Juliana Luzardo Rigol Chachamovich

Investigating quality of life and health-related quality of life in infertility: a systematic review

Objective. To review the findings on quality of life (QOL) and health-related quality of life (HRQOL) among infertile women, men and couples. Design. Systematic review. Methods. Publications between January 1980 and July 2009 in Medline, PsycInfo, Embase and Health and Psychosocial Instruments were compiled using the following inclusion criteria: papers published in peer-reviewed journals; written in English, French, Spanish or Portuguese; presented original findings; assessed quality of life or health-related quality of life as an outcome; included infertile subjects without other clinical conditions; used validated measures. Interventions. None. Main Outcome Measures. Quality of life and health-related quality of life. Results. Fourteen studies were included in the review. Educational level, will to have children, poor marital relationship, previous in-vitro fertilisation attempt and duration of the infertility were predictors of lower mental health scores in infertile men. Women had significant lower scores on mental health, social functioning and emotional behaviour. Among infertile subjects, women had lower scores in several QOL or HRQOL domains in comparison to men. Conclusions. Evidences indicate important QOL or HRQOL impairments in infertile women. Among men, it does not appear to be intense. There is scarce knowledge regarding the impact of infertility on couples.

Congruence of quality of life among infertile men and women: findings from a couple-based study

BACKGROUND It has been consistently demonstrated that infertility is associated with quality of life (QOL) impairments. Research to date has mostly focused on individuals reactions to infertility (mainly women), without an examination of how the partner is reacting to the same condition. The few studies that assessed QOL among couples did not use couple-based analyses, consequently not considering the intra-couple effects. The objectives of this study were to explore the congruence of QOL perception within infertile couples and to estimate the effect of depression levels on the congruence. METHODS In total, 162 couples were interviewed in an assisted reproduction clinic cross-sectionally. Subjects completed a socio-demographic form, World Health Organization Quality of Life-BREF and the Beck Depression Inventory independently. The statistical strategy was guided to ensure that subjects would be explored within pairs at all times and not as independent groups. Paired t-tests were run, and Cohens effect was estimated. Depression levels were controlled by linear multiple regressions and repeated-measures ANCOVAs. RESULTS Out of the five QOL domain scores, only two showed a significant discrepancy between partners (psychological and social relationship domains). Male depression was a significant predictor for all five QOL difference scores, whereas female depression was associated with three (overall, psychological and physical). Moreover, it was demonstrated that, except for the psychological domain and for the female depression on the physical domain, the load of depression as a predictor of the QOL difference scores was markedly low, accounting for not more than 7.5% of the variance of congruence between mens and womens QOL. CONCLUSION Our findings suggest that QOL scores do not differ markedly between spouses. Since QOL seemed similarly affected in both men and women, consideration might be given to offering interventions to them as a dyad. These results are not in line with the previous non-paired studies, and further investigations are required to address this dissimilarity.

Do men and their wives see it the same way? Congruence within couples during the first year of prostate cancer.

Objective: The purpose of this study was to determine the psychosocial adjustment congruence within couples through the first year of prostate cancer experience, and to explore the personal variables that could predict congruence within couples.

Psychological distress as predictor of quality of life in men experiencing infertility: a cross-sectional survey.

BackgroundInfertility is associated with impairment in human life. The quality of life (QOL) construct allows measuring the impact of health conditions in a broader way. The study aimed to explore the impact of the psychological distress on QOLs dimensions in men experiencing infertility.Methods162 men were completed a socio-demographic form, SF-36, WHOQOL-BREF, Beck Anxiety Inventory and Beck Depression Inventory. Hierarchical regressions included demographic and clinic variables, and subsequently depression and anxiety were added.Results and DiscussionModel 1 was not accurate in predicting QOL. R2 values ranged from 0.029 (Social Functioning) to 0.149 (Mental Health). Eight domains were not associated with any of the predictors. In the second model, a R2increase was observed in all domains. R2 of QOL scores ranged from .209 (Role Physical) to .406 (Social Functioning). The intensity of the depression was a significant predictor for all outcomes. The load of depression was higher than the ones of the socio-demographic and clinical variables. Anxiety levels have also presented the same effect, but with less intensity.ConclusionSubthreshold depression and anxiety were major predictors of QOL in men experiencing infertility. Health professionals need to include assessment of psychological symptomatology to plan more efficient interventions to infertile patients.

Psychosocial Adjustment of Men During the First Year of Prostate Cancer

Background: The psychosocial dimension of prostate cancer has received increased attention over the past 2 decades. Objectives: The objectives of the study were to investigate the men’s psychosocial adjustment over the course of the first year of prostate cancer and to examine the sense of coherence, couple cohesion and adaptability, sexual and urinary symptoms, and mood disturbance as predictors of their adjustment. Methods: There were 81, 69, and 61 men visited at home prior to treatment (T1), 3 months later (T2), and 1 year after the first visit (T3), respectively. Repeated-measures analyses of variance were used to examine adjustment over time. Multiple regressions determined whether the predictors were associated with the adjustment domains. Results: Sexual relationship deteriorated and social environment improved between T1 and T2. Between T1 and T3, sexual, domestic, and family relationships deteriorated, whereas social environment improved. Mood disturbance, sense of coherence, couple cohesion, and couple adaptability were predictors of psychological, vocational, and domestic domains at T1. At T2, mood disturbance and sexual functioning were predictors of healthcare, vocational, social, psychological, and family domains. At T3, couple cohesion and adaptability and urinary functioning were predictors to vocational, domestic, social, and psychological adjustment. Conclusions: During the first year of prostate cancer, men showed deterioration in sexual, close-family, and extended-family relationship domains. Implications for Practice: Sexuality is an important topic, and spousal communication should be encouraged throughout the first year following diagnosis. Preparedness for the changes associated with prostate cancer along with continuing support to couples, rather than to patients only, might be the strongest approach to enhancing men’s adjustment.

Percepções de um grupo de mulheres sobre a doença hipertensiva específica da gestação

The objective of this study was to identify the knowledge women in childbirth have regarding gestational hypertension disease (DHEG); to learn their perceptions of its risk and gravity; and to understand the repercussions of DHEG for these women and their families. This is a qualitative research aiming at an exploratory study. Data collection took place through individual semi-structured interviews with ten women in childbirth who were diagnosed with DHEG and data analysis was performed using the Analysis of Content. So, thematic categories emerged addressing the women´s knowledge of DHEG; their perceptions about the diagnosis and the professional care offered; and the repercussions DHEG had for them and their families. The study highlights the necessity to rethink and to reorganize the model of perinatal care, not only at the tertiary level but also at the basic health centers.Objetivou-se identificar o conhecimento das puerperas em relacao a doenca hipertensiva especifica da gestacao (DHEG), conhecer suas percepcoes quanto ao risco e gravidade da doenca e conhecer as repercussoes da DHEG para estas mulheres e suas familias. Trata-se de uma pesquisa qualitativa na perspectiva de um estudo exploratorio descritivo. A coleta de informacoes ocorreu com dez puerperas com diagnostico de DHEG por meio de entrevistas individuais semi-estruturadas, analisadas conforme referencial da Analise de Conteudo. Assim, emergiram categorias tematicas abordando o conhecimento sobre DHEG, percepcoes sobre o diagnostico e o cuidado profissional, e repercussoes da DHEG para as mulheres e suas familias. O estudo aponta a necessidade de se repensar e reorganizar o modelo de assistencia perinatal, nao apenas a nivel terciario, mas nas unidades basicas de saude.This study aims to identify the knowledge women in childbirth (puerperas) have regarding gestational hypertension disease (GHD), to learn how they perceive its risk and gravity, and to understand the repercussions of GHD for these women and their families. This is a descriptive exploratory study using qualitative research methods. Data collection took place through individual semi-structured interviews with ten women in childbirth (puerperas) who were diagnosed with GHD. The analysis of the data was performed using Content Analysis. Thematic categories emerged addressing the womens knowledge of GHD; how they perceive diagnosis and the professional care offered; and the repercussions GHD had for them and their families. The study highlights the necessity to rethink and to reorganize the model of perinatal care, not only at the tertiary level but also at primary healthcare centers.

Perceptions of a group of women about gestational hypertension disease

The objective of this study was to identify the knowledge women in childbirth have regarding gestational hypertension disease (DHEG); to learn their perceptions of its risk and gravity; and to understand the repercussions of DHEG for these women and their families. This is a qualitative research aiming at an exploratory study. Data collection took place through individual semi-structured interviews with ten women in childbirth who were diagnosed with DHEG and data analysis was performed using the Analysis of Content. So, thematic categories emerged addressing the women´s knowledge of DHEG; their perceptions about the diagnosis and the professional care offered; and the repercussions DHEG had for them and their families. The study highlights the necessity to rethink and to reorganize the model of perinatal care, not only at the tertiary level but also at the basic health centers.Objetivou-se identificar o conhecimento das puerperas em relacao a doenca hipertensiva especifica da gestacao (DHEG), conhecer suas percepcoes quanto ao risco e gravidade da doenca e conhecer as repercussoes da DHEG para estas mulheres e suas familias. Trata-se de uma pesquisa qualitativa na perspectiva de um estudo exploratorio descritivo. A coleta de informacoes ocorreu com dez puerperas com diagnostico de DHEG por meio de entrevistas individuais semi-estruturadas, analisadas conforme referencial da Analise de Conteudo. Assim, emergiram categorias tematicas abordando o conhecimento sobre DHEG, percepcoes sobre o diagnostico e o cuidado profissional, e repercussoes da DHEG para as mulheres e suas familias. O estudo aponta a necessidade de se repensar e reorganizar o modelo de assistencia perinatal, nao apenas a nivel terciario, mas nas unidades basicas de saude.This study aims to identify the knowledge women in childbirth (puerperas) have regarding gestational hypertension disease (GHD), to learn how they perceive its risk and gravity, and to understand the repercussions of GHD for these women and their families. This is a descriptive exploratory study using qualitative research methods. Data collection took place through individual semi-structured interviews with ten women in childbirth (puerperas) who were diagnosed with GHD. The analysis of the data was performed using Content Analysis. Thematic categories emerged addressing the womens knowledge of GHD; how they perceive diagnosis and the professional care offered; and the repercussions GHD had for them and their families. The study highlights the necessity to rethink and to reorganize the model of perinatal care, not only at the tertiary level but also at primary healthcare centers.

Impresión de un grupo de mujeres sobre la enfermedad hipertensiva específica de la gestación

The objective of this study was to identify the knowledge women in childbirth have regarding gestational hypertension disease (DHEG); to learn their perceptions of its risk and gravity; and to understand the repercussions of DHEG for these women and their families. This is a qualitative research aiming at an exploratory study. Data collection took place through individual semi-structured interviews with ten women in childbirth who were diagnosed with DHEG and data analysis was performed using the Analysis of Content. So, thematic categories emerged addressing the women´s knowledge of DHEG; their perceptions about the diagnosis and the professional care offered; and the repercussions DHEG had for them and their families. The study highlights the necessity to rethink and to reorganize the model of perinatal care, not only at the tertiary level but also at the basic health centers.Objetivou-se identificar o conhecimento das puerperas em relacao a doenca hipertensiva especifica da gestacao (DHEG), conhecer suas percepcoes quanto ao risco e gravidade da doenca e conhecer as repercussoes da DHEG para estas mulheres e suas familias. Trata-se de uma pesquisa qualitativa na perspectiva de um estudo exploratorio descritivo. A coleta de informacoes ocorreu com dez puerperas com diagnostico de DHEG por meio de entrevistas individuais semi-estruturadas, analisadas conforme referencial da Analise de Conteudo. Assim, emergiram categorias tematicas abordando o conhecimento sobre DHEG, percepcoes sobre o diagnostico e o cuidado profissional, e repercussoes da DHEG para as mulheres e suas familias. O estudo aponta a necessidade de se repensar e reorganizar o modelo de assistencia perinatal, nao apenas a nivel terciario, mas nas unidades basicas de saude.This study aims to identify the knowledge women in childbirth (puerperas) have regarding gestational hypertension disease (GHD), to learn how they perceive its risk and gravity, and to understand the repercussions of GHD for these women and their families. This is a descriptive exploratory study using qualitative research methods. Data collection took place through individual semi-structured interviews with ten women in childbirth (puerperas) who were diagnosed with GHD. The analysis of the data was performed using Content Analysis. Thematic categories emerged addressing the womens knowledge of GHD; how they perceive diagnosis and the professional care offered; and the repercussions GHD had for them and their families. The study highlights the necessity to rethink and to reorganize the model of perinatal care, not only at the tertiary level but also at primary healthcare centers.