标题：Effectiveness of two guided self-administered interventions for psychological distress among women with infertility: a three-armed, randomized controlled trial
作者：Bai, Cai-Feng; Cui, Nai-Xue; Xu, Xian; Mi, Guang-li; Sun, Ji-Wei; Shao, Di; Li, Jie; Jiang, Yin-Zhi; Yang, Qian-Qian; Zhang, Xuan; 更多 作者机构：[Bai, Cai-Feng; Cui, Nai-Xue; Sun, Ji-Wei; Li, Jie; Yang, Qian-Qian; Zhang, Xuan; Cao, Feng-Lin] Shandong Univ, Sch Nursing, 44 Wenhua Xi Rd, Jinan 25 更多
通讯作者地址：[Cao, FL]Shandong Univ, Sch Nursing, 44 Wenhua Xi Rd, Jinan 250012, Shandong, Peoples R China.
关键词：infertility; mindfulness; gratitude; depression; sleep quality;; randomized controlled trial
摘要：STUDY QUESTION:; What is the effect of two guided self-administered interventions on psychological distress in women undergoing IVF or ICSI?; SUMMARY ANSWER: A brief mindfulness intervention significantly reduced depression and improved sleep quality, while the gratitude journal intervention showed no significant effect on any outcome variables.; WHAT IS KNOWN ALREADY: Mindfulness and gratitude journal interventions have been found to be beneficial in reducing negative affect and improving well-being. However, there are very few mental health professionals who implement such interventions in low- and middle-income countries. Therefore, two guided self-administered interventions for women with infertility were designed to help them cope with their psychological distress.; STUDY DESIGN, SIZE, DURATION: A three-armed, randomized controlled trial was designed to evaluate the mindfulness and gratitude journal interventions for women undergoing IVF/ICSI. Between May 2016 and November 2017, at the reproductive center in a public hospital, 234 women were randomly assigned to the brief mindfulness group (BMG, n = 78), gratitude journal group (GJG, n = 78) or control group (CG, n = 78). The inclusion criteria were being a woman undergoing her first cycle of IVF, having at least junior middle school education and having no biological or adopted children.; PARTICIPANTS/MATERIALS, SETTING, METHODS: Female infertility patients (n = 346) were approached, and 112 did not meet the inclusion criteria. All three randomized groups completed questionnaires on the day of down-regulation (TI), the day before embryo(s) transfer (T2), and 3 days before the pregnancy test (T3). The BMG completed four sessions and listened to a 20-minute audio daily, including guided mindfulness breathing and body scan. The GJG completed four sessions and wrote three gratitude journals daily. The CG received routine care. A generalized estimating equation was used in an intention-to-treat analysis. The primary outcome was depression. Secondary outcomes were anxiety, sleep quality, infertility-related stress, mindfulness and gratitude.; MAIN RESULTS AND THE ROLE OF CHANCE: Participants of the BMG showed decreased depression (mean difference (MD) = 1.69, [-3.01, 0.37], d = 0.44) and improved sleep quality (MD = 1.24, [-1.95, 0.39], d = 0.43) compared to the CG, but the effect was not significant for anxiety, Fertility Problem Inventory totals, mindfulness, gratitude scores or pregnancy rates. The BMG showed a significant reduction in depression and improvement in sleep quality between T1 and T2, a continuous significant reduction between TI and T3 and no reduction between 12 and T3. There were no significant effects on any of the variables for the GJG.; LIMITATIOSIS, REASONS E011 CAUTION: The inclusion criteria may result in bias because some participants with low education were excluded and only women with infertility were included. A low compliance rate occurred in the gratitude journals group. Moreover, men were not included in this study. Further research should consider including spouses of the target population.; WIDET IMPLCATIONS OF THE FINDINGS: The brief mindfulness intervention was beneficial in decreasing depression and improving sleep quality. Implementation of guided self-administered mindfulness could make the psychological counseling service more accessible for patients with infertility in resource-poor settings. The efficiency and feasibility of the gratitude journal intervention needs to be investigated further.