Emotional Distress In Women Research Articles

To Assess the Impact of the Quality and Level of Family Support to Pregnant Women on Maternal and Fetal Outcomes

Abstract Background: Throughout pregnancy, women need support from the family to gain better maternal and fetal outcomes. Emotional distress in women during pregnancy is known to increase the risk of adverse outcomes in women and newborns. Increasing family support can improve birth outcomes and maternal wellbeing and can reduce complications in mother and increased neonatal birth weight. Aim and Objective: This study aims to evaluate the influence of the level and quality of family support during pregnancy on maternal and fetal outcomes and to identify any association between sociodemographic variables and the impact of the level and quality of family support during the third trimester. Materials and Methods: This study used a quantitative approach combined with a survey research design. Data were collected from four primary health centers (Rethare, Vadgaon, Kale, and Supane) at Karad, Maharashtra, India. A consecutive sampling technique was used to select the 344 subjects from the Rethare, Vadgaon, Kale, and Supane areas of Karad Taluka. Data were collected before the completion of the first trimester, then during the second trimester, and post-delivery. Upon evaluation, the tool was validated by experts representing the fields of community health nursing, mental health nursing, obstetric gynecology, and pediatric care. A pilot study was conducted on 30 samples. The data collected were analyzed by using descriptive and inferential statistics. Result: Findings regarding level of family support show that 133 women (38.7%) received good total support, 164 (47.7%) received moderate support, and 47 (13.7%) received poor family support during the third trimester. Results regarding maternal outcomes show that there was a significant association found between type of delivery and family support received after delivery with maternal outcomes and total support during the third trimester (P < 0.05). It means that physical, emotional, and psychosocial support (total support) received by women would prevent complications during delivery, i.e., prevent Cesarean sections, results in the mother giving normal birth to baby. Hence, the mother needs total support during the third trimester. Conclusion: Total family support is needed by pregnant women during the third trimester to achieve maternal and fetal outcomes.

Women's experience of preterm birth in an East African context: a qualitative study.

Approximately 15 million children are born each year prematurely, representing more than 10 percent of all childbirths worldwide. Prematurity is an acute event and the leading cause of death among newborns and children under five. Sixty percent of these premature deaths occur in Sub-Saharan Africa and Southeast Asia. The current study aimed to explore and understand women's experiences and perceptions regarding giving birth prematurely at the National Hospital of Muhimbili in Dar es Salaam, Tanzania. A qualitative method, using Interpretive Phenomenological Analysis approach was chosen to understand and describe the women's experiences. A semi-structured guide was used during the interviews. All interviews were audio-recorded and transcribed verbatim. Eight in-depth interviews were conducted. The analysis revealed three superordinate themes: (a) Emotional turmoil: unmet expectations shattering maternal identity, emotional distress, and loss of hope; (b) Adapting to preterm birth and challenges: the unexpected situation, lack of proper care, strenuous breastfeeding routines, and socioeconomic challenges; (c) Significance of proper care and emotional support: good maternal care, mother-to-mother and family support. This study provided a deeper understanding of women's experiences and perceptions of premature childbirth. The current study indicated the importance of caregivers' awareness of the women's emotional distress, their need to adapt to a sudden unexpected situation, and the necessity of emotional support.

A test of the dyadic associations between ineffective arguing, emotional distress, and violence perpetration and victimization among couples seeking therapy.

Researchers have tested associations between ineffective arguing and emotional distress among couples without relationship violence. Moreover, studies have demonstrated associations between physical violence perpetration and victimization in the aftermath of emotional distress. However, there is a paucity of research examining linkages between ineffective arguing, emotional distress, and physical violence perpetration or victimization. Dyadic data from 231 married, heterosexual couples seeking therapy were used to test a model examining pathways between ineffective arguing and physical violence perpetration and victimization through emotional distress. The hypothesized model was compared to two plausible alternative models. Results revealed higher levels of men's ineffective arguing were positively associated with men's physical violence perpetration, both directly and indirectly, through higher levels of emotional distress. Higher levels of men's ineffective arguing were associated with lower men's physical violence perpetration through higher levels of women's emotional distress. Results can inform the clinical treatment of interpersonal violence by targeting ineffective arguing and emotional distress.

The Effectiveness of Acceptance and Commitment Therapy (ACT) on Perceived stress & Psycho-Somatic Signes & emotional distress in IVF infertile women

Aim: The aim of this study was to investigate the effect of acceptance and commitment therapy on perceived stress, psychosomatic symptoms and emotional distress in women undergoing IVF infertility treatment. Methods: The method of this research is quasi-experimental and is a pretest-posttest design with a control group. The statistical population in this study included women undergoing IVF infertility treatment who referred to infertility treatment centers and clinics in Tehran in 2019. Cohen's table was used to determine the sample size. According to this table, with an effect size of 0.5 and a power of 0.76 with an alpha of 0.05, the sample size of 30people was estimated and the available sampling method was selected, in which 15 people were randomly assigned in each group (experimental and control). Cohen et al.'s Perceived Stress Questionnaire (1983), Lovibond & Lovibond LacourtAnxiety, Stress and Depression (1995), Lacourt Psychosomatic Symptoms (2013), and Acceptance and Practice Version II (2011) were used to collect information in two stages: pre-test and post-test. The experimental group underwent acceptance and commitment group therapy Based on Hayes therapy package (2002), in 8 sessions of 90 minutes, while the control group did not receive any intervention. SPSS-22 software was used to evaluate the results. Results: The results of repeated-measures analysis of variance showed that acceptance and commitment based therapy is effective in reducing perceived stress, psychosomatic symptoms and emotional distress in women undergoing IVF infertility treatment (P <0.001). Also, the results were stable in the follow-up phase. Conclusion: It is recommended that therapists and counselors of infertility treatment centers use acceptance and commitment therapy in infertility clinics to reduce the needs and psychological problems of infertile women undergoing IVF treatment.

Personality Characteristics and Emotional Distress Among Chinese Pregnant Women: A Moderated Mediation Model.

Previous studies have suggested that certain personality characteristics are associated with emotional distress during pregnancy. However, the underlying mechanism of this association is rarely understood. The current study investigated the links between personality and pregnant women's emotional distress (depressive and anxiety symptoms), tested the chain mediating effects of two resilience factors—social support and positive coping, and explored whether socioeconomic status (SES) could moderate the effects (including direct and/or indirect effects) of personality on their emotional distress. Results of a relatively large sample of pregnant women in China (N = 1157) showed positive associations for psychoticism and neuroticism with depressive and anxiety symptoms as well as negative associations for extraversion with depression and anxiety. After controlling for four important variables (the first pregnancy or not, having adverse pregnancy experience or not, being pregnant as planned or not, and number of weeks of pregnancy), social support and positive coping acted as chain mediators on the associations of personality with depressive symptoms as well as of personality with anxiety. Overall, the association of personality and depressive symptoms demonstrated invariance across socioeconomic status (SES). However, SES moderated the relationship between personality and anxiety. Specifically, the negative association of positive coping with anxiety symptoms was weaker for low SES women than for high SES ones. Results highlight the importance of social support and positive coping to decrease personality-related depressive and anxiety symptom among pregnant women. Furthermore, identifying other resilience factors that alleviate anxiety in women with low SES is urgently called for.

Effectiveness of progressive muscle relaxation and laughter therapy on mental health and treatment outcomes in women undergoing in vitro fertilization: A randomized controlled trial.

A majority of infertile women experience emotional problems, such as anxiety and depression. Nurses need nonpharmacological methods rather than drugs to address women's emotional distress during the in vitro fertilization (IVF) process. The purpose of this study was to examine the effect of progressive muscle relaxation exercises and laughter therapy on the mental health and treatment outcomes of women receiving IVF treatment. This parallel-group, randomized controlled trial was conducted in a private IVF center. Participants were randomly assigned to the intervention group (IG; n = 71) and control group (CG; n = 70). The IG received progressive muscle relaxation and laughter therapy for 40 min in each session for 3-4 sessions, whereas the CG received routine care. Data were obtained from the patient information form, State-Trait Anxiety Inventory, Beck Depression Inventory, and medical records. The questionnaire was completed at recruitment (T1) and oocyte pick-up day (T2). In the evaluation performed on the day of the oocyte pick-up, depression and trait anxiety scores of the IG were found to be lower than those in the CG, and the effect size was small. Group × time interaction was significant for depression (large effect size) and trait anxiety (small effect size). The estradiol levels, the number of oocytes, transfer status, and pregnancy rates (according to a blood test) were similar between groups. Women receiving IVF treatment who received progressive muscle relaxation and laughter therapy demonstrated psychological changes; however, the treatment did not affect medical outcomes.

Work Time Matters for Mental Health: A Gender Analysis of Paid and Unpaid Labor in the United States

Based on Midlife in the United States (MIDUS) survey data for 2013–14, this paper examines the association between work time (inclusive of both paid and unpaid work time) and the mental health outcomes of men and women in the United States, controlling for economic and social buffers, education, and demographic factors. In the United States, even though women constitute close to half of the paid labor force, they still perform the lion’s share of unpaid work. The findings indicate that total work time is positively related with emotional distress for women, while there is no statistically significant relationship for men. For women, the relationship between work time and mental health is primarily driven by unpaid work rather than paid work. Evaluating the relationship between mental health and both productive and reproductive work is critical to develop effective public policies toward gender equity and social well-being. JEL classification: I14, J16, J01

The Emotional Status, Attitudes in Decision-Making Process, and Their Impact on Surgical Choices in Korean Breast Cancer Patients.

Purpose We examined the incidence of emotional distress in women with newly diagnosed breast cancer to determine whether the degree of emotional distress affected their choice of breast-conserving surgery (BCS) or mastectomy and evaluated how the patient's preferred role in decision-making influenced her choice of surgical method. Methods This prospective study included 85 patients newly diagnosed with in situ or invasive breast cancer eligible for BCS. Their degree of depression/anxiety and attitude toward the decision-making process were measured using the Hospital Anxiety and Depression Scale (HADS) and Control Preference Scale (CPS), respectively. After receiving information on both surgical methods, the patients indicated their preferred surgical method and completed the CPS at their initial and second visits before surgery. Results After the diagnosis of breast cancer, 75.3% of patients showed abnormal or borderline HADS scores for depression and 41.2% for anxiety. Patients with borderline or abnormal degrees of depression were more likely to have coexisting abnormal degrees of anxiety (p < 0.001). However, the presence of depression or anxiety was not associated with patients' surgical choices (p=0.394 and 0.530, respectively). Patients who preferred a more active role in the decision-making process were more likely to choose mastectomy over BCS, while those who were passive or collaborative chose BCS more frequently (p=0.001). Conclusion Although many patients with newly diagnosed breast cancer experience depression and anxiety before surgery, these do not affect the choice of surgical method; however, their attitudes toward the decision-making process do.

Long-term treatment for emotional distress in women with breast cancer.

Breast cancer patients have many needs, including strategies to cope with the associated distress, during and after cancer treatment. Establishing and implementing adequate social and emotional support for these women, to reduce the detrimental effects of stress resulting from their treatment and disease, is the need of the hour. This study aims to assess how women, diagnosed and treated for breast cancer, combat emotional stress using mechanisms of coping and control and emotional defense, as well as to identify potential groups among them, with different long-term patterns and needs. 98 patients belonging to a local breast cancer support association (ALMOM), were enrolled in this study. A questionnaire specifically designed for them was administered, and its internal consistency and reliability assessed. A hierarchical clustering was employed to classify the women. The questionnaire focused on four sections, including personal feelings, coping strategies, environmental influences and maladaptive coping. An adequate internal reliability was obtained with Cronbach's α near or greater than 0.60. Personal feelings were significant and clearly correlated with coping strategies and maladaptive coping. Three groups of women with different patterns of emotional characteristics and needs were identified: positivist, unsafe, and hopeless women, with different long-term emotional needs to be satisfied. Psychological therapeutic interventions should be maintained in many breast cancer patients over time, even after treatment completion, in order to consolidate adaptive and sustainable responses.

Cognitive-Behavioral Therapy Plus Hypnosis for Distress During Breast Radiotherapy: A Randomized Trial

Radiotherapy is a common and effective treatment for women with breast cancer. However, radiotherapy has also been shown to adversely affect patients’ emotional well-being. Currently, few mind–body interventions are designed to improve patients’ quality of life during radiotherapy. One intervention which has demonstrated clinical efficacy in the breast cancer radiotherapy setting is Cognitive-Behavioral Therapy plus Hypnosis. The goal of this study was to investigate the impact of Cognitive-Behavioral Therapy plus Hypnosis on emotional distress in women with breast cancer undergoing radiotherapy. One hundred patients were randomly assigned to either the Cognitive-Behavioral Therapy plus Hypnosis (n = 50) or Attention Control (n = 50) group. Results revealed significant benefits of Cognitive-Behavioral Therapy plus Hypnosis on emotional distress at the mid-point (d = 0.54), the conclusion (d = 0.64), and 4 weeks following the conclusion (d = 0.65) of radiotherapy (all ps < 0.05). In summary, results support further study of Cognitive-Behavioral Therapy plus Hypnosis as an evidence-based intervention to reduce emotional distress in women with breast cancer. Cognitive-Behavioral Therapy plus Hypnosis has the benefits of being brief, noninvasive, lacking side-effects, and producing beneficial effects which last beyond the conclusion of radiotherapy. Given these strengths, we propose that Cognitive-Behavioral Therapy plus Hypnosis is a strong candidate for greater dissemination and implementation in cancer populations.

A study among women attending Suraksha clinic in a tertiary care hospital: their socio-demographic profile, myths and misconceptions related to RTIs

Background: Reproductive tract infections (RTIs) represent a vast reservoir of infections among women of reproductive age group observed more often in developing countries.Besides being a major public health problem RTIs and STDs are responsible for infections in post abortion &amp; puerperal period, fetal and perinatal deaths, infertility and cervical cancer. These are a reason for emotional distress in women and a reason for their social rejection.Despite the ability to cure these infections, they continue to be a major public health problem worldwide especially in developing countries.Hence, a hospital based study was done amongst women of reproductive age group reporting to Rajindra Hospital Patiala with RTI, in terms of their socio-demographic profile, myths and misconceptions related to RTIs.Methods: This study was conducted with the objective of evaluating the socio-demographic profile, myths and misconceptions related to RTIs among reproductive age group women in Suraksha Clinic, Gynae OPD in Rajindra Hospital, Patiala from January 2014 to December 2014. A pretested structured Performa was used to collect data from 500 women with RTIs in 15-45 age group. Data was collected, compiled and analyzed statistically.Results: Out of 500 diagnosed patients of RTIs, only 120 (i.e. 24%) had various myths and misconceptions about reproductive tract infections and among them 40% had believe that vaginal discharge was normal phenomena. Majority of RTI patient 12% had bad physical hygiene. However 49.20% among them had poor menstrual hygiene.Conclusions: The influence of socio-demographic factors like age, educational status, socioeconomic status, menstrual hygiene also has its direct effect on occurrence of RTI in community.

Patterns of Service Utilization Among Women Who Are Victims of Domestic Violence: The Contribution of Cultural Background, Characteristics of Violence, and Psychological Distress.

The study examined patterns of utilization of various services among female victims of domestic violence in Israel. The study looked at how cultural background, characteristics of violence, attempts at separation from partner, and women's emotional distress contributed to patterns of service utilization. The sample of participants included 499 women who arrived at 12 shelters in Israel. Of those participants, 142 were Jewish, 156 were Arab, 125 had been born in the former Soviet Union (FSU), and 76 had been born in Ethiopia. Latent class analysis procedure was applied to identified patterns of service utilization. The procedure identified three patterns of service utilization: substantial use, frequent use of welfare and criminal justice services, and minimal use. Among Arab women, the likelihood of making substantial use of services was greater than the likelihood of making minimal use. Moreover, among the entire sample, the higher the levels of sexual abuse, violence, and posttraumatic stress disorder (PTSD), the greater the likelihood of substantial versus minimal use of services. In addition, being employed, enduring higher levels of violence, and making attempts to separate increased the likelihood of utilization of welfare and criminal justice services versus minimal use. The study highlights the factors that motivate women to make use of services and the distinct strategies they use in the help-seeking process. At the practice level, the study emphasizes the need to take into account both the woman's cultural context and the stage of help seeking she is at. In this way, professionals can provide differential treatment accordingly.

Post-traumatic stress, anxiety and depression following miscarriage or ectopic pregnancy: a prospective cohort study

ObjectivesThis is a pilot study to investigate the type and severity of emotional distress in women after early pregnancy loss (EPL), compared with a control group with ongoing pregnancies. The...

Assessment of psychosocial factors and distress in women having adjuvant endocrine therapy for breast cancer: the relationship among emotional distress and patient and treatment-related factors.

PurposeThe aims of this study were to comprehensively describe the psychosocial and medical characteristics of women who initiated tamoxifen or aromatase inhibitors for breast cancer and to compare levels of emotional distress according to their medical (tumor demographics, treatment type, treatment duration) and psychosocial (self-esteem, perceived social support, sociodemographic) characteristics.MethodsA total of 104 women currently receiving tamoxifen or aromatase inhibitors was recruited from outpatient clinics and they were asked to complete self-report questionnaires including the Rosenberg Self-Esteem Scale, the Multidimensional Scale of Perceived Social Support and the Hospital Anxiety and Depression Scale during their routine follow-up. Psychosocial and medical characteristics of the patients were first described and subsequently the score of emotional distress was compared with these.ResultsThe patients’ mean age was 52.49 ± 10.30 and they were being treated for an average of 24.3 months. Out of the patients’ characteristics, educational and marital status, level of perceived social support and self-esteem were all significantly related with emotional distress. As for medical variables, the score of distress was relatively higher among patients in the first 2 years of their treatment than the patients who were in the second to fifth years of treatment, but this was not statistically significant.ConclusionsGiven the results of this study, it appeared that patient variables, rather than the medical or treatment characteristics, were related with emotional distress in women undergoing endocrine treatment. For that reason it is critical that medical staff are aware of patient factors that relate to distress during a long period of adjuvant endocrine therapy.

E-Therapy to reduce emotional distress in women undergoing assisted reproductive technology (ART): a feasibility randomized controlled trial.

Is it feasible to evaluate a personalized e-therapy program (Internet based) for women during fertility treatment aimed to reduce the chance of having clinically relevant symptoms of anxiety and/or depression after unsuccessful assisted reproductive technology (ART) treatment within a randomized controlled trial (RCT)? The evaluation of a personalized e-therapy program is feasible, reflected by good acceptability and integration within current guidelines, but adjustments to the e-therapy program and study design of the RCT have to be made to enhance demand, practicality and efficacy. Internet-based interventions are promising in reducing psychological distress, especially when treatment is personalized to specific risk profiles of patients. However in fertility care, the beneficial effects of personalized e-therapy on psychological distress and its implementation in daily clinical care still have to be evaluated. To evaluate the feasibility of a personalized e-therapy program, we conducted a two-arm, parallel group, single-blind feasibility randomized controlled trial with a 1:1 allocation. Feasibility was assessed in terms of demand, acceptability, practicality, implementation, integration and limited efficacy. Women were included between 1 February 2011 and 1 June 2013. Women in the control group received care as usual, whereas women in the intervention group received in addition to their usual care access to a personalized e-therapy program. Women were monitored until 3 months after the start of their first ART cycle. In a university hospital in the Netherlands women who were screened as at risk for emotional adjustment problems and intended to start their first ART cycle were invited, and of them 120 were randomized. Of these women, 48% in the intervention group were compliant to the intervention. Outcome measures associated with the feasibility to analyse this e-therapy program within an RCT were assessed. It is feasible to evaluate a personalized e-therapy program within an RCT. The acceptability was good, as was the integration within current clinical guidelines and care. However, the demand reflected by a participation rate of 44% was low, since most women declined participation because they felt no need for support at that moment. The practicality of the intervention was moderate illustrated by a relatively high dropout rate (30%) due to practical concerns. The intervention was effective, shown by a reduction in the percentage women having clinically relevant symptoms of anxiety and/or depression in the compliant intervention group compared with the control group 3 months after the first ART cycle; risk difference of 24% (95% CI: 2-46%; ITALIC! P = 0.03). The large non-participation rate (56%) needs further evaluation. This also could have influenced results on limited efficacy. Barriers for participation could be assessed more in-depth. Moreover, ∼30% dropped out. This percentage is comparable with other e-health studies. Finally, this is a single-centre study. Generalizability could be enlarged by a multi-centre approach. In clinical fertility care, personalizing an e-therapy program to the patients' risk profile is promising and feasible. However, in future studies, we recommend modification of the study protocol by for example offering the intervention to the preferred moment in the treatment process. Moreover, adjustment of the study protocol tailored to the found barriers and facilitators is needed. When performing a multi-centre consecutive RCT to assess the effectiveness of personalized e-therapy in fertility care, the findings of this study, for example concerning the preferred timing or reasons for non-participation, could be helpful. NutsOhra (Study Number 0702-94) funded this study with an unrestricted grant. There were no competing interests. ClinicalTrials.gov NCT 01283607. 21 January 2011. February, 2011.

Emotional distress and sense of coherence in women completing a motivational program in five countries. A prospective study.

The purpose of this paper is to investigate changes in, and associations between, sense of coherence (SOC) and emotional distress in women who participated in an accredited motivational program (VINN) in correctional institutions in five countries. A prospective study with a pre- and post-test design included 316 participants from Sweden, Estonia, Denmark, Russia and Norway. Global emotional distress was measured by the Hospital Anxiety and Depression Scale. SOC was measured using the 13-item Orientation to Life Questionnaire. One-way analysis of variance and multilevel regression models were used in the statistical analyses. An increase in SOC was associated with a decrease in emotional distress. Emotional distress decreased significantly -3.80 points (95 percent CI (-4.61, -2.97)), and SOC significantly improved from pre- to post-measurement by 1.82 points (95 percent CI (0.72, 2.92)), regardless of country and correctional institution. Practical implications - The results add new knowledge regarding a coherent theoretical foundation of a motivational program for women. The ability of a program promoting health is important for researchers, health-care workers and facilitators delivering programs for women in correctional facilities. An increase in SOC can act as a protective factor in order to manage stressors and risk factors among women serving in correctional facilities. The present study indicates that enhancing women's coping resources and providing income alternatives to crime is fundamental to their capacity to desist from criminal behavior.

The relationship between body image, age, and distress in women facing breast cancer surgery

Research suggests that the strength of the relationship between body image and emotional distress decreases with age. Past research has focused on expected aging-related body changes, and has not yet examined unexpected body changes (e.g., breast cancer surgery). The present post-hoc study assessed relationships between age, body image, and emotional distress in women facing breast cancer surgery. Older (≥ 65 years, n = 40) and younger (<65 years, n = 40) women were matched on race/ethnicity, marital status, and surgery type. Within one week prior to surgery, participants completed measures of demographics, aspects of body image, and emotional distress (general and surgery-specific). Results indicated that: (1) body image did not differ by age (p > 0.999); (2) older women reported less pre-surgical emotional distress than younger women (p's < 0.01); and, (3) age moderated the relationship between body image and emotional distress (p's < 0.06). The results suggest that younger women, particularly those with poor body image, are at an increased risk for pre-surgical emotional distress. These women may benefit from pre-surgical interventions designed to improve body image or to reduce pre-surgical emotional distress.

Socio-economic status and emotional distress of female Turkish immigrants and native German women living in Berlin

BackgroundMany immigrants face more economic strains and hardship than non-immigrants. Income inequality and an increasing social gap between immigrants and non-immigrants in Europe warrant further studies on the impact of socioeconomic factors on health in immigrant groups. The purpose of this study was to examine the association of socioeconomic status (SES) and emotional distress in women of Turkish descent and in women of German descent. Methods and SubjectsA total of 405 women of German or Turkish descent residing in Berlin were interviewed. Emotional distress was assessed by the General Health Questionnaire-28 (GHQ-28), and SES was examined by level of education, employment status, and income. The associations of emotional distress and SES were estimated in multivariate linear regression analyses. ResultsUnemployment was associated with increased levels of emotional distress in all women, with the highest level of distress in the group of unemployed Turkish women. The overall SES level was related to a greater level of emotional distress in Turkish women, but not in German women (−3.2, 95%CI −5.9 – −.5; p=.020 vs. −.8, 95%CI −2.7 – 1.2; p=.431). Further stratified analyses by relationship status revealed that the association of SES and emotional distress only remained significant among single women. ConclusionThe impact of socioeconomic hardship appears to be complicated by social roles and expectations related to these. Further in-depth study of the complex nature of the interaction of social roles and socioeconomic position in female Turkish immigrants in Germany is needed to better understand differing risk patterns for emotional distress.

The indirect effect of contextual factors on the emotional distress of infertile couples

Few studies were dedicated to study the role of contextual factors, such as the socioeconomic status and urban or rural residence in emotional distress of infertile couples. This study aimed to explore the impact of contextual factors on emotional distress, either directly or by affecting the importance of parenthood in one's life, which in turn affects emotional distress. In this cross-sectional study, 70 couples recruited during hormonal stimulation phase prior to in vitro fertilisation completed clinical and sociodemographic forms and self-report questionnaires assessing representations about the importance of parenthood and emotional distress. Path analysis using structural equation modelling was used to examine direct and indirect effects among variables. Results indicated that socioeconomic status and place of residence had an impact in emotional distress by affecting the representations about the importance of parenthood in one's life. Gender differences were found regarding model paths, suggesting that the social context may have a stronger influence on women's emotional distress than on their partners’ distress. When delineating psychological interventions, health care providers should consider that cultural values about children and parenthood contribute to shape the infertility experience.

Emotional distress in infertile women and failure of assisted reproductive technologies: meta-analysis of prospective psychosocial studies

Objective To examine whether pretreatment emotional distress in women is associated with achievement of pregnancy after a cycle of assisted reproductive technology.Design Meta-analysis of prospective psychosocial studies.Data sources PubMed, Medline,...