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Jung and Kim: Factors Influencing Infertility-related Quality of Life in Women Undergoing Assisted Reproductive Techniques: Focusing on Depression and Resilience
Original Article

Korean Journal of Women Health Nursing 2017; 23(2): 117-125.

Published online: 27 June 2017

DOI: https://doi.org/10.4069/kjwhn.2017.23.2.117

Factors Influencing Infertility-related Quality of Life in Women Undergoing Assisted Reproductive Techniques: Focusing on Depression and Resilience

You Jung Jung1, Hye Young Kim2

1Keimyung University Dongsan Medical Hospital, Daegu, Korea.

2College of Nursing, Keimyung University, Daegu, Korea.

Corresponding author: Kim, Hye Young. College of Nursing, Keimyung University, 1095 Dalgubeol-daero, Dalseo-gu, Daegu 42601, Korea. Tel: +82-53-580-3934, Fax: +82-53-580-3916, hye11533@kmu.ac.kr

Received 28 February 2017       Revised 13 April 2017       Accepted 8 June 2017

© 2017 Korean Society of Women Health Nursing

(open-access):

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to investigate factors affecting on infertility-related quality of life in women undergoing assisted reproductive techniques focusing on depression and resilience.

Methods

With correlational survey design, 125 infertile women who were receiving inpatient and outpatient treatment in K university hospital in D city completed a structured questionnaire.

Results

There was a significant negative correlation between depression and resilience and between the depression and the quality of life. There was a significant positive correlation between resilience and the quality of life. The factors affecting on infertility-related quality of life were depression, burden of expenses, and relationship with husband which explained 48% in the quality of life.

Conclusion

It is necessary to develop and apply nursing programs that include individual counseling and education for infertile couple. Social support including financial support and better environment for these women will be also essential.

Keywords: Infertility, Quality of life, Assisted reproductive techniques, Nursing

Figures and Tables

Table 1

Levels of Depression, Resilience and Infertility-related Quality of Life (N=125)

kjwhn-23-117-i001
Characteristics Categories n (%) or M±SD Minimum Maximum
Depression 16.7±9.1 3.0 45.0
0~13 54 (43.2)
14~19 31 (24.8)
20~28 25 (20.0)
29~63 15 (12.0)
Resilience 117.7±22.4 37.0 162.0
Personal competence 80.3±15.9 25.0 109.0
Acceptance of self and life 34.7±7.6 12.0 50.0
Infertility-related quality of life 53.8±14.1 19.1 81.6
Core fertility quality of life Emotional 53.5±19.4 12.5 87.5
Mind/Body 51.4±23.1 0.0 95.8
Relational 52.0±10.4 29.1 75.0
Social 56.0±19.2 8.3 91.7
Treatment Environment 56.7±13.0 20.8 100.0
Fertility quality of life Tolerability 53.4±23.5 0.0 100.0
Table 2

Differences in Depression, Resilience and Infertility-related Quality of Life by Subjects' General Characteristics (N=125)

kjwhn-23-117-i002
Characteristics Categories n (%) Depression Resilience Infertility-related quality of life
M±SD t or F (p) M±SD t or F (p) M±SD t or F (p)
Age (yr) <35 36 (28.8) 16.20±9.90 0.12
(.726)		 121.30±21.50 1.28
(.260)		 52.40±14.90 0.44
(.507)
≥35 89 (71.2) 16.90±8.70 116.20±22.60 54.30±13.70
Husband age (yr) <35 16 (12.8) 18.10±11.10 0.43
(.512)		 121.80±21.40 0.64
(.425)		 51.60±17.20 0.42
(.514)
≥35 109 (87.2) 16.50±8.70 117.00±22.50 54.10±13.60
Marriage period (month) <36 37 (29.6) 16.97±9.90 0.03
(.846)		 123.13±24.47 3.06
(.083)		 53.89±14.60 0.07
(.966)
≥36 88 (70.4) 16.62±8.76 124.47±23.32 53.77±13.94
Educational level High schoola 24 (19.2) 21.04±9.32 4.18
(.017)
a>c† 		109.25±24.59 1.90
(.154)		 49.47±14.46 2.75
(.068)
Collegeb 90 (72.0) 16.05±8.96 115.43±21.60 54.06±13.48
Graduate Schoolc 11 (8.8) 12.81±9.07 124.90±22.65 61.22±15.93
Job Housewifea 61 (48.8) 18.14±9.21 2.05
(.092)		 111.13±21.70 3.39
(.011)
b, d>a† 		53.33±13.50 2.56
(.042)
d>e†
Professionb 21 (16.8) 13.90±8.43 125.00±19.61 56.19±13.11
Companyc 19 (15.2) 15.78±10.7 113.68±22.22 53.59±17.55
Public officiald 14 (11.2) 13.14±6.72 127.21±18.06 60.39±11.40
Self-employede 10 (8.0) 20.80±6.59 104.00±28.00 42.86±10.78
Income (10,000 won) Under 200 3 (2.4) 12.66±4.93 1.86
(.121)		 119.00±6.00 0.767
(.549)		 44.60±5.98 0.36
(.831)
200~300 30 (24.0) 16.90±9.44 109.76±18.33 54.36±14.28
300~400 33 (26.4) 20.03±9.27 113.84±20.41 53.38±15.28
400~500 34 (27.2) 14.61±9.29 117.85±22.87 54.71±14.19
Over 500 25 (20.0) 15.52±7.57 118.84±29.22 53.58±13.22
Religion Christianity 33 (26.4) 15.30±10.21 0.48
(.696)		 115.93±24.22 0.372
(.773)		 55.43±14.07 0.72
(.540)
Catholic 10 (8.0) 15.70±3.97 118.10±16.81 55.14±14.50
Buddhism 24 (19.2) 17.70±7.77 110.87±25.94 50.15±13.09
None 58 (46.4) 17.31±9.57 115.81±20.98 54.17±14.50

†Posterior test: Scheffé test.

Table 3

Differences in Depression, Resilience and Infertility-related Quality of Life by Subjects' Disease-related Characteristics (N=125)

kjwhn-23-117-i003
Characteristics Categories n (%) Depression Resilience Infertility-related quality of life
M±SD t or F (p) M±SD t or F (p) M±SD t or F (p)
Infertility Unknown 49 (39.2) 16.20±8.25 0.10
(.958)		 115.71±20.94 0.86
(.464)		 14.90±2.12 0.25
(.859)
Cause Wife 57 (45.6) 17.05±9.84 112.77±24.43 13.61±1.80
Husband 12 (9.6) 16.75±7.41 124.08±19.79 10.09±2.91
Mixed 7 (5.6) 17.71±12.13 114.00±19.88 19.52±7.37
Infertility treatment period <36 74 (59.2) 17.93±9.56 3.25
(.074)		 116.13±24.42 0.85
(.356)		 53.21±14.17 0.31
(.573)
≥36 51 (40.8) 14.98±8.05 119.92±19.02 54.67±14.05
Abortion experience Nonea 67 (53.6) 15.79±8.81 1.10 (.334) 119.37±20.23 3.27
(.041)
a>c† 		54.46±14.13 0.154
(.858)
Spontaneous abortionb 39 (31.2) 17.12±8.57 112.20±22.20 53.05±12.91
Abortion inducedc 19 (15.2) 19.21±10.84 105.84±27.43 53.06±16.68
Person who gives infertility stress Husbanda 8 (6.4) 20.12±10.68 4.04
(.002)
b>f† 		111.62±17.54 0.38
(.857)		 51.19±13.38 1.84
(.109)
Parents-in-lowb 32 (25.6) 20.93±10.05 111.12±26.95 52.11±13.09
Parentsc 6 (4.8) 22.66±9.66 113.16±21.01 49.14±18.85
Myselfd 30 (24.0) 13.83±7.21 117.14±22.59 57.76±13.93
Otherse 7 (5.6) 18.14±10.41 117.66±19.09 42.33±16.24
Nonef 42 (33.6) 13.85±7.27 115.28±22.64 55.35±13.31
Relationship with husband Very satisfieda 25 (20.0) 12.04±7.80 7.30
(<.001)
d>a, b, c† 		122.16±16.19 3.09
(.018)
a, b, c, d>e† 		61.58±12.95 5.58
(<.001)
a>d, e†
Satisfiedb 29 (23.2) 14.68±7.76 120.82±20.62 54.64±14.96
Nor dissatisfidc 39 (31.2) 16.00±8.95 110.12±26.07 53.88±12.12
Dissatisfiedd 29 (23.2) 23.10±8.12 112.89±21.17 48.50±12.71
Very dissatisfiede 3 (2.4) 23.33±9.07 86.00±4.00 31.37±14.08
Burden of expenses Nonea 5 (4.0) 10.40±3.36 3.56
(.009)
e>a† 		139.80±18.53 7.62
(<.001)
a>e† 		65.29±11.51 9.37
(<.001)
b>e†
Littleb 12 (9.6) 15.91±7.76 116.66±19.53 61.94±3.75
Moderatec 12 (9.6) 12.0±6.00 134.00±7.67 67.46±8.14
Burdend 36 (28.8) 14.77±7.73 119.41±18.83 54.88±13.07
Very burdene 60 (48.0) 19.53±10.02 106.31±22.98 47.85±13.44
National support experience Yes 105 (84.0) 16.39±8.98 0.90
(.343)		 114.92±22.53 0.03
(.859)		 53.34±14.06 0.71
(.401)
No 20 (16.0) 18.50±9.57 115.90±22.51 56.25±14.29
Infertility counseling experience Yes 17 (12.8) 12.93±6.71 3.02
(.084)		 115.26±22.54 0.83
(.973)		 59.60±11.58 2.93
(.089)
No 108 (87.2) 17.24±9.25 115.05±22.53 53.02±14.25
Demand of infertility counseling Moderatelya 24 (19.2) 17.45±10.14 0.33
(.713)		 113.83±25.13 3.13
(.047)
b>c† 		54.38±14.15 2.37
(.097)
A great dealb 54 (43.2) 15.96±8.65 120.46±21.94 56.48±13.08
Completelyc 47 (37.6) 17.23±9.11 109.53±20.52 50.45±14.74

†Posterior test: Scheffé test.

Table 4

Relationships among Depression, Resilience and Infertility-related Quality of Life (N=125)

kjwhn-23-117-i004
Variables Depression Resilience Infertility-related quality of life
r (p) r (p) r (p)
Depression 1.00
Resilience −.49 (<.001) 1.00
Infertility-related quality of life −.62 (<.001) .48 (<.001) 1.00
Table 5

Factors affecting on Infertility-related Quality of Life (N=125)

kjwhn-23-117-i005
Factors B SE β t p
Depression −0.65 .12 −.42 −5.29 <.001
Burden of expenses −3.44 .86 −.28 −4.02 .006
Relationship with husband 1.90 .90 .15 2.12 .036
Adjusted R2=.48, F=30.6, p<.001

Notes

This manuscript is condensed form of the first author's master's thesis from Keimyung University.

Summary Statement

▪ What is already known about this topic?
Infertility primarily affects emotional status negatively and reduces the fertility quality of life undergoing Assisted Reproductive Techniques.
▪ What this paper adds?
The factors affecting on the quality of life were depression, burden of expenses, and relationship with husband in the quality of life on infertile women.
▪ Implications for practice, education and/or policy
It is necessary for these women to develop and apply nursing programs consisting individual counseling and education.

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