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1.
Pediatr Allergy Immunol ; 34(5): e13953, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-37232280

RESUMO

BACKGROUND: Studies on the relationship between childhood allergic disease and health-related quality of life (HRQOL) have mostly been confined to a single allergic condition. Therefore, a composite allergic score (CAS) was derived to assess the accumulated effect of eczema, asthma, and allergic rhinitis on HRQOL in Hong Kong schoolchildren. METHODS: Parents of grade one/two or grade eight/nine schoolchildren completed a questionnaire assessing the prevalence and severity of eczema (POEM), asthma (C-ACT/ACT), and allergic rhinitis (VAS) and schoolchildren's HRQOL (PedsQL). Three rounds of recruitment were conducted. A total of 19 primary and 25 secondary schools agreed to participate. RESULTS: Data from 1140 caregivers of grade one/two schoolchildren and 1048 grade eight/nine schoolchildren were imputed and analyzed. The proportion of female respondents were lower in grade one/two (37.7%) but higher in grade eight/nine (57.3%). 63.8% of grade one/two and 58.1% of grade eight/nine schoolchildren reported having at least one allergic disease. In general, greater disease severity was significantly associated with lower HRQOL. After controlling for age, gender, and allergic comorbidity in hierarchical regressions, CAS significantly predicted all HRQOL outcomes in both grade one/two and grade eight/nine schoolchildren. Female grade eight/nine schoolchildren reported lower HRQOL outcomes. CONCLUSION: Composite allergic score may be a practical tool to evaluate allergic comorbidity and the effectiveness of treatments targeting common pathological mechanisms of allergic diseases. Non-pharmaceutical approaches should be considered, especially for patients with more than one allergic disease and greater severity.


Assuntos
Asma , Eczema , Rinite Alérgica , Humanos , Feminino , Criança , Hong Kong/epidemiologia , Qualidade de Vida , Asma/epidemiologia , Asma/complicações , Eczema/epidemiologia , Rinite Alérgica/epidemiologia , Rinite Alérgica/complicações , Inquéritos e Questionários , Prevalência
2.
J Sex Med ; 20(1): 30-37, 2023 01 14.
Artigo em Inglês | MEDLINE | ID: mdl-36897240

RESUMO

BACKGROUND: Cross-sectional studies have shown that sexual dysfunction and poor quality of life were prevalent among couples undergoing assisted reproduction at specific time points, but nothing is known about how these outcomes change over the course of their intrauterine insemination (IUI) journey. AIM: We investigated the longitudinal changes in sexual function and quality of life of infertile couples undergoing IUI. METHODS: Sixty-six infertile couples completed an anonymous questionnaire at 3 time points: after IUI counseling (T1), 1 day before IUI (T2), and 2 weeks after IUI (T3). The questionnaire consisted of demographic data, Female Sexual Function Index (FSFI) or International Index of Erectile Function-5, and Fertility Quality of Life (FertiQoL). OUTCOMES: Descriptive statistics, significance testing with the Friedman test, and post hoc analysis with the Wilcoxon signed rank test were used to compare changes in sexual function and quality of life at different time points. RESULTS: Overall, 18 (26.1%), 16 (23.2%), and 12 (17.4%) women and 29 (42.0%), 37 (53.6%), and 31 (44.9%) men were at risk for sexual dysfunction at T1, T2, and T3, respectively. There were significant differences in mean FSFI scores in arousal (3.87, 4.06, 4.10) and orgasm (4.15, 4.24, 4.39) domains at T1, T2, and T3. After post hoc analysis, only the increase in mean orgasm FSFI scores between T1 and T3 was statistically significant. Men's FertiQoL scores remained high during IUI (74.33-75.63 out of 100). Men also scored significantly higher than women on all FertiQoL domains except environment at the 3 time points. Post hoc analysis showed significant improvement in women's FertiQoL domain scores between T1 and T2: mind-body, environment, treatment, and total. Women's FertiQoL score at T2 for the treatment domain was also significantly higher than that at T3. CLINICAL IMPLICATIONS: Men should not be neglected during IUI as their erectile function got worse in the process, with half of the men being affected. Although women's quality of life showed some improvement during IUI, most of their scores were lower than men's. STRENGTHS AND LIMITATIONS: The use of psychometrically validated questionnaires and a longitudinal approach are the major strengths; a small sample size and the lack of a dyadic approach are the major limitations. CONCLUSION: During IUI, women's sexual performance and quality of life improved. The proportion of men having erectile problems was high for this age group, but men's FertiQoL scores remained good and were better than their partners' throughout IUI.


Assuntos
Disfunção Erétil , Infertilidade , Disfunções Sexuais Fisiológicas , Masculino , Humanos , Feminino , Estudos Longitudinais , Qualidade de Vida/psicologia , Estudos Transversais , Infertilidade/psicologia , Inquéritos e Questionários , Inseminação
3.
Hum Fertil (Camb) ; 26(2): 289-301, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35850620

RESUMO

The emotional consequences of infertility are well documented. However, relatively few studies have emphasized the dyadic emotional interaction within couples, despite infertility being a shared life event. This study adopted a dyadic (between two people) approach to explore the emotional complexity that infertile couples face. A descriptive qualitative study was conducted with 24 participants, including eight infertile couples and eight wives undergoing infertility treatments. Conjoint and individual interviews were conducted through purposive sampling in a large fertility centre in Tianjin, China, between June and August 2015. Thematic analysis identified two main themes: (i) 'decisional ambivalence', with subthemes of 'ambivalent attitudes towards treatment', 'uncertainty about treatment outcomes', and 'treatment-related lifestyle changes'; and (ii) 'relational ambivalence' which included subthemes of 'intergenerational ambivalence' and 'partner ambivalence'. Complex emotions of ambivalence among infertile couples were common as infertility clearly shattered their assumptive world on family formation. With complex entanglement of mixed emotions, ambivalence was intimately associated with cultural norms, social expectations, and active or over engagement of family members in Chinese societies. Since ambivalence could threaten mental and physical health during pregnancy, healthcare professionals should be prepared to assist infertile couples with identifying, articulating, and normalizing decisional and relational ambivalence during the treatment process.


Assuntos
Infertilidade , Humanos , Infertilidade/terapia , Infertilidade/psicologia , Emoções , Fertilidade , Família , Fertilização in vitro
4.
BMJ Open ; 12(3): e059150, 2022 03 16.
Artigo em Inglês | MEDLINE | ID: mdl-35296490

RESUMO

INTRODUCTION: Atopic dermatitis (AD) is the most common childhood inflammatory skin problem affecting 15%-30% of children. Although AD adversely impacts the psychosocial well-being of children and their parent caregivers, parents' psychosocial well-being is seldom mentioned in most non-pharmacological education programmes. A family-based psychosocial intervention, Integrative Body-Mind-Spirit (I-BMS) intervention, is examined. This study compares the efficacy of two versions of the I-BMS intervention (one delivered to both parents and children; one delivered to parents only) with a health education active control (delivered to parents only) in promoting adaptive emotional regulation and quality of life of children with AD and their parent caregivers. METHODS AND ANALYSIS: This is a three-arm, with equal randomisation, parallel randomised controlled trial. 192 parent-child dyads will be recruited through hospitals and non-governmental organisations in Hong Kong. Each dyad will complete an individual pre-group screening interview. Eligible dyads will be randomised in a ratio of 1:1:1 into one of the three arms. Each arm consists of six weekly sessions. A computer-generated list of random numbers will be used to perform randomisation. The primary outcomes are quality of life and emotional regulation. Assessments are administered at baseline, post-intervention and 6-week follow-up. Mixed factorial Analysis of Covariance (ANCOVAs) based on intention-to-treat principle will be conducted to examine the efficacy of the two I-BMS interventions. Structural equation modelling will be conducted to examine the parent-child interdependent effects of intervention. ETHICS AND DISSEMINATION: Ethics approval was obtained from the Human Research Ethics Committee of the University of Hong Kong (EA2001001) and the Institutional Review Board of the Hospital Authority of Hong Kong (UW 21-400, KC/KE-20-0360/FR-2, NTEC-2021-0408). Consent will be sought from participating parents and children. Parental consent for child participants will also be obtained. Findings will be presented in peer-reviewed journals and at conferences in medical dermatology, paediatrics and social work. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov Registry (NCT04617977).


Assuntos
Dermatite Atópica , Eczema , Criança , Dermatite Atópica/terapia , Humanos , Relações Pais-Filho , Pais/psicologia , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto
5.
Hum Fertil (Camb) ; 25(3): 593-599, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33432863

RESUMO

Couples undergoing assisted reproductive technologies (ART) are prone to sexual dysfunction and lower quality of life (QoL), but whether the incidence of these problems differs with the type of ART is unknown. As such, we conducted this cross-sectional survey to compare the sexual function and QoL of 75 couples undergoing intrauterine insemination (IUI), and 160 couples undergoing in vitro fertilization (IVF). They completed an anonymous questionnaire which included: (i) demographic characteristics; (ii) female sexual function index (FSFI) or (iii) international index of erectile function-5 (IIEF-5); and (iv) fertility QoL questionnaire (FertiQoL). Overall, 22.6% of wives and 39.1% of husbands were at risk for sexual dysfunction, and the risk was similar in IUI and IVF groups. Mean core/treatment/total FertiQoL scores of husbands were higher than wives: 74.98 vs. 68.24/70.02 vs. 65.87/73.52 vs. 67.54 (all p < 0.001). FertiQoL scores were similar in IUI and IVF groups except wives' treatment FertiQoL score was significantly higher in the IUI group (68.93 vs. 64.44; p = 0.009). This study confirms that risks for sexual dysfunction were similar in IUI and IVF couples. Wives undergoing IVF had significantly lower treatment FertiQoL score. In both IUI and IVF groups, husbands' QoL was better than wives' QoL.


Assuntos
Fertilização in vitro , Qualidade de Vida , China , Estudos Transversais , Feminino , Humanos , Masculino , Estudos Prospectivos
6.
Arch Womens Ment Health ; 24(1): 11-27, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-32514730

RESUMO

Polycystic ovary syndrome (PCOS) has been proposed to be associated with several mental health problems, including anxiety, depression, diminished sexual satisfaction, and lowered health-related quality of life, etc. A systematic review and meta-analysis of published literature was conducted comparing the mental health of women with and without PCOS. Ten English and Chinese databases were searched up to 12/31/2018. Random-effects models were introduced, and subgroup analysis, sensitivity test, and meta-regression were carried out to determine the source for heterogeneity among studies. Forty-six studies, including 30,989 participants (9265 women with PCOS and 25,638 controls), were qualified for review according to the inclusion criteria. Twenty-eight studies reported depression symptoms, 22 studies were on anxiety, 16 studies showed quality of life (QoL) status, 12 studies were about sexual dysfunction, five on emotional distress, four on binge eating, and four on somatization. Women with PCOS reported significantly higher depression (SMD = 0.64; 95% CI 0.50-0.78), anxiety (SMD = 0.63; 95% CI 0.50-0.77), lower QoL (SMD = - 0.55; 95% CI -0.69 to -0.40), and not significant sexual dysfunction (SMD = - 0.24; 95% CI - 0.49 to 0.01). Studies from different countries, adopting various diagnosis criteria, using diverse instruments, as well as in different years, have reported heterogenetic results. Women with PCOS in China reported a larger effect size of depression and anxiety than patients from other countries. The results of this study have indicated that women with PCOS suffer from depression, anxiety, and experience a lower quality of life, whereas their sexual function is not distinct from that of healthy women. Psychological health care interventions for women with PCOS were addressed.


Assuntos
Síndrome do Ovário Policístico , Ansiedade/epidemiologia , China , Depressão/epidemiologia , Feminino , Humanos , Saúde Mental , Síndrome do Ovário Policístico/epidemiologia , Qualidade de Vida
7.
Health Soc Care Community ; 28(3): 862-873, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31828879

RESUMO

Atopic dermatitis (AD) imposes significant physical and psychosocial burdens on affected children. However, little has been done to learn from the subjective experiences, perspectives and emotions of children living with AD. Their voices are not heard in healthcare settings. This study aims to share these children's voices and provide a deep understanding of the subjective experiences of children living with AD. We conducted qualitative research by conducting semi-structured interviews and analysing the drawings of 17 children in Hong Kong aged between 8 and 12 years who were diagnosed with AD. Using a phenomenological approach, we transcribed, coded and described the interviews. We found that for the children in this study, living with AD meant contending with an accumulation of challenges and crises. At the individual level, the essential experience of living with AD manifested a vicious cycle of skin and mental issues. At the family level, conflicts between children and parents concerning AD management coexisted with parental support. The children commonly experienced bullying and isolation in school and discrimination and stigmatisation in their neighbourhood, thereby making living with AD a traumatic experience. The synergy between individual and environmental factors contributed to shaping an incapable and wounded "self" living with AD. Based on our findings, we propose a child-centred biopsychosocial framework for understanding the living experiences of children with AD. This study suggests different practice strategies for healthcare professionals working with the individual challenges experienced by children living with AD and the challenges these children experience in their family, school, and neighbourhood. The needs of these children should be addressed through an integrated, holistic approach for improving their long-term health outcomes.


Assuntos
Dermatite Atópica/psicologia , Solidão/psicologia , Criança , Emoções , Família/psicologia , Feminino , Hong Kong , Humanos , Entrevistas como Assunto , Masculino , Pais/psicologia , Pesquisa Qualitativa
8.
BMC Womens Health ; 19(1): 153, 2019 12 05.
Artigo em Inglês | MEDLINE | ID: mdl-31805920

RESUMO

BACKGROUND: While the literature on healthcare decision-making has long focused on doctor-patient interaction, fertility treatment is an exception, characterized by a triangular interplay between the doctor, the woman and her partner. This study examined treatment decision-making preferences of women undergoing in vitro fertilization (IVF) treatment, following an unsuccessful IVF cycle, especially their preferred level of doctor and spousal involvement. METHODS: A cross-sectional survey was conducted with 246 Chinese women undergoing IVF recruited from an assisted reproduction clinic of a university-affiliated hospital in Hong Kong. Data collection was conducted between January 2014 and August 2015. RESULTS: Most participants preferred sharing the decision-making tasks with their doctors (92%). In the doctor-patient relationship, passive roles were associated with higher marital satisfaction, presence of religious affiliation and secondary infertility, while autonomous roles were related to female-factor infertility. Fifty-two percent of participants anticipated sharing decision-making, while 46% preferred handing over the decision to their husbands. Preference for a passive rather than a shared role in the spousal relationship was related to a higher husband's age, greater marital satisfaction and higher anxiety. CONCLUSIONS: In brief, women tended to prefer sharing decision-making tasks with their doctor as well as actively engaging their partner in making decisions about fertility treatment. This study adds to our understanding of women's role preference and level of involvement in infertility treatment decision-making by providing quantitative evidence from women's experience. It highlights the importance of healthcare professionals in facilitating shared decision-making among couples.


Assuntos
Tomada de Decisões , Fertilização in vitro/psicologia , Infertilidade Feminina/psicologia , Preferência do Paciente/psicologia , Resolução de Problemas , Adulto , Ansiedade/psicologia , Estudos Transversais , Feminino , Hong Kong , Humanos , Infertilidade Feminina/terapia , Casamento/psicologia , Relações Médico-Paciente , Parceiros Sexuais/psicologia
9.
Arch Sex Behav ; 48(5): 1543-1554, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31123949

RESUMO

Sexual minority women are at an elevated risk for depression compared to heterosexual women, yet less is known about how gender roles affect the mental health of sexual minority women. Existing studies examining the role of self-esteem in the relationship between gender roles and depression are scarce and have predominantly focused on heterosexual populations. Using a cross-sectional survey of Chinese lesbians in Hong Kong (N = 438), the study tested the direct and indirect effects of different types of gender roles (masculine, feminine, and androgynous) on depression through the mediating factor of self-esteem. We found that masculinity and androgyny were positively associated with self-esteem, while femininity was negatively associated with self-esteem. More importantly, self-esteem fully mediated the inverse relationship between masculinity and depression and that between androgyny and depression. The positive relationship between femininity and depression was also fully mediated by self-esteem. By examining different types of gender roles and incorporating gender roles, self-esteem, and depression into a unified framework, the research highlighted the particularly protective effect of androgyny, which had the strongest positive direct effect on self-esteem and indirect effect on depression through the mediation of self-esteem compared to the effects of other types of gender roles. Our results illuminate the importance of understanding how individual differences in gender roles relate to the mental health of sexual minority women in future research and interventions. Implications for interventions that help Chinese lesbians cope with gender expectations and improve their mental health are discussed.


Assuntos
Depressão/psicologia , Identidade de Gênero , Autoimagem , Minorias Sexuais e de Gênero/psicologia , Adolescente , Adulto , Povo Asiático , Estudos Transversais , Feminino , Humanos , Masculino , Adulto Jovem
10.
Hum Reprod Open ; 2018(4): hoy014, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30895255

RESUMO

STUDY QUESTION: What is the intention to have a second child among women attending outpatient gynecology clinics in three major cities in China? SUMMARY ANSWER: In total, 69.3% of the participants expressed the intention to have a second child and this was related to infertility status, pronatalist attitudes, and sociodemographic factors. WHAT IS KNOWN ALREADY: In 2016, the new universal two-child policy was introduced in China enabling all Chinese couples to have a second child. A government-led national survey revealed that the majority of women included under the policy would be 35 years old and older and thus would be at higher risk of infertility. Previous studies found that fertility intention differs by infertility status. STUDY DESIGN SIZE DURATION: A cross-sectional survey was performed to examine the intention of having a second child and its associated factors among infertile and fertile women attending gynecology outpatient clinics in three major cities in China. Clinical nurses approached eligible women in person while waiting for their consultations. Recruitment and data collection were conducted from April to August 2016. PARTICIPANTS/MATERIALS SETTING METHODS: The survey involved four gynecology outpatient clinics in Beijing, Shenzhen, and Hohhot. Married women aged 20-45 years who were seeking outpatient gynecology care for non-malignant problems were invited to participate. MAIN RESULTS AND THE ROLE OF CHANCE: Data from 974 women were included in the analysis. A total of 69.3% of the women expressed the intention to have a second child, and infertile women were more likely to want a second child compared to fertile women (76.6% vs 61.9%, respectively; P < 0.001). Greater ideal parity facilitated the intention for a second child in both groups, while pronatalist attitudes (meaning that they preferred to have their first childbirth at a younger age and attached greater significance to traditional childbearing beliefs), unexplained infertility, presence of a living child and religious affiliation were associated with greater intention among infertile women. In contrast, in the fertile group, older age, full-time work and lower confidence in achieving parity goals diminished the intention for a second child. Although infertile women displayed greater agreement with pronatalist attitudes and desired a higher ideal parity, they had less confidence in achieving their parity goals than their fertile counterparts. LIMITATIONS REASONS FOR CAUTION: In addition to self-report and self-selection bias, our participants were recruited from urbanized areas and were more educated than the general population. Owing to the extremely busy environment in the clinics, difficulties were encountered in keeping track of the number of women whom the nurses approached, and the response rate was therefore unavailable. WIDER IMPLICATIONS OF THE FINDINGS: With the introduction of the universal two-child policy, there is a need to enhance fertility awareness and to encourage reproductive life planning, as well as to lower the cost of childcare, in order to increase the birth rate in China. Effort is required to make childbearing more compatible with current employment, career and educational development, the burdens of family care (e.g. for elderly parents), social environments and cultural expectations. This is particularly relevant for families who already have a child, as our findings show that their hesitation toward a second child was largely related to difficulties with extra childcare within the woman's current work and family life. STUDY FUNDING/COMPETING INTERESTS: This study did not receive any funding. The authors declared no competing interests. TRIAL REGISTRATION NUMBER: Not applicable.

11.
Res Nurs Health ; 41(1): 69-77, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29193167

RESUMO

The primary goal of this study was to examine and describe the importance of childbearing as perceived by infertile women in the Chinese familial and social context. We adopted a qualitative descriptive method and conducted semi-structured interviews with female patients diagnosed with infertility. Participants were recruited at a high-volume fertility clinic in Tianjin, China. Fifteen women with a diagnosis of infertility were interviewed for 60-90 min. Data were analyzed by thematic analysis. Two themes supported the importance of childbearing for Chinese women with infertility: childbearing as natural law, and childbearing for relational harmony. Childbearing as natural law referred to intrinsic forces to seek a child, including (i) achieving motherhood and womanhood and (ii) experiencing a developmental transition with childbearing as a landmark. Relational harmony included three primary factors: (i) to maintain marital quality by preventing marital failure and rejuvenating an unsatisfactory marital relationship; (ii) to fulfill both authoritative and reciprocal filial piety; (iii) to build a sense of normalcy within family and social networks. In summary, infertility resulted in loss of motherhood, womanhood, and a smooth developmental transition. Moreover, it threatened relationship harmony in the marriage, family, and social life. These insights on the value of childbearing in the Chinese context can inform healthcare professionals in identify infertility-related demands and developing relevant psychosocial services for people with infertility.


Assuntos
Adaptação Psicológica , Infertilidade Feminina/psicologia , Comportamento Reprodutivo/psicologia , Estresse Psicológico , Adulto , China , Feminino , Humanos , Pessoa de Meia-Idade , Pesquisa Qualitativa
12.
BMC Med Educ ; 17(1): 221, 2017 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-29157232

RESUMO

BACKGROUND: Interprofessional learning is gaining momentum in revolutionizing healthcare education. During the academic year 2015/16, seven undergraduate-entry health and social care programs from two universities in Hong Kong took part in an interprofessional education program. Based on considerations such as the large number of students involved and the need to incorporate adult learning principles, team-based learning was adopted as the pedagogy for the program, which was therefore called the interprofessional team-based learning program (IPTBL). The authors describe the development and implementation of the IPTBL program and evaluate the effectiveness of the program implementation. METHODS: Eight hundred and one students, who are predominantly Chinese, participated in the IPTBL. The quantitative design (a pretest-posttest experimental design) was utilized to examine the students' gains on their readiness to engage in interprofessional education (IPE). RESULTS: Three instructional units (IUs) were implemented, each around a clinical area which could engage students from complementary health and social care disciplines. Each IU followed a team-based learning (TBL) process: pre-class study, individual readiness assurance test, team readiness assurance test, appeal, feedback, and application exercise. An electronic platform was developed and was progressively introduced in the three IUs. The students' self-perceived attainment of the IPE learning outcomes was high. Across all four subscales of RIPLS, there was significant improvement in student's readiness to engage in interprofessional learning after the IPTBL. A number of challenges were identified: significant time involvement of the teachers, difficulty in matching students from different programs, difficulty in making IPTBL count towards a summative assessment score, difficulty in developing the LAMS platform, logistics difficulty in managing paper TBL, and inappropriateness of the venue. CONCLUSIONS: Despite some challenges in developing and implementing the IPTBL program, our experience showed that TBL is a viable pedagogy to be used in interprofessional education involving hundreds of students. The significant improvement in all four subscales of RIPLS showed the effects of the IPTBL program in preparing students for collaborative practice. Factors that contributed to the success of the use of TBL for IPE are discussed.


Assuntos
Ocupações em Saúde/educação , Relações Interprofissionais , Estudantes de Ciências da Saúde , Disciplinas das Ciências Biológicas/educação , Comportamento Cooperativo , Feminino , Hong Kong , Humanos , Masculino , Medicina Tradicional Chinesa , Serviço Social/educação , Universidades , Adulto Jovem
13.
Hum Reprod ; 31(12): 2772-2780, 2016 12.
Artigo em Inglês | MEDLINE | ID: mdl-27664215

RESUMO

STUDY QUESTION: What is the relationship between decisional conflict, decisional regret and psychological well-being in women following unsuccessful IVF cycles? SUMMARY ANSWER: The mediating effect of decisional regret on the relationship between decisional conflict and fertility-related quality of life (FRQOL) has been found to be moderated by the availability (versus absence) of frozen embryos after an unsuccessful IVF cycle. WHAT IS KNOWN ALREADY: Infertility treatment is marked by its open-ended nature. Stresses in treatment decision-making could be aggravated by a culture which honours families through procreation. While studies have investigated treatment-related decision-making among infertile women, little is known about the mental health consequences of decisional conflict and decisional regret following an unsuccessful IVF cycle. STUDY DESIGN, SIZE, DURATION: A study was conducted over a 3-month period with infertile women who had recently experienced a failed IVF cycle (T0). Decisional conflict when they decided on terminating or continuing treatment (T1) and decisional regret 3 months later (T2) were measured. Participants reported their levels of depression, anxiety and FRQOL at three time points. A total of 151 participants completed all time points (attrition rate: 39%). The average age of participants was 37.2 years, and they had had 1.1 cycles (range: 0-8) on average at the time of study intake. The duration of the study was 2 years. PARTICIPANTS/MATERIALS, SETTING, METHODS: Participants were infertile women who were not pregnant following an IVF cycle recruited from a university-affiliated assisted reproduction centre. Following the notification of a negative pregnancy result, patients were invited to complete measures of FRQOL, depression and anxiety across three time points and decisional conflict and decisional regret at T1 and T2 respectively. MAIN RESULTS AND THE ROLE OF CHANCE: Decisional regret partially mediated the effect of decisional conflict on overall and treatment-specific FRQOL (P < 0.05). The mediation by decisional regret was present only among participants who had no remaining frozen embryos after their unsuccessful IVF cycle (P < 0.05). LIMITATIONS, REASON FOR CAUTION: Self-selection bias at recruitment remains a concern. WIDER IMPLICATIONS OF THE FINDINGS: Our results show for the first time how mental health implications of decisional conflict may vary among patients with different clinical characteristics (i.e. availability of frozen embryos), despite their common experience of an unsuccessful IVF cycle. Healthcare professionals should be aware of the psychological ramifications of treatment decision-making difficulties, as well as individual differences in adjustment to unsuccessful treatment. STUDY FUNDING/COMPETING INTERESTS: The study was funded by the Hong Kong University Grant Council-General Research Fund (HKU740613) and the authors have no conflicts of interest. TRIAL REGISTRATION NUMBER: HKU Clinical Trials Registry (Trial registration number: HKUCTR-1680).


Assuntos
Conflito Psicológico , Tomada de Decisões , Ajustamento Emocional , Emoções , Fertilização in vitro/psicologia , Infertilidade Feminina/terapia , Adulto , Feminino , Humanos , Infertilidade Feminina/psicologia , Estudos Longitudinais , Falha de Tratamento
14.
J Nurs Res ; 21(3): 179-86, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23958607

RESUMO

BACKGROUND: Depression is a leading cause of disability worldwide. There is a need to develop effective strategies to treat depression and prevent recurrence. Treatments that combine pharmacological and psychotherapeutic approaches are preferred for treating severe forms of depression. PURPOSE: The study assesses the effect of an integrated body-mind-spirit group intervention in patients with depression. METHODS: This pilot study was a pretest-posttest design study. Thirty adult patients diagnosed with depression attending the psychiatric outpatient department at a district hospital were randomly assigned to either the intervention group or comparison group. Each group had 15 patients. The intervention group received both the intervention and routine hospital treatment and underwent four group integrated body-mind-spirit group intervention therapy sessions. These sessions were held once per week on either Saturday or Sunday, with each session lasting more than 3 hours. Comparison group participants received routine hospital treatment only. Outcome measures, including level of depression, well-being, and work and social adjustment, were measured using the Beck Depression Inventory-II, body-mind-spirit well-being scale, and work and social adjustment scale. Both groups were evaluated at baseline, 1 month, 2 months, and 3 months. RESULTS: Results showed that both groups had significant reductions in the level of depression, improvements in well-being, and work and social adjustment at 3-month follow-up compared with baseline. In addition, the intervention group showed significant mean differences in levels of depression, well-being, and work and social adjustment compared with the comparison group. CONCLUSION: The integrated body-mind-spirit group intervention model appears to reduce depressive symptoms and improve well-being in patients with depression.


Assuntos
Depressão/terapia , Relações Metafísicas Mente-Corpo , Humanos , Índia , Projetos Piloto
15.
Artigo em Inglês | MEDLINE | ID: mdl-23762156

RESUMO

Objective. To evaluate clinical trial evidence of the effectiveness of qigong exercise on depressive and anxiety symptoms. Methods. Thirteen databases were searched from their respective inception through December 2012. Relevant randomized controlled trials (RCTs) were included. Effects of qigong across trials were pooled. Standardized mean differences (SMDs) were calculated for the pooled effects. Heterogeneity was assessed using the I (2) test. Study quality was evaluated using the Wayne Checklist. Results. Twelve RCTs met the inclusion criteria. The results of meta-analyses suggested a beneficial effect of qigong exercise on depressive symptoms when compared to waiting-list controls or usual care only (SMD = -0.75; 95% CI, -1.44 to -0.06), group newspaper reading (SMD = -1.24; 95% CI, -1.64 to -0.84), and walking or conventional exercise (SMD = -0.52; 95% CI, -0.85 to -0.19), which might be comparable to that of cognitive-behavioral therapy (P = 0.54). Available evidence did not suggest a beneficial effect of qigong exercise on anxiety symptoms. Conclusion. Qigong may be potentially beneficial for management of depressive symptoms, but the results should be interpreted with caution due to the limited number of RCTs and associated methodological weaknesses. Further rigorously designed RCTs are warranted.

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