Who is at risk of emotional problems and how do you know? Screening of women going for IVF treatment
Authors: Verhaak, C.M.; Lintsen, A.M.E.; Evers, A.W.M.; Braat, D.D.M.
Source: Human Reproduction, Volume 25, Number 5, 22 May 2010 , pp. 1234-1240(7)
Publisher: Oxford University Press
Abstract:BACKGROUNDFertility problems are accompanied by a lot of emotional distress, resulting in a considerable proportion of female patients showing severe maladjustment after assisted reproductive technology. Although this interferes with their daily life, emotional distress has also shown to be related to dropout of treatment and deterioration of health behaviour. Early identification of women at risk enables the provision of timely psychosocial support and the focusing psychosocial resources on those who need it most. This study investigated the psychometric characteristics of a screening tool SCREENIVF to identify women at risk of emotional problems at an early stage of treatment.METHODSRisk factors for emotional maladjustment were identified in a previous study and incorporated in SCREENIVF which consists of 34 items on general and infertility specific psychological factors. A group of 279 women in their first IVF treatment cycle completed SCREENIVF at both pretreatment and 34 weeks after the pregnancy test. Linear Regression analyses were performed to investigate the predictive value of SCREENIVF, and sensitivity and specificity as well as likelihood ratios were described.RESULTSSCREENIVF successfully identified 75 of the patients as at risk or not at risk. The negative predictive value was high: 89. The positive predictive value was low (48 in the total sample and 56 after unsuccessful treatment). Sensitivity was 69, specificity was 77.CONCLUSIONSFor its use as a first screening for emotional problems, SCREENIVF is an acceptable instrument to identify women at risk. These women could be offered more detailed diagnostics e.g. an interview to further investigate to what extent they could benefit from psychological treatment. In addition, physicians can anticipate on this risk profile when communicating with these patients.
Document Type: Research article
Publication date: 2010-05-22
- Human Reproduction features full-length, peer-reviewed papers reporting original research, clinical case histories, as well as opinions and debates on topical issues. Papers published cover the scientific and medical aspects of reproductive physiology and pathology, endocrinology, andrology, gonad function, gametogenesis, fertilization, embryo development, implantation, pregnancy, genetics, genetic diagnosis, oncology, infectious disease, surgery, contraception, infertility treatment, psychology, ethics and social issues. The highest scientific and editorial standard is maintained throughout the journal along with a rapid rate of publication.