Assess the Psychosocial Stressors among Infertile Women Undergoing Infertility Treatment

Kharde S. N.¹, Patted S. S.²

¹Prof. & HOD OBG (N), KLE University Institute of Nursing Sciences, Belgaum Karnataka

²Consultant OBG and Infertility Specialist, Visiting Professor OBG, KLE University Belgaum Karnataka

Corresponding Author Email: sangeeta.kharde@gmail.com

ABSTRACT:

Objectives: The study was carried out to identify the psychosocial stressor of infertile women undergoing infertility treatment.

Method: The study was conducted on women undergoing infertility treatment in ARC KLE Dr Prabhakar Kore Hospital and MRC Belgaum. Using a convenience sampling technique a single blinded randomized controlled trial was done on 460 infertile women ( 230 in study and 230 in control) by envelop method. Data collection was done through a special proforma prepared by the investigator. The psychosocial stressors identified were personal emotional, family interpersonal and social. Total 25 questions were analysed using inferential statistics.

Conclusion: The study result indicated that there was significant difference in question 3, 4, 5, 7, 9, 9.1, 9.2, 10, 12, 14, 15, 16, 18, 19, 20, 22 in both the groups.

KEY WORDS: Psychosocial stressors, infertile women, infertility treatment.

INTRODUCTION:

Infertility is perceived as a problem virtually in all cultures and societies. 10%-15% of couples in reproductive age group are infertile. Among infertile couples, wives experienced more emotional disturbances than their husbands. (Anderson et al, 2002).¹

In Indian context, women are often dependent on husbands financially and emotionally and failure to conceive is considered as a stigma. Women are blamed more than men. Hence women experience a sense of loss and diminished self-esteem. In recent years, the number of couples seeking treatment for infertility has dramatically increased. This increasing participation in fertility treatment has inspired several investigators to study the psychological impact of infertility and its treatmen.²

METHODOLOGY:

An evaluative approach was used in the study. The research design was single blinded randomized controlled trial. Sampling design was convenience sampling. Sample size was 460 (230 in Study and 230 in Control). The randomization of the infertile women into study and control group was done by envelop method. Psychosocial stressors were identified with the help of special proforma prepared by the investigator. Total 25 questions were analysed using inferential statistics.

RESULTS:

Psychosocial stressors in study and control group

Psychosocial stressors	Pearson Chi- Square Value	P-Value
Q. 1.: Are you ashamed for embarrassed about you childlessness?	0.020	0.887
Q. 2.: Do you blame yourself regarding this problem?	1.035	0.309
Q. 6. Are you being neglected in decision making regarding home affairs?	1.528	0.216
Q. 8. Does your husband spend sufficient time with you?	1.080	0.299
Q. 11. Does your husband regret being married to you?	1.590	0.207
Q. 13. Do you go with your husband for vacation / trips / picnics?	0.010	0.919
Q. 17. Are you treated differently by your family members because of your childlessness?	2.008	0.156
Q. 21. Are you undergoing fear due to societal pressure to conceive ?	0.376	0.540
Q. 23. Are you comfortable in attending family and social get together?	0.043	0.836
Q. 24. Are you being stopped attending your social functions considering you to be a bad luck?	0.000	1.000
Q. 25. Are you unhappy about your sexual life as a result of your childlessness?	3.205	0.073

There is no significant difference in the two groups

Psychosocial stressors in study and control group

Psychosocial stressors	Pearson Chi- Square Value	P-Value
Q. 3. Do you experience any guilt feeling about use of contraceptives/ abortion ?	4.562	0.033*
Q. 4. Do you Indulge constantly in blaming others and fault finding which results ineffective communication?	5.251	0.022*
Q. 5. Are you worried of your old age because you don’t have child to care of?	8.548	0.003*
Q. 7. Do you have privacy to share your problems with your spouse?	4.612	0.032*
Q. 9. Are you insecure about being divorced by your husband?	9.828	0.002*
Q. 9.1. Is your husband planning for second marriage to have child ?	14.692	<0.001*
Q. 9.2. Do you encourage his second marriage to have child?	6.025	0.014*
Q. 10. Are you blamed by your husband for this problem?	5.676	0.017*
Q. 12. Are your parents being blamed by your husband because of this problem?	6.425	0.011*
Q. 14. Are you harassed by your in laws for this problem?	16.100	<0.001*
Q. 15. Are you being targeted by your mother in law in front of your relatives ?	5.764	0.016*
Q. 16. Do your in laws support your husband where as blame you always for childlessness?	13.981	<0.001*
Q. 18. Are you completely dependent on your husband regarding financial matters?	5.328	0.021*
Q. 19. Are you being forced by your family members to adopt a child?	11.017	<0.001*
Q. 20. Are you isolated from all spiritual events (pooja) because of your barrenness?	4.709	0.030*
Q. 22. Does your family tradition demand all marriages must result in children preferably male?	8.236	0.004*

There is significant difference in the two groups

DISCUSSION:

The psychosocial stressors identified in infertile women between both the groups showed significant association related to guilt feeling about use of contraceptives and abortion. Another study also revealed that women felt guilty for miscarriage or postponement of pregnancy. ³ This guilt felt by women may be due to our Indian social belief that women are completely responsible for pregnancy. Other psychosocial stressors of our study identified in infertile women in both the groups showed significant association in constantly blaming others and fault findings resulting in ineffective communication. An infertile individual faces important challenge related to communication as infertility affects relationship with one’s partner as well as other social and family relationships. As per Lazarus and Folkman, ability to communicate with others refers to the social skills. ⁴

Schmidt study showed improvement in communication among couples in fertility treatment after attending the intervention that is, communication and stress management training program. Participants, who frequently chose to remain silent, started talking more often with their partner about infertility and its treatment after intervention. Most participants reported that their partner communication had improved with counseling. Even communication with others like family and friends showed marked improvement. ⁵

Our study revealed the most common psychosocial stressor in Indian context that, women were worried as there was no child to take care of them in old age. Jindal UN and Gupta AN Study supported same results that women were insecure, unhappy and anxious as children were considered their physical and financial security in old age. ⁶

In our study regarding privacy to share the problems with the spouse, psychosocial stressor showed significant association in both the groups. According to reports of Jindal and Gupta this study too, revealed in Indian couples lack of privacy problem. This may be due to the joint family system, in which there is family influence and dominance of elders usually seen. Couples may not be getting sufficient time to spend with each other. ⁷

In a similar study conducted in Andhra Pradesh, India by Unisa S. revealed that only 4 % of the infertile women reported that their husbands were forcing them to give divorce so that, they can bring a new wife for the sake of producing children. But in 12% of the women, the husband already had more than one wife and 16% of women reported that they felt that their husbands were showing interest in bringing second wife through second marriage or else they had extra marital relationships. Unisa study also revealed that two-thirds of the women reported harmonious and peaceful relationships without any threats from husband or any other family members. This could be due to infertility treatment awareness and may be the fact that women alone were not responsible for this condition was also known to them. But two thirds of the women experienced violence from their husbands and the main reason they reported was that of childlessness. ⁸

CONCLUSION:

Medical staff working with this group needs to be aware of this additional psychosocial stressors identification approach and it should be adjunct to conventional infertility medical treatment.

BIBLIOGRAPHY:

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Received on 06.03.2015 Modified on 18.03.2015

Accepted on 21.03.2015 © A&V Publication all right reserved

Int. J. Nur. Edu. and Research 3(2): April-June, 2015; Page 140-142