Academic journal article The Qualitative Report

Empowerment and Sense of Adequacy in Infertile Couples: A Fundamental Need in Treatment Process of Infertility-A Qualitative Study

Academic journal article The Qualitative Report

Empowerment and Sense of Adequacy in Infertile Couples: A Fundamental Need in Treatment Process of Infertility-A Qualitative Study

Article excerpt

About 80 million people around the world suffer from infertility (Van Empel, et al., 2010). Infertility rate differs from country to country (Behboodi-Moghadam, Salsali, Eftekhar-Ardabily, Vaismoradi, & Ramezanzadeh, 2012), being lower in developed countries and higher in developing countries due to limitations in diagnostic and treatment equipment (Kamel, 2010). Prevalence of primary infertility has been reported as 24.9 % in Iran in 2004. In addition, almost a quarter of Iranian couples experience primary infertility (Vahidi, Ardalan, & Mohammad, 2009). Infertility is diagnosed in couples when the wife does not get pregnant after one year of sexual intercourse without using contraceptive methods; this period is six months for women older than 35 years (Martins, Peterson, Almeida, & Costa, 2011; Stark, Keathley, & Nelson, 2011). Infertility is a bio-psycho-social phenomenon; that is, it impacts intrapersonal and interpersonal aspects which interact with one another and can enhance or undermine a person's health (Ramazanzadeh, Noorbala, Abedinia, RahimiForooshani, & Naghizadeh, 2011).

Technological and scientific advancements as well as novel methods of infertility treatment have brought fresh hope to infertile couples, but have imposed great stress and longer periods of treatment (Latifnejad Roudsari, Rasoulzadeh-Bidgoli, Mousavifar, & Modarres-Gharavi, 2011). Infertile couples often consider their infertility period as the most stressful event of their life and have often defined the prolong treatment periods as repetitive crisis periods (Molaeinejad, Jafarpour, Jahanfar, & Jamshidi, 2001). Assisted Reproductive Technologies (ARTs) have been regarded as one of the most stressful infertility treatment methods. The application of these techniques brings about much emotional and physical burden, depression, anxiety and stress which ultimately leads to more distrust as well as dropout of patients in these treatment programs (Dancet et al., 2011; Hammerli, Znoj, & Berger, 2010; Van Empel et al., 2010). Two factors, namely the psychological burden (72%) and lack of medical staffs empathy (32%), play a great role in patients' dropout from treatment programs. This indicates that lack of patient-centered cares can lead to patients' dropout due to non-medical reasons. This signifies the fact that reproductive medicine must address the other aspects of quality of care alongside the their effectiveness (i.e., increasing the pregnancy chance). The patient-centeredness aspect of the treatment is almost forgotten in the treatment programs. To provide high quality and patient-centered fertility cares, the treatment team need to know more about patients and their understanding of their needs during treatment of infertility (Dancet et al., 2011). Provision of care conforming to infertile couples' needs and expectations turns the treatment cycles into a more pleasant experience, reduces emotional stress and may even increase the success rate of the treatment (Brandes et al., 2009).

Based on available evidence, physical treatments of infertility are often not enough, and it is believed that infertile couples have various emotional, spiritual, and psycological needs in addition to medicine and usual treatments (Daniluk, 2001; Hamdieh, Alizadegan, & Nikzad, 2009; Khodakarami, Seddigh, Hashemi, Hamdieh, & Taheri-Panah, 2009; Pakgohar, Vijeh, Babaei, Ramezanzadeh, & Abedinia, 2008; Schmidt, 1998; Van Empel et al., 2010). To this end, healthcare providers must be proactive in regard with identification of infertile couples' needs during treatment (Paterno, 2008). Identification of needs prior to selection of the solutions can increase the efficacy and effectiveness of programs in the healthcare system (Yarmohamadian, Bahrami, & Foroughi-Abri, 2003). Therefore, special attention must be paid to planning and re-organization of diagnosis and treatment processes in infertility treatment clinics and centers, the relationship between patients and medical staff as well as infertile couples' emotional needs so as to improve the efficacy and quality of care (Sundby, Olsen, & Schei, 1994). …

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