A Study to Assess the level of Stress and Adapted coping mechanism among Infertile women at selected Infertility clinic, Dehradun Uttrakhand In a view of developing an information booklet
Ms. Smita*
Assistant Professor, Doon Institute of Medical Sciences, Dehradun, Uttarakhand, India.
*Corresponding Author E-mail: smita.mehar138@gmail.com
ABSTRACT:
A descriptive study was carried out for the purpose to investigate the level of stress and coping and to determine the relationship between stress and various coping mechanism among infertile women in selected two infertility clinic to find out the variables and their significance that may be related to study including (age, educational level, occupation, duration of infertility, …ect). The study sample consisted of 200 infertile women who were diagnosed as infertile and who were visiting infertility clinic during the data collection and met the inclusion criteria for the study. Self-developed likert scale for assessing the level of stress and coping in infertile women In this study, we used inferential and Descriptive Statistics, mean, standard deviation and mean percentage ,Correlation Coefficient Pearson, anova and unpaired t test were used in the study, the results showed that there is a moderately positive relationship between infertility related stress and coping mechanism, 47.21% was the total stress in total population, 40% have mild stress, 49.50% have moderate stress and 10.5% have severe stress. 53% have moderate coping 24% have inadequate coping 23% have adequate coping. The findings of the current study found that there is statistical significances at p>0.05. The study found significant association in age and year of infertility with stress calculated value was greater than tabulated value at p>0.05 type of family,income,substance use and exposure to stress reduction therapy have no association because the calculated value is less than tabulated value at p>0.05 and no significance in occupation, education and income per month. type of family, substance use, exposure to stress reduction technique, income with coping at p>0.05. Psychological aspect of infertility should be given more attention, and be considered in all stages of treatment and medical interventions to decrease the psychological suffering of the infertile women and to prevent developing of the psychological disorder.
KEYWORDS: Stress, Infertile women, coping Mechanism.
INTRODUCTION:
Reproduction is the only means of sustaining human life, Pregnancy and childbirth typically both are associated with positive emotions Furthermore, Human beings want to have children not only for the joy but also as a deep desire to continue their generation and leave a valuable memory of themselves.
Then when the desires and needs did not fulfill it eventually cause stress and even can lead to a mental disorder. "Desire cannot be met or satisfied in the same way that can be said for need. Desire remains with us, pushing us to search for the next best thing. In this sense desire is non-referential because we are unable to locate its true end or its fulfillment."(Ward and Peter, 2002)
As women around the world enjoy broader opportunies and expanding roles they are also experiencing one another increase in their live that is stress. Nielson’s study which was conducted from feb to april of 2011 polled almost 6500 women throughout 21 developed and emerging countries have stress. The result of the polls showed that an astounding 87% of Indian women claim feeling stressed most of the time with an additional 82% asserting they had in sufficient time to relax. when stress starts interfering with your ability to live a normal life for extended period it become even more dangerous. The longer the stress last the worse it is for both your mind and body. Women might feel fatigued, unable to concentrate or irritable for no good reason, but chronic stress causes wear and tear on your body. 1 in 8 couples (or 12% of married women) have trouble getting pregnant or sustaining a pregnancy. (2006-2010 National Survey of Family Growth, CDC)
Approximately one-third of infertility is attributed to the female partner, one-third attributed to the male partner and one-third is caused by a combination of problems in both partners or, is unexplained (www.asrm.org)
Infertility problem have been a source of concern in India lately. According to a 2013 World Bank estimate the drop infertility started about 10 year ago in India in India with a steady 17% decline from the year 2000.- Times of india.
The national family health survey of 1998-99 furnished state level estimate for the total fertility rate and other demographic and health care utilization characteristics. women in uttrakhand have on average 2.6 children through their reproductive span, which is approximately 1.4 children 41.2% of women in uttrakhand report reproductive health problems.
OBJECTIVES:
Objective of the study is to:
1. Develop a tool for assessing the level of stress and adapted coping mechanism among infertile women.
2. Assess the level of stress and adapted coping mechanism among infertile women.
3. Evaluate the relationship between stress and coping mechanism among infertile women.
4. Find out the association between level of stress of infertile women with their selected socio demographic variable.
5. Find out the association between level of coping of infertile women with their selected socio demographic variable.
HYPOTHESIS:
The study aim is to test the following hypothesis. all the hypothesis will be tested at p<0.05 level of significance. The hypothesis of the study are:
H1: There will be a significant relationship between stress and coping mechanism among infertile women.
H2: There will be a significant association between level of stress of infertile women with their selected demographic variable
H3: There will be a significant association between various coping mechanism of infertile women with their selected demographic variable.
REVIEW OF LITERATURE:
Infertility related Stress review:
M.Pilar Matud, (march 2004) the study examines gender difference in stress and coping in sample of 2816 people between 18 and 65 years old with different sociodemographic characteristics. The result of mancova after adjusting for sociodemographic variables, indicated that the women scored higher than men in chronic stress and minor daily stressor and their coping style is more emotion focused than that of men
Balasubramanian Vimala, Chokalingam Madhavi study explores the influence of age and experience on stress and depression and the relationship between stress and depression among women information technology (IT) professionals in Chennai, India. The study was conducted in Chennai, India with a sample of 500 women IT professionals. This study also reveals that 84% of the respondents experience medium level of depression and also suggest that age and experience significantly influence the overall stress and depression experienced by the employees. Our study shows that there might be a strong relationship between overall stress and depression.
Smeenk jm, Verhaak cm, Eugster a, Van minnen a, Zielhuis ga, Brat dd. (July 2001) a multicentre prospective study 291out of 359 (81%) consecutively invites women agreed to participate a study aim was to clarify the role of anxiety and depression on the outcome in assisted reproductive treatment.
Hidehiko matsubayashi, Takashi hosaka, Shunichiro izumii, Takahiro Suzuki and Tsunehisa Makino (January 31, 2001.) In this Japanese population, infertile women reported higher levels of emotional distress than pregnant women, suggesting psychological support is needed for infertile women. Infertile women with positive HADS indicating emotional disorders (39/101, 38.6%) were significantly (P = 0.0008, χ2 test) more than those of pregnant women (13/81, 16.0%) when the threshold was set at 12/13 of total HADS scores. The HADS scores were not affected by the women's age, duration of infertility, experience of conception, routine tests, and work states.
Coping Related Reviews:
Donkor, Sandall (2009). Perform a study to explore the coping strategies adopted by 615 women seeking infertility treatment in southern Ghana. Both closed and open-ended questions were used through a survey conducted using face-to-face interviews in three languages at three health sites--a hospital, a health center and a private clinic. The findings suggest that the majority of the women preferred to keep issues of their fertility problems to themselves. The reason could be due to the associated stigma of infertility. Further, the majority of the women coped through drawing on their Christian faith. Others also coped through the support they received from their husbands, their occupation by way of achieving economic independence, and some avoided situations that reminded them of their infertility problem
Abdul-Aziz aflakseir and Masoumeh zarei (2013 Oct-Dec) One hundred twenty infertile women were recruited from several infertility clinics in Shiraz using convenience sampling method. The participants completed research measures including the Infertility Problem Stress Inventory and the Ways of Coping Scale (passive-avoidance, active-avoidance, active-confronting, meaning-based). Multiple regression analysis was used for data analysis. A p-value less than 0.05 was considered as statistically significant
RESEARCH METHODOLOGY:
Research Aproach:
The investigation has employed the survey approach (quantitative research) a survey approach is an non experimental design is one in which researchers collect data without making changes or introducing treatments. data obtained are analyzed and the results may lead to the formation of hypothesis that can then be tested experimentally.
Research Design:
The research design refers to overall strategies that you choose to integrate the different component of study in a coherent and logical way, thereby ensuring you will effectively address the research problem, it constitutes the blue print for the collection, measurement and analysis of data. research design is non experimental (univariant descriptive) this design is undertaken because it describes the frequency of occurrence of a phenomenon and it can involve one or more variable in the study level of stress and coping is assess of infertile women.
INSTRUMENT:
An instrument termed as likert scale related to stress in infertile women inventory. and likert scale related to adaptive coping mechanism in infertile women inventory. these tools were use to assess the infertile women stress and coping; another tool was socio demographic scale. in this way 3 tools were used
1. Socio demographic performa
2. Self develop likert scale related to stress in infertile women inventory.
3. Self develop likert scale related to adaptive coping mechanism in infertile women inventory
Sampling Method:
The sample selection approach used was the non probability one, out of six non probability design the purposive sampling technique was found most appropriate. a purposive sample is a group of individuals who is readily available for participation in study
Frequency and percentage distribution of infertile women on socio demographic characteristic:
|
S. No. |
Demographic variable |
Range |
Frequency (f) |
% |
|
1. |
Age |
25 to 30 |
109 |
54.5% |
|
31 to 35 |
42 |
21% |
||
|
36 to 40 |
40 |
20% |
||
|
41 to 45 |
9 |
4.5% |
||
|
2. |
Education |
informal |
22 |
11% |
|
Primary |
13 |
6.5% |
||
|
Medium |
75 |
37.5% |
||
|
Diploma |
54 |
27% |
||
|
degree and above |
36 |
18% |
||
|
3. |
Occupations |
House wife |
127 |
63.5% |
|
Private |
61 |
30.5% |
||
|
government |
12 |
6% |
||
|
4. |
Family Income |
<5000 |
0 |
0 |
|
5001-7500 |
12 |
6% |
||
|
7501-10000 |
17 |
8.5% |
||
|
ABOVE 10000 |
171 |
85.5% |
||
|
5. |
Family Type |
Small |
107 |
53.5% |
|
Joint |
93 |
46.5% |
||
|
6. |
Substance Use |
Yes |
5 |
2.5% |
|
No |
195 |
97.5% |
||
|
7. |
Exposure to Stress Reduction Therapy |
Yes |
2 |
1% |
|
No |
198 |
99% |
||
|
8. |
Year of Infertility |
1-3 |
75 |
37.5% |
|
4-6 |
73 |
36.5% |
||
|
7-9 |
28 |
1.4% |
||
|
10-12 |
20 |
10% |
||
|
13-15 |
4 |
2% |
To assess the level of stress among infertile women.
|
Level of stress |
Frequency |
% |
|
Mild |
80 |
40% |
|
Moderate |
99 |
49.5% |
|
Severe |
21 |
10.5% |
|
Total |
200 |
100% |
To assess the coping mechanism among infertile women.
|
Level of stress |
Frequency |
% |
|
Adequate |
46 |
23% |
|
Moderate |
106 |
53% |
|
Inadequate |
48 |
24% |
|
Total |
200 |
100% |
To evaluate the relationship between stress and coping mechanism among infertile women
|
Corealtion |
R |
Interpretation |
|
STRESS and COPING |
0.026827735 |
Moderately + ve corelation |
Significant association was done where calculated value is greater than tabulated value at p>0.05 so we accept the research hypothesis their association between level of stress and various demographic variables age, year of infertility while in education, occupation income per month has no association as calculated value is less than tabulated value at p>0.05.
Type of family, income, substance use and exposure to stress reduction therapy have no association because the calculated value is less than tabulated value at p>0.05.so we reject the research hypothesis.
Significance association with level of coping as the calculated value is less than tabulated value at p>0.05 so we reject the research hypothesis there is no association between level of coping and age, education, occupation income per month and year of infertility, level of coping and type of family substance use and exposure to stress reduction therapy.
CONCLUSION:
The study concluded that the level of stress in infertile women is moderate as coping strategies are being used ,also the correlation between level of stress and coping is moderately positive , the study had an implication ,The public awareness regarding stress and its management would be created by mass media and also by conducting seminar and workshops.Special guidance and counselling programme would be initiated for the eligible couples on infertility related stress and its management.nursing implication The study findings can be added to the research review regarding the stress in infertility and coping.The study findings can serve as the baseline data and further research can be conducted in different settings.
RECOMMENDATIONS:
Based on the findings of the study, the following recommendations are made:
The study could be replicated in other parts of the country on large samples and with different settings like urban areas.
Cross-sectional designs that replicate this study using infertile populations not pursuing treatment or who recently completed treatments would be valuable. This would allow researchers to more fully understand the relationship between coping and infertility stress, marital adjustment and depression across the various phases of the infertility experience
An experimental study could be conducted to find out the effectiveness of the seminar and workshop in enhancing the knowledge level of infertile women regarding stress and coping and how to manage it.
LIMITATIONS:
The limitations of the study were:
1. The study was only limited to the infertility clinics.
2. The study was limited to womens.
REFERENCES:
1. Health care seeking behavior and psychosocial consequences of infertile women; jarin rosal; http;//www.academia.edu/8291976/ health care seeking behavior and psychosocial consequences of infertile women.
2. Mcnaughton-Cassill et al. (2002) Efficacy of Brief Couples Support Groups Developed to Manage the Stress of In Vitro Fertilization Treatment, Mayo Clin Proc.;77: pp (1060-1066)
3. Merwe E. (2010), Infertility-Related Stress and Specific Aspects of The Marital Relationship, University of Stellenbosch, Master thesis, in press, p.p. (9-13).
4. Rachel Goldstein. Study indian women are the most stressed on earth 13 july 2011.http://newsfeed.time.com/2011/07/13/study-for-women-india-is-the-most-stressful-country-on-earth/
5. Marry JJ. Stress management for health care personnel. nightingle nursing times. 2000; 14(11): 16
6. Stuart W. Gail. A text book of principles and practice of psychiatric nursing. edition 9. Noida India. 2009. Publisher Elsevier. page no 49.
7. The Ronald O. Perelmanand Claudia Cohen Centre for reproductive medicineat weill cornell medical college 19-4-2015 http:// www.resolve.org/about/fast-facts-about-fertility.html
8. Prasanta Kumar Deka and Swarnali Sarma. Psychological aspects of infertility; 2010; 3(3): a336.www.bjmp.org>content>. psychological
9. Jacqueline M. MC Grath, Ksenia Zukowsky, Haifa A Samra and Brenda Baker. parenting after infertility: issues for families and infants. American Journal of Maternal/ Child Nursing
10. Arthur L. Greil, Kathleen and Julia Social Health Illn. 2010; 32(1): 140-162 http://www.ncbi.nlm.nih.gov/pmc/articles/pmc3383794/
11. Broeck and et al. (2010), predictors of psychological distress in patients starting ivf treatment: infertility-specific versus general psychological characteristics, human reproduction, vol.25, no.6 pp. 1471–1480.
12. Roshni Mahesh infertility rate among indian couples on the rise, says survey september 20, 2013 14:55 ist http://www.ibtimes.co.in/ infertility-rate-among-indian-couples-on-the-rise-says-survey-507672#7tuuzkbucpjyjli5.99
13. Reproductive child health and population policy issues in uttrakhand; s.c. gulati, suresh Sharma, Population Research Centre Institute of Economic Growth, New Delhi, pg no 31,34.
14. M. Pilar Matud. Personality and Individual Difference 37(7): 1401-1415
Balasubramanian Vimala, Chokalingam Madhavi 5 August 2009 Voulme 2 https://www.dovepress.com/a-study-on-stress-and-depression-experienced-by-women-it-professionals-peer-reviewed-article-prbm
17. Inbar Zaig, Foad Azem, Shaul Schreiber, Yael Gottlieb-Litvin, Hadas Meiboom, Miki Bloch July 06 2012. Archies of Women’s Mental Health October 2012; 15(5): pp 352-359
18. Hidehiko Matsubayashi, Takashi Hosaka, Shun-Ichiro Izumi 1, Takahiro Suzuki and Tsunehisa Makino; emotional distress of infertile women in Japan; January 31, 2001; http:// humrep.oxfordjournals.org/content/ 16/5/966.abstract
Received on 26.05.2021 Modified on 01.06.2021
Accepted on 11.06.2021 ©A&V Publications All right reserved
Int. J. of Advances in Nur. Management. 2021; 9(3):264-268.
DOI: 10.52711/2454-2652.2021.00060