Volume 19, Issue 1 (3-2025)
Qom Univ Med Sci J 2025, 19(1): 231-243 |
Back to browse issues page
Ethics code: IR.IAU.SDJ.REC.1402.060
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Ghobadi S, Kakabraee K, Goudarzi M. Designing and Validation of a Cognitive-behavioral Therapy Protocol for Infertility Stress in Infertile Women. Qom Univ Med Sci J 2025; 19 (1) : 2987.1
URL: http://journal.muq.ac.ir/article-1-3870-en.html
URL: http://journal.muq.ac.ir/article-1-3870-en.html
1- Department of Psychology, Sanandaj Branch, Islamic Azad University, Sanandaj, Iran.
2- Department of Psychology, Kermanshah Branch, Islamic Azad University, Kermanshah, Iran. ,keivan@iauksh.ac.ir
3- Department of Family Counseling, Sanandaj Branch, Islamic Azad University, Sanandaj, Iran.
2- Department of Psychology, Kermanshah Branch, Islamic Azad University, Kermanshah, Iran. ,
3- Department of Family Counseling, Sanandaj Branch, Islamic Azad University, Sanandaj, Iran.
Full-Text [PDF 702 kb]
(335 Downloads)
| Abstract (HTML) (1256 Views)
Full-Text: (263 Views)
Introduction
In most cultures, fertility is very important and the desire to have children is one of the most basic human motivations. Infertility in couples can be frustrating and devastating. It puts a lot of stress on them and can threaten their health in many ways. Women with infertility feel powerless, worthless and inadequate. As a result, they have an unfavorable perception of their physical condition. The purpose of this study is to design and validate a cognitive-behavioral therapy (CBT) protocol for infertility stress.
Methods
This is a qualitative study using the content analysis method. The study population consists of all infertile women who were referred to the clinics of gynecologists and infertility treatment clinics in Kermanshah, Iran, in 2022. Based on the principle of theoretical saturation, 70 women were selected using a purposive sampling method after checking the inclusion criteria (a history of infertility for at least 3 years, diagnosis of infertility according to the gynecology/ infertility specialist) and exclusion criteria (unwillingness to participate in the study and having mental disorders).
The entry criterion for selecting the panel of experts in family psychology and psychotherapy (n=10) was at least 5 years of work experience in the related field. The articles related to infertility stress and infertile women published from 2015-2021 were also reviewed. The focus of interviews with infertile women was to understand their cognitive, emotional and behavioral states, as well as their coping strategies.
Using the interview and literature, the factors that lead to reducing infertility stress in infertile women were extracted and the educational protocol was designed for infertile women. In the next step, the content validity of the protocol was examined by the panel of experts and the content validity ratio was calculated using the Lawshe method. The content validity index (CVI) was also calculated. Then, educational sessions were designed in 12 sessions, each for 120 minutes.
Results
The content of the CBT protocol for infertility stress included identifying concerns, introducing various coping strategies, problem-solving techniques and choosing the best solution to solve the problem, training in managing one’s inner sphere, analyzing thoughts and how to logically reconstruct thoughts (managing and listing negative thoughts, strengthening and listing positive thoughts, positive reinforcement of coping in stressful situations) the technique of changing negative thoughts through changing behavior, coping with stressful thoughts through acceptance. For each item, related goals were identified and introduced. The protocol had acceptable content validity.
Conclusion
The designed CBT for infertility stress protocol can practically help infertile women reduce their stress of infertility along with drug treatment. The training protocol includes complete instructions for each session and considers the expectations of infertile women.
Ethical Considerations
Compliance with ethical guidelines
This study was approved by the Ethics Committee of the Islamic Azad University, Sanandaj Branch (Code: IR.IAU.SDJ.REC.1402.060).
Funding
This research did not receive any grant from funding agencies in the public, commercial, or non-profit sectors.
Authors contributions
Conceptualization and research: Samaneh Ghobadi; Editing and review: Keyvan Kakabraei and Mahmoud Gudarzi.
Conflicts of interest
The authors declare no conflicts of interest.
Acknowledgements
The authors would like to thank all the infertile women who participated in this research for their cooperation.
In most cultures, fertility is very important and the desire to have children is one of the most basic human motivations. Infertility in couples can be frustrating and devastating. It puts a lot of stress on them and can threaten their health in many ways. Women with infertility feel powerless, worthless and inadequate. As a result, they have an unfavorable perception of their physical condition. The purpose of this study is to design and validate a cognitive-behavioral therapy (CBT) protocol for infertility stress.
Methods
This is a qualitative study using the content analysis method. The study population consists of all infertile women who were referred to the clinics of gynecologists and infertility treatment clinics in Kermanshah, Iran, in 2022. Based on the principle of theoretical saturation, 70 women were selected using a purposive sampling method after checking the inclusion criteria (a history of infertility for at least 3 years, diagnosis of infertility according to the gynecology/ infertility specialist) and exclusion criteria (unwillingness to participate in the study and having mental disorders).
The entry criterion for selecting the panel of experts in family psychology and psychotherapy (n=10) was at least 5 years of work experience in the related field. The articles related to infertility stress and infertile women published from 2015-2021 were also reviewed. The focus of interviews with infertile women was to understand their cognitive, emotional and behavioral states, as well as their coping strategies.
Using the interview and literature, the factors that lead to reducing infertility stress in infertile women were extracted and the educational protocol was designed for infertile women. In the next step, the content validity of the protocol was examined by the panel of experts and the content validity ratio was calculated using the Lawshe method. The content validity index (CVI) was also calculated. Then, educational sessions were designed in 12 sessions, each for 120 minutes.
Results
The content of the CBT protocol for infertility stress included identifying concerns, introducing various coping strategies, problem-solving techniques and choosing the best solution to solve the problem, training in managing one’s inner sphere, analyzing thoughts and how to logically reconstruct thoughts (managing and listing negative thoughts, strengthening and listing positive thoughts, positive reinforcement of coping in stressful situations) the technique of changing negative thoughts through changing behavior, coping with stressful thoughts through acceptance. For each item, related goals were identified and introduced. The protocol had acceptable content validity.
Conclusion
The designed CBT for infertility stress protocol can practically help infertile women reduce their stress of infertility along with drug treatment. The training protocol includes complete instructions for each session and considers the expectations of infertile women.
Ethical Considerations
Compliance with ethical guidelines
This study was approved by the Ethics Committee of the Islamic Azad University, Sanandaj Branch (Code: IR.IAU.SDJ.REC.1402.060).
Funding
This research did not receive any grant from funding agencies in the public, commercial, or non-profit sectors.
Authors contributions
Conceptualization and research: Samaneh Ghobadi; Editing and review: Keyvan Kakabraei and Mahmoud Gudarzi.
Conflicts of interest
The authors declare no conflicts of interest.
Acknowledgements
The authors would like to thank all the infertile women who participated in this research for their cooperation.
Type of Study: Original Article |
Subject:
روانشناسی
Received: 2023/11/24 | Accepted: 2024/03/3 | Published: 2025/03/30
Received: 2023/11/24 | Accepted: 2024/03/3 | Published: 2025/03/30
References
1. Purkayastha N, Sharma H. Prevalence and potential determinants of primary infertility in India: Evidence from Indian demographic health survey. Clin Epidemiology Glob Health. 2020; 9:162-70. [DOI:10.1016/j.cegh.2020.08.008] [DOI:10.1016/j.cegh.2020.08.008]
2. Starabadi M, Aminfakhraei A, Keramati K, Samavi A. [Effectiveness of acceptance and commitment therapy on stress and depression in infertile couples (Persian)]. Women Stud. 2020; 11(31):1-18. [DOI:10.30465/ws.2020.5344]
3. Samadi H, Shirazi A, Sadegh Esfahani N. [Investigation of the effectiveness of theater therapy on general health of infertile women (Persian)]. J Fac Med Mashhad Univ Med Sci. 2018; 62:160-8. [DOI:10.22038/mjms.2019.14208]
4. Kohi Kamali S, Sodagar S, Pour Sharifi H, Ashairi H. [The effectiveness of treatment based on acceptance and commitment on sexual satisfaction of infertile women (Persian)]. J Prevent Med. 2019; 7(4):57-67. [DOI:10.29252/jpm.7.4.67] [DOI:10.29252/jpm.7.4.67]
5. Rezvani F, Vaziri S, Lotfi Kashani F. [Structural equation modelling of infertility stress based on emotional schemas, marital conflict, self-compassion, social support as a mediation (Persian)]. IJPN 2019; 7(4):74-83. [Link]
6. Kim M, Moon S, Kim J. Effects of psychological intervention for korean infertile women under in vitro fertilization on infertility stress, depression, intimacy, sexual satisfaction and fatigue. Arch Psychiatr Nurs. 2020; 34(4):211-7. [DOI:10.1016/j.apnu.2020.05.001] [DOI:10.1016/j.apnu.2020.05.001]
7. Bräuner EV, Nordkap L, Priskorn L, Hansen ÅM, Bang AK, Holmboe SA, et al. Psychological stress, stressful life events, male factor infertility, and testicular function: A cross-sectional study. Fertil Steril. 2020; 113(4):865-75. [DOI:10.1016/j.fertnstert.2019.12.013] [DOI:10.1016/j.fertnstert.2019.12.013]
8. Bahrami-Kerchi A, Manshaee G, Keshtiaray N. [The effectiveness of psychological empowerment therapy and dialectical behavior therapy on infertility stress of infertile women in pretreatment stage of in vitro fertilization (Persian)]. Feyz Med Sci J. 2020; 24(5):554-64. [Link]
9. Askari P, Saedi S. [The effectiveness of immunization training against stress on the quality of life of infertile women (Persian)]. Thought Behav Clin Psychol. 2012; 6(24):19-28. [Link]
10. Golshani F, Hasanpour S, Mirghafourvand M, Esmaeilpour Kh. Effect of cognitive behavioral therapy-based counseling on perceived stress in pregnant women with history of primary infertility: A controlled randomized clinical trial. BMC Psychiatry. 2021; 21:278. [DOI:10.1186/s12888-021-03283-2] [DOI:10.1186/s12888-021-03283-2]
11. Hassannejad Emamchay M, Zabihi R. The effect of mindfulness-based stress reducing program on tolerance of ambiguity, rumination, and metacognitive awareness in infertile women. Br J Guidance Counc. 2021; 52(2):233-42. [DOI:10.1080/03069885.2021.1961209] [DOI:10.1080/03069885.2021.1961209]
12. Wojsiat J, Korczyński J, Borowiecka M, Żbikowska HM. The role of oxidative stress in female infertility and in vitro fertilization. Postepy Hig Med Dosw. 2017; 71(0):359-66. [DOI:10.5604/01.3001.0010.3820] [PMID] [DOI:10.5604/01.3001.0010.3820]
13. Rooney KL, Domar AD. The relationship between stress and infertility. Dialogues Clin Neurosci. 2018; 20(1):41-7. [DOI:10.31887/DCNS.2018.20.1/klrooney] [PMID] [DOI:10.31887/DCNS.2018.20.1/klrooney]
14. Santa-Cruz DC, Agudo D. Impact of underlying stress in infertility. Curr Opin Obstet Gynecol. 2020; 32(3):233-6. [DOI:10.1097/GCO.0000000000000628] [PMID] [DOI:10.1097/GCO.0000000000000628]
15. Shahi Senobari S, Moeenizadeh M, Aghamohammadian Sharbaf HR, Noferesti A. [Investigating the effectiveness of teaching the positive thinking based on belief to good on life satisfaction and hope of infertile women (Persian)]. J Modern Psychol Res. 2022; 17(66):189-97. [DOI:10.22034/jmpr.2022.15279]
16. Gelgoot EN, Kelly-Hedrick M, Miner SA, Robins S, Chan P, Ells C, et al. Predictors of infertility-related concerns in a Canadian survey of men and women seeking fertility treatment. Patient Educ Counc. 2020; 103(9):1812-20. [DOI:10.1016/j.pec.2020.03.016] [DOI:10.1016/j.pec.2020.03.016]
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
Owned by Qom University of Medical Sciences
Published by Qom University of Medical Sciences Press
eISSN: 2008-1375
pISSN: 1735-7799
Email: journal[at]muq.ac.ir
j.mua.ac[at]gmail.com
