Schmidt L, Holstein B E, Christensen U, Boivin J
Institute of Public Health, University of Copenhagen, Panum Institute, 3 Blegdamsvej, DK-2200 Copenhagen N, Denmark.
Hum Reprod. 2005 Nov;20(11):3248-56. doi: 10.1093/humrep/dei193. Epub 2005 Jul 8.
We investigated coping strategies and communication strategies as predictors of fertility problem stress 12 months after start of fertility treatment.
We used a prospective, longitudinal cohort design including 2250 people beginning fertility treatment with a 12-month follow-up. Data were based on self-administered questionnaires measuring communication with partner and with other people, coping strategies: active-avoidance coping, active-confronting coping, passive-avoidance coping, meaning-based coping, and fertility problem stress. The study population included those participants (n = 816, men and women) who had not achieved pregnancy by assisted reproduction or delivery at follow-up.
Among both men and women, difficulties in partner communication predicted high fertility problem stress (odds ratio for women, 3.47, 95% confidence interval 2.09-5.76; odds ratio for men, 3.69, 95% confidence interval 2.09-6.43). Active-avoidance coping (e.g. avoiding being with pregnant women or children, turning to work to take their mind off things) was a significant predictor of high fertility problem stress. Among men, high use of active-confronting coping (e.g. letting feelings out, asking other people for advice, seeking social support) predicted low fertility problem stress in the marital domain (odds ratio 0.53, 95% confidence interval 0.28-1.00). Among women, medium or high use of meaning-based coping significantly predicted low fertility problem stress in the personal and marital domain.
The study provides information about where to intervene with fertility patients in order to reduce their stress after medically unsuccessful treatment.
我们调查了应对策略和沟通策略,将其作为生育治疗开始12个月后生育问题压力的预测因素。
我们采用了前瞻性纵向队列设计,纳入了2250名开始生育治疗的患者,并进行了12个月的随访。数据基于自我管理的问卷,测量与伴侣及他人的沟通、应对策略(积极回避应对、积极面对应对、消极回避应对、基于意义的应对)以及生育问题压力。研究人群包括那些在随访时未通过辅助生殖或分娩实现怀孕的参与者(n = 816,男女均有)。
在男性和女性中,与伴侣沟通困难均预示着较高的生育问题压力(女性的优势比为3.47,95%置信区间为2.09 - 5.76;男性的优势比为3.69,95%置信区间为2.09 - 6.43)。积极回避应对(例如避免与孕妇或儿童在一起、通过工作转移注意力)是高生育问题压力的重要预测因素。在男性中,较多使用积极面对应对(例如宣泄情绪、向他人寻求建议、寻求社会支持)预示着婚姻领域的生育问题压力较低(优势比为0.53,95%置信区间为0.28 - 1.00)。在女性中,中等或高度使用基于意义的应对显著预示着个人和婚姻领域的生育问题压力较低。
该研究提供了有关如何对生育患者进行干预以减轻其在治疗未成功后的压力的信息。