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Feasibility of screening patients for emotional risk factors before in vitro fertilization in daily clinical practice: a process evaluation.
Hum Reprod. 2012 Dec; 27(12):3493-501.HR

Abstract

STUDY QUESTION

Is patient screening for emotional risk factors before starting IVF treatment feasible?

SUMMARY ANSWER

Introduction of screening for emotional risk factors by a validated instrument (SCREENIVF) in couples treated by IVF or ICSI is feasible, indicated by a moderate to high and stable uptake rate, a high acceptance of the process of SCREENIVF, and a high acceptability of the presented risk profile by the patients.

WHAT IS KNOWN ALREADY

SCREENIVF is a validated screening tool to identify women at risk for emotional maladjustment preceding the start of their IVF/ICSI treatment.

STUDY DESIGN, SIZE AND DURATION

This was a prospective cohort study, including data of two cohorts of patients (304 and 342 patients), with a duration of 3 months per cohort. For the first cohort, we sent a process evaluation to 210 patients and it was completed by 91 patients.

PARTICIPANTS/MATERIALS, SETTING AND METHODS

All 304 patients (male and female) who started IVF/ICSI between 1 December 2009 and 28 February 2010 in our tertiary IVF clinic were eligible. The uptake rate of SCREENIVF was assessed as the response rate to the screening questionnaire. One year later, we re-assessed the uptake rate in 342 new patients to assess the stability of the uptake rate. A non-responder assessment in patients who did not complete SCREENIVF was carried out. Finally, patients' characteristics and their experiences with SCREENIVF as well as their consequent actions were assessed by an additional process evaluation questionnaire sent some months later to 210 patients.

MAIN RESULTS AND THE ROLE OF CHANCE

The uptake rate of SCREENIVF was 78-80%. One-third of the responders were found to be at risk for emotional maladjustment, which was comparable with previous studies using SCREENIVF. Of 27 non-responders to SCREENIVF, 41% explained non-response by 'no actual need for psychological help' and 19% forgot to complete the screening. The response rate to the process evaluation was 43% (n = 91). Of these, 90% found the screening was useful, and almost all patients were positive about the SCREENIVF questionnaire. Furthermore, 93% recognized themselves in the risk profile based on SCREENIVF. Of the patients at risk, 21% reported planning to seek professional help, but 46% of the at-risk patients experienced travelling distance as an obstacle to seek psychological help. We concluded that screening patients for emotional risk factors is feasible. In future, psychosocial care offered by the Internet may be promising in meeting the barrier of travelling distance.

LIMITATIONS, REASONS FOR CAUTION

People were asked to fill in SCREENIVF for clinical purposes pretreatment. There might be a selection bias in the people who did not fill in SCREENIVF, which may be due to already existing psychological problems or language problems. The low response rate of the process evaluation questionnaire and the mono-centre evaluation may be confounders and may have influenced our analysis opportunities.

WIDER IMPLICATIONS OF THE FINDINGS

The generalizability of this data is unknown with respect to other ethnic groups. Furthermore, more research is needed to evaluate psychosocial factors in male partners. Future research should also focus on the barriers and facilitators for help-seeking behaviour.

STUDY FUNDING/COMPETING INTEREST(S)

There was no funding for this study and no conflict of interest.

Authors+Show Affiliations

Department of Obstetrics and Gynaecology, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB, Nijmegen, The Netherlands. a.vandongen@obgyn.umcn.nlNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23001780

Citation

Van Dongen, A J C M., et al. "Feasibility of Screening Patients for Emotional Risk Factors Before in Vitro Fertilization in Daily Clinical Practice: a Process Evaluation." Human Reproduction (Oxford, England), vol. 27, no. 12, 2012, pp. 3493-501.
Van Dongen AJ, Kremer JA, Van Sluisveld N, et al. Feasibility of screening patients for emotional risk factors before in vitro fertilization in daily clinical practice: a process evaluation. Hum Reprod. 2012;27(12):3493-501.
Van Dongen, A. J., Kremer, J. A., Van Sluisveld, N., Verhaak, C. M., & Nelen, W. L. (2012). Feasibility of screening patients for emotional risk factors before in vitro fertilization in daily clinical practice: a process evaluation. Human Reproduction (Oxford, England), 27(12), 3493-501. https://doi.org/10.1093/humrep/des324
Van Dongen AJ, et al. Feasibility of Screening Patients for Emotional Risk Factors Before in Vitro Fertilization in Daily Clinical Practice: a Process Evaluation. Hum Reprod. 2012;27(12):3493-501. PubMed PMID: 23001780.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Feasibility of screening patients for emotional risk factors before in vitro fertilization in daily clinical practice: a process evaluation. AU - Van Dongen,A J C M, AU - Kremer,J A M, AU - Van Sluisveld,N, AU - Verhaak,C M, AU - Nelen,W L D M, Y1 - 2012/09/20/ PY - 2012/9/25/entrez PY - 2012/9/25/pubmed PY - 2013/4/30/medline SP - 3493 EP - 501 JF - Human reproduction (Oxford, England) JO - Hum Reprod VL - 27 IS - 12 N2 - STUDY QUESTION: Is patient screening for emotional risk factors before starting IVF treatment feasible? SUMMARY ANSWER: Introduction of screening for emotional risk factors by a validated instrument (SCREENIVF) in couples treated by IVF or ICSI is feasible, indicated by a moderate to high and stable uptake rate, a high acceptance of the process of SCREENIVF, and a high acceptability of the presented risk profile by the patients. WHAT IS KNOWN ALREADY: SCREENIVF is a validated screening tool to identify women at risk for emotional maladjustment preceding the start of their IVF/ICSI treatment. STUDY DESIGN, SIZE AND DURATION: This was a prospective cohort study, including data of two cohorts of patients (304 and 342 patients), with a duration of 3 months per cohort. For the first cohort, we sent a process evaluation to 210 patients and it was completed by 91 patients. PARTICIPANTS/MATERIALS, SETTING AND METHODS: All 304 patients (male and female) who started IVF/ICSI between 1 December 2009 and 28 February 2010 in our tertiary IVF clinic were eligible. The uptake rate of SCREENIVF was assessed as the response rate to the screening questionnaire. One year later, we re-assessed the uptake rate in 342 new patients to assess the stability of the uptake rate. A non-responder assessment in patients who did not complete SCREENIVF was carried out. Finally, patients' characteristics and their experiences with SCREENIVF as well as their consequent actions were assessed by an additional process evaluation questionnaire sent some months later to 210 patients. MAIN RESULTS AND THE ROLE OF CHANCE: The uptake rate of SCREENIVF was 78-80%. One-third of the responders were found to be at risk for emotional maladjustment, which was comparable with previous studies using SCREENIVF. Of 27 non-responders to SCREENIVF, 41% explained non-response by 'no actual need for psychological help' and 19% forgot to complete the screening. The response rate to the process evaluation was 43% (n = 91). Of these, 90% found the screening was useful, and almost all patients were positive about the SCREENIVF questionnaire. Furthermore, 93% recognized themselves in the risk profile based on SCREENIVF. Of the patients at risk, 21% reported planning to seek professional help, but 46% of the at-risk patients experienced travelling distance as an obstacle to seek psychological help. We concluded that screening patients for emotional risk factors is feasible. In future, psychosocial care offered by the Internet may be promising in meeting the barrier of travelling distance. LIMITATIONS, REASONS FOR CAUTION: People were asked to fill in SCREENIVF for clinical purposes pretreatment. There might be a selection bias in the people who did not fill in SCREENIVF, which may be due to already existing psychological problems or language problems. The low response rate of the process evaluation questionnaire and the mono-centre evaluation may be confounders and may have influenced our analysis opportunities. WIDER IMPLICATIONS OF THE FINDINGS: The generalizability of this data is unknown with respect to other ethnic groups. Furthermore, more research is needed to evaluate psychosocial factors in male partners. Future research should also focus on the barriers and facilitators for help-seeking behaviour. STUDY FUNDING/COMPETING INTEREST(S): There was no funding for this study and no conflict of interest. SN - 1460-2350 UR - https://www.unboundmedicine.com/medline/citation/23001780/Feasibility_of_screening_patients_for_emotional_risk_factors_before_in_vitro_fertilization_in_daily_clinical_practice:_a_process_evaluation_ L2 - https://academic.oup.com/humrep/article-lookup/doi/10.1093/humrep/des324 DB - PRIME DP - Unbound Medicine ER -