Lansakara Nirosha, Wickramasinghe Ananda Rajitha, Seneviratne Harshalal Rukka
Family Health Bureau, Ministry of Health, Sri Lanka.
Women Health. 2011 Jun 21;51(4):383-99. doi: 10.1080/03630242.2011.574790.
Primary infertility may have a considerable impact on the psychological well-being of women. In the present study, the authors investigated the psychological well-being and its correlates among Sri Lankan women with primary infertility. A total of 177 women with primary infertility were compared with 177 fertile women matched for age and duration of marriage to identify differences in the psychological well-being between the two groups. They were recruited from a prevalence survey conducted in the district of Colombo, Sri Lanka from August 2005 to February 2006. The General Health Questionnaire-30 (GHQ-30) and Mental Health sub-components of the Short Form-36 (SF-36) were used to measure psychological well-being. In addition, infertile women with and without psychological distress were compared to identify the social, marital, treatment, and demographic factors independently associated with psychological distress. A significantly higher proportion of women with primary infertility (66.1%; 95% CI 58.6-73.0%) had psychological distress as compared to fertile women (18.6 %; 95% CI 13.2-25.2%; P < 0.001). After adjustment for confounding factors, infertile women who were psychologically distressed were significantly less educated (OR = 55.3; 95% CI 15.2-201.0), had poor marital communication (OR = 3.5; 95% CI 1.3-9.8), had a higher priority for having children (OR = 4.2; 95% CI 1.3-13.8), and had been previously (OR = 39.1; 95% CI 8.3-185.4) or currently (OR = 11.0; 95% CI 3.0-40.6) investigated/treated for infertility when compared with infertile women without distress. Women with primary infertility reported more distress as compared to fertile women. Psychological distress among infertile women was associated with poorer education, being previously/currently investigated/treated, placing higher importance on having children, and having poor marital communication. The need for psychological intervention targeting infertile women in clinics and community settings is highlighted.
原发性不孕可能会对女性的心理健康产生相当大的影响。在本研究中，作者调查了患有原发性不孕的斯里兰卡女性的心理健康状况及其相关因素。将177名原发性不孕女性与177名年龄和婚姻持续时间相匹配的可育女性进行比较，以确定两组之间心理健康状况的差异。她们是从2005年8月至2006年2月在斯里兰卡科伦坡地区进行的一项患病率调查中招募的。使用一般健康问卷-30（GHQ-30）和简短健康调查问卷-36（SF-36）的心理健康子分量表来测量心理健康状况。此外，对有心理困扰和没有心理困扰的不孕女性进行比较，以确定与心理困扰独立相关的社会、婚姻、治疗和人口统计学因素。与可育女性（18.6%；95%可信区间13.2-25.2%；P<0.001）相比，原发性不孕女性中存在心理困扰的比例显著更高（66.1%；95%可信区间58.6-73.0%）。在对混杂因素进行调整后，有心理困扰的不孕女性受教育程度显著较低（比值比=55.3；95%可信区间15.2-201.0），婚姻沟通不良（比值比=3.5；95%可信区间1.3-9.8），生育孩子的优先级较高（比值比=4.2；95%可信区间1.3-13.8），并且与没有心理困扰的不孕女性相比，以前（比值比=39.1；95%可信区间8.3-185.4）或目前（比值比=11.0；95%可信区间3.0-40.6）接受过不孕相关的检查/治疗。与可育女性相比，原发性不孕女性报告的困扰更多。不孕女性的心理困扰与受教育程度较低、以前/目前接受过检查/治疗、对生育孩子更为重视以及婚姻沟通不良有关。强调了在诊所和社区环境中针对不孕女性进行心理干预的必要性。
