The feasibility and effects of a 'partnership and coping enhancement programme (PCEP)' for couples undergoing in vitro fertilization treatment

xix, 365 pages : color illustrationsPolyU Library Call No.: [THS] LG51 .H577P SN 2017 YingBackground: Couples undergoing In Vitro Fertilization (IVF) Treatment suffer as dyads from the stressful experience of the painful treatment and the fear that the cycle will fail. In the process of treatment, couples have experienced elevated emotional distress, particularly during the waiting period before pregnancy test. The failed IVF cycle had long-term negative psychological consequences on both spouses. They are likely to report that their marital relationship has become unstable due to the prolonged period of treatment. Mental health status and marital relationship of couples can be strained and there is a need for a supportive intervention to improve the psychological well-being and marital relationship of couples undergoing IVF treatment. Aim: This is a feasibility study to examine the effects of a 'Partnership and Coping Enhancement Programme (PCEP)' on improving the psychological well-being and marital functions of the couples undergoing In Vitro Fertilization treatment. Methods: The Medical Research Council (MRC) framework for developing and evaluating the complex intervention was adopted to guide the development of the Partnership and Coping Enhancement Programme (PCEP). This project conducted the first two stages of the process of the development-evaluation-implementation of a complex intervention, namely, the development and piloting of the intervention. In developing the PCEP, three steps were taken, namely: (1) identifying evidence by conducting literature reviews, a concept analysis, and a qualitative study; (2) identifying / developing a theory: in this case, a preliminary Endurance with Partnership Conceptual Framework (P-EPCF) was proposed; and (3) modelling the process and outcomes of the PCEP.In the stage of piloting, the acceptability and preliminary effects of the 'Partnership and Coping Enhancement Programme (PCEP)' were examined by a feasibility study with quasi-experimental controlled design. A total of 100 couples (100 males and 100 females) were recruited consecutively and assigned to a PCEP intervention group or a routine care control group. Couples in both groups received three 30 min-sessions of health teaching on medical information related to the treatment, while the PCEP group also received an additional face-to-face, couple-based, 90 min-session on enhancement of partnership and coping on the day of embryo transfer (ET). The programme consists of experience sharing, psycho-education, meditation exercise, skill practice, and supplemental written materials. The dyadic outcome measures were: psychological well-being (anxiety and depression) and marital benefits (marital satisfaction and marital adjustment). The partnership mediator and dyadic coping were also measured. The outcome measures were assessed at baseline (T0), 10 days after the ET (T1), and one month after the ET (T2). Results: The recruitment rates were 94.3% and 87.7% for intervention group and control group respectively. In the intervention group, the retention rates for T1 and T2 assessment were 88% and 82%, while the corresponding retention rates in the control group were 92% and 80%. Significant improvements were seen in partnership and dyadic coping in women at one month after embryo transfer (T2). The level of anxiety of the women was lower in the intervention than control group at waiting period (T1). The men of infertile couples only reported significantly improvement in the scores of partnership at T2. The effect sizes (Cohen's d) for these variables ranged from 0.42 to 0.46. Conclusion: The findings of this feasibility study indicated that the PCEP is feasible and acceptable for couples undergoing IVF treatment. Improvement in the dosage and the various components of the intervention are to be considered, before a full-range and multi-centered randomized controlled trial is needed to further confirm the effectiveness of the PCEP.School of NursingPh.D., School of Nursing, The Hong Kong Polytechnic University, [2017]Doctorat