This study explored the individual and dyadic coping processes of men and women in infertile couples and their relationship to infertility stress, marital adjustment, and depression. Study participants were comprised of 1,026 men and women (420 of which were couples) who were referred to a university-affiliated teaching hospital for advanced reproductive treatments between the years of 1991 and 2001. Three months prior to treatment, participants completed the Ways of Coping Questionnaire (WCQ), the Fertility Problem Inventory (FPI), the Dyadic Adjustment Scale (DAS), and the Beck Depression Inventory (BDI). Findings from the study showed that escape avoidance, accepting responsibility, and self controlling were strongly related to increased stress, depression, and decreased marital adjustment for both men and women; while seeking social support was related to increased marital adjustment. Multivariate analyses of variance and covariance consistently showed that participants in four groups of couples who used high and low amounts of coping differed in their reports of infertility stress, marital adjustment, and depression. In addition, gender differences were found, with females consistently reporting greater levels of stress and depression than males. Several significant couple pairings among the four groups were found. Clinical implications linking study findings with marital and family therapies and ideas for future research are discussed. / Ph. D.

Submitted by Noeme Timbo (noeme.timbo@metodista.br) on 2018-01-04T18:48:22Z No. of bitstreams: 1 VictorZaia.pdf: 2047527 bytes, checksum: 7858d54d0ef6a892713e11b89f935efc (MD5) / Made available in DSpace on 2018-01-04T18:48:23Z (GMT). No. of bitstreams: 1 VictorZaia.pdf: 2047527 bytes, checksum: 7858d54d0ef6a892713e11b89f935efc (MD5) Previous issue date: 2017-11-07 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / This study investigated whether and how Infertility Stress, Importance of Parenthood and resilience impacted on assisted reproductive treatment (ART) in infertile couples. 423 people participated in the research: 189 women, 183 men, mean age of 37 years, 72.1% first treatment of ART, 69.3% primary infertility, 64% sedentary life, 21.9% had aborted anteriorly, 71% had to make use of the in vitro fertilization technique. 49.3% of the participants believed they had over 60% chance of success in their treatment. To measure the variables, the instruments chosen were: Infertility Related-Stress Scale (IRSS); Importance of Parenthood in the Infertility Scale (IPIS) and Connor-Davidson Resilience Scale (CD-RISC 10) and treatment outcome measures in ART were verified. The main statistical analyzes indicated that the participants with the increased stress levels were: women, had more time of treatment in ART, lower monthly income, believed excessively in the success of the treatment; higher levels of importance of parenting were found in people who followed a religion and with a female’s infertility. Resilience has been positively associated with older people. Infertility Stress and Importance of Parenthood are positively correlated, and both are reverse with resilience. Furthermore, the importance of parenthood has been correlated to higher levels of displayed oocytes. The infertility stress, in intrapersonal domain, explains 6.5% of the variance of pregnancy, classifying 65% of cases correctly. The results indicate that women suffer more with infertility than men. When the cause of infertility is in both partners, adequate levels of importance of parenthood and scholastic level are protective factors for infertility stress. To believe excessively in the success of ART treatment and to follow a religion is not in itself negative. The ART outcome measures are altered by stress levels, which in turn is influenced by the resilience, which should be developed in individuals undergoing treatment for infertility. It is therefore necessary, a continuous focus on the emotional aspects of infertile patients, thus promoting the resilience, the reduction of stress levels, and the autonomy in the path chosen to have their children. Establishing protocols that measure levels of infertility stress, the importance of parenthood and resilience in patients receiving ART, would allow specific interventions that would lead to better adaptation to infertility and better outcomes measures in ART. / Este estudo investigou como e se o estresse, a importância da parentalidade e a resiliência impactaram no tratamento de infertilidade de casais. Participaram do estudo 423 pessoas, 189 mulheres e 183 homens, de média de idade de 37 anos, no primeiro tratamento em reprodução humana (72,1%), com infertilidade primária (69,3%), vida sedentária (64%) e histórico de aborto (21,9%) que iriam fazer fertilização in vitro (71%). Quase a metade deles (49,3%) acreditava possuir mais de 60% de chance de sucesso no tratamento que se iniciaria. Para avaliação das variáveis fez-se uso dos seguintes instrumentos: Infertility Related-Stress Scale (IRSS); Importance of Parenthood in Infertility Scale (IPIS) e Connor-Davidson Resilience Scale (CD-RISC 10), além de repostas ao tratamento de Reprodução Humana Assistida. Os principais resultados de análises estatísticas descritivas, correlacionais e de regressões logísticas indicaram que os participantes com maior estresse eram mulheres, tinham mais tempo de tratamento, menor renda e crença no sucesso do tratamento; maior importância da parentalidade em pessoas com alguma religião, causa feminina de infertilidade. A resiliência foi encontrada em maiores níveis em pessoas mais velhas. Estresse da infertilidade e importância da parentalidade se correlacionaram e ambas são inversas à resiliência. A importância da parentalidade também foi correlacionada a maiores níveis de oócitos visualizados. O estresse relatado da infertilidade, no domínio intrapessoal explica 6,5% da variância da gravidez, classificando 65% dos casos corretamente. Os resultados permitiram identificar que a mulher sofre maior impacto pela situação de infertilidade do que o homem. A causa de infertilidade em ambos os parceiros indica que melhor nível da importância da parentalidade e a escolaridade são fatores protetivos ao estresse. A crença no tratamento, apesar de supervalorizada, não é por si negativa, bem como o possuir alguma religião. Os resultados do tratamento podem ser modificados pelos níveis de estresse, que por sua vez são influenciados pela resiliência, a qual deveria ser trabalhada e ampliada nas pessoas em tratamento de infertilidade. É necessário, portanto, um olhar contínuo sobre os aspectos emocionais dos pacientes inférteis, de modo a favorecer a resiliência e a redução de estresse, de modo a possibilitar uma vivência de autonomia dessas pessoas na busca de terem o próprio filho. Para tanto, estabelecer protocolos de averiguação dos níveis de estresse, importância da parentalidade e resiliência, nos pacientes que iniciam o trajeto de reprodução humana, auxiliaria em intervenções mais específicas que favoreceriam melhor adaptação e melhores resultados no tratamento.