Current Status And Relationship Of Cognitive Emotional Regulation,Infertility-related Stress And Stigma In Female IVF-ET Patients

Objective:Stigma is an important factor in the physical and mental impairment of female infertility patients undergoing ivf/embryo transfer.This paper investigated the status and correlation of stigma,cognitive emotion regulation strategy and fertility related pressure in female ivf-et patients,discussed the influencing factors of stigma,and tested the mediating effect of cognitive emotion regulation strategy on fertility related pressure and stigma.In addition,interviews were conducted to understand the application status of cognitive emotion regulation strategies in female ivf-et patients,to further explain and verify the role of cognitive emotion regulation strategies in regulating stigma in ivf-et patients,so as to provide reference for developing intervention measures to prevent or alleviate stigma in female ivf-et patients.Methods:A hybrid approach was adopted in this study.The volume study adopted convenience sampling method to select 572 female ivf-et patients who met the research standards from January to September 2019 in the reproductive medicine department of a third-grade a hospital in kunming city for questionnaire survey.The general information questionnaire,the fertility related stress questionnaire,the cognitive emotion regulation strategy questionnaire and the stigma scale of female infertility patients were used to carry out the questionnaire.Using SPSS 25.0 statistical analysis,using the mean,standard deviation,variance analysis,Pearson correlation analysis,stepwise regression analysis,the Bootstrap sampling method and other methods for statistical analysis and description of IVF-ET shame,birth female patients disease pressure,the status quo of cognitive emotionregulation strategies,and to explore the correlation of between internal mechanism,as well as the influence factors of the disease in patients with shame.The qualitative study adopted the method of objective sampling,and 14 ivf-et female patients included in the quantitative study were selected as the interview subjects.The interview data were analyzed by means of semi-structured interview and template analysis.Results:1.The average total stigma score of female ivf-et patients was(70.81±21.38),and the items in each dimension were: social withdrawal(3.13±0.96),self-derogatory(2.62±1.03),family insult(2.46±0.84),and surrounding group insult(2.45±0.87).Disease shame scores on social and demographic data(different patients/spouse residence,culture degree,occupation,personal monthly income)and disease related information(reproductive history,marriage time,infertility,cause of infertility,the types of family life,before treatment,whether patients are only daughter,whether want to birth boy,whether more willing to communicate with patients rather than family or friends,whether or not bearing pressure mainly comes from the husband/in-laws/their parents/neighbor friends and colleagues)differences statistically significant(P < 0.05).2.The average total score of fertility related stress in female ivf-et patients was(159.42±30.30),and the scores of all dimension items were averaged: parental role demand(4.37±0.91),rejection of childless lifestyle(4.08±1.01),marital relationship(3.15±0.68),social pressure(3.00±0.89),and sexual pressure(2.71±0.92).3.IVF-ET women with cognitive emotion regulation strategies,nine factors divide entries from big to small order are: self blame(3.48 + 0.75)points,accepting(3.26 + 0.58),meditation(3.23 + 0.77)points,refocus plan(2.99-0.73),positive to refocus on(2.85 +0.60)points,disaster(2.82 + 0.67),positive reappraisal(2.81 + 0.71)points,rational analysis(2.69 + 0.45)(2.28 + 0.65)points,blame others.4.The total score of stigma and its 4 dimensions in female ivf-et patients were positively correlated with the total score of fertility related stress and its 5 dimensions(P<0.01).The total score of stigma was negatively correlated with the five factors of acceptance,positive re-attention,re-attention plan,positive re-evaluation and rationalanalysis in the cognitive emotion regulation strategy(P<0.01),and positively correlated with the four factors of self-accusation,meditation,catastrophization and blaming others(P<0.01).The total score of fertility related stress was negatively correlated with the 4factors of positive re-attention,re-attention plan,positive re-evaluation and rational analysis in the cognitive emotion regulation strategy(P<0.01),and positively correlated with the 4 factors of self-censure,meditation,disaster-making and censure others(P<0.01).5.Patients with fertility pressure total score,self criticism,meditation,positive attention again,a renewed focus on planning,positive reappraisal,patients and family members want to birth boy,whether stress mainly comes from her husband,patient patients to breed pressure is mainly comes from personal monthly income,therefore,patients live 11 women with variable is IVF-ET disease shame predictors of the total score.6.The mediating effects of self-censure,meditation,positive reevaluation,positive re-attention and re-attention plan on the fertility related stress and stigma in female ivf-et patients were 21.54%,15.31%,3.92%,3.52% and 3.12%,respectively.7.Qualitative research,according to the results of self criticism of cognitive emotion regulation strategies,meditation,disaster tendency of IVF-ET female patients have more shame experience,show positive attention,a renewed focus on planning,positive reappraisal tendency of disease in patients with less shame experience,and whether patients accept,rational analysis,blame others tend to be shame experience has no obvious correlation with disease.Conclusion:1.Stigma in female ivf-et patients is prevalent and serious,and is affected by patients' socio-demographic factors and disease-related factors;2.Female ivf-et patients are under relatively high pressure related to fertility.The commonly used cognitive emotional regulation strategies are,in turn,self-censure,acceptance,meditation,re-attention plan,positive re-attention,disaster-ization,positive re-evaluation,rational analysis,and censure of others.3.Stigma in female ivf-et patients was positively correlated with childbearing relatedstress;Stigma and childbearing related stress were positively correlated with self-censure,rumination,catastrophization and censure of others in cognitive emotion regulation strategies,and negatively correlated with positive re-attention,re-attention planning,positive re-evaluation and rational analysis.4.Female patients with ivf-et can positively predict stigma through fertility related stress,self-censure and meditation,and negatively predict stigma through positive re-attention,re-attention planning and positive re-evaluation.At the same time,self-censure,meditation,positive re-focus,re-focus planning and positive re-evaluation play a part in mediating the relationship between child-related stress and stigma.5.The stigma of female ivf-et patients can be improved from the social level,the medical care level and the individual level.