Academic journal article The Qualitative Report

What Are the Issues Confronting Infertile Women? A Qualitative and Quantitative Approach

Academic journal article The Qualitative Report

What Are the Issues Confronting Infertile Women? A Qualitative and Quantitative Approach

Article excerpt

Introduction

Infertility is a stressful experience (Menning, 1980). But what exactly is meant by stressful experience in this context? What are the key issues confronting infertile patients? Little is known about the specific themes and burdens affecting infertile patients.

Many psychological studies have focused on the psychological consequences of infertility and its medical treatment. For instance, the effects of assisted reproductive treatment (ART) have frequently been discussed in the literature: ARTs are considered the most stressful techniques used to treat infertility (Eugster & Vingerhoets, 1999). Undergoing ART presents a physical and emotional burden associated with high levels of depressive symptoms, anxiety, and distress (Brkovich & Fisher, 1998; Chen, Chang, Tsai, & Juang, 2004; Eugster & Vingerhoets; Greil, 1997). The waiting period between embryo transfer and pregnancy test as well as the failure of such pregnancy attempts are described as presenting great strains for infertile patients (Boivin & Takefman, 1995; Klonoff-Cohen, Chu, Natarajan, & Sieber, 2001; Verhaak, Smeenk, Nahuis, Kremer, & Braat, 2007). In addition, stress surrounding infertility may be attributed to any number of specific issues, including prevention or postponement of an important life goal (having a child), the cyclic nature of treatment, the side effects of fertility medications, or marital conflicts related to infertility (Mahlstedt, 1985). Nevertheless, overall levels of mental distress, anxiety, and depression found among infertile patients do not appear to differ much from those observed in general populations (Covington & Burns, 2006; Dunkel-Schetter & Lobel, 1991; Leiblum & Greenfeld, 1997). High levels of mental distress found among infertile patients are often interpreted as short-term reactions (Chen et al.; Eugster & Vingerhoets; Wischmann, 2005).

Historically, the psychological impact of infertility was first examined using qualitative methods (Valentine, 1986). Based on initial qualitative findings, numerous quantitative studies followed. These studies used standard instruments and designs in order to acquire data on the impact of infertility on individuals' mental health and on couples' relationships (Hammerberg, Astbury, & Baker, 2001; Slade, Emery, & Lieberman, 1997).

In recent years, the importance of qualitative research in this area has once again gained attention (Green, Galvin, & Horne, 2003; Peddie, van Teijlingen, & Bhattacharya, 2005; Redshaw, Hockley, & Davidson, 2007). However, to the best of our knowledge, no qualitative studies have been undertaken that investigate the psychosocial issues considered important by infertile patients as well as infertile patients' responses to these issues. Thus, the aim of the present study was to identify these critical themes and corresponding patient responses. In addition, we were interested in possible associations between specific responses to infertility and levels of mental health as measured by standard self-report questionnaires. The findings of qualitative research supply a richness of detail that is often absent in quantitative studies and may provide additional insights into the complexity of infertile women's psychological reactions and their impact on personal mental health.

Position of the researchers

The present study represents a follow-up to a quantitative research project by us, the present authors. The first author originally examined psychological interventions for infertile patients in her doctoral dissertation. The second author is a specialist in the field of health psychology. The third author is an expert in internet-based treatments, having developed an internet-based intervention for patients with social phobia. Based on our experiences conducting face-to-face group interventions for infertile couples, we developed and evaluated an internet-based psychological treatment for infertile patients, which supplied the data examined in the present study. …

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