الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Infertility is a deeply distressing experience life event that brings about psychological and social problems to women. Infertility and its related problems negatively affect quality of life of the infertile women. Quality of life (QoL) is influenced by physical health, mental state, personal beliefs, level of independence, as well as socioeconomic, cultural, security, and the environment factors. Scarce researches exist in this regard. Therefore the aim of the present study was to assess quality of life as perceived by infertile women at Tanta city. To fulfill the study’s aim: Setting: The study will be carried out at Obstetrics and Gynecological department and outpatient clinics of Tanta University Hospital. Subjects: A purposive sample of 100 infertile women from Tanta city were included in the study who fulfilled the following inclusive criteria: age ranged from 20-45 years old, married for more than 12 months and have regular unprotected sexual intercourse, free from any medical or psychological problems, have primary or secondary infertility, undergoing to infertility management, and agree to participate in the study. Tools of data collection: To achieve the aim of this study, the following two tools were used for data collection: Tool (I): A structured interview schedule: It was developed by the researcher to collect basic data and it included three parts as follows: Part(1): Biosocial-demographic data of the studied infertile women: It included age, level of education, occupation, family income, residence, type and number of family members, number of rooms (crowding index), duration of marriage, consanguinity, weight, height and body mass index (weight (kg) / height (m2). Part (2): Family history of the studied infertile women: It included presence of hereditary diseases or genetic disorders. Part (3): Obstetrics and gynecological history: It included the following: -Menstrual history: Such as age at menarche, number of socked pad that changed daily, duration, interval, and rhythm of the menstrual cycle. -Reproductive history: Such as gravidity, parity, number of abortion, number of still birth, number of living children, mode and place of past deliveries, and previous complications. -Gynecological history: Such as previous gynecological infection or any previous gynecological operation. -Infertility history: Such as duration, causes, investigations, treatment and previous interventions of infertility. Tool (II): Fertility specific quality of life questionnaire (FertiQOL): This tool will be adapted from Boivin (2009) (123), and used to assess the infertile women’s quality of life. It included 36 questions that covered two parts: (1) the Core, and (2) the Management, as well as two additional items. Part (1): Core-Fertility quality of life questionnaire included 24 questions categorized into four subscales, covered Emotional, Mind/Body, Marital relation, and Social subscales. 1. The Emotional subscale included (6) questions that showed the impact of negative emotions on the infertile woman’s quality of life. 2. The Mind-Body subscale included (6) questions that reported the impact of infertility on physical health of the infertile woman. 3. The Marital Relation subscale included (6) question that revealed the impact of infertility on sexuality, communication and marital relationship of infertile women. 4. The Social subscale included (6) questions that illustrated the extent to which infertility problems affected social interactions. Part (2): Management Fertility quality of life questionnaire contained 10 questions categorized into two subscales including: management environment subscales and management tolerability subscales. 1- The Management Environment subscale included (6) questions that showed the extent to which the accessibility and quality of the treatment has impacted the quality of life. 2- The Management Tolerability subscale included (4) questions that revealed the extent to which the infertile woman had experienced mental and physical symptoms as a result of the fertility treatment and their impact on quality of their daily life. 3- The Two additional items are marked as (A and B on the FertiQoL questionnaire). They captured an overall evaluation of physical health and satisfaction with quality of life. The results of the current study can be summarized as follows: - The socio-demographic characteristics of women: More than one third (39.0%) of the studied infertile women aged >25-30 years with a mean age 27.45±4.79. More than two fifths of them (44.0%) were married at age between ≥20-24 years old with a mean 23.33±4.52. Nearly one half (48.0%) of the studied infertile women had university education and the minority (9%) of them were read and write. - Obstetrics and gynecological history of the studied infertile women: The mean age of menarche of the studied infertile women was (12.64±1.19) and the mean duration of menstrual cycle among them was (35.10±10.06). The duration of menstruation among more than one half (53.0%) of the studied infertile women was (5-7) days. There was (17.0%) of the studied infertile women had previous pregnancy, (8.0%) of them had previous deliveries and (9.0%) had previous abortion. More than four fifths (87.5%) of the studied infertile women who had previous deliveries had no complications during delivery. - Infertility history and previous intervention among the studied infertile women. There was (1.0%) of the studied infertile women made MRI. More than one quarter (27.0%) of the studied infertile women had invetro fertilization (IVF), and (3.0%) of them made intrauterine insemenation. - Overall evaluation of the studied infertile women in relation to their physical health and satisfaction with quality of life: There was three-fifths (60.0%) of the studied infertile women had good health and nearly one tenth (9.0%) had very good health. Slightly more than one half (51.0%) of the studied infertile women were satisfied with their quality of life and nearly one third (30.0%) of them were neither satisfied nor dissatisfied. - Overall quality of life of the studied infertile women: The majority (91.0%) of the studied infertile women had fair emotional quality of life, nearly one tenth (8.0%) had poor emotional quality of life, while only (1.0%) of them had good emotional quality of life. A significant correlation was found between emotional quality of life subscale and body mass index of the studied infertile women (p=0.005*) A significant correlation was also observed between emotional subscale and age in years of the studied infertile women (p=0.001*). Finally, there was no significant correlation between quality of life subscales and age at menarche of the studied infertile women. Conclusion Based on the findings of the present study, it can be concluded that the research question of the present study has been answered regarding quality of life as perceived by the studied infertile women at Tanta city. It was very evident that: Infertility had fair impact on all aspects of the studied woman’s quality of life. The majority of the studied infertile women had fair emotional quality of life. Slightly more than two thirds of them had fair mind-body quality of life. Nearly one third of the studied infertile women had poor mind-body quality of life. Nearly one third of them had poor marital relation quality of life. The majority of the studied infertile women had fair social quality of life. There was a significant positive correlation between age and body mass index of the studied infertile women. Finally, there was a significant positive correlation between age and emotional quality of life of the studied infertile women. Recommendations: Based on the findings of the present study, the following recommendations are derived and suggested: I) Recommendations for basic nursing education: - The importance and effectiveness of improving quality of life of infertile women should be included in the curriculum of all levels of nursing education. - The maternity nurses should conduct health education to infertile women about healthy life style and health promotion through seeking methods of infertility management, in order to improve their quality of life. II) Recommendations for hospitals, and maternal and child health centers’ administration: - Refreshing courses, pre-service and in-service training programs should be provided to nurses of different job categories to improve their skills regarding infertility management. - Constant supervision by the Ministry of Health and Population through Council Health Management Teams to improve quality of life counselling provided by nurses toward supporting infertile women. - Conduct conferences, workshops and continuous training for healthcare providers about their role in infertility management to improve quality of life of the infertile women. - Develop guidelines for nurse’s role in infertility clinics and primary healthcare settings. III) Recommendations for nurses: - Nurses and other healthcare providers should provide comprehensive sensitive competent nursing care and emotional support for the infertile women, as well as their couples and family members to enhance their quality of life. IV) Recommendations for public health education: - Mass media and community organizations should be utilized for dissemination of simple, correct and relevant information about supporting infertile women and improving their quality of life. - Increase the community awareness about the infertility problems, infertile women’s needs, and suffering to encourage public support for infertile women and their partners. V) Recommendations for further studies: Further studies are needed to: - Assess effect of health education program regarding advances in infertility management on quality of life of infertile women. - Assess effect of individualized coping strategies on quality of life of infertile women. - Identify barriers that hinder the treatment journey of infertile couples.