Grado de satisfacción del paciente con la consulta de enfermería de Reproducción Humana Asistida / Patient' degree of satisfaction with the consultation of infirmary of Human Assisted Reproduction

En el año 2008 aparecieron las primeras Consultas de Enfermería en Reproducción Humana Asistida en España, dos años después se presentaron los beneficios de su implantación y, en el año 2012, se impuso como imprescindible la atención en estas consultas, gracias a un estudio Delphy de consenso. Pese al éxito alcanzado por esta Consulta en el entorno profesional, sólo se puede terminar de valorar su relevancia conociendo la satisfacción del usuario, porque de ella se deriva la utilización de la misma. Con este objetivo surge el presente estudio basado en una encuesta de satisfacción, con fiabilidad excelente (alfa de Cronbach de 0.97),  cuyo resultado ha sido que el 100 % de los pacientes están satisfechos y la consulta se valora con una media de 8,65 puntos sobre 10 (por encima de la media nacional en satisfacción sanitaria). En conclusión, se aconseja la implantación de estas consultas

In the year 2008 the first Consultations of Infirmary appeared in Human Reproduction Represented in Spain, two years later they presented the benefits of his implantation and, in the year 2012, the attention was imposed like indispensably in these consultations, thanks to a study Delphy. In spite of the success reached by this Consultation in the professional environment, only it is possible to stop valuing his relevancy knowing the satisfaction of the user, because from her the utilization of the same one stems. With this aim there arises the present study based on a survey of satisfaction, with excellent reliability (Cronbach's alpha of 0.97), which result has been that 100 % of the patients is satisfied and the consultation is valued by an average of 8,65 points on 10 (over the national average). In conclusion, is advised the implantation of these consultations

Ejercicio Profesional de la Enfermería Española en las Consultas de Reproducción Humana Asistida. Estudio / No disponible

Las actividades de enfermería no siempre están bien especificadas, lo que lleva consigo una gran heterogeneidad en la atención prestada que impide que se cumpla con la Ley de ordenaciones sanitarias, el código deontológico de enfermería, la política de atención basada en el paciente, la mejora de la calidad asistencial y la búsqueda de satisfacción del paciente. Por esta razón se ha decidido realizar el presente estudio Delphi, en el que se define lo que debería ser el "Ejercicio Profesional de la Enfermería Española en las Consultas de Reproducción Humana Asistida", gracias al consenso de un grupo de expertos reconocidos a nivel nacional

Nursing activities in assisted reproduction are actually not well specified, what sometimes means a heterogeneous framework and insufficient definition of patients-centred nursing cares. These issues probably make difficult the observance of legal regulations and even deontological requirements. The objective of this study is to assess, using Delphi method, a proposal about professional functions and roles of nursery in assisted reproduction

Influencia de la ingesta alimentaria en la calidad seminal / Influence of food intake on seminal quality

Objetivo: valorar la calidad de la dieta de los pacientes, conocer su influencia en la calidad seminal y planificar actividades para la modificación de hábitos dietéticos. Método: estudio descriptivo transversal de los hábitos dietéticos sobre 50 varones derivados a la Unidad de Reproducción Asistida, en la cual, junto a sus parejas, acudían para recibir tratamiento de fecundación in vitro (FIV). Se recogió la ingesta autorreportada de dos días no consecutivos. Se utilizó el programa Dietsource 3.0 para procesar la información dietética. En el análisis bivariante se empleó el coeficiente de correlación de Pearson y el de Spearman. Como valores de referencia se han utilizado las ingestas recomendadas para la población española. Resultados: más de la mitad de los varones presentó valores de ingesta calórica inferiores a las 3.000 kcal/d (mediana= 2.700,10). El consumo de carbohidratos fue inferior a la cantidad recomendada mientras que los lípidos, y sobre todo las proteínas, se ingirieron en exceso. Únicamente se encontró relación estadísticamente significativa (p= 0,025) entre la ingesta proteica (g/d) y el recuento de espermatozoides móviles (REM) (a valores de ingesta proteica altos, mayores recuentos de espermatozoides móviles). Conclusiones: los varones estudiados ingirieron una proporción mayor de proteínas y grasas de las recomendadas, siendo básicamente una dieta normo-hipocalórica, hiperproteica e hiperlipídica. Sin embargo, tan solo se halló relación entre la ingesta proteica y la cantidad de espermatozoides móviles en el laboratorio (REM). Se constató una amplia dispersión tanto en el recuento como en movilidad de los espermatozoides, seguramente determinada por la indicación de la FIV (AU)

Objective: to evaluate the quality of patient diet, to understand its influence on seminal quality, and to plan activities for the modification of dietary habits. Method: a descriptive transversal study of dietary habits on 50 men referred to the Assisted Reproductive Unit, which they attended with their partners in order to receive in vitro fertilization treatment. Their self-reported food intake was collected for two non-consecutive days. The Dietsource 3.0 program was used to process this diet information. Pearson and Spearman correlation coefficients were used for bivariate analysis. The reference values used were the recommended intakes for the Spanish population. Results: over half of men presented values of calorie intake < 3,000 kcal/day (median= 2,700.10). Carbohydrate intake was below the recommended level, while there was an excessive intake of lipids, and most of all of proteins. Statistically significant association (p= 0.025) was only found between protein intake (g/day) and motile sperm count (MSC): at high values of protein intake, higher motile sperm counts. Conclusions: the intake proportion of proteins and lipids in those men studied was above recommendations; their diet was basically normal or low-calorie, hyperproteic and hyperlipidic. However, the only association found was between protein intake and the motile sperm count (MSC) at the lab. A wide dispersion was confirmed, both in sperm count and motility, probably determined by the IVF indication (AU)

Reproducción asistida: Profesionales que ayudan a cumplir un sueño / No disponible

No disponible

Spiritual aspects of living with infertility: A synthesis of qualitative studies.

AIMS AND OBJECTIVES: To identify the spiritual aspects of patients experiencing infertility and seek a deeper and broader meaning of the involuntary childlessness experience. BACKGROUND: Infertility can be the cause for a spiritual crisis among some couples. Those who endure this involuntary childlessness condition frequently experience contradictory feelings and needs. In this context, core aspects of spirituality such as meaning and purpose in life are often questioned. DESIGN: A review and synthesis of qualitative empirical research was undertaken to seek a deeper understanding of the spiritual aspects of patients' experiences of infertility. METHODS: An aggregative synthesis was conducted according to Saini and Shlonsky (Systematic synthesis of qualitative research, 2012, Oxford University Press, Oxford), using thematic analysis. RESULTS: A total of 26 studies included female, male and couples. Settings revealed interviewees in different infertility phases such as diagnosis, assisted reproductive technologies and following fertility treatments. Two main themes emerged: spiritual needs and spirituality as a coping resource for infertility. CONCLUSION: Infertility affects the holistic existence of the couples. This adversity awakens spiritual needs along with unmet needs of parenthood. Coping strategies incorporating spirituality can enhance the ability of couples to overcome childlessness and suffering. RELEVANCE TO CLINICAL PRACTICE: Infertile couples' experiences of infertility may offer an opportunity for spiritual care particularly related to the assessment of spiritual needs and the promotion of spiritual coping strategies. Effective holistic care should support couples in overcoming and finding meaning in this life and health condition.

Client perspectives of midwifery care in the transition from subfertility to parenthood: a qualitative study in the Netherlands.

BACKGROUND: Pregnancy, childbirth and the postpartum period after fertility treatment are considered "normal" in the Netherlands, with no indication of an increased obstetric risk, and can therefore be monitored by a primary care midwife. However, there is little evidence on the experiences of couples and women who finally get pregnant after fertility treatment and a lack of training for midwives exists on this subject. The aim of this study was to map the midwifery care needs of the subfertile client with past fertility problems. METHODS: In 2011, we interviewed two couples and seven women who conceived through fertility treatment and received primary midwifery care at some point during their pregnancies. This explorative, qualitative study was based on the interpretivist/constructivist paradigm. RESULTS: Although the participants are not representative of all subfertile clients, the findings of our qualitative study highlight the needs of women and their partners who have become pregnant through fertility treatment including help from the primary care midwife in understanding the likely course of their pregnancy, more psychosocial support and acknowledgement of the fertility treatment history, and more consultations and frequent ultrasound scans than usual to confirm pregnancy. CONCLUSIONS: Our study points out that the women who have become pregnant through fertility treatment and their partners communicate seemingly paradoxical prenatal care needs. It can help maternity care providers to optimally meet the care needs of subfertile clients and empower them during their transition from subfertility to parenthood.

La enfermera como apoyo para mejorar la calidad de vida / Nurses as a support to improve the quality of life during assisted reproduction

OBJETIVO: Medir cómo afecta a la calidad de vida de las parejas tanto la infertilidad como los tratamientos de reproducción asistida (incluyendo la inseminación artificial), y a la vez evaluar cómo la presencia y participación de la enfermera puede ayudar en este proceso y paliar en parte la ansiedad y la disminución de la calidad de vida de estos pacientes. MÉTODO: Se ha realizado un estudio observacional analítico transversal en el que se han estudiado 48 pacientes (26 ciclos) de nuestra Unidad de Reproducción Asistida desde el 2 de diciembre de 2013 hasta el 30 de abril de 2014 y hemos analizado los datos sociodemográficos, los resultados del test FertiQoL antes y después del tratamiento, y las consultas realizadas telefónicamente y mediante correo electrónico por estos pacientes. RESULTADOS: Los resultados obtenidos muestran una disminución en la calidad de vida de estos pacientes, siendo en algunos aspectos más acusado en los hombres y en las personas que no tienen hijos previos. Nuestros resultados también indican que un cuidado personalizado de los pacientes mejoró la calidad de vida y la tolerancia al tratamiento y que la mayoría de las pacientes recurrieron a la enfermera para resolver sus consultas. CONCLUSIONES: Nuestro estudio muestra que la enfermera puede desempeñar un importante papel en la mejora de la calidad de vida de los pacientes sometidos a un tratamiento de reproducción asistida

OBJECTIVE: The aim of this study was to measure how infertility and assisted reproduction treatments (including artificial insemination) could affect the quality of life, and to evaluate how nurses could be helpful in this process, by alleviating anxiety and increasing the quality of life. Method: A cross-sectional observational study was conducted on 48 patients (26 cycles) in an Assisted Reproduction Unit from 2nd December 2013 to 30th April 2014. Socio-demographic data were obtained, with the quality of life being assessed using the FertiQoL questionnaire before and after the treatment, and the consultations with a nurse by telephone or e-mail of these patients were also analyzed. RESULTS: The study results show a decreased quality of life in these patients, which was worse in men and in couples who had no previous children. Patient-centered care improved quality of life and tolerability to the assisted reproduction treatment. Patients frequently telephoned the nurse to solve their doubts and problems. CONCLUSIONS: The present study suggests that nurses can play an important role in improving the quality of life of patients undergoing assisted reproduction treatment

[Nurses as a support to improve the quality of life during assisted reproduction]. / La enfermera como apoyo en la calidad de vida en la reproducción asistida. (corrected).

OBJECTIVE: The aim of this study was to measure how infertility and assisted reproduction treatments (including artificial insemination) could affect the quality of life, and to evaluate how nurses could be helpful in this process, by alleviating anxiety and increasing the quality of life. METHOD: A cross-sectional observational study was conducted on 48 patients (26 cycles) in an Assisted Reproduction Unit from 2nd December 2013 to 30th April 2014. Socio-demographic data were obtained, with the quality of life being assessed using the FertiQoL questionnaire before and after the treatment, and the consultations with a nurse by telephone or e-mail of these patients were also analyzed. RESULTS: The study results show a decreased quality of life in these patients, which was worse in men and in couples who had no previous children. Patient-centered care improved quality of life and tolerability to the assisted reproduction treatment. Patients frequently telephoned the nurse to solve their doubts and problems. CONCLUSION: The present study suggests that nurses can play an important role in improving the quality of life of patients undergoing assisted reproduction treatment.

Representações sociais de enfermeiros da área de saúde sexual e reprodutiva sobre reprodução humana assistida / Social representations of nurses of sexual and reproductive health on assisted human reproduction

A pesquisa em tela teve como objeto de estudo as representações sociais de enfermeiros da área de saúde sexual e reprodutiva sobre reprodução humana assistida (RHA). Pesquisa qualitativa, do tipo descritivo exploratório com aplicação da teoria das representações sociais (TRS), segundo Serge Moscovici. O estudo teve como objetivos: descrever as representações sociais de enfermeiros que trabalham/atuam na saúde sexual e reprodutiva sobre RHA e analisar a atuação do enfermeiro na RHA, tendo em vista suas representações sociais sobre biotecnologias reprodutivas. Os participantes do estudo foram (30) trinta enfermeiros que trabalham/atuam na área de saúde sexual e reprodutiva do município do Rio de Janeiro, divididos em dois grupos, a saber: primeiro grupo representado por 16 participantes que trabalham na área de saúde sexual e reprodutiva, porém não trabalham diretamente com RHA, denominado grupo 1-NTRHA, e o segundo formado por 14 participantes que trabalham na área proposta e atuam diretamente com RHA, nomeado grupo 2 ­ TRHA. Os dados produzidos receberam tratamento específico com posterior triangulação de dados. No Teste ALI houve categorização das evocações que forneceu indícios de RS sobre o objeto estudado; a caracterização dos participantes da pesquisa foi obtida pelos dados numéricos que receberam tratamento estatístico simples, que traçou o perfil socioeconômico e demográfico (grupo de pertença), e a Entrevista Semiestruturada forneceu dois "corpus" que foram processados pelo software Alceste versão 2012®, no qual o corpus do grupo 1-NTRH obteve 76% de aproveitamento, gerando cinco classes e do grupo 2 ­ TRHA 68% de aproveitamento, produzindo seis classes. A pesquisa apresentou como resultados: para o grupo 1-NTRH, a reprodução humana ficou expressivamente ligada aos aspectos da natureza humana, como um evento biológico intocável e designado à esfera humana, portanto a interferência tecnológica da RHA, no contexto da concepção, emerge como algo perturbador e não deve ser considerada solução para demandas reprodutivas não atendidas. Esse grupo se apresenta distanciado da RHA, nesse sentido opta pela adoção de criança, como resolução para as demanda reprodutivas não alcançadas. Esse grupo, não incorpora a prática do cuidado pré-natal de gestações advindas de RHA, por considerarem que essas gestações sucedem de um contexto conceptivo de excessiva medicalização e manipulação da vida. Como traço quase hegemônico, o grupo 2 ­ TRHA, também atribui a reprodução humana como algo inerente à natureza humana, no entanto, representam a RHA enquanto recurso biotecnológico reprodutivo conectado, contextualmente, com a sociedade contemporânea, portanto atende como solução para dificuldade reprodutiva. Esses profissionais estão envolvidos com as novidades do universo biotecnológico reprodutivo, portanto se apresentam favoráveis e seguros quanto à incorporação do cuidado pré-natal pelo enfermeiro de gestações advindas de RHA, apesar de considerarem como uma gravidez diferenciada, em virtude da carga emocional/afetiva envolvida na mulher/casal. Esse grupo reconhece o campo da RHA como passível de dilemas bioéticos, nesse sentido apontou a carência de informação acadêmica que abordem a temática da RHA durante a formação acadêmica, seja na graduação e/ou pós-graduação, assim como assinalaram a ausência de respaldo legal dos conselhos/entidades de classe de enfermagem para apoio ao cotidiano laboral.(AU)

[When the unconscious is not infertile]. / Quand l'inconscient n'est pas stérile.

Among infertile couples who are undergoing the process of medically assisted reproduction, those for whom no biological cause for their infertility has been detected are offered a meeting with a liaison psychiatry team. They can then continue consultations with a psychiatrist in private practice. These consultations confront the couples with the various conflicts, injuries and impulses, buried in their unconscious which can cause symptoms of infertility. What is at play for these men and women and for the structure of each couple in its singularity?

Papel de las enfermeras en reproducción asistida: dimensión emocional / The role of nurses in Assisted Reproduction: the emotional dimensión

OBJETIVO: analizar y actualizar el papel que llevan a cabo las enfermeras en el ámbito de la reproducción humana asistida desde la perspectiva psicosocial. MÉTODO: revisión narrativa mediante búsqueda bibliográfica en las bases de datos PubMed, Cuiden, Red SciELO, Cochrane Plus y Cinahl, con lenguaje libre y controlado (términos MeSH), utilizándolos operadores booleanos y, en algunos casos, el truncado. La búsqueda se limitó a artículos publicados entre 2004 y 2014. Se seleccionaron 10 artículos en total, en función de los criterios de inclusión y exclusión establecidos. RESULTADOS: se identificaron cinco categorías de análisis: el apoyo emocional, la labor educativa y la formación, la continuidad de los cuidados, la relación enfermera-paciente y el trabajo en equipo. Las enfermeras llevan a cabo un rol múltiple, proporcionando cuidados holísticos a las mujeres y parejas que reciben técnicas de reproducción asistida (TRA), siendo un proceso notablemente costoso en el ámbito emocional. CONCLUSIONES: las enfermeras se presentan como unas profesionales imprescindibles en las Unidades de Reproducción Asistida(URA) para proporcionar una asistencia sanitaria de calidad. Es necesario aplicar los últimos avances a la práctica clínica, fomentarla utilización de la metodología enfermera y promover la labor investigadora en esta temática

OBJECTIVE: to review and update the role performed by nurses in the setting of Human Assisted Reproduction from a psychosocial perspective. METHOD: a narrative review through bibliographic search in the following databases: PubMed, Cuiden, Red SciELO, Cochrane Plus and Cinahl, with free and controlled language (MeSH terms),using boolean operators, and truncation in some cases. The search was limited to articles published between 2004 and2014. Ten articles were selected in total, based on the established inclusion and exclusion criteria. RESULTS: five categories were identified for review: emotional support, educational activities and training, continuity of care, nurse-patient relationship, and team work. Nurses conduct a multiple role, providing holistic care to those women and couples who receive Assisted Reproduction Techniques (ARTs), which represents a significantly difficult process in the emotional setting. CONCLUSIONS: nurses appear as indispensable professionals in the Assisted Reproduction Units (ARUs), in order to provide high quality healthcare. It is necessary to implement the latest advances in clinical practice, to encourage the use of nursing methodology, and to promote research work within this subject

Evaluation of the training course for a nursing intervention programme to promote maternal role attainment in pregnant Japanese women who have undergone assisted reproductive technology.

This study evaluated the effectiveness of a 2 day training course for a nursing intervention programme to promote maternal role attainment in pregnant Japanese women who have undergone assisted reproductive technology. Participants were 12 Japanese nurses with more than 3 years of clinical experience at reproductive institutions. The effectiveness of the training course was evaluated by assessing the following: (i) understanding of the nursing intervention programme; (ii) attitudes of nurses towards women who are pregnant following assisted reproductive technology; and (iii) self-efficacy for implementing the programme. The training course was effective in increasing basic understanding of the programme and in assisting self-evaluation of the attitudes of participants towards pregnant women. However, acquisition of effective interview skills and changes to make the programme clinically feasible are still needed. Findings suggest that researchers who use this training programme may need to evaluate and include training of nurses in interview skills suitable for their working environments.

Indagación desde los conocimientos, actitudes y prácticas en salud reproductiva femenina: algunos aportes desde la investigación / Inquiry based on knowledge, attitudes & practices in women's reproductive health: some insights from research

La morbilidad materna es una de las primeras causas de alteración del bienestar de la mujer en el mundo en vías de desarrollo, por lo cual la salud reproductiva de la mujer sigue siendo una prioridad investigativa en la mayoría de estas sociedades. Sin embargo, es notable la hegemonía de la investigación clínica biomédica en esta área que ha dejado ver la ausencia y la necesidad de estudios que den cuenta del fenómeno desde una perspectiva integral. Los estudios de "conocimientos, actitudes y prácticas" (CAP) son una alternativa conceptual para acercase a la complejidad del fenómeno en el área de la salud reproductiva. La propuesta de los estudios tipo CAP plantea un acercamiento integral para entender los comportamientos con respecto a la salud de las personas a través de sus tres elementos; y sus resultados han sido base fundamental de los diagnósticos para la creación, ejecución y evaluación de programas sanitarios. Por lo anterior, este artículo se propone mostrar y discutir algunas evidencias relacionadas con la utilidad de este tipo de trabajos en el área de la salud reproductiva de las mujeres (AU)

Maternal morbidity is one of the first causes of women`s welfare alteration in the less-developed countries; therefore, their reproductive health has been a research priority in most of these societies. However, the dominance of the clinical/biomedical research on this topic has been notable, and shown the gap and need for studies reporting this phenomenon from an integral perspective. The Knowledge, Attitude and Practices (KAP) studies are an alternative design to approaching this complex situation. The KAP proposal offers a comprehensive approach to understanding the behaviors related to people`s health through its three main components, and its results have been cornerstone for the situation diagnoses, leading to the creation, execution and evaluation of sanitary programs. Hence, the objective of this paper is to show and to discuss some evidences related to the utility of this approach in women`s reproductive health (AU)

Parenting after infertility: issues for families and infants.

This article reviews the research related to parenting after assisted reproduction and uses that research to discuss clinical implications for nurses who work to support these families and the development of their children. The worldwide diagnosis of infertility continues to rise and now hovers near 20%. The increased availability and success of assisted reproductive technologies (ARTs) provides a potential option for infertile families to conceive and begin a family, but as nurses know, infertility treatments are not easy to tolerate, are time-consuming, physically taxing, and expensive. In addition, a positive outcome is far from guaranteed. Even when infertile couples successfully give birth, they can continue to struggle with the psychological aspects of infertility and the ongoing care of a child who may be premature, low birth weight, or afflicted with another high-risk condition such as long-term developmental or behavioral problems. Unfortunately, the psychological needs of the couple and the family may not be addressed during ART treatment or after the birth of a child. Parenting is a challenging life task; parenting when the partners may have to work through the psychological aspects of infertility and the care of a high-risk child is even more complex and may have long-lasting effects on the partners as well as their children.

One consequence of infertility treatment: multifetal pregnancy.

This article discusses the issue of multifetal pregnancy as a result of fertility treatments. Pregnancies with multiple gestations are associated with serious infant and maternal health risks as well as psychological distress and significant financial consequences, and are a far too common consequence of infertility treatments such as assisted reproductive technology (ART) and ovulation induction drugs. Women with multifetal pregnancies are at a higher risk for multiple pregnancy complications and maternal morbidity/mortality as well as stress, depression, and anxiety disorders, especially when there is the threat of a loss of one or more fetuses. The rise in rates of multifetal gestation and the accompanying increased risk to both mother and fetuses have led the American Society for Reproductive Medicine and the Society for Assisted Reproductive Technology to develop guidelines to limit the number of transferred embryos during in vitro fertilization. Nurses who work with infertile women are in a position to educate them about the risks, benefits, and alternatives associated with ARTs and multifetal pregnancies, and should endeavor to learn as much as possible about this topic.

Psychosocial distress in young cancer survivors.

OBJECTIVES: To review existing literature about the psychosocial reactions of cancer patients and provide information about the needs of patients wishing to preserve fertility. DATA SOURCES: Journal articles, research studies. CONCLUSION: The desire for biological parenthood is an important issue for cancer survivors. Patients may not receive accurate, timely information about fertility-sparing options; those not receiving this information are at increased risk for psychological distress. IMPLICATIONS FOR NURSING PRACTICE: Fertility-preservation decisions are complex and a team approach may identify patients at risk for psychological distress and provide opportunities for discussion of psychosocial issues involved. Nurses must be informed about the emotional reactions and informational needs of their patients.