The Illness Experience Of Women With Premature Ovarian Insufficiency:A Qualitative Study

Background: Premature ovarian insufficiency(POI)is defined as a cessation of ovarian function before the age of 40 years.It is characterized by menstrual disorders,raised gonadotropins and low estradiol.In recent years,the prevalence is gradually rising.There is a tendency in younger population of POI.Previous studies have shown that POI can lead to psychological problems in women such as depression,anxiety,low self-esteem,which seriously affect the quality of life of women.Illness experience refers to the feeling of the patients' physical symptoms and the attitude towards disease,in addition,it also involves the interaction between patients and medical staff.However,investigative study is difficult to fully cover the patient's feelings and experiences regarding this disease,at present,only a small number of qualitative studies from abroad have discussed the experience and emotional needs of patients with POI,and there are few domestic studies involving in the research of this topic.Objective: The purposes of this study were to gain insight into the illness experience of women with POI,to understand how they perceived and coped with this disease,so as to increase the understanding of clinical staff to this population,and provide scientific basis for clinical intervention and social support.Methods: Descriptive phenomenology was used.Women with POI were recruited via purposive sampling at the reproductive clinic of a general hospital in Wuhan.In-depth,face-to-face,semi-structured interviews were conducted with these participants.After the interview,the researcher listened repeatedly to the recordings and transcribed them verbatim into word text within twenty-four hour and wrote bracketing notes.The Colaizzi's analysis method was used for data analysis.The collection,transcription and analysis of information were carried out simultaneously.The researcher continued to gather data until the stage when the concepts and progress for the possible answer to the research question start to repeat(when the research reaches the saturation point).Results: A total of 19 women were interviewed in this study.We identified six themes and seventeen sub-themes.The first theme was "Delay in the diagnosis",which included two sub-themes: "Insensitive to the symptoms of POI" and "Inadequate awareness of the severity".The second theme was "Complicated response when diagnosed",which contained three sub-themes: "Shock and doubt","Look for causal factors" and "Have no choice but to accept the fact".The third theme was "Suffer physical and psychological pressure",which comprised five sub-themes: "Physical changes","Conceiving difficulty","An altered body image","Economic burden" and "Worry about the side effects of treatments".The fourth theme was "Positive coping strategies",which included three sub-themes: "Change the lifestyle","Choose to resign" and "Adjust emotion".The fifth theme was "Lack of social support",which comprised two sub-themes: "Family members' concern and support" and "Medical staff's support".The last theme was "Patients' care needs",which contained two subthemes: "Needs for hospitals" and "Needs for society".Conclusion: This study demonstrates that the illness experience of women with POI.For many diagnosed women,the initial symptoms of POI are often overlooked.Women with POI not only suffer from physical uncomfortable,but also face psychological burdens due to conceiving difficulty,sexual disorders,early aging.The symptoms of POI are obscured.Therefore,it is necessary to strengthen the publicity and popularization of POI and improve the sensitivity to the symptoms of POI.Clinical staff are expected to provide women with POI with emotional support and information guidance according to a woman's own needs,preferences and expectations.Attention should be paid to improve the physical and mental health of women with POI,so as to improve their quality of life.