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辅助生殖技术治疗期间心理干预早期终止的预测因素。

Predictors for the Early Termination of a Psychological Intervention During Treatment with Assisted Reproductive Technologies.

作者信息

Bernd Marie, Schick Maren, Rösner Sabine, Germeyer Ariane, Strowitzki Thomas, Moessner Markus, Bauer Stephanie, Ditzen Beate, Wischmann Tewes

机构信息

Institute of Medical Psychology, Centre for Psychosocial Medicine, University Hospital, Heidelberg, Germany.

Department of Gynecological Endocrinology and Fertility Disorders, University Women's Hospital Heidelberg, Heidelberg, Germany.

出版信息

Geburtshilfe Frauenheilkd. 2020 Feb;80(2):190-199. doi: 10.1055/a-0918-6118. Epub 2020 Feb 21.

Abstract

Assisted reproductive technologies are typically perceived by couples as being an emotional burden. The objective of the study "Positive Ausrichtung bei unerfülltem Kinderwunsch" [Positive adjustment in infertility] (PACI) is to examine the efficacy and acceptance of a smartphone-supported psychosocial intervention during infertility treatment. In this investigation, the early drop-out of study subjects from the study is of primary interest. The objective of the investigation was to find predictors for ending a psychological intervention prematurely. There are data available from an eight-month randomised, controlled study in which 141 patients and their partners participated. Sociodemographic and fertility-related data were collected at the start of the study. The couples received the ScreenIVF questionnaire at two points in time. As part of a post-evaluation, a survey was conducted on the efficacy of the psychological online intervention. To analyse the data, a dyadic data structure was used in order to determine connections within the study subject couples between the selected stress indicators and the drop-out. In addition, a "risk score" as a possible predictor for the drop-out was tested. The descriptive observation of the sample indicates in this interim assessment that the study subjects recruited are less stressed patient couples. Actor-partner interdependence models indicate statistically significant connections between the stress indicators of anxiety, little social support and helplessness and an early drop-out. The statistically significant effects found in this study with regard to the stress indicators in connection with drop-outs from psychosocial intervention studies indicate that it is advisable to continue to seek measures for people undergoing stressful medical treatments in order to motivate and support them and thus optimally utilise the opportunities of a medical treatment. The number of patients who endure their ART treatment may also increase as a result, which could lead in turn to increased patient satisfaction over the long term (and thus possibly to higher pregnancy rates).

摘要

辅助生殖技术通常被夫妇视为一种情感负担。“未实现生育愿望时的积极调整”(PACI)研究的目的是检验在不孕治疗期间智能手机支持的心理社会干预的效果和可接受性。在这项调查中,研究对象提前退出研究是主要关注的问题。该调查的目的是找出心理干预过早结束的预测因素。有一项为期八个月的随机对照研究的数据,141名患者及其伴侣参与了该研究。在研究开始时收集了社会人口学和生育相关数据。这些夫妇在两个时间点接受了ScreenIVF问卷。作为评估后调查的一部分,对心理在线干预的效果进行了调查。为了分析数据,使用了二元数据结构,以确定研究对象夫妇中选定的压力指标与退出之间的联系。此外,还测试了作为退出可能预测因素的“风险评分”。在本次中期评估中,对样本的描述性观察表明,招募的研究对象是压力较小的患者夫妇。行为者-伴侣相互依赖模型表明,焦虑、社会支持少和无助等压力指标与提前退出之间存在统计学上的显著联系。本研究在心理社会干预研究中发现的与退出相关的压力指标的统计学显著影响表明,对于正在接受压力较大的医学治疗的人,继续寻求措施来激励和支持他们,从而最佳地利用医学治疗的机会是可取的。结果,忍受辅助生殖技术治疗的患者数量也可能增加,这反过来可能会导致长期患者满意度提高(从而可能导致更高的妊娠率)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa5f/7035134/58c09922fa5c/10-1055-a-0918-6118-igf01.jpg

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