Shu-Hsin Lee

Grief responses and coping strategies among infertile women after failed in vitro fertilization treatment

Reproductive technology has increased the childbearing potential for many infertile women, but in vitro fertilization (IVF) failures are common, which often trigger grief responses and coping strategies to manage the stressful life event. The present cross-sectional study investigated 66 women who had experienced at least one failure with IVF treatment. The data were gathered by a self-administered structured questionnaire, and included the participants personal profile, grief responses and the Jalowiecs coping scale. The most common grief response among the respondents was bargaining, followed by acceptance, depression, anger, denial, and isolation. The order of coping strategies used, from highest-to-lowest, were confrontative, optimistic, self-reliant, fatalistic, supportive, evasive, palliative, and emotive. Use and self-perceived effectiveness among all coping strategies had a high correlation, except emotion. Bargaining, the most common grief response, was associated with a variety of coping strategies. All coping strategies were correlated with grief responses. The results of identifying the grief responses and associated coping strategies of women who have undergone failed IVF treatment may assist nurses and other health care professionals in their efforts to provide appropriate information, care and psychological support.

Birth outcomes and risk factors in adolescent pregnancies: Results of a Taiwanese national survey

Background:  This study explores birth outcomes and determinants in adolescent pregnancies, using subjects drawn from the Taiwan Birth Cohort Study (TBCS) from 2005.

Postpartum depression and correlated factors in women who received in vitro fertilization treatment.

INTRODUCTION Postpartum depression is a significant mental health problem that occurs more frequently in the first 4 weeks postpartum and also may occur later during the first postpartum year. Women who receive in vitro fertilization (IVF) treatment have a particular perinatal experience that may create postpartum mental health concerns. The purpose of this cross-sectional study was to evaluate factors associated with postpartum depression in women who received IVF treatment. METHODS Sixty of 71 eligible postpartum women who were treated at an infertility treatment center and who conceived by IVF were included in this study, which used a self-administered, structured questionnaire. RESULTS The prevalence of postpartum depression was 25%, including mild (16.7%), moderate (6.7%), and severe (1.7%). Pearson correlation analysis showed that the frequency of receiving IVF treatment and perceived stress were positively correlated with postpartum depression, whereas family function and social support were negatively correlated with postpartum depression. Multiple regression analysis showed that the frequency of receiving IVF treatment, birth method, and social support were significant predictive factors for postpartum depression when covariates were controlled (R(2) 56.6%). DISCUSSION A higher frequency of IVF treatment, cesarean birth, and inadequate social support increase the possibility of postpartum depression, and clinicians should provide appropriate anticipatory education or counseling.

How family support affects physical activity (PA) among middle-aged and elderly people before and after they suffer from chronic diseases.

The more support elderly people have from their family, the less likely they are to suffer from chronic diseases. The objective of this study is to investigate how family support affects the PA middle-aged and elderly people engage in before and after they suffer from chronic diseases. We interviewed 428 middle-aged and elderly people using a structured questionnaire to measure their aerobic PA. Eighteen percent of middle-aged and elderly people did participate in PA after suffering from chronic diseases. Using multivariate logistic regression models, we found that middle-aged and elderly people who rely on family members when they are sick (OR=1.87, 95%CI=1.08-3.25) and who are accompanied by family members (OR=2.09, 95%CI=1.20-3.62) when they are healthy are more likely to exercise. The more middle-aged and elderly people are supported by their family, the more likely they are to exercise. Strengthening family relationships should help reduce the prevalence of chronic diseases among middle-aged and elderly people.

The effects of age and aboriginality on the incidence of low birth weight in mountain townships of Taiwan

BACKGROUND This study aimed to examine the associations between aboriginality, age, demographic and socioeconomic factors of the mother and the risk of low birth weight (LBW) in mountain townships of Taiwan. METHODS We analyzed the LBW proportion of single live babies born to 2032 first-time mothers between 2004 and 2005. Data were analyzed using the chi-square test, analysis of variance, the Scheffe test and logistic regression. RESULTS About 14.8% of Aboriginal mothers and 18.7% of Aboriginal teen mothers gave birth to infants of LBW. Aboriginal mothers were found to be at higher risk of delivering LBW infants; however, after controlling for marital status and education, the influence of aboriginality and age was no longer significant. CONCLUSIONS Marital status and education are more important determinants of LBW than aboriginality and age in mountain townships of Taiwan.

Significant Association of Elevated Concentration of Plasma YKL-40 with Disease Severity in Patients With Pelvic Inflammatory Disease

To date, no study reports the implication of YKL‐40 in pelvic inflammatory disease (PID). Therefore, we investigate the levels of plasma YKL‐40 in patients with PID and further associate its expression with the severity of disease.

Social support and mortality among the aged people with major diseases or ADL disabilities in Taiwan: A national study

OBJECTIVE To determine the effects of social support on mortality among the aged people with major diseases or ADL disabilities. METHOD In this prospective cohort study, data were retrieved from the Taiwan Longitudinal Study on Aging from 1996 to 2007. Data for 1297 males and 1666 females aged ≥65 years were collected. The participants were divided into having major diseases or ADL disability or none. Subjects received financial, instrumental, and emotional support, and they actively provided instrumental and emotional support to others. The effect of the association between providing and receiving social support on mortality was examined using Cox regression analysis after adjusting several covariates. RESULTS Results showed a significant finding that providing instrumental support can lower mortality rates in the aged people [Hazard ratio (HR)=0.77; 95% confidence interval (CI)=0.66-0.90; p=0.0009] and those with major diseases or impairment of activities of daily living [Hazard ratio (HR)=0.62; 95% confidence interval (CI)=0.50-0.78; p≤0.0001] after adjusting for several covariates. Providing instrumental social support to others may prolong life expectancy in the aged people and even those with major diseases or those facing difficulties performing ADL. CONCLUSION Based on the finding, we should encourage older adults who have major diseases or ADL disabilities to be supporting providers especially in providing instrumental social support.

Development of a Chinese childbearing attitude questionnaire for infertile women receiving in vitro fertilization treatment.

The purpose of this study was to report the second phase of instrument development, a culturally sensitive questionnaire of childbearing attitudes to assess the psychosocial responses of infertile women. Using a nonexperimental quantitative design, we investigated 238 women who are undergoing in vitro fertilization treatment. Data collection and relevant planning occurred in two phases: in-depth interviews of women to generate items for the questionnaire and establishing the questionnaire’s content and construct validity. Through factor analysis, five factors were extracted from the “attitude toward childbearing questionnaire”: gender identification with self and society, insurance of marriage and inheritance, happy family life, spiritual investment, and continuing the family line and procreation. The total variance of these five factors was 64.31%. Cronbach’s α and test–retest reliability were between .72 and .87 and between .60 and .76, respectively, demonstrating acceptable internal consistency and stability. The information obtained through the questionnaire could be used to provide infertile women with personal counseling and appropriate psychological support during and after assisted reproductive technology.

THE EXPERIENCES OF ADOLESCENT HEALTH CARE AT A COLLEGE HOSPITAL IN TAIWAN

In 1993 the major causes of death in Taiwan for the age group of 15-24 years were (in order of prevalence) accidents, suicides, malignancies, homicides and heart diseases III, as shown in Table 1. The mortality rate for accidents was 64.16/100,000 in 1993. Sixty-five percent of accidental deaths were due to motorcycle accidents resulting in head injury. Drowning accounted for 11% of accidental deaths. As summarized in Table 2, in 1993 the highest health authority, the Department of Health, Executive Yuan, R.O.C. identified the following priority health care issues for adolescents in Taiwan /2/: dental caries, myopias, accidental injuries, unexpected pregnancy, pinworm infestations, pediculosis capitis, renal diseases, insulin