Smartphone-supported Positive Adjustment Coping Intervention (PACI) for couples undergoing fertility treatment: a randomised controlled trial protocol

Maren Schick, Sabine Roesner, Ariane Germeyer, Markus Moessner, Stephanie Bauer, Beate Ditzen, Tewes Wischmann, Maren Schick, Sabine Roesner, Ariane Germeyer, Markus Moessner, Stephanie Bauer, Beate Ditzen, Tewes Wischmann

Abstract

Introduction: Infertility generally counts as a profound crisis in the lives of couples and as an emotionally stressful experience. For couples undergoing fertility treatment, this is especially true of the waiting period following embryo transfer, which couples say is the most stressful period during treatment. However, at this specific phase, psychosocial counselling is not always available on the spot. The aim of this randomised controlled trial (RCT) study was to test the Positive Adjustment Coping Intervention (PACI), a low-dose, smartphone-supported psychological intervention for women and men undergoing fertility treatment.

Methods and analysis: The effectiveness of PACI is tested by means of a prospective two-arm RCT. During the 14-day waiting period between oocyte puncture/oocyte thawing and pregnancy test, participants are randomly assigned to one of the two groups, and both women and men receive daily text messages on their smartphones. One group receives text messages with statements reflecting positive-adjustment coping attitudes, the other group messages containing cognitive distractions. The primary outcome of this study is the reduction of psychosocial burden during the waiting period of reproductive treatment. Furthermore, we want to assess whether there are differences between the interventions in a pre-post assessment. The secondary outcomes are information on perceived effectiveness and practicability of the intervention one month after the waiting period.

Ethics and dissemination: Ethical approval has been obtained from the Ethics Committee of Heidelberg University Faculty of Medicine (S-074/2017). Study findings are planned for dissemination via peer-reviewed journal articles and at national and international conferences.

Trial registration number: NCT03118219; Pre-results.

Protocol version: Version 2.0 dated 18/02/2019.

Keywords: assisted reproductive technology; embryo transfer; online intervention; randomised controlled trial (RCT); smartphone-supported intervention; waiting period.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1
Figure 1
Positive Adjustment Coping Intervention: schedule of enrolment, interventions and assessments.
Figure 2
Figure 2
Positive Adjustment Coping Intervention: flow chart.

References

    1. Peddie VL, Porter M. Limitations of infertility treatment: psychological, social and cultural. Therapy 2007;4:313–22. 10.2217/14750708.4.3.313
    1. Wischmann T. Einführung Reproduktionsmedizin: Medizinische Grundlagen – Psychosomatik – Psychosoziale Aspekte. München, Basel: Reinhardt, 2012.
    1. Greil AL, Slauson-Blevins K, McQuillan J. The experience of infertility: a review of recent literature. Sociol Health Illn 2010;32:140–62. 10.1111/j.1467-9566.2009.01213.x
    1. Schmidt L. Social and psychological consequences of infertility and assisted reproduction - what are the research priorities? Hum Fertil 2009;12:14–20. 10.1080/14647270802331487
    1. Sezgin H, Hocaoglu C, Guvendag-Guven ES. Disability, psychiatric symptoms, and quality of life in infertile women: a cross-sectional study in Turkey. Shanghai Arch Psychiatry 2016;28:86–94. 10.11919/j.issn.1002-0829.216014
    1. Cousineau TM, Domar AD. Psychological impact of infertility. Best Pract Res Clin Obstet Gynaecol 2007;21:293–308. 10.1016/j.bpobgyn.2006.12.003
    1. Fisher JR, Baker GH, Hammarberg K. Long-term health, well-being, life satisfaction, and attitudes toward parenthood in men diagnosed as infertile: challenges to gender stereotypes and implications for practice. Fertil Steril 2010;94:574–80. 10.1016/j.fertnstert.2009.01.165
    1. Jaffe J, Diamond MO, Trauma R. Psychotherapy with infertility and pregnancy loss clients. Washington: American Psychological Association, 2010.
    1. Edelmann RJ, Connolly KJ. Gender differences in response to infertility and infertility investigations: Real or illusory. Br J Health Psychol 2000;5:365–75. 10.1348/135910700168982
    1. Gameiro S, Boivin J, Dancet E, et al. . ESHRE guideline: routine psychosocial care in infertility and medically assisted reproduction-a guide for fertility staff. Hum Reprod 2015;30:2476–85. 10.1093/humrep/dev177
    1. Verhaak CM, Smeenk JM, Evers AW, et al. . Predicting emotional response to unsuccessful fertility treatment: a prospective study. J Behav Med 2005;28:181–90. 10.1007/s10865-005-3667-0
    1. Verhaak CM, Lintsen AM, Evers AW, et al. . Who is at risk of emotional problems and how do you know? Screening of women going for IVF treatment. Hum Reprod 2010;25:1234–40. 10.1093/humrep/deq054
    1. Ockhuijsen HDL, van Smeden M, van den Hoogen A, et al. . Validation study of the SCREENIVF: an instrument to screen women or men on risk for emotional maladjustment before the start of a fertility treatment. Fertil Steril 2017;107:1370–9. e1375 10.1016/j.fertnstert.2017.04.008
    1. Lopes V, Canavarro MC, Verhaak CM, et al. . Are patients at risk for psychological maladjustment during fertility treatment less willing to comply with treatment? Results from the Portuguese validation of the SCREENIVF. Hum Reprod 2014;29:293–302. 10.1093/humrep/det418
    1. Osuna EE. The psychological cost of waiting. J Math Psychol 1985;29:82–105. 10.1016/0022-2496(85)90020-3
    1. Boivin J, Lancastle D. Medical waiting periods: imminence, emotions and coping. Womens Health 2010;6:59–69. 10.2217/whe.09.79
    1. Drageset S, Lindstrøm TC. Coping with a possible breast cancer diagnosis: demographic factors and social support. J Adv Nurs 2005;51:217–26. 10.1111/j.1365-2648.2005.03495.x
    1. Parker J, Kennedy P. Factors predictive of distress in people awaiting a lower gastro-intestinal endoscopy. Psychol Health Med 2010;15:26–33. 10.1080/13548500903440221
    1. Wischmann T. Implications of psychosocial support in infertility--a critical appraisal. J Psychosom Obstet Gynaecol 2008;29:83–90. 10.1080/01674820701817870
    1. Hämmerli K, Znoj H, Barth J. The efficacy of psychological interventions for infertile patients: a meta-analysis examining mental health and pregnancy rate. Hum Reprod Update 2009;15:279–95. 10.1093/humupd/dmp002
    1. van Dongen AJCM, Nelen WLDM, IntHout J, et al. . e-Therapy to reduce emotional distress in women undergoing assisted reproductive technology (ART): a feasibility randomized controlled trial. Hum Reprod 2016;31:1046–57. 10.1093/humrep/dew040
    1. Wischmann T, Thorn P. Psychosoziale Kinderwunschberatung in Deutschland - Status Quo und Erfordernisse für eine bessere Konzeptualisierung, Implementierung und Evaluation. Bericht für das Bundesfamilienministerium. Berlin: BMFSFJ, 2012.
    1. Lancastle D, Boivin J. Dispositional optimism, trait anxiety, and coping: unique or shared effects on biological response to fertility treatment? Health Psychol 2005;24:171–8. 10.1037/0278-6133.24.2.171
    1. Lancastle D, Boivin J. A feasibility study of a brief coping intervention (PRCI) for the waiting period before a pregnancy test during fertility treatment. Hum Reprod 2008;23:2299–307. 10.1093/humrep/den257
    1. Lazarus RS, Folkmann S. Stress, appraisal, and coping. New York: Springer, 1984.
    1. Rockliff HE, Lightman SL, Rhidian E, et al. . A systematic review of psychosocial factors associated with emotional adjustment in in vitro fertilization patients. Hum Reprod Update 2014;20:594–613. 10.1093/humupd/dmu010
    1. Li J, Liu B, Li M. Coping with infertility: a transcultural perspective. Curr Opin Psychiatry 2014;27:320–5. 10.1097/YCO.0000000000000091
    1. Terry DJ, Hynes GJ. Adjustment to a low-control situation: Reexamining the role of coping responses. J Pers Soc Psychol 1998;74:1078–92. 10.1037/0022-3514.74.4.1078
    1. Ockhuijsen H, van den Hoogen A, Eijkemans M, et al. . The impact of a self-administered coping intervention on emotional well-being in women awaiting the outcome of IVF treatment: a randomized controlled trial. Hum Reprod 2014;29:1459–70. 10.1093/humrep/deu093
    1. Ghasemi M, Kordi M, Asgharipour N, et al. . The effect of a positive reappraisal coping intervention and problem-solving skills training on coping strategies during waiting period of IUI treatment: An RCT. Int J Reprod Biomed 2017;15:687–96. 10.29252/ijrm.15.11.687
    1. Ockhuijsen HD, van den Hoogen A, Boivin J, et al. . Exploring a self-help coping intervention for pregnant women with a miscarriage history. Appl Nurs Res 2015;28:285–92. 10.1016/j.apnr.2015.01.002
    1. Bailey S, Bailey C, Boivin J, et al. . A feasibility study for a randomised controlled trial of the Positive Reappraisal Coping Intervention, a novel supportive technique for recurrent miscarriage. BMJ Open 2015;5:e007322 10.1136/bmjopen-2014-007322
    1. Seaton CL. Psychological adjustment. The encyclopedia of positive psychology: Blackwell Publishing. Blackwell Reference Online, 2009.
    1. Ward C, Kennedy A. Acculturation strategies, psychological adjustment, and sociocultural competence during cross-cultural transitions. International Journal of Intercultural Relations 1994;18:329–43. 10.1016/0147-1767(94)90036-1
    1. Phelps C, Bennett P, Iredale R, et al. . The development of a distraction-based coping intervention for women waiting for genetic risk information: a phase 1 qualitative study. Psychooncology 2006;15:169–73. 10.1002/pon.937
    1. Bennett P, Phelps C, Brain K, et al. . A randomized controlled trial of a brief self-help coping intervention designed to reduce distress when awaiting genetic risk information. J Psychosom Res 2007;63:59–64. 10.1016/j.jpsychores.2007.01.016
    1. Phelps C, Bennett P, Hood K, et al. . A self-help coping intervention can reduce anxiety and avoidant health behaviours whilst waiting for cancer genetic risk information: results of a phase III randomised trial. Psychooncology 2013;22:837–44. 10.1002/pon.3072
    1. Wolgast M, Lundh L-G, Viborg G, et al. . Cognitive restructuring and acceptance: an empirically grounded conceptual analysis. Cognitive Therapy and Research 2013;37:340–51. 10.1007/s10608-012-9477-0
    1. Ockhuijsen H, van den Hoogen A, Eijkemans M, et al. . Clarifying the benefits of the positive reappraisal coping intervention for women waiting for the outcome of IVF. Hum Reprod 2014;29:2712–8. 10.1093/humrep/deu253
    1. Domar AD, Gross J, Rooney K, et al. . Exploratory randomized trial on the effect of a brief psychological intervention on emotions, quality of life, discontinuation, and pregnancy rates in in vitro fertilization patients. Fertil Steril 2015;104:440–51. e447 10.1016/j.fertnstert.2015.05.009
    1. Ghasemi Gojani M, Kordi M, Asgharipour N, et al. . Comparison of the effects of a positive reappraisal coping intervention and problem-solving skills training on depression during the waiting period of the result of intrauterine insemination treatment: a randomized control trial. Int J Fertil Steril 2018;12:13–18. 10.22074/ijfs.2018.5155
    1. Schick M, Rösner S, Toth B, et al. . Effects of medical causes, role concepts and treatment stages on quality of life in involuntary childless men. Andrologia 2016;48:937–42. 10.1111/and.12519
    1. Volmer L, Rösner S, Toth B, et al. . Infertile Partners' Coping Strategies Are Interrelated - Implications for Targeted Psychological Counseling. Geburtshilfe Frauenheilkd 2017;77:52–8. 10.1055/s-0042-119200
    1. Ockhuijsen HD, van den Hoogen A, Macklon NS, et al. . The PRCI study: design of a randomized clinical trial to evaluate a coping intervention for medical waiting periods used by women undergoing a fertility treatment. BMC Womens Health 2013;13:35 10.1186/1472-6874-13-35
    1. Faul F, Erdfelder E, Lang AG, et al. . G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 2007;39:175–91. 10.3758/BF03193146
    1. Kindermann S, Moessner M, Ozer F, et al. . Associations between eating disorder related symptoms and participants' utilization of an individualized Internet-based prevention and early intervention program. Int J Eat Disord 2017;50:1215–21. 10.1002/eat.22774
    1. Kenny DA, Judd CM. A general procedure for the estimation of interdependence. Psychol Bull 1996;119:138–48. 10.1037/0033-2909.119.1.138
    1. White IR, Horton NJ, Carpenter J, et al. . Strategy for intention to treat analysis in randomised trials with missing outcome data. BMJ 2011;342:d40 10.1136/bmj.d40

Source: PubMed

3
Předplatit