心理社会干预对接受体外受精的不孕夫妇心理健康、妊娠率及婚姻功能的影响：一项系统综述
The effects of psychosocial interventions on the mental health, pregnancy rates, and marital function of infertile couples undergoing in vitro fertilization: a systematic review.
作者信息
Ying Liying, Wu Lai Har, Loke Alice Yuen
机构信息
School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China.
School of Nursing, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
出版信息
J Assist Reprod Genet. 2016 Jun;33(6):689-701. doi: 10.1007/s10815-016-0690-8. Epub 2016 Mar 16.
PURPOSE
The purpose of this study was to examine the effects of psychosocial interventions on the mental health, pregnancy rates, and marital function of infertile couples undergoing in vitro fertilization (IVF), as determined through RCT studies.
METHODS
Using the electronic databases PubMed, EMBase, Cochrane Library, CINAHL, PsycInfo, and CAJ, a systematic literature search was conducted in July 2015. MeSH terms, key words, and free words such as "infertility," "fertilization in vitro," "psychotherapy," "intervention," "anxiety," "depression," and "marital satisfaction" were used to identify all potential studies. The quality of the studies that were included was assessed using the risk of bias assessment tool developed by the Cochrane Back Review Group. Descriptive analysis was adopted to synthesize the results.
RESULTS
A total of 20 randomized controlled trials were included in this review. There were reports of positive effects on the anxiety levels, pregnancy rates, or marital function of infertile couples in six studies that adopted different psychosocial approaches, including mind body intervention (Eastern body-mind-spirit, Integrative body-mind-spirit, and Mind/body intervention), cognitive behavioral therapy, group psychotherapy, and harp therapy. However, there were methodological or practical issues related to measurement points and attrition rates in these studies. None of these interventions were found to be efficacious in relieving the depression or stress of individuals or couples undergoing IVF treatment. None of the included studies tackled or measured the mental health status of the couples during the most stressful time of waiting for the pregnancy results of their treatment.
CONCLUSIONS
A complex intervention, based on sound evidence, should be developed targeting both females and males of infertile couples undergoing IVF treatment, particularly during the stressful period of waiting for the results of the pregnancy test result and after failed cycles.
目的
本研究旨在通过随机对照试验（RCT）研究，探讨心理社会干预对接受体外受精（IVF）的不孕夫妇心理健康、妊娠率和婚姻功能的影响。
方法
2015年7月，利用电子数据库PubMed、EMBase、Cochrane图书馆、CINAHL、PsycInfo和中国学术期刊全文数据库（CAJ）进行了系统的文献检索。使用医学主题词（MeSH）、关键词和自由词，如“不孕症”“体外受精”“心理治疗”“干预”“焦虑”“抑郁”和“婚姻满意度”，以识别所有潜在研究。采用Cochrane循证医学协作网偏倚风险评估工具对纳入研究的质量进行评估。采用描述性分析对结果进行综合。
结果
本综述共纳入20项随机对照试验。六项采用不同心理社会方法的研究报告称，对不孕夫妇的焦虑水平、妊娠率或婚姻功能有积极影响，这些方法包括身心干预（东方身心灵、整合身心灵和心身干预）、认知行为疗法、团体心理治疗和竖琴疗法。然而，这些研究在测量点和损耗率方面存在方法学或实际问题。未发现这些干预措施能有效缓解接受IVF治疗的个体或夫妇的抑郁或压力。纳入的研究均未解决或测量夫妇在等待治疗妊娠结果的最紧张时期的心理健康状况。
结论
应基于充分的证据，开发一种针对接受IVF治疗的不孕夫妇双方的综合干预措施，尤其是在等待妊娠试验结果的紧张时期以及周期失败后。
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