Resilience acts as a moderator in the relationship between infertility-related stress and fertility quality of life among women with infertility: a cross-sectional study

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Abstract

Background

Infertility-related stress can seriously impact the fertility quality of life (QoL) of infertile women. Resilience, as a coping resource, can effectively combat psychological stress. This study aimed to evaluate the fertility QoL of infertile women and to examine whether resilience moderates the association of infertility-related stress with fertility QoL.

Methods

This cross-sectional study was conducted in northeast of China from December 2017 to February 2018. Out of 559 women outpatients with infertility, 498 (89.1%) completed self-reported questionnaires including the FertiQoL Scale, Fertility Problem Inventory (FPI) and Connor-Davidson Resilience Scale (CD-RISC). Hierarchical multiple regression analysis and simple slope analysis were applied to explore the influencing factors related to fertility QoL as well as to examine the moderating effect of resilience on the association of infertility-related stress with fertility QoL.

Results

The mean FertiQoL score was 64.54 ± 16.90 among the participants. Household monthly income and causes of infertility were significantly related to fertility QoL. In addition, infertility-related stress was negatively related to fertility QoL, and resilience was positively associated with fertility QoL, explaining 36.3% of the variance. Resilience moderated the association of infertility-related stress with fertility QoL. Specifically, the effect of infertility-related stress on fertility QoL varied by low(1 SD below the mean, B = - 0.496, β = - 0.714, P < 0.001), mean ( B = - 0.293, β = - 0.422, P < 0.001) and high (1 SD above the mean, B = - 0.090, β = - 0.130, P < 0.001) levels of resilience. The higher resilience was, the weaker the effect of infertility-related stress on fertility QoL was.

Conclusions

Overall, women with infertility in China had relatively low FertiQoL scores. Resilience influenced the association of infertility-related stress with fertility QoL. Infertile patients’ psychological status must be addressed and adequate resilience-based interventions such as mindfulness-based skills should be provided to improve fertility QoL of women with infertility.

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Most cited references 53

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Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC).

Kathryn M Connor, Jonathan Davidson (2003)

Resilience may be viewed as a measure of stress coping ability and, as such, could be an important target of treatment in anxiety, depression, and stress reactions. We describe a new rating scale to assess resilience. The Connor-Davidson Resilience scale (CD-RISC) comprises of 25 items, each rated on a 5-point scale (0-4), with higher scores reflecting greater resilience. The scale was administered to subjects in the following groups: community sample, primary care outpatients, general psychiatric outpatients, clinical trial of generalized anxiety disorder, and two clinical trials of PTSD. The reliability, validity, and factor analytic structure of the scale were evaluated, and reference scores for study samples were calculated. Sensitivity to treatment effects was examined in subjects from the PTSD clinical trials. The scale demonstrated good psychometric properties and factor analysis yielded five factors. A repeated measures ANOVA showed that an increase in CD-RISC score was associated with greater improvement during treatment. Improvement in CD-RISC score was noted in proportion to overall clinical global improvement, with greatest increase noted in subjects with the highest global improvement and deterioration in CD-RISC score in those with minimal or no global improvement. The CD-RISC has sound psychometric properties and distinguishes between those with greater and lesser resilience. The scale demonstrates that resilience is modifiable and can improve with treatment, with greater improvement corresponding to higher levels of global improvement. Copyright 2003 Wiley-Liss, Inc.

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FACTOR ANALYSIS AND PSYCHOMETRIC EVALUATION OF THE CONNOR-DAVIDSON RESILIENCE SCALE (CD-RISC) WITH CHINESE PEOPLE

Xiaonan Yu, Jianxin Zhang (2007)

This study examines the psychometric properties of the Chinese version of Connor and Davidson's Resilience Scale (CD-RISC; 2003), an American instrument originating from a posttraumatic stress disorder research program. Confirmatory factor analysis of the Chinese data failed to verify the original 5-factor structure of CD-RISC obtained in the USA, while exploratory factor analysis resulted in a 3-factor structure of resilience (labeled respectively as Tenacity, Strength, and Optimism). The reliability coefficient of the Chinese version of CD-RISC was 0.91. The validity of CD-RISC was also satisfying in terms of the actual data matching the expected correlation between resilience measure and the variables of selfesteem, life satisfaction, and personality trait factors of NEO-FFI. It is concluded that the construct of resilience and its measurement from the West can be helpful and applicable in understanding Chinese adaptive behaviors, however, the understanding of the construct may also need some modification according to Chinese culture.

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The experience of infertility: a review of recent literature.

Arthur L Greil, Kathleen S Slauson-Blevins, Julia McQuillan (2010)

About 10 years ago Greil published a review and critique of the literature on the socio-psychological impact of infertility. He found at the time that most scholars treated infertility as a medical condition with psychological consequences rather than as a socially constructed reality. This article examines research published since the last review. More studies now place infertility within larger social contexts and social scientific frameworks although clinical emphases persist. Methodological problems remain but important improvements are also evident. We identify two vigorous research traditions in the social scientific study of infertility. One tradition uses primarily quantitative techniques to study clinic patients in order to improve service delivery and to assess the need for psychological counselling. The other tradition uses primarily qualitative research to capture the experiences of infertile people in a sociocultural context. We conclude that more attention is now being paid to the ways in which the experience of infertility is shaped by social context. We call for continued progress in the development of a distinctly sociological approach to infertility and for the continued integration of the two research traditions identified here.

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Author and article information

Contributors

Yifei Li: lyf4075@126.com

Xin Zhang: 297211797@qq.com

Meng Shi: mshi@cmu.edu.cn

Shuaishuai Guo: shuaishuai197411@sina.com

Lie Wang:

ORCID: http://orcid.org/0000-0002-3910-5825

liewang@cmu.edu.cn

Journal

Journal ID (nlm-ta): Health Qual Life Outcomes

Journal ID (iso-abbrev): Health Qual Life Outcomes

Title: Health and Quality of Life Outcomes

Publisher: BioMed Central (London )

ISSN (Electronic): 1477-7525

Publication date (Electronic): 15 February 2019

Publication date PMC-release: 15 February 2019

Publication date Collection: 2019

Volume: 17

Electronic Location Identifier: 38

Affiliations

[1 ]ISNI 0000 0000 9678 1884, GRID grid.412449.e, Department of Social Medicine, School of Public Health, , China Medical University, ; No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122 China

[2 ]ISNI 0000 0000 9678 1884, GRID grid.412449.e, English Department, School of Fundamental Sciences, , China Medical University, ; No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122 China

[3 ]Reproductive Medicine Center, Shenyang Women’s and Children’s Hospital, No.87 Danan Road, Shenhe Area, Shenyang, 110000 China

Author information

Lie Wang http://orcid.org/0000-0002-3910-5825

Article

Publisher ID: 1099

DOI: 10.1186/s12955-019-1099-8

PMC ID: 6377764

PubMed ID: 30770738

SO-VID: 90e83651-3674-48b7-90bb-1a0fac8753f2

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 10 August 2018

Date accepted : 24 January 2019

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ScienceOpen disciplines: Health & Social care

Keywords: infertility,quality of life,infertility-related stress,resilience,moderating role

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ScienceOpen disciplines: Health & Social care

Keywords: infertility, quality of life, infertility-related stress, resilience, moderating role

Resilience acts as a moderator in the relationship between infertility-related stress and fertility quality of life among women with infertility: a cross-sectional study

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Asian Journal of Quality of Life (AjQoL)

Most cited references 53

Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC).

FACTOR ANALYSIS AND PSYCHOMETRIC EVALUATION OF THE CONNOR-DAVIDSON RESILIENCE SCALE (CD-RISC) WITH CHINESE PEOPLE

The experience of infertility: a review of recent literature.

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