ABSTRACT
In view of the higher incidence of endometrial pathology in tamoxifen-treated breast cancer patients, it has been recommended that endometrial surveillance be performed on these women by means of transvaginal sonography. Our study investigated how breast cancer patients experience the endometrial surveillance and which personality factors influence this experience. We also studied compliance with the recommended examination. Fifty-three consecutive asymptomatic postmenopausal breast cancer patients who had taken tamoxifen for at least 6 months were included. Our results show that 23% of the women felt very anxious just before the examination. One woman in five evaluated the procedure as annoying, unpleasant, invasive and awkward, but only 3% found it really unacceptable. Difficulties in coping with mastectomy as well as anxiety negatively affected the experience of the examination. One in six women were doubtful about their ability to comply with such an examination in the future. Women who have difficulties in coming to terms with the mastectomy, anxious women, and women with a low tolerance towards common medical procedures are at especial risk of becoming dropouts. Suggestions are made for developing strategies that might improve these women's compliance.
Subject(s)
Antineoplastic Agents, Hormonal/therapeutic use , Breast Neoplasms/psychology , Drug Monitoring/psychology , Endometrium/diagnostic imaging , Tamoxifen/therapeutic use , Adaptation, Psychological , Attitude to Health , Breast Neoplasms/drug therapy , Endometrium/drug effects , Endosonography/psychology , Female , Humans , Middle Aged , Patient Compliance , Postmenopause , Self Efficacy , Uterine Diseases/chemically induced , Uterine Diseases/prevention & controlABSTRACT
OBJECTIVE: To examine the influence of depression levels and coping on IVF outcome in women, taking into account the cause of infertility. DESIGN: Prospective clinical study. SETTING: A university hospital. PATIENT(S): Ninety-eight women undergoing IVF treatment. INTERVENTION(S): Psychometric tests were administered at the first visit (day 3) of the investigated treatment cycle. MAIN OUTCOME MEASURE(S): Achievement of pregnancy. RESULTS: The nonpregnant group reported increased expression of negative emotions. In the subgroup with a female indication for IVF, increased depressive symptomatology (correlated with increased expression of negative emotions) was associated with lower pregnancy rates (PRs), whereas in the subgroup with a male indication for IVF, increased depressive symptomatology (correlated with decreased expression of negative emotions) was associated with higher PRs. CONCLUSION(S): Expression of negative emotions predicts depression levels and outcome in IVF. The cause of infertility should be taken into account when investigating the relation between psychologic functioning and outcome in IVF.
