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The effectiveness of a mindfulness-based program on stress, salivary cortisol level, marital relationships, and the incidence of successful pregnancy in infertile couples undergoing assisted reproductive treatment: mixed methods |
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| รหัสดีโอไอ | |
| Title | The effectiveness of a mindfulness-based program on stress, salivary cortisol level, marital relationships, and the incidence of successful pregnancy in infertile couples undergoing assisted reproductive treatment: mixed methods |
| Creator | Chalermsri Kerdmakmee |
| Contributor | Puangpaka Kongvattananon, Advisor |
| Publisher | Thammasat University |
| Publication Year | 2568 |
| Keyword | Mindfulness, Infertile, Assisted reproductive treatment, Stress, Salivary cortisol, Marital relationship, การเจริญสติ, ภาวะการมีบุตรยาก, การรักษาด้วยเทคโนโลยีเจริญพันธุ์, ความเครียด, คอร์ติซอลในน้ำลาย, สัมพันธภาพคู่สมรส |
| Abstract | Women and spouse underwent assisted reproductive treatment(ART), they were uncertain for a stressful during treatment. The ART treatment effect the relationship between the couples and their increasing stress towards the success of infertility treatment. The purpose this study was a mixed methods explanatory sequential research design to study the effectiveness of a mindfulness-based program on stress, salivary cortisol level, marital relationships, and the incidence of successful pregnancy in infertile couples undergoing assisted reproductive treatment between 1 December 2022 and 30 April 2023. In Phase1,The study was a randomized controlled trial (RCT) to study the effectiveness of a mindfulness-based program. The sample group was a ramdom assigment by the straty and consisted of 75 women undergoing treatment for infertility and their spouses, divided into a control group with usual nursing care only (37 couples) and an experimental group with usual nursing care combined with mindfulness-based program (38 couples). The instruments included Fertility Problem Inventory for stress measurement were CVI , alpha conbath resplety and the dyadic adjustment scale (DAS) were CVI , alpha conbath resplety used to measure marital relationship quality. Repleted measure MANOVA was used to test the effects of mindfulness-based program on stress and marital relationships in infertile women and their spouses when measured over time. The salivary cortisol of women undergoing treatment for infertility was analyzed by independent t-test. The difference in pregnancy success was analyzed by Chi-square test. The results found that the stress and marital relationship in both the infertile women yielded a statistically significant difference over time between the experimental and the control groups (p=.000). Whereas, the stress and marital relationship in the spouses of infertile women revealed a statistically significant difference over time between the experimental and the control groups (p=.000). The one-way repeated measures multivariate analysis of variance (MANOVA) measurement was repeated, during each period of time showed that Time 1 (base time), Time 2, Time 3, and Time 4 had statistically significant differences in the experimental group of at least one pair (F=2005.241, p=.000 and F=85.816, p=.000 respectively). The t-test revealed that the salivary cortisol level in infertile women in the experimental group and the control groups were statistically significant different (p=.009). For the successful pregnancy rate in infertile women after embryo transfer, there was a statistically significant difference between the experimental group and the control groups (ꭓ2=0.417, p=.041).In Phase 2, The study was a qualitative research to study the experiences of women and spouse underwent treatment for infertility after participating in the mindfulness-based program. The purposive sampling was selected including 7 successful of pregnancy and 5 couples unsuccessful of pregnancy. Data were collected through face-to-face, in-depth interviews and analyzed by content analysis. The trustworthiness applied triangulation member checking . The study finding three main theme that were: Theme 1) Be a strong-minded person , consisting of 5 sub-themes: calm and peaceful mind, enjoyment in body and mind, be mindful every moment, have a refuge; something to lean on, and straight to the heart; mental comfort. Theme 2) Be a perfect family, comprising 3 sub-themes: every effort to get pregnant, complete family; perfect family, and happiness to be pregnant, Theme 3) Be a mutual family relationship, consisting of 3 sub-themes: gender role sharing, mutual empathy and family communication.Moreover, this study showed that the mindfulness-based program lower salivary cortisol levels than those in the control group that can improve successful pregnancy in infertile couples. Women and spouse underwent had a lower level of stress and a higher relationship between the couples. As well, women in the experimental group had higher rate of success in getting pregnant when compared to those in the control group. Nurse and health care provider can apply the mindfulness program to enhance successful pregnancy in infertile couples. |
