ااثربخشي مداخله روان‌شناختي جامع‌نگر بر سلامت روان‌شناختي و نرخ باروري زنان با نابارور با علت نامشخص و تحت درمان IVF

The effectiveness of holistic-oriented psychological intervention on psychological health and pregnancy rate of unexplained infertile women undergoing IVF

مداخله روان‌شناختي جامع‌نگر برنامه درماني نويني است كه بر اساس مشكلات و نيازهاي رواني افراد نابارور طراحي شده است. هدف از پژوهش حاضر بررسي اثربخشي مداخله روان‌شناختي جامع‌نگر بر سلامت روان‌شناختي و نرخ بارداري زنان با ناباروري نامشخص و تحت درمان لقاح آزمايشگاهي است. بدين منظور با استفاده از نمونه‌گيري دردسترس از ميان كليه زنان نابارور مراجعه كننده به مركز ناباروري معتضدي كرمانشاه 30 زن نابارور تحت درمان IVF كه در دو حيطه از سه حيطه مقياس21DASS- نمره متوسط به بالا داشتند، انتخاب و به شيوه تخصيص تصادفي در دو گروه قرار گرفتند. گروه آزمايشي تحت 11 جلسه مداخله روان‌شناختي جامع‌نگر 120 دقيقه‌اي قرار گرفت. گروه كنترل هيچ مداخله درماني را دريافت نكرد. شركت‌كنندگان قبل و بعد از مداخله و در پيگيري يك ماهه، مقياس افسردگي، اضطراب و استرس 21DASS- را تكميل كردند. نرخ بارداري در دو گروه بر اساس نتيجه آزمايش βHCG سنجيده شد. تحليل داده‌ها با روش كوواريانس چند متغيره نشان داد كه مداخله روان‌شناختي جامع‌نگر در مرحله پس آزمون به طور معني‌داري موجب كاهش افسردگي، اضطراب و استرس گروه آزمايشي شده بود (001/0< p)، و اين تأثير در پيگيري يك ماهه همچنان تداوم داشت (001/0< p). نرخ بارداري در گروه آزمايشي 7/46% و در گروه كنترل 3/13% به دست آمد و از نظر آماري معني‌دار بود (05/0>p). به عبارت ديگر مداخله روان‌شناختي جامع‌نگر در كاهش اضطراب، افسردگي و استرس و افزايش سلامت روان‌شناختي و نرخ بارداري زنان با نابارور نامشخص تحت درمان لقاح آزمايشگاهي مؤثر است.

Intoduction The desire of having a child is one of the most important functions of family and is also a base for human survival. Infertility is considered as a failure that is accompanied by physical and psychological tensions in family and society as well. Different psychological methods have been already utilized to help infertile people. The holistic-oriented psychological intervention (HPI) is a new therapeutic plan with bio-psycho-social pattern that has been designed according to psychological problems and needs of infertile people. After determining tension factors this therapeutic plan chooses techniques with high effectiveness rate in solving the mentioned problems, using eclectic techniques. The aim of present study is to examine the effectiveness of HPT on psychological health and fertility rate in women with unexplainable infertility undergoing in vitro fertilization treatment (IVF). Method The design of this study was a quasi- experimental one with pretest-posttest of experimental and control group. Thirty infertile women, undergoing IVF treatment, were selected, using available sampling. The sample was selected from among patients who referred to Moatazedi Infertility Center, Kermanshah, Iran. They completed two subscales of three subscales of DASS-21 scale who got the above average score. They were randomly assigned to two groups (each group 15 subjects). The experimental group was treated by the holistic-oriented psychological intervention for 11 sessions of 120-minutes. The control group did not receive any intervention. Participants completed the Depression, Anxiety and Stress Scale before and after intervention and after one month later. The pregnancy rate was measured in two groups based on the β-HCG test result. Data were analyzed by SPSS software (version 21). Results The results of multivariate covariance analysis indicated that depression, anxiety and stress levels in the experimental group (p = 0.0001), significantly decreased in posttest group after holistic-oriented psychological intervention and this effect was observed and lasted in the one month follow up (p = 0.0001). The pregnancy rate in the experimental group was 46.7% and in the control group was 13.3% which were statistically significant (p <0.05). Discussion The results of this study showed that the holistic-oriented psychological intervention is effective in decreasing anxiety, depression and stress and increasing the psychological health and pregnancy rate of women with unexplainable infertility under In-Vitro Fertilization treatment.