Diagnósticos de enfermagem dos domínios autopercepção e enfrentamento/tolerância ao estresse relacionados à infertilidade feminina / Nursing diagnoses of the domains self-perception and coping/tolerance of stress related to female infertility

Objetivou-se caracterizar o perfil de diagnósticos de enfermagem dos domínios Autopercepção e Enfrentamento/Tolerância ao estresse apresentados por mulheres com queixa de infertilidade. Estudo descritivo, quantitativo, realizado com 40 mulheres, em uma unidade de assistência primária à saúde. Dados foram coletados por meio de formulário de entrevista elaborado para esta pesquisa. Identificou-se 20 diagnósticos. Disposição para poder melhorado, Disposição para enfrentamento melhorado, Disposição para resiliência melhorada, Ansiedade e Baixa autoestima situacional apresentaram maior frequência. Os achados revelaram que a infertilidade pode gerar ansiedade e afetar negativamente a autopercepção da mulher. Entretanto, esta clientela demonstrou disposição para otimizar seu nível de bem-estar. A identificação de diagnósticos contribui para o planejamento do cuidado e enriquece a qualidade do atendimento, possibilitando o preparo destas mulheres para a conquista ou não da maternidade, por meio de intervenções de enfermagem individualizadas, incluindo apoio emocional e psicossocial de acordo com a necessidade de cada uma

The objective was to characterize the profile of nursing diagnoses of the domains Self-perception and Coping/Tolerance of stress of women with infertility complaints. A descriptive, quantitative study conducted with 40 women, in a primary health care unit. Data was collected with an interview form created for this study. We identified 20 diagnoses. Improved readiness for power, Improved readiness for coping, Improved readiness for resilience, Anxiety and, Low situational self-esteem presented were more frequent. The findings revealed that infertility can generate anxiety and negatively affect women's self-perception. However, this clientele demonstrated readiness to optimize their wellbeing. Identification of diagnoses contributes with care planning and enriches the quality of assistance, allowing women to be prepared for achieving maternity or not, through individualized nursing interventions, including emotional and psychosocial support according to the need of each one of them.

Fertility preservation in paediatric nephrology: results of a physician survey.

OBJECTIVE: Fertility preservation (FP) is a widespread practice in paediatric oncology when gonadotoxic medications such as cyclophosphamide (CPO) are used. FP practice outside of oncology has not been studied, although nephrologists regularly use CPO. This is the first study to explore FP practice by paediatric nephrologists when CPO is used. DESIGN: Survey study. Descriptive statistics and chi-squared analyses were employed to analyse the data. PARTICIPANTS: US paediatric nephrologists were sent a survey via email. The survey queried participants about FP practice behaviours, FP attitudes and barriers to practice. MAIN OUTCOME MEASURES: Of 579 nephrologists invited, 32% responded to the survey. RESULTS: CPO was dosed in mg/kg by 23% of physicians, g/m(2) by 40% and both by 37%. About 80% agreed that pubertal females should be offered a fertility referral, while 58% report that they actually refer. Factors negatively associated with referral include lack of training, lack of referral network and adherence to gonadotoxic dose limits. Results were similar for male patients. CONCLUSION: The survey showed that FP practice in the United States is widespread among nephrologists. Lack of referral networks is a notable barrier for nephrologists. Perceived adherence to dose limits may be problematic given the variable dosing regimens utilised. This is due to the risk of unintended overdose in large adolescents dosed in mg/kg whose cumulative dose exceeds gonadotoxic limits in g/m(2) . This paper has implications for nephrology care providers and other specialists who utilise CPO, generalists who care for these patients and oncologists with extant FP referral networks.

Somatic symptoms, psychological distress and sleep disturbance among infertile women with intrauterine insemination treatment.

AIMS AND OBJECTIVES: To explore sleep quality in infertile women and examine the factors that contribute to sleep disturbances during intrauterine insemination treatment. BACKGROUND: Sleep disturbance is an important factor of human health and well-being. Sleep disturbances tend to occur among infertile women during intrauterine insemination treatment. Although many studies have focused on the high percentage of somatic symptoms and psychological distress in infertile women associated with their treatment, few studies have investigated factors linked to their sleep disturbances. DESIGN: A cross-sectional study. METHODS: The study was conducted during the period of September 2010-January 2011 in a teaching hospital in Taiwan. Infertile women (n = 117) who received assisted reproduction with intrauterine insemination treatment completed a questionnaire. Demographic data, somatic symptoms, psychological distress and perceived sleep quality were collected. RESULTS: More than one-third (35%) of the infertile women reported having sleep disturbances. Their nausea symptoms and psychological distress were risk factors that contributed to sleep disturbance. CONCLUSIONS: The variables of nausea and psychological distress significantly explained 30% of the sleep disturbances in the infertile women. The evaluation of nausea symptoms and/or psychological distress among infertile women is an important area of future research; such research should aim to identify the best compromise between infertility treatment and sleep quality. RELEVANCE TO CLINICAL PRACTICE: Clinical obstetrics and gynaecology nurses should develop strategies to help infertile women reduce their nausea symptoms and psychological distress during intrauterine insemination treatment to promote healthy sleep.

A randomized controlled trial of the effects of nursing care based on Watson's Theory of Human Caring on distress, self-efficacy and adjustment in infertile women.

AIMS: To investigate the effects of nursing care based on the Theory of Human Caring on distress caused by infertility, perceived self-efficacy and adjustment levels. BACKGROUND: Infertility leads to individual, familial and social problems. Nursing care standards for women affected by infertility have yet to emerge. DESIGN: A randomized controlled trial. METHODS: This study was conducted from May 2010-February 2011, with 105 Turkish women with infertility (intervention group: 52, control group: 53). We collected data using the Infertility Distress Scale, the Turkish-Infertility Self Efficacy Scale Short Form and the Turkish-Fertility Adjustment Scale. The intervention group received nursing care based on the Theory of Human Caring. Data were analysed using t-tests, chi-square tests and intention-to-treat analyses. RESULTS: The intervention and control groups significantly differed with regard to infertility distress, self-efficacy and adjustment levels. The intervention group's mean self-efficacy score increased by seven points and adjustment score decreased by seven points (in a positive direction). In addition, there was a significant reduction in infertility distress scores in the intervention group, but there was no change in the control group. CONCLUSION: Nursing care based on the Theory of Human Caring decreased the negative impact of infertility in women receiving infertility treatment and increased self-efficacy and adjustment.

Ultrasound for nurses in reproductive medicine.

Nurses are in an ideal position to perform pelvic ultrasound evaluations, and appropriately trained nurses can perform limited ultrasound evaluations as part of the assessment and treatment of infertility. In this article, the author provides detailed descriptions and accompanying ultrasonic images illustrating the use of ultrasound in providing vital clinical information in reproductive medicine and in the assessment of the first trimester of pregnancy.

Development of the Fertility and Cancer Project: an Internet approach to help young cancer survivors.

PURPOSE/OBJECTIVES: To describe the development of the Fertility and Cancer Project (FCP), an Internet approach to supplement information about fertility; describe FCP study participants' characteristics, fertility, cancer knowledge, and Internet use; and assess perceived information and support from the oncology team. DESIGN: Descriptive. SETTING: Internet, international. SAMPLE: 106 young survivors of breast cancer from eight countries. METHODS: FCP content was developed from the literature and interviews with breast cancer survivors, oncology professionals, and young women without cancer who were having fertility problems. Participants learned about the FCP through advocacy groups, cancer care providers, and Web searches. After enrollment, they completed five surveys: sociodemographic, breast cancer and health status, knowledge of fertility, Internet use, and the Medical Outcomes Study-Social Support Survey. MAIN RESEARCH VARIABLES: Sociodemographics, breast cancer, health status, fertility knowledge, Internet use, and social support. FINDINGS: Prior to diagnosis, most survivors had no fertility concerns, but more than 14% reported fertility problems. Following breast cancer diagnosis and treatment, 23 reported fertility problems. About half reported receiving little information about fertility options from the oncology team and were referred to a reproductive endocrinologist. Internet use to obtain support and health information was common. Most reported frequent computer use and Internet access in their homes. Participants were most knowledgeable of the general and treatment-related factors that could affect fertility; they were least knowledgeable of infertility treatment. CONCLUSIONS: Results provide preliminary evidence about the demographic, cancer treatment, and support characteristics of young survivors of breast cancer who seek online information about fertility. IMPLICATIONS FOR NURSING: The Internet is a promising format for engaging young cancer survivors who seek information about fertility and cancer. Future studies can evaluate FCP effectiveness in delivering education and support interventions.

Cancer and its treatment effect on young breast cancer survivors.

OBJECTIVES: To discuss issues of fertility after chemotherapy and the young breast cancer survivor. DATA SOURCES: Research articles and literature reviews. CONCLUSION: Reproductive concerns are important to young breast cancer patients. Discussing these concerns and exploring options are crucial before beginning cancer treatment. IMPLICATIONS FOR NURSING PRACTICE: Reproductive effects from treatment can have a significant impact on the long-term health and quality of life of young women with breast cancer. Oncology nurses are a vital source to discuss concerns and explore options with the patient.

Young cervical cancer patients and fertility.

OBJECTIVES: To review the incidence of cervical cancer in reproductive age women and identify reproductive issues for these patients. To identify surgical methods of fertility preservation in cervical cancer and advanced reproductive technologies available to patients. DATA SOURCES: Epidemiologic data, published research reports, and patient management guidelines. CONCLUSION: Young women with cervical cancer are a special population with unique needs regarding fertility. IMPLICATIONS FOR NURSING PRACTICE: Nurses caring for young patients with cervical cancer must be aware of both the surgical fertility preservation options, which patients are candidates for these surgeries and the options for assisted reproductive technology. Nurses need to be able to coordinate care for these patients with gynecologic oncologists and reproductive endocrinologists in order to facilitate optimal outcomes.

Breast cancer survivors and fertility preservation: ethical and religious considerations.

OBJECTIVES: To review religious and ethical considerations for health care professionals when discussing fertility preservation with young survivors. DATA SOURCES: Published research reports and articles, published guidelines, and web sites. CONCLUSION: Although advances in assisted reproductive technology have increased fertility preservation options, not all treatments are acceptable or available for all young survivors. IMPLICATIONS FOR NURSING PRACTICE: The ongoing provision of information from health care professionals allows young survivors to make high-quality decisions about fertility across the survivorship continuum. Knowledge of the influence that religious beliefs and economics have on decisions help nurses to better understand and support patients during this difficult time.

Technology application to assist young survivors with fertility concerns.

OBJECTIVES: To provide an overview of the relationship of communication technology with cancer and fertility concerns; a brief description of one example of a project for young breast cancer survivors; a profile of women who participated in the project; and a consideration of the future role of oncology nurses in developing and utilizing technology to address cancer and fertility concerns. DATA SOURCES: Literature, experiential original data. CONCLUSION: Communication technology provides an ever increasing array of tools, but it is the oncology nurse who is in a pivotal position to maximize the benefits that patients realize through the use of such supportive technologies. IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses are in a pivotal position to assure that communication technologies are appropriately used to provide access to evidence-based information about cancer and fertility.

[Self-care and demand for social support in women with infertility]. / Ocena mozliwosci samoopieki i zapotrzebowania na zródla wsparcia spolecznego u kobiet z problemem nieplodnosci.

INTRODUCTION: The prevalence of infertility among married couples is growing. It is estimated that every fifth married couple in Poland is infertile. Infertility is often a source of significant stress for the spouses. It is therefore important to provide professional support, demonstrate interest, listen to the problem, and be present in difficult moments. Social support considerably reduces the feeling of abandonment, fosters self-care, accelerates recovery, strengthens coping, and helps modify views and habits or attitudes towards treatment. The aim of this study was to assess self-care in women with infertility and to identify the most common sources of social support. MATERIAL AND METHODS: The study group consisted of 100 women diagnosed or treated for infertility at the Department of Reproduction and Gynecology, Pomeranian Medical University in Szczecin. The diagnostic poll was done with the aid of a standardised research tool--the Social Support Scale Questionnaire by Danuta Zarzycka. The study protocol was approved by the Bioethics Committee of the Pomeranian Medical University. The study was performed between July 2005 and March 2007. CONCLUSIONS: (1) Self-care in women with infertility is adequate. (2) Women with infertility usually expect professional support from a physician; the role of the nurse is undervalued. Thus, the role of the nurse and midwife needs further promotion.

The practice gap in the care of women following successful infertility treatments: unasked research questions in midwifery and nursing.

The aim of this paper is to highlight the gap between existing research evidence and nursing and midwifery practices in caring for women following successful in vitro fertilization (IVF) and gamete intrafallopian transfer (GIFT), and to suggest directions for research within these disciplines. We argue that although the number of couples in the UK experiencing fertility problems has risen, 1.4% of all births in the UK are as the result of infertility treatments (HFEA, 2005/2006); yet there is little research into the experiences of motherhood for women who successfully achieve pregnancy following IVF or GIFT. Consequently, there is negligible research evidence for nurses and midwives practicing in this area, and British healthcare staff appear to be unaware of the specific needs of infertile women during pregnancy, birth and early motherhood. In this paper we review the existing literature on this group of women, which falls into three areas: studies into the psychosocial development of the child conceived via IVF/GIFT/donor insemination; comparative studies into experiences of women following successful infertility treatment and women who conceive naturally; and studies into the experiences of women following successful IVF treatment. We review this literature to argue for research into the needs of infertile women following successful IVF/GIFT, to inform evidence for practice.

A suggestion for the role of infertile woman and support.

Data were collected in semi-structured interviews with four women who have experienced infertility treatments and the results were analyzed based on their expressed feelings, particularly the support they demanded from their nursing attendants. We came to five conclusions: Feeling imperfect; Feeling the pressure of achievement from their families and future; Infertility treatments have no guarantees and the medical attendants are also uncertain; They feel that they undergo infertility treatments alone but the support of a fellow patient helps them; Infertility treatments have an age limit so the patients worry about time.