Department of Clinical Sciences, University of Bristol, Whitson Street, Bristol BS1 3NY, UK
Department of Clinical Sciences, University of Bristol, Whitson Street, Bristol BS1 3NY, UK.
Hum Reprod Update. 2014 Jul-Aug;20(4):594-613. doi: 10.1093/humupd/dmu010. Epub 2014 Mar 27.
IVF treatment is usually stressful for patients, but individual differences in emotional response do exist. Differences in the stress response may be related to reproductive outcomes as well as to the development of psychiatric problems. This review collates research exploring which psychosocial factors (e.g. personality traits and coping strategies) are associated with the emotional adjustment of IVF patients. The aim is to reveal what is currently known about risk and protective factors for coping with the stress of IVF treatment and where further enquiry would be most beneficial.
The databases, MEDLINE/PUBMED (US National Library of Medicine), PsycINFO (American Psychological Association), Web of Science (Social Sciences Citation Index) and EMbase, were searched from 1978 to September 2012 using relevant key words. All published peer-reviewed studies exploring associations between psychosocial factors and emotional adjustment outcomes were considered for inclusion.
There were 23 studies identified for review. One-third of the psychosocial factors explored were found to be significantly related to emotional adjustment outcome measures. Neuroticism and the use of escapist coping strategies were positively associated with distress by multiple studies. Social support was negatively associated with distress by several studies. A number of other psychosocial variables appear to be associated with distress, including self-criticism, dependency, situation appraisals and attachment style, but these have only been explored by one or two studies at most. There is a paucity of research using positive emotional outcome measures (e.g. well-being, positive affect, happiness or life satisfaction) to quantify emotional adjustment.
Whilst some psychosocial variables appear to be consistently associated with distress for IVF patients, two-thirds of the variables tested to date do not appear to be associated with emotional adjustment. This review highlights key psychosocial factors to assist the identification of patients at high risk of psychological distress. These findings highlight at least two psychological factors that may be amenable to alteration with psychological or educational interventions. Future work should explore whether experimental manipulation of such psychosocial factors can provide effective stress reduction in this clinical context.
体外受精（IVF）治疗通常会给患者带来压力，但个体的情绪反应存在差异。应激反应的差异可能与生殖结局以及精神问题的发展有关。本综述收集了研究，以探讨哪些心理社会因素（如人格特质和应对策略）与 IVF 患者的情绪调整有关。目的是揭示目前已知的与应对 IVF 治疗压力相关的风险和保护因素，以及进一步研究的最佳方向。
从 1978 年到 2012 年 9 月，使用相关关键词，检索 MEDLINE/PUBMED（美国国家医学图书馆）、PsycINFO（美国心理学会）、Web of Science（社会科学引文索引）和 EMbase 数据库。纳入所有探讨心理社会因素与情绪调整结果之间关联的已发表同行评议研究。
共确定了 23 项研究进行综述。三分之一的探索的心理社会因素与情绪调整结果测量指标显著相关。多项研究发现神经质和逃避应对策略与困扰呈正相关。几项研究发现社会支持与困扰呈负相关。一些其他心理社会变量似乎与困扰有关，包括自我批评、依赖性、情境评估和依恋风格，但这些变量大多只被一到两项研究探讨过。目前使用积极的情绪结果测量（如幸福感、积极情绪、快乐或生活满意度）来量化情绪调整的研究较少。
虽然一些心理社会变量似乎与 IVF 患者的困扰始终相关，但迄今为止测试的三分之二的变量似乎与情绪调整无关。本综述突出了关键的心理社会因素，以帮助识别有心理困扰高风险的患者。这些发现至少强调了两个可能通过心理或教育干预改变的心理因素。未来的研究应探讨这种心理社会因素的实验性干预是否可以在这种临床环境中有效减轻压力。
