Quality of Infertility Care Services and Emotional Health of South Asian Women

Sehar-un-Nisa Hassan,1,2 Aqeela Zahra,3 Nuzhat Parveen,4 Naveed Iqbal,4 Sarwat Mumtaz,5 Asma Batool6 1Department of Public Health, College of Public Health and Health Informatics, University of Ha’il, Ha’il, 81451, Kingdom of Saudi Arabia; 2Department of Behavioral Sciences, School of Social Sciences and Humanities, National University of Sciences and Technology (NUST), Islamabad, Pakistan; 3Department of Family and Community Medicine, College of Medicine, University of Ha’il, Ha’il, 81451, Kingdom of Saudi Arabia; 4Department of Obstetrics and Gynecology, College of Medicine, University of Ha’il, Ha’il, 81451, Kingdom of Saudi Arabia; 5Department of Health Management, College of Public Health and Health Informatics, University of Ha’il, Ha’il, 81451, Kingdom of Saudi Arabia; 6Obstetrics and Gynecology, Maternity and Children Hospital Ha’il, Ha’il, Kingdom of Saudi ArabiaCorrespondence: Sehar-un-Nisa Hassan, Department of Public Health, College of Public Health and Health Informatics, University of Ha’il, Ha’il, 81451, Kingdom of Saudi Arabia, Tel +966 5576 629 275, Email s.nisa@uoh.edu.sa; sehar_nisa@hotmail.com Nuzhat Parveen, Department of Obstetrics and Gynecology, College of Medicine, University of Ha’il, Ha’il, 81451, Kingdom of Saudi Arabia, Email n.parveen@uoh.edu.saAbstract: Background: Treatment tolerability and treatment environment are two major spheres of infertility care that may associate with women’s emotional health and coping mechanisms.Aim: The present study aimed at assessing the relationship between infertility treatment quality and various aspects of emotion-focus coping, problem-focus coping, and avoidance coping mechanisms.Method: The study was completed by using standardized tools and data from this descriptive, cross-sectional, correlational study were collected from 350 women undergoing infertility treatments in private reproductive healthcare centers in Quetta, Pakistan.Findings: Treatment tolerability was found to be positively associated with positive reframing (p < 0.02) and negatively associated with the use of emotional support (p < 0.03); acceptance (p < 0.01); humor (p < 0.03); behavioral disengagement (p < 0.01) and venting (p < 0.01). The quality of the treatment environment demonstrated a negative correlation between religious coping (p < 0.02) and behavioral disengagement (p < 0.01), whereas it showed a positive correlation with active coping (p < 0.03) and planning (p < 0.02). The linear regression analysis demonstrated that treatment tolerability significantly increased with positive reframing (R2 = 0.118, F(304) = 2.22, p < 0.03). Behavioral disengagement significantly decreased with better treatment environment (R2 = 0.111, F(304) = 2.09, p < 0.02).Discussion: We discussed the findings keeping in view the role of social, cultural, and economic factors related to infertility care in the context South-Asian culture, and recommendations are made to promote women’s mental health and coping by improving some specific aspects of infertility treatment quality.Conclusions: High treatment tolerability may associate with some useful aspects of emotion-focus coping, such as positive reframing, whereas low treatment tolerability may associate with avoidance coping, such as behavioral disengagement and venting. Besides, the quality of the infertility treatment environment enables women to use problem-focus coping mechanisms, such as planning and active coping.Keywords: infertility, treatment quality, FertiQol, coping mechanisms, mental health, reproductive healthcare, treatment tolerability, treatment environment, psychological well-being