The Infertility-related Stress And Subjective Well-being Among Infertile Women:the Mediating Role Of Family Resilience And Sleep Quality

ObjectivesTo investigate the current situation of subjective well-being of infertile women,and explore the factors influencing subjective well-being among infertile women in terms of socio-demographic factors,infertility-related stress,family resilience and sleep quality,and further to analyze the mediating role of family resilience and sleep quality between infertility-related stress and subjective well-being,which might provide a theoretical basis for enhancing subjective well-being of infertile women.MethodsIn this cross-sectional study,women with infertility who attended outpatient clinics at a fertility hospital and a tertiary hospital reproductive medicine center in Jinan,Shandong Province from March 2022 to August 2022 were conveniencely selected as the respondents.The General Information Questionnaire,the General Well-Being Scheduling(GWB),the Fertility Problem Inventory(FPI),the Family Resilience Assessment Scale(FRAS),and the Pittsburgh Sleep Quality Index(PSQI)were used to measure general sociodemographic variables,subjective well-being,infertility-related stress,family resilience,and sleep quality.Data were analyzed using SPSS 25.0 and Process v3.3 plug-in.Results1.Descriptive statistical analysis showed that the subjective well-being score of 403 infertile women was(79.27±13.30);the total infertility-related stress score was(152.05±31.69),the mean item score was(3.3 1±0.69),and among the mean item scores of each dimension,the parental role demand score was the highest(4.26±0.96)and the sexual stress score was the lowest(2.67±0.98);the total score of family resilience was(101.99±14.42),the mean item score was(3.19±0.45),and among the mean item scores of each dimension,the score of holding positive views(3.24±0.49)was the highest and the score of using social resources(3.04±0.48)was the lowest;the total score of sleep quality was(5.19±2.78),in which 39.5%of women with infertility had sleep disturbances.2.The results of univariate analysis showed that subjective well-being of infertile women differed significantly in duration of infertility(F=8.008,P<0.001);infertility-related stress scores differed significantly in age(F=4.685,P=0.010),age at marriage(F=3.875,P=0.022),duration of infertility(F=4.958,P=0.007),duration of treatment(F=6.644,P=0.001),education(F=9.508,P<0.001),occupation(t=2.685,P=0.008),and monthly household income(H=13.230,P=0.001);family resilience scores were not statistically significantly different in any of the sociodemographic variables;sleep quality scores were statistically different in residence(F=3.988,P=0.019)and monthly household income(H=7.102,P=0.029);sleep quality scores differed significantly in in sleep quality scores on residence(F=3.988,P=0.019)and monthly household income.3.Correlation analysis showed that infertility-related stress and sleep quality scores were significantly negatively correlated with subjective well-being(r=-0.431,-0.546,all P<0.01)and family resilience was significantly positively correlated with subjective well-being(r=0.366,P<0.01);infertility-related stress was fignificantly negatively correlated with family resilience(r=-0.296,P<0.01)and positively correlated with sleep quality scores(r=0.185,P<0.01).Family resilience was significantly negatively correlated with sleep quality scores(r=-0.213,P<0.01).4.The mediating effect results showed that infertility-related stress had a significant direct negative predictive effect on subjective well-being,and the chain mediating effect of family resilience and sleep quality between infertility-related stress and subjective well-being was significant.Conclusions1.Subjective well-being of infertile women needs to be further improved.Duration of infertility can be used as a predictor of subjective well-being in infertile women.2.Infertility-related stress negatively predicted subjective well-being.Family resilience and sleep quality positively predicted subjective well-being in women with infertility.3.Among women with infertility,family resilience and sleep quality have a chain mediating effect between infertility-related stress and subjective well-being.Increasing family resilience and improving sleep quality may reduce the effect of infertility-related stress on subjective well-being.Clinical practitioners need to develop interventions to enhance subjective well-being of infertile women at both individual and family levels.