Steuber Keli R, High Andrew
Faculty of Communication Studies, The College of New Jersey, Ewing, NJ 08628, USA
Faculty of Communication, University of Iowa, Iowa City, IA 52241, USA.
Hum Reprod. 2015 Jul;30(7):1635-42. doi: 10.1093/humrep/dev093. Epub 2015 May 6.
Do the strategies women use to disclose information about their infertility to social network members impact the quality of the support they receive and their quality of life?
The data showed that women who disclosed infertility-related information in direct ways, rather than in indirect ways (e.g. by incremental disclosures or through third parties), to social network members perceived higher quality support and reported greater quality of life related to their infertility experience.
Social support has been shown to buffer stress associated with various health issues including infertility. The way people disclose information about stressors has been associated with the quality of the support they receive. Disclosing information in a way that most effectively elicits support is beneficial because women with infertility who have lower levels of stress are more likely to seek and remain in treatment.
STUDY DESIGN, SIZE, DURATION: This cross-sectional study of 301 infertile women was conducted in the USA.
PARTICIPANTS/MATERIALS, SETTING, METHODS: To determine the variation in length of infertility and treatment decisions, we conducted an online survey of 301 American women coping with infertility. We investigated the strategies women used to disclose infertility-related information with social network members, their perceptions of support from friends and family, and their quality of life both in general (overall quality of life) and related to the experience of infertility (fertility quality of life).
Direct disclosure of experiences related to infertility was positively and significantly associated with the perceived quality of social support received (P < 0.01). Strategies of disclosure that use entrapment or indirect media were negatively associated with fertility quality of life (P < 0.001). Directly (P < 0.01) and incremental disclosures (P < 0.01) were positively associated with overall quality of life, while the use of humor was negatively associated with overall quality of life (P < 0.01). Perceived support quality also mediated the influence of direct disclosures on women's fertility quality of life (95% CI: 0.18, 1.05) and overall quality of life (95% CI: 0.10, 0.30). This effect is particularly noteworthy for the model predicting fertility quality of life, which exhibited a non-significant main effect with direct disclosures. The non-significant main effect combined with the significant indirect effect suggests that perceived support quality fully mediates the association between direct disclosures and fertility quality of life.
LIMITATIONS, REASONS FOR CAUTION: The cross-sectional nature of our convenient sample did not allow us to test cause and effect. It is equally plausible that women who perceive support are more likely to disclose. Longitudinal data are necessary to test the cyclic nature of these variables and confirm directionality.
When women make the decision to reveal information about their infertility, direct disclosure (i.e. face-to-face, clearly, verbally and with the opportunity for an immediate response) was the only strategy that significantly corresponded with perceived support quality and was one of only two strategies that were positively associated with quality of life. To the extent that social support reduces stress, and lower stress increases the chance that people seek and stay in treatment, infertility clinics and therapists can use this information as a low-cost strategy for supporting infertile women. Scholars and practitioners can also instruct women coping with infertility about how to most effectively engage in seeking effective support.
STUDY FUNDING/COMPETING INTERESTS: No external funding was either sought or obtained for this study and no competing interests are declared.
女性向社交网络成员披露自身不孕信息的策略是否会影响她们获得的支持质量以及生活质量？
数据显示，直接向社交网络成员披露不孕相关信息的女性，而非通过间接方式（如逐步披露或通过第三方）披露的女性，感知到更高质量的支持，并且在与不孕经历相关的生活质量方面表现更佳。
社会支持已被证明可以缓冲与包括不孕在内的各种健康问题相关的压力。人们披露压力源信息的方式与他们获得的支持质量有关。以最有效地引出支持的方式披露信息是有益的，因为压力水平较低的不孕女性更有可能寻求并坚持治疗。
研究设计、规模、持续时间：这项对301名不孕女性的横断面研究在美国进行。
参与者/材料、设置、方法：为了确定不孕时间长短和治疗决策的差异，我们对301名应对不孕的美国女性进行了在线调查。我们调查了女性用于向社交网络成员披露不孕相关信息的策略、她们对朋友和家人支持的看法，以及她们总体的生活质量（整体生活质量）和与不孕经历相关的生活质量（生育生活质量）。
直接披露与不孕相关的经历与所获得的社会支持的感知质量呈正相关且具有显著性（P < 0.01）。使用诱导或间接媒介的披露策略与生育生活质量呈负相关（P < 0.001）。直接披露（P < 0.01）和逐步披露（P < 0.01）与整体生活质量呈正相关，而使用幽默与整体生活质量呈负相关（P < 0.01）。感知到的支持质量也介导了直接披露对女性生育生活质量（95%置信区间：0.18，1.05）和整体生活质量（95%置信区间：0.10，0.30）的影响。对于预测生育生活质量的模型而言，这种效应尤为值得注意，该模型在直接披露方面呈现出不显著的主效应。不显著的主效应与显著的间接效应相结合表明，感知到的支持质量完全介导了直接披露与生育生活质量之间的关联。
局限性、谨慎理由：我们便利样本的横断面性质不允许我们检验因果关系。同样合理的是，感知到支持的女性更有可能披露信息。需要纵向数据来检验这些变量的循环性质并确认方向性。
当女性决定透露她们的不孕信息时，直接披露（即面对面、清晰、口头且有立即回应的机会）是唯一与感知到的支持质量显著相关的策略，并且是与生活质量呈正相关的仅有的两种策略之一。就社会支持减轻压力而言，而较低的压力增加了人们寻求并坚持治疗的机会，不孕诊所和治疗师可以将此信息用作支持不孕女性的低成本策略。学者和从业者也可以指导应对不孕的女性如何最有效地寻求有效的支持。
研究资金/利益冲突：本研究既未寻求也未获得外部资金，并且声明无利益冲突。
