Gender differences in coping with infertility among couples undergoing counselling for In Vitro Fertilization treatment / Diferencias de género a la hora de enfrentar problemas de esterilidad entre parejas que reciben consejería para el tratamiento de fertilización in vitro

OBJECTIVE: To identify gender differences in coping responses and the association between coping and psychological distress in couples undergoing In Vitro Fertilization (IVF) treatment at the University of the West Indies (UWI). METHODS: All men and women (n = 52) who were offered psychological counselling prior to beginning IVF treatment between October 2003 and May 2004 were invited to complete questionnaires on their coping responses, self-reported distress and socio-demographic data. One female declined. RESULTS: Of the 51 participants, 52had completed secondary education, 44tertiary education, and 37were 38 years or older; 42of the couples were trying for more than seven years to have a child. Gender differences in coping included more women than men keeping others from knowing their pain (p < 0.01) and more women ruminating about what they did wrong to cause the infertility (p < 0.01). These strategies were also associated with reports of heightened distress (p < 0.05). Talking to others to obtain information was associated with less negative feelings. Coping skills that were commonly used by both genders included seeking medical advice and engaging in wishful thinking. CONCLUSION: Women coping with infertility may be at risk for self-depreciation and isolation because of their choice of coping strategies and the meaning they ascribe to the infertility. As a result, they are likely to experience more heightened distress than men who are also infertile. Counselling that is specific to gender-needs is indicated.

OBJETIVO: Identificar las diferencias de género en las respuestas de enfrentamiento, y la asociación entre la angustia (distrés) del enfrentamiento y la angustia psicológica en las parejas que reciben tratamiento de fertilización in vitro (FIV) en el Hospital Universitario de West Indies. MÉTODOS: A todos los hombres y mujeres (n = 52) a quienes se les ofreció consejería psicológica antes de comenzar el tratamiento de FIV entre octubre de 2003 y mayo de 2004, se les invitó a llenar cuestionarios sobre sus respuestas de enfrentamiento, auto-reporte de su angustia, y datos socio-demográficos. Una mujer rechazó la encuesta. RESULTADOS: De los 51 participantes, 52% habían terminado su educación secundaria, 44% la educación terciaria, y 37% tenían 38 años o más, en tanto que el 42% de las parejas había estado tratando de tener un hijo o hija por más de siete años. Las diferencias de género al enfrentar el problema de la infertilidad incluían más mujeres que hombres en cuanto a evitar que otros supieran del dolor (p < 0.01) y más mujeres rumiando que habrían hecho mal que provocó la esterilidad (p < 0.01). Estas estrategias estuvieron también asociadas con reportes de intenso distrés (p < 0.05), mientras que el hablar a otros para obtener información estuvo asociado con sentimientos menos negativos. Las habilidades de enfrentamiento usadas comúnmente por ambos géneros incluían la búsqueda de consejo médico y el juego a hacerse ilusiones. CONCLUSIONES: En su enfrentamiento al problema de la esterilidad, las mujeres pueden correr el riesgo de la auto-depreciación y el aislamiento debido a su elección de estrategias de enfrentamiento, y al significado que adscriben a la esterilidad. A consecuencia de ello, es probable que experimenten angustia con más intensidad que los hombres estériles. Se indica que la consejería debe realizarse en correspondencia con las necesidades específicas de cada género.

Suicidal behaviour and risk factors in children and adolescents in Jamaica

Suicidal attempts and ideation were examined in children attending child and adolescent mental health clinics in the Kingston Metropolitan Area during October 1998 to September 1999. The case records of fifty-seven 6-18 year-olds were selected for review in order to identify social and familial factors that place Jamaican children and adolescents at risk for suicidal behaviour. In addition, in order to examine the consistency of risk factors, data from child and adolescent mental health clinics were compared over a ten-year period between 1989 and 1999. The results indicated that having a poor relationship with the primary caregiver was significantly associated with suicidal behaviour (p < 0.01) as well as experiencing abuse (p < 0.05). These children also tended to externalize their behaviours (p < 0.01). The findings suggest that, over the ten-year period, Jamaican children seem to be more readily talking about, contemplating and attempting, suicide. The importance of managing intrafamilial issues affecting children is highlighted

Autism in Jamaica

This paper reviews childhood autism, a serious psychopathological disorder, with emphasis placed on aetiology and management; and outlines briefly the care of the autistic population in a few well organized programmes existing in Jamaica. There is a need for increased awareness, local research and dissemination of information to appropriate personnel and organizations.

Do relatives of terminally ill patients also benefit from hospice care?

An analysis was carried out on the extent to which staff responded to the relatives of cancer patients who had been admitted to the Consie Walters Hospice Care Centre, and the Pain Centre, both located in Kingston, Jamaica. Although no relationship was found between frequency of intervention and relatives' (caregivers') health, grief reactions were found to be related to a need for staff interaction. The more caregivers reported that they needed staff emotional suport and practical assistance, the more intensely the reported grief, and the greater were their reports of anxiety and insomnia. Age was found to influence the relationship between adjustment and receiving intervention