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 individual's 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 Cohen's 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 men's and women's 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.

What variables predict generic and health-related quality of life in a sample of Brazilian women experiencing infertility?

BACKGROUND: Infertility is a condition associated with impairment in several areas of life. Questionnaires about quality of life (QoL) allow the examination of the impact of health conditions in a broader way, comprehending outcomes beyond symptomatology, morbidity and mortality. The aim of this study was to identify factors associated with various aspects of QoL. METHODS: Cross-sectional study using the following: a socio-demographic and clinical data form, the Health Survey Short Form (SF-36) which examines health-related QoL and the WHOQOL-BREF which examines general QoL. RESULTS: 177 women seeking fertility assistance were interviewed. The sample was predominantly composed of women between 30 and 40 years old (64%), who had known about their infertility for <5 years (57%) and who had had no previous attempts at assisted reproduction (79%). Logistic regression indicated the following predictor variables: age (for better general health and physical functioning), previous in vitro fertilization (for lower vitality and poor psychological health scores), previous reproductive tract surgery (for worse general health but higher environment scores), advanced education (for higher vitality, mental health and environment scores, but for worse social relationships) and perception of worse sexual life (for lower overall scores). CONCLUSIONS: The identification of factors associated with better or worse QoL, in its different domains, is vital in order to propose and test scientifically based interventions on infertile women.

Images of the body and the reproductive system among men and women living in Shantytowns in Porto Alegre, Brazil.

This paper presents the results of anthropological research on graphic and verbal images of the reproductive system carried out among 99 women and 103 men living in four shantytowns in Porto Alegre, Brazil. Interviewers were instructed to ask for the drawings in the course of interviews lasting 12-20 hours. Some 55 drawings of the female reproductive system by men and 99 by women were produced and are analysed here together with information from the interviews and observational data. The majority of the men's drawings of women's reproductive system tended to include 'external' body parts only, in contrast with the 'hidden' nature of the internal body parts, which were commonly depicted by the women. Women have been more exposed to the health system than men and the majority made basic biomedical types of drawings. However, their verbal representations were sometimes informed by other notions and values and their physical experience of their bodies. Lack of contact with the health system does not fully account for the men's apparent lack of knowledge about the reproductive body. Rather, biomedical knowledge was simply not a point of reference for the men's understandings of the body. The majority of drawings made by men of the female reproductive body portrayed the primacy of sexuality in their view of the reproductive system.

Marital change during the transition to parenthood.

An ecological conceptual framework that supports the interdependence of the marital and the parent-child relationships is used to guide this discussion of the determinants of marital change during the transition to parenthood. New parents are at risk of experiencing increased marital conflict after the birth of their infant, which is associated with negative developmental outcomes for their children. Descriptive questions that pediatric nurses can ask both parents in assessing marital satisfaction and suggestions for interventions to ease the stresses of the transition for parents are presented.

Predictors of parental sense of competence for the couple during the transition to parenthood.

The purpose of this longitudinal panel study was to determine whether changes occur in parents' satisfaction with family functioning and in the importance they attribute to family relationships during the transition to parenthood, and whether these variables Predict parental sense of competence in 114 couples. Repeated measures ANOVA and paired t-test analyses supported a significant decline in satisfaction with family functioning for mothers and fathers. Prenatal conditions contributed to variations in parents' satisfaction with family functioning. Importance of family relationships did not change across time for mothers and remained significantly (p<.05) greater at each test period than for fathers. Multiple regression analyses showed that satisfaction with family functioning was significantly (p<.05) more important for mothers' parental sense of competence than it was for fathers'. This knowledge can contribute to strategies for identifying problems that can be addressed through family-based interventions.

[Tuberculosis treatment adherence in Pelotas, Brazil, from the patient's perspective]. / Adesão à terapêutica da tuberculose em Pelotas, Rio Grande do Sul: na perspectiva do paciente.

This study deals with adherence to tuberculosis treatment among men and women as well as the disease's links and consequences vis-à-vis life styles and treatment outcomes. The ethnographic study was a component of the Tuberculosis Epidemiological Control Project in the city of Pelotas and aimed to identify the reasons patients failed to complete treatment. Direct ethnographic observations and semi-structured interviews were used. Use of the term "adherence" is justified by the concern for extending to other fundamental factors in addition to the patient's own individual responsibility. This approach fostered an understanding of views towards disease, social dynamics among the various protagonists involved in the disease process, and treatment. Some of the factors considered in adherence to treatment were: socio-demographic characteristics, cultural factors, popular beliefs, the cost-benefit relationship, physical and chemical aspects of the drugs, the physician-patient relationship, and level of family participation in treatment.

The factor structure of the perception of birth scale.

The factor structure of the perception of birth scale (POBS) was explored using a sample of 320 women who had vaginal or unplanned cesarean deliveries. Exploratory factor analysis yielded a 25-item instrument with five factor-based subscales: Labor Experience, Delivery Experience, Delivery Outcome, Partner Participation, and Awareness. The total POBS demonstrated adequate internal consistency reliability, with a Cronbach's alpha coefficient of .85. The new 25-item version of POBS can be used to measure selected aspects of a woman's perception of the birth experience. Additional research with samples large enough to permit confirmatory factor analysis is recommended.

Community nursing centers: removing impediments to success.

The purpose of this article is to address impediments to the success of existing community nursing centers and to the development of new centers. A realistic plan for removing these impediments is proposed.