İnfertilitede Birey-Çift ve Grup Danışmanlığı

Bir çiftin biyolojik çocuk sahibi olma yeteneğine sahip olmadıklarını öğrenmeleri, beklenmedik, stresli ve hayatlarını değiştirecek bir deneyim olmaktadır. Genel nüfus ile karşılaştırıldığında, infertilite ve infertilite tedavisi sürecinde olan bireylerde kaygı, sıkıntı, depresif belirtiler, azalmış benlik saygısı ve azalmış cinsel tatmin daha fazla görülmektedir. Kadında depresyon, anksiyete, cinsel fonksiyon bozukluğu artmakta, duygusal iyilik hali ve yaşam kalitesi olumsuz yönde etkilenmektedir. Erkek kaynaklı infertilite tedavisinde, erkekler de düşük benlik saygısı, özgüven kaybı, beceriksizlik düşüncesi, izolasyon, yalnızlık, suçluluk, korku, öfke, utanç, hayal kırıklığı gibi sorunlar yaşayabilmektedir. Danışmanlık, birey/çiftin yaşadığı üzüntü ve suçlulukla ilgili sorunların ifade edilmesini ve baş etme mekanizmalarını kullanabilmesini, eşlerin birbirlerini desteklemesini, ortak kararlar alınmasını ve cinsiyet faklılıklarından kaynaklanan sorunların çözümünü sağlayacaktır. Danışmanlık verecek ekipte hekim, embriyolog, infertilite hemşiresi ile birlikte psikolog, psikoterapist, psikiyatrist de bulunmalıdır. İnfertilite tedavi ekibinin önemli üyelerinden biri olan hemşireler, infertil birey/çiftlerin yaşadıkları bu zor süreçte sağladıkları hümanistik bakım ile anahtar rol oynamaktadır.

Individual, Couple and Group Counseling in Infertility

For a couple, facing the reality of not being able to have a biological baby is an unexpected and stressful situation that makes them totally change their lives. When compared with the general population, infertility and its treatment make the infertile couples experience anxiety, depression, a low quality of life, and sexual dysfunction. Infertility causes women to experience depression, anxiety, and sexual desire disorders, and their quality of life and emotional wellness can be affected in negative ways as well. Men who have undergone infertility treatment can feel emotional deprivation, low self-esteem, a loss of confidence, incompetence, loneliness, guilt, fear, anger, shame and disappointment. Counseling will help couples cope with their feelings of sorrow and grief that have resulted from being infertile. Counseling will also help them use defense mechanisms in order to support each other, make co-decisions and solve the problems caused by gender differences. The infertility counseling team must consist of physicians, embryologists, and infertility nurses along with psychologists, psychotherapists, and psychiatrists. Nurses are one of the most important members of the infertility team and play a key role in providing humanistic care to infertile individuals and couples during this difficult process

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1. Repokari L, Punamaki RL, Unkila-Kallio L, Vilska S, Poikkeus P, Sinkkonen J, et al. Infertility treatment and marital relationships: A one-year prospective study among successfully treated ART couples and their controls. Hum Reprod 2007; 22:1481-1491.
2. Peterson BD, Newton CR, Rosen KH. Examining congruence between partners perceived infertility-related stress and its relationship to marital adjustment and depression in infertile couples. Fam Process 2003; 42:59-70.
3. Eugster A, Vingerhoets AJJM. Psychological aspects of in vitro fertilization: a review. Soc Sci Med 1999; 48:575589.
4. Rashibi B, Montazeri A, Ramezanzadeh F, Shariat M, Abedinia N, Ashrafi M. Health-related QOL in infertile couples receiving IVF or ICSI treatment. BMC Health Serv Res 2008;8:186. doi:10.1186/1472-6963-8-186.
5. Montazeri A. Infertility and Health-Related QOL: A minireview of the literature. J Fam Reprod Health 2007; 1(2):55-58.
6. Verhaak CM, Smeenk JMJ, Evers AWM, Kremer JAM, Kraaimant FW, Braat DDM. Womens emotional adjustment to IVF: A systematic review of 25 years of research. Hum Repord Update 2007; 13:27-36.
7. Broeck UV, Emery M, Wischmann T, Thorn P. Counseling in infertility: Individual, couple and group interventions. Patient Education and Counseling 2010; 81:422428.
8. Carter J, Applegarth L, Josephs L, Grill E, Baser ER, Rosenwaks Z. A cross-sectional cohort study of infertile women awaiting oocyte donation: The emotional, sexual and quality of life impact. Fertility and Sterility 2011; 95(2):711-716.
9. Applegarth LD. Individual counseling and psychotherapy. In: CR Newton, editor. Counseling the infertility couple. A comprehensive handbook for clinicians. Second edition. Cambridge University Press; 2006. pp.129-141.
10. Cousineau TM, Domar AD. Psychological impact of infertility. Best Pract Res Clin Obstet Gynaecol 2007; 21:293-308.
11. Donkor ES, Sandal J. The impact of perceived stigma and mediating social factors on infertility related stress among women seeking infertility treatment in South Ghana. Soc Sci Med 2007; 65:1683-1684.
12. Ahuja M. Counseling in infertility. South Asian Federation of Obstetrics and Gynecology May-August 2009; 1(2):38-43.
13. Burnett AJ. Cultural consideration in counseling couples who experiences infertility. Journal of Multicultural Counseling and Development 2009; 37:168-177.
14. Coşkun A, Yılmaz S, Yılmaz T. İnfertil çiftlerde eğitim ve danışmanlık süresi, hemşirelik yaklaşımı. N Kızılkaya Beji, editör. İnfertilite Hemşireliği. İstanbul: Acar Basım ve Cilt San; 2009. ss. 147-162.
15. Yanıkkerem E, Kavlak O, Sevil Ü. İnfertil çiftlerin yaşadıkları sorunlar ve hemşirelik yaklaşımı. Atatürk Üniversitesi Hemşirelik Yüksekokulu Dergisi, 2008; 11(4):112-121.
16. Akyüz A. İnfertilite tanı ve tedavi sürecinde eğitim ve danışmanlık. 5. Uluslararası Üreme Sağlığı ve Aile Planlaması Kongre Kitabı. Ankara: Bilimsel Araştırmalar Yayın ve Tanıtım Ltd. Şti.; 2007. ss.23-29.
17. Atıcı D. İnfertilite tedavi sürecinde hemşirelik bakımı. 4. Uluslar Arası Üreme Sağlığı ve Aile Planlaması Kongresi. Ankara: Bilimsel Araştırmalar Yayın ve Tanıtım Ltd. Şti.; 2003. s.67.
18. Matthews LM. Age-related infertility: counseling, testing and treatment. Postgraduate Obstetrics&Gynecology 2009; 9(5):1-7. doi:10.1097/01.PGO.0000345587.71775.9d.
19. Hammerli K, Znoj H, Barth J. The efficacy of psychological interventions for infertile patients: a meta-analysis examining mental health and pregnancy rate. Human Reproduction Update 2009; 15(3):279295.
20. Hosaka T, Matsubayashi H, Sugiyama Y. Effect of a psychiatric group intervention on emotions, natural-killer cell activity, and pregnancy rate in infertile Japanese women. Psychosomatics 2003; 44:134-135.
21. Koszycki D, Bisserbe JC, Blier P, Bradwejn J, Markowitz J. Interpersonal psychotherapy versus brief supportive therapy for depressed infertile women: first pilot randomized controlled trial. Arch Womens Ment Health 2012; 15(3):193-201.
22. Shu-Hsin L. Effects of using a nursing crisis intervention program on psychosocial responses and coping strategies of infertile women during in vitro fertilization. Nurs Res 2003; 11(3):197-208.
23. Volsten H, Svanberg AS, Olsson P. Unresolved grief in women and men in Sweden three years after undergoing unsuccessful in vitro fertilization treatment. Acta Obstet Gynecol Scand 2010; 89(10):1290-1297.
24. Lemmes GM, Vervaeke M, Enzlin P, Bakelants E, Vanderschueren D, DHooghe T. Coping with infertility: A body-mind group intervention programme for infertile couples. Hum Repord 2004; 19:1917-1923.
25. Holzle C, Brandt U, Lutkenhaus R. Wirtz M. Solution-focused counseling for involuntarily childless couples. In: B Strauss, editor. Involuntary childlessness: psychological assessment, counseling and psychotherapy. Seattle: Hogrefe&Huber; 2002. pp. 105-126.
26. Boivin J. A Review of psychosocial interventions in infertility. Soc Sci&Med 2003; 57:2325-2341.
27. Machin L. A hierarchy of needs? Embryo donation, in vitro fertilization and the provision of infertility counseling. Patient Education and Counseling 2011; 85(2):264268.
28. Liz TM and Strauss B. Differential efficacy of group and individual/ couple psychotherapy with infertile patients. Human Reproduction 2005; 20(5):13241332.
29. Covington SN, Burns LH. Group approaches to infertility counseling. In: CR Newton, editor. Counseling the infertility couple. A comprehensive handbook for clinicians. Second edition. Cambridge University Press; 2006. pp:156-167.
30. Gorayeb R, Borsari AC, Rosa-e-Silva AC, Ferriani RA. Brief cognitive behavioral intervention in groups in a Brazilian assisted reproduction program. Behav Med 2012; 38(2):29-35.
31. Van den Broeck U, Emery M, Wischmann T, Thorn P. Counseling in infertility: individual, couple and group interventions. Patient Educ Couns 2010; 81(3):422-428.
32. Malik SH, Coulson NS. Coping with infertility online: an examination of self-help mechanisms in an online infertility support group. Patient Educ Couns 2010; 81:315318.
33. Aşçı Ö, Kızılkaya BN. İnfertilite danışmanlığı. İstanbul Üniversitesi Florence Nigthingale Hemşirelik Dergisi. 2012; 20(2):154-159.
34. Oskay YÜ, Bayram OG, Dişsiz M. İnfertilitenin psikososyal ve pisikoseksüel etkileri. N Beji Kızılkaya, editör. İnfertilite hemşireliği. İstanbul: Acar Basım ve Cilt San.; 2009. ss.177-195.