved through the following objectives: dyadic study designs used in health research; some of the challenges that can occur in recruitment and data collection and strategies that can be used to overcome them; dyadic data analysis: some methodological and substantive considerations that require consideration when using dyadic data analysis.

The Analysis of Anxiety and Depression in Different Stages of in vitro Fertilization-Embryo Transfer in Couples in China

BACKGROUND

This study aimed to examine the differences in anxiety and depression between infertile Chinese couples in diverse stages of in vitro fertilization-embryo transfer (IVF-ET) and their relationship with the IVF-ET outcomes.

METHODS

From February 2016 to December 2018, a total of 247 couples that were undergoing IVF-ET were randomly selected for this study. On the day they started their treatment (T1), the day human chorionic gonadotropin was administered (T2), and 4 days after the embryo transfer (T3), self-designed questionnaires, the Self-Rating Anxiety Scale, and the Self-Rating Depression Scale were completed to investigate anxiety and depression in different stages.

RESULTS

Age had an effect on the anxiety and depression in women. Male infertility type and the cause of infertility had an effect on the anxiety and depression in men. The incidence of anxiety in women in the T1, T2, and T3 stages was 29.96%, 44.94%, and 17.81%, respectively. The anxiety scores of women were 46.14 ± 8.37, 50.83 ± 8.50, and 44.09 ± 8.17, respectively, which were significantly higher than those of men (p < 0.05). The anxiety score in stage T2 was the highest in women, and the depression score of women in stage T1 was the highest. The incidence of anxiety in men in the T1, T2, and T3 stages was 20.65%, 8.50%, and 6.07%, respectively. The incidence of anxiety was not significantly different in diverse stages (p > 0.05), and the same result was obtained for the incidence of depression. The anxiety and depression scores of the infertile couples in different stages were not related to the outcome of IVF-ET.

CONCLUSION

The incidence of anxiety and depression in infertile couples in diverse stages of IVF-ET is different, especially in women, and the anxiety and depression of infertile couples in the process of IVF-ET may not be related to the outcome of assisted pregnancy.

Quality of Life and General Health in Pregnant Women Conceived with Assisted Reproductive Technology: A Case-Control Study

Background

Infertility affects different aspects of life including the quality of life (QOL) in infertile couples. Many infertile couples conceive via using assisted reproductive technology (ART). However, the effect of pregnancy and childbearing on QOL is not known in these couples. This study aimed to evaluate QOL and general health during pregnancy and after successful treatment of infertility, in women conceived with ART.

Materials and Methods

In this case-control study, QOL and general heath were evaluated in 40 women conceived with ART and 40 women who conceived spontaneously and served as the control group. WHO quality of life- BREF (WHOQOL-BREF) inventory was used to evaluate QOL and General Health Questionnaire-28 (GHQ-28) was applied to evaluate general health. These two questionnaires were completed in the first and second trimester of pregnancy and results were compared between the two groups.

Results

Mean age of women was 29.4 ± 4.4 and 29.6 ± 5 years in ART and control group, respectively. QOL in women conceived with ART was similar to QOL in the control group in the first and second trimester of pregnancy while general health score (distress level) in women conceived with ART was significantly higher than that of the control group in both trimesters. Although distress level decreased in the second trimester in ART group, but yet, it was higher than that recorded for the control group.

Conclusion

After pregnancy, QOL in women conceived with ART is similar to women conceived spontaneously. However, these women experience higher distress level in the first and second trimester of pregnancy compared to women conceived spontaneously.

The effects of depression, anxiety and stress symptoms on the clinical pregnancy rate in women undergoing IVF treatment

OBJECTIVE

Women undergoing assisted reproductive technology treatment, are often anxious and depressed because of their fertility problem and the uncertainties of the treatment with which they have to deal. On the other hand, recent studies have shown that the effects of psychological distress on the IVF treatment outcome is unclear. This study aimed to examine the effects of anxiety, depression, and stress symptoms before IVF treatment on the clinical pregnancy rate, controlling for known confounders.

RESULTS

In total, 142 women undergoing IVF treatment participated in this prospective study. The clinical pregnancy rate was 26.8% in this study. Controlling for age, infertility duration, and cause of infertility, there were no relationship between IVF outcome and anxiety (relative risk (RR) = 1.00; 95% CI 0.91-1.09), depression (RR = 0.96; 95% CI 0.88-1.05), and stress (RR = 1.01; 95% CI 0.96-1.07) symptoms. High woman's age and women with both cause of infertility were independent predictors of IVF clinical pregnancy rate. In sum, we found that anxiety, depression, and stress symptoms were not associated with the IVF clinical pregnancy rate.