Intervention Of Solution Focused Approach On Anxiety And Depression In Elderly Female Patients With In Vitro Fertilization-Embryo Transfer

Objective:To explore the intervention effects of solution-focused approach on anxiety and depression,sleep quality,quality of life and clinical pregnancy rate In elderly female patients undergoing In vitro fertilization and embryo transfer(IVF-ET).To understand patients’ satisfaction with solution-focused approach intervention.Methods:This is a quasi-experimental study.The convenience sampling method was used to select 112 elderly female patients with in vitro fertilization and embryo transfer from December 2021 to December 2022 in a reproductive medicine department of a tertiary hospital in Lanzhou as the research object.Patients were divided into the intervention group with odd numbers and the control group with even numbers according to the end number of the medical card.The control group(n=56)was given routine nursing,while the intervention group(n=56)was given solution-focused nursing on the basis of the control group.The intervention was conducted for 5 times,about 30 minutes each time.The Self-rating Anxiety Scale(SAS),Self-rating Depression Scale(SDS),Pittsburgh Sleep Quality Index(PSQI),and Fertility Quality of Life questionnaire(Ferti Qo L)were used to measure the scores of anxiety,depression,sleep quality,and quality of life before the intervention(enrollment day)and after the intervention(embryo transfer day);After the fifth intervention.the satisfaction of patients in the intervention group with the solution-focused approach was evaluated.Clinical pregnancy rates were collected 28～30 days after transplantation in both groups.SPSS26.0 statistical software was used to analyze the data.Result:(1)A total of 112 elderly female patients with in vitro fertilization-embryo transfer were enrolled in this study,with 56 cases in the intervention group and 56 cases in the control group.During the study,2 patients in the intervention group were lost to followup after the second intervention,2 patients canceled transplantation,and 3 patients canceled transplantation in the control group,with a total dropout rate of 6.25%.A total of 105 elderly female patients with in vitro fertilization-embryo transfer were finally included in this study,including 52 cases in the intervention group and 53 cases in the control group.There was no statistically significant difference in social demographic data and infertility related data between the intervention group and the control group(P > 0.05).There were no statistically significant differences in SAS,SDS,PSQI and Ferti Qo L scores between the two groups before intervention(P > 0.05).(2)Anxiety: the SAS score of the intervention group was(60.70±5.61)before the intervention,and(48.46±6.37)after the intervention,and the difference was statistically significant(t=11.906,P<0.001).The SAS score of the control group was(61.41±4.62)before intervention and(60.50±5.52)after intervention,and the difference was not statistically significant(P > 0.05).After intervention,the SAS score of the intervention group was lower than that of the control group,and the difference was statistically significant(t=-10.348,P<0.001).(3)Depression: the SDS score of the intervention group was(63.51±6.31)before the intervention,and decreased to(50.70±6.70)after the intervention,which was significantly lower than that before the intervention,and the difference was statistically significant(t=14.991,P<0.001).The SDS score of the control group was(62.69±5.74)before intervention and(61.75±6.75)after intervention,and the difference was not statistically significant(P > 0.05).After intervention,the SDS score of the intervention group was lower than that of the control group,and the difference was statistically significant(t=0.697,P<0.001).(4)Sleep quality: the PSQI score of the intervention group was(7.27±2.54)before the intervention,and(5.02±1.26)after the intervention.The PSQI score of the intervention group was significantly lower than that before the intervention(t=7.055,P<0.001).The PSQI score of the control group was(7.17±2.37)before intervention and(6.5±2.27)after intervention.The PSQI score of the control group after intervention was slightly lower than that before intervention,but the difference was not statistically significant(P > 0.05).After intervention,the PSQI score of the intervention group was lower than that of the control group,and the difference was statistically significant(t=-5.087,P<0.001).(5)Fertility quality of life: the Ferti Qo L score of the intervention group was(57.06±9.05)before the intervention,and it changed to(61.28±8.28)after the intervention.The Ferti Qo L score of the intervention group was significantly lower than that before the intervention,and the difference was statistically significant(t=-2.828,P<0.001).The Ferti Qo L score of patients in the control group was(56.47±10.57)before the intervention,and changed to(57.16±9.36)after the intervention.The Ferti Qo L score of patients in the control group was slightly higher than that before the intervention,but the difference was not statistically significant(P > 0.05).After the intervention,the Ferti Qo L score of the intervention group was significantly higher than that of the control group,and the difference was statistically significant(t=2.389,P<0.001).(6)The clinical pregnancy rate of the intervention group was 48.1%,which was higher than 45.3% of the control group,but the difference was not statistically significant(P > 0.05).(7)The overall evaluation of the intervention group was very satisfied or satisfied with the solution-focused approach.Conclusion:Solution-focused approach can effectively alleviate anxiety and depression in elderly female patients undergoing IVF-ET,and improve sleep quality and fertility quality of life.Solution focused approach has no significant effect on the clinical pregnancy rate of patients.Patients in the intervention group were satisfied with the solution focused approach.