希望导向团体心理咨询对体外受精失败女性心理健康的影响：一项随机对照试验。
Effect of Hope-oriented group counseling on mental health of infertile women with failed IVF cycles: a randomized controlled trial.
机构信息
Student Research Committee, Department of Midwifery, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran.
Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Artesh Street, Tabriz, Iran.
出版信息
BMC Psychiatry. 2021 Jun 2;21(1):286. doi: 10.1186/s12888-021-03280-5.
BACKGROUND
Considering the prevalence of infertility in the community and the consequences of failure of infertility treatments on women's mental health, interventions that can control stress, anxiety and depression in infertile women with a history of IVF failure will be very helpful. This study aimed to determine the effects of hope-oriented group counseling on mental health (primary outcome) and quality of life (QoL) (secondary outcome) of women with failed IVF cycles.
METHOD
This randomized controlled trial was conducted on 60 women with failed IVF cycles visiting Infertility Clinic at Al-Zahra Teaching Hospital of Tabriz- Iran. Participants were allocated to the intervention group (n = 30) and control group (n = 30) based on a randomized block design. Hope-oriented group counseling was provided to the intervention group in six 45-60 min sessions (once a week). The control group only received routine care to undergo another IVF cycle. The Depression Anxiety Stress Scale-21 (DASS-21) and the SF-12 Quality of Life Scale were filled out by interviewing the participants before the intervention and one week and one month after the intervention. After intervention 26 participants in each group were included in the analysis.
RESULTS
There was no significant difference between the intervention and control groups in the socio-demographic profile of participants (P > 0.05). The post-intervention mean score of stress (adjusted mean difference = - 1.7, 95% confidence interval: - 3.2 to - 0.3, P = 0.018) and depression (adjusted mean difference = - 1.3, 95% confidence interval: - 4.7 to - 1.5, P < 0.001) was significantly lower in the intervention group compared to the control. Although the mean anxiety score was lower in the intervention group compared to the control, the difference between them was not statistically significant (adjusted mean difference = - 1.1, 95% confidence interval: - 2.6 to 0.4, P = 0.153). The mean score of QoL was significantly higher in the intervention group than that of the control group (adjusted mean difference = 6.9, 95% confidence interval: 5.1 to 8.8, P < 0.001).
CONCLUSION
Hope-oriented group counseling was effective in reducing stress and depression and improving QoL in women with failed IVF cycles. It is recommended to use this counseling approach, along with other methods, to improve the mental health of women with failed IVF cycles.
TRIAL REGISTRATION
TCT Registration Number: TCTR 20191017003 , registered on October 17, 2019.
背景
考虑到社区中不孕不育的普遍性，以及不孕不育治疗失败对女性心理健康的影响，对于有体外受精失败史的不孕女性，能够控制压力、焦虑和抑郁的干预措施将非常有帮助。本研究旨在确定以希望为导向的团体咨询对有 IVF 失败史的女性的心理健康（主要结果）和生活质量（次要结果）的影响。
方法
本随机对照试验纳入了在伊朗大不里士 Al-Zahra 教学医院不孕不育科就诊的 60 名 IVF 失败的女性。参与者按照随机区组设计分为干预组（n=30）和对照组（n=30）。对干预组进行了以希望为导向的团体咨询，共 6 次，每次 45-60 分钟（每周一次）。对照组仅接受常规护理以进行另一次 IVF 周期。在干预前、干预后一周和一个月通过访谈的方式让参与者填写抑郁焦虑压力量表 21 项（DASS-21）和 SF-12 生活质量量表。干预后每组有 26 名参与者纳入分析。
结果
干预组和对照组在参与者的社会人口统计学特征方面没有显著差异（P>0.05）。与对照组相比，干预组的压力（调整后平均差异=-1.7，95%置信区间：-3.2 至-0.3，P=0.018）和抑郁（调整后平均差异=-1.3，95%置信区间：-4.7 至-1.5，P<0.001）的后干预平均得分显著降低。尽管与对照组相比，干预组的焦虑平均得分较低，但差异无统计学意义（调整后平均差异=-1.1，95%置信区间：-2.6 至 0.4，P=0.153）。与对照组相比，干预组的生活质量平均得分显著更高（调整后平均差异=6.9，95%置信区间：5.1 至 8.8，P<0.001）。
结论
以希望为导向的团体咨询可有效降低 IVF 失败女性的压力和抑郁，提高生活质量。建议将这种咨询方法与其他方法结合使用，以改善 IVF 失败女性的心理健康。
试验注册
TCT 注册号：TCTR 20191017003，注册于 2019 年 10 月 17 日。
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