Boivin Jacky, Lancastle Deborah
Cardiff Fertility Studies Research Group, School of Psychology, Cardiff University, Tower Building, Park Place, Cardiff, CF10 3AT, Wales, UK.
Womens Health (Lond). 2010 Jan;6(1):59-69. doi: 10.2217/whe.09.79.
The diagnosis and treatment of various medical conditions requires patients to wait for results that are potentially threatening to their wellbeing (e.g., breast biopsy results, pregnancy test results after fertility treatment and genetic screening outcomes). Little research has been carried out to document the psychological processes that unfold during such waiting periods. The aim of the present study was to document the course of anxiety, depression, positive affect and coping during the waiting period before a pregnancy test result in fertility treatment. Using a daily record-keeping chart designed for fertility treatment, 61 women undergoing IVF were monitored daily for emotional reactions (e.g., anxiety, depression and positive affect) and coping during 7 days of active treatment (stimulation), 7 days of waiting to find out whether a pregnancy was achieved (waiting) and 4 days of reacting to the pregnancy test results (outcome). The stimulation stage of treatment was characterized by positive affect with a lesser degree of anxiety, whereas the predominant emotions in the waiting stage were a combination of positive affect and anxiety symptoms versus depression. From the pregnancy test day onwards, the predominant emotion was depression. There was a significant increase in coping activity between the stimulation and waiting stages, with variable effects across coping strategies. It was concluded that whilst medical waiting periods have a clearly defined emotional trajectory, the coping pattern is less differentiated. This may explain why waiting for medical test results is so demanding. Healthcare professionals can assist their patients by facilitating coping strategies that better fit the demands of the waiting period and by offering support once outcomes are known.
各种医疗状况的诊断和治疗都需要患者等待可能对其健康构成威胁的结果(例如,乳房活检结果、生育治疗后的妊娠试验结果和基因筛查结果)。很少有研究记录在这些等待期间所发生的心理过程。本研究的目的是记录在生育治疗中等待妊娠试验结果期间焦虑、抑郁、积极情绪和应对方式的变化过程。使用为生育治疗设计的每日记录图表,对61名接受体外受精的女性在积极治疗的7天(刺激阶段)、等待知晓是否怀孕的7天(等待阶段)以及对妊娠试验结果做出反应的4天(结果阶段)期间,每天监测其情绪反应(如焦虑、抑郁和积极情绪)及应对方式。治疗的刺激阶段以积极情绪为主,焦虑程度较低,而等待阶段的主要情绪是积极情绪与焦虑症状以及抑郁情绪的混合。从妊娠试验日起,主要情绪是抑郁。在刺激阶段和等待阶段之间,应对活动显著增加,不同应对策略的效果各异。研究得出结论,虽然医疗等待期有明确界定的情绪轨迹,但应对模式的差异较小。这或许可以解释为何等待医学检查结果如此令人煎熬。医疗保健专业人员可以通过促进更符合等待期需求的应对策略,并在知晓结果后提供支持来帮助患者。