Analysis Of Factors And Pathways Affecting The Quality Of Reproductive Life Of Infertile Men

Objective: Exploring the influencing factors of quality of life in infertile men and constructing a path model for quality of life of infertile men to provide recommendations for improving their quality life.Methods: Men with infertility(n=250)attending a fertility centre in a hospital in Xinjiang and 1:2 matched men with health check-ups at the same time were selected as the control group(n=500),and the Fertile Quality of Life Scale(Ferti Qol),Social Support Scale(SSRS),Fertility Stress Inventory(FPI)and Positive Attention Awareness Scale(MAAS)were used to investigate.The maximum likelihood estimation method was applied in Mplus 8.3 software to construct a model to explore the factors influencing the quality of reproductive life of infertile men and to explore the fit of the actual data to the theoretical model as well as the direct and indirect effect pathways and effect sizes.Results:(1)The differences between the case and control groups were statistically significant(P<0.05)in total fertility quality of life scores,core entry dimensions,emotional response,mind-body relationship,selective treatment dimensions,and treatment tolerance;previous medical history,positive thinking,fertility stress,social support,exposure to harmful environments and health insurance reimbursement were factors influencing fertility quality of life in infertile men(P<0.05);fertility history,history of previous illness,positive thinking and health insurance reimbursement were factors influencing the emotional response dimension in infertile men(P <0.05);history of previous illness,positive thinking and health insurance reimbursement were factors influencing the mind-body relationship in infertile men(P<0.05).(2)The differences in total social support score,subjective support and objective support between the case and control groups were statistically significant(P<0.05);alcohol consumption and quality of reproductive life were factors influencing social support in infertile men(P <0.05);ethnicity,history of previous illness and quality of reproductive life were factors influencing subjective support in infertile men(P<0.05);occupation was state agency and institution The subjective support of men with infertility was higher among workers in state agencies and institutions,corporate employees,and health care workers compared with other occupations(P<0.05),and monthly household income of 7,000-9,999 and >10,000 yuan positively influenced the subjective support of men with infertility(P<0.05).(3)The differences between the case and control groups were statistically significant(P <0.05)in total fertility stress score,sexual stress,couple relationship and parenthood needs;positive thoughts(β=-0.290,β=-0.295)and quality of fertility life(β=-0.154,β=-0.199)both negatively influenced fertility stress and sexual stress(P<0.05);health care workers were predictors of couple relationship(P<0.05);and positive thoughts negatively influenced the need for parenthood(P<0.05).(4)The difference between the case and control groups was statistically significant(P <0.05)in terms of total positive thinking scores;fertility stress negatively influenced positive thinking(β=-0.281,P <0.05),with positive thinking decreasing by 0.281 units for every1 increase in fertility stress and increasing by 0.207 units for every 1 increase in fertility quality of life(P<0.05).(5)Quality of fertility life was significantly correlated with social support,fertility stress and positive thinking(P<0.01)and positively correlated with social support(r=0.350)and positive thinking(r =0.285);and negatively correlated with fertility stress(r =-0.236).Social support was positively associated with positive thinking(r=0.135,P<0.05).Fertility stress was negatively correlated with positive thoughts(r=0.334,P<0.01).(6)Structural equation modelling was constructed and the model fit indicators were: 2/df=1.56,CFI=0.968,TLI=0.920,RMSEA=0.047,SRMR=0.045,good model fit;(7)disease history→social support→fertility quality of life(95% CI: 0.011 to 0.095),mediating significant effect,disease history can directly affect reproductive quality of life(β=0.131,P<0.05)and can indirectly affect reproductive quality of life through social support(β=0.044,P<0.05);(8)mindfulness→fertility stress→fertility quality of life(95%CI: 0.001 to 0.087),mediated The effect was significant,with positive thoughts directly affecting quality of reproductive life(β=0.190,P<0.05)and indirectly through fertility stress(β=0.044,P<0.05);mindfulness→social support→fertility quality of life(95% CI:0.005-0.075),mediated effect was significant,with positive thinking indirectly affecting quality of reproductive life through social support(β=0.033,P <0.05).Conclusion: The quality of life concerning fertility is not optimistic for infertile men.Previous medical history,exposure to harmful environments,medical insurance coverage,social support,reproductive pressure,and mindfulness are important factors that affect the quality of life of infertile men.Improving mindfulness,reducing reproductive pressure,and increasing social support levels are recommended to improve the quality of life of infertile men,boosting confidence in clinical diagnosis and treatment and promoting positive coping strategies.