Xu Yangying, Hao Cuifang, Zhang Huimin, Liu Yingxue, Xue Wei
Reproductive Medicine Center of Qingdao Women and Children's Hospital Affiliated with Qingdao University, Qingdao, China.
Front Cell Dev Biol. 2024 Aug 7;12:1405250. doi: 10.3389/fcell.2024.1405250. eCollection 2024.
The infertile patient's knowledge, attitude, and practice (KAP) toward embryo transfer may affect treatment outcomes and the mental health of women who underwent fertilization-embryo transfer (IVF-ET). This study aimed to investigate the KAP of embryo transfer among women who underwent IVF-ET.
This cross-sectional study was conducted on women who underwent IVF-ET at our Hospital between May 2023 and November 2023, using a self-designed questionnaire.
A total of 614 valid questionnaires were finally included. The mean KAP scores were 19.46 ± 5.06 (possible range: 0 28), 39.41 ± 5.20 (possible range: 12-60), and 48.02 ± 6.75 (possible range: 0-60), respectively. The structural equation model demonstrated that knowledge has a direct effect on attitude (β = 0.27, < 0.001) and attitude has a direct effect on practice (β = 0.55, < 0.001) and anxiety (β = 0.59, < 0.001). Moreover, multivariable linear regression analysis showed that anxiety score [coefficient = 0.09, 95% confidence interval (CI): 0.03-0.16, = 0.003], BMI (coefficient = 0.09, 95%CI: 0.03-0.16, = 0.003), education (coefficient = 5.65-6.17, 95%CI: 1.09-10.7, < 0.05), monthly per capita income (coefficient = 1.20-1.96, 95% CI: 0.21-3.07, = 0.05), reasons for IVF (coefficient = -1.33-1.19, 95% CI: -2.49-0.09, < 0.05), and more than 5 years of infertility (coefficient = -1.12, 95% CI: -2.11-0.13, = 0.026) were independently associated with sufficient knowledge. Knowledge (coefficient = 0.19, 95% CI: 0.12-0.26, < 0.001), anxiety (coefficient = 0.39, 95% CI: 0.34-0.45, < 0.001), monthly per capita household income >10,000 (coefficient = 1.52, 95% CI: 0.61-2.43, < 0.001), and three or more cycles of embryo transfer (coefficient = -2.69, 95% CI: -3.94-1.43, < 0.001) were independently associated with active attitude. Furthermore, attitude (coefficient = 0.21, 95% CI: 0.11-0.30, < 0.001) and anxiety (coefficient = 0.57, 95% CI: 0.49-0.65, < 0.001) were independently associated with proactive practice.
Women who underwent IVF-ET had inadequate knowledge and negative attitudes but proactive practice toward embryo transfer, which were affected by anxiety, income, and reasons for IVF. It is necessary to strengthen the continuous improvement of patient education to improve the management of embryo transfer.
不孕患者对胚胎移植的知识、态度和行为（KAP）可能会影响治疗结果以及接受体外受精-胚胎移植（IVF-ET）女性的心理健康。本研究旨在调查接受IVF-ET的女性对胚胎移植的KAP。
本横断面研究于2023年5月至2023年11月在我院对接受IVF-ET的女性进行，采用自行设计的问卷。
最终共纳入614份有效问卷。KAP平均得分分别为19.46±5.06（可能范围：0-28）、39.41±5.20（可能范围：12-60）和48.02±6.75（可能范围：0-60）。结构方程模型表明，知识对态度有直接影响（β=0.27，P<0.001），态度对行为有直接影响（β=0.55，P<0.001）以及对焦虑有直接影响（β=0.59，P<0.001）。此外，多变量线性回归分析显示，焦虑评分[系数=0.09，95%置信区间（CI）：0.03-0.16，P=0.003]、体重指数（BMI）（系数=0.09，95%CI：0.03-0.16，P=0.003）、教育程度（系数=5.65-6.17，95%CI：1.09-10.7，P<0.05）、人均月收入（系数=1.20-1.96，95%CI：0.21-3.07，P=0.05）、IVF原因（系数=-1.33-1.19，95%CI：-2.49-0.09，P<0.05）以及不孕超过5年（系数=-1.12，95%CI：-2.11-0.13，P=0.026）与具备充足知识独立相关。知识（系数=0.19，95%CI：0.12-0.26，P<0.001）、焦虑（系数=0.39，95%CI：0.34-0.45，P<0.001）、家庭人均月收入>10000（系数=1.52，95%CI：0.61-2.43，P<0.001）以及三次或更多次胚胎移植周期（系数=-2.69，95%CI：-3.94-1.43，P<0.001）与积极态度独立相关。此外，态度（系数=0.21，95%CI：0.11-0.30，P<0.001）和焦虑（系数=0.57，95%CI：0.49-0.65，P<0.001）与积极行为独立相关。
接受IVF-ET的女性对胚胎移植知识不足且态度消极，但行为积极，这受到焦虑、收入和IVF原因的影响。有必要加强患者教育的持续改进以改善胚胎移植管理。
