Effects of Acupuncture on Anxiety in Infertile Women: A Systematic Review of the Literature

Background & aim: Stress and anxiety due to waiting for treatment results and uncertainty of treatment success are common problems in infertile women. Acupuncture has been suggested as an effective strategy to relieve anxiety. This study aimed to review the available evidence on the effects of acupuncture on anxiety in infertile women. Methods: This systematic review was conducted via searching in databases such as MEDLINE, PubMed, Cochrane Library, and PsycINFO, as well as clinical trial registries and reference lists of the retrieved articles. Selected articles included the studies published since the initiation of each database until March 2015. All randomized controlled trials regarding the effects of acupuncture on the anxiety of infertile women were reviewed in this study. Moreover, methodological qualities of the selected studies were examined based on the checklist of Oxford Center for Evidence-Based Medicine by two independent investigators. Results: Literature search yielded 193 relevant titles and abstracts, which were narrowed down to four randomized controlled trials involving 595 women.The majority of the reviewed articles showed that use of acupuncture could decrease anxiety in infertile women. Conclusion: According to the results of this systematic review, acupuncture is an effective technique in controlling the anxiety of infertile women. However, it is recommended that future studies with more appropriate design and methodology be conducted in this regard

The perception and experience of infertile women who received acupressure in relation to anxiety: A qualitative study

Background: Women, who are in a critical situation like infertility, are more prone to depression, anxiety, and low self-esteem than other people. The aim of this study was to explore the deep experience of anxiety in infertile women who received acupressure during in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI). Materials and Methods: This qualitative, conventional content analysis study was performed on 14 infertile female participants in the Milad IVF Center in Mashhad, Iran, from September 2015 to August 2016. The study subjects included Iranian women, aged 20–45 (mean [standard deviation, SD] 29.07 [4.06]) years with primary infertility. Acupressure was performed on the Heart 7 and Pericardium 6 acupoints in 12 sessions. Data were gathered through semi-structured interviews, and transcribed, coded, and organized in different categories based on three primary phases of preparation, organization, and reporting. Results: The results showed the two major categories of “body perceptions of anxiety diminution” and “mind experiences.” The body perceptions category consisted of three subcategories, namely, reduction of nervous, cardiovascular, and gastrointestinal signs and symptoms. The subcategories of the mind experiences category consisted of emotional and cognitive consequences. Conclusions: The qualitative findings showed a number of positive outcomes in the physical and mental signs and symptoms of anxiety in infertile women undergoing IVF/ICSI, so acupressure can be used for reducing the unpleasant feelings and body perceptions of these women

Evaluation of acupressure effects on self-efficacy and pregnancy rate in infertile women under in vitro fertilization/intracytoplasmic sperm injection treatment: A randomized controlled trial

Context: Infertility is one of the major stressful events in individual life, especially women. Self-efficacy means a person can perceive a potentially threatening and stressful situation as being amenable to influences of personal control. Aims: This study was conducted to determine the acupressure effects on self-efficacy and pregnancy rate in infertile women under in vitro fertilization (IVF)/intracytoplasmic sperm injection treatment. Settings and Design: This study was a randomized controlled trial in infertile women. It performed at Milad IVF Center, Mashhad, Iran, from September 2015 to August 2016. Materials and Methods: The sample size was 144 participants. The participants were randomly divided into three groups: real and sham acupressure and control groups. Acupressure performed on the H7 and P6 acupoints on both the hands. The infertility self-efficacy scale was completed before and after intervention. Beta-human chorionic gonadotropin hormone assay was measured to determine pregnancy. Data analysis was done by Chi-square, Fisher's exact, paired sample t, Kruskal–Wallis, and ANOVA test and general linear model and multinomial logistic. Levels of significance were reported at P < 0.05. Results: The mean age of women was 30.84 ± 5.34 years. The ovulation factor (P = 0.02) and spouse's job (P = 0.05) were statistically significant difference between the groups. The score of self-efficacy and frequency of clinical pregnancy were no significant difference among three groups. Using linear regression, only the score of primary self-efficacy (before intervention) was in a significant relationship with self-efficacy after the intervention (P < 0.001). Conclusion: To our results, we recommend more research for assessing acupressure effects on self-efficacy and clinical pregnancy rate in infertile women

Factors Influencing Anxiety in Infertile Women Undergoing IVF/ICSI Treatment

Background & aim: Infertility can lead to a diminished sense of well-being and is associated with a high frequency of psychosomatic and somatic disorders. Generally, infertile women are more affected by infertility than men. This study aimed to determine factors influencing anxiety among infertile women undergoing in-vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). Methods: This cross-sectional study was conducted on 224 infertile women who were candidate for IVF/ICSI referred to Milad IVF Center, Mashhad, Iran, from September 2015 to July 2016. Prior to the treatment, the participants completed the demographic characteristics questionnaire and Beck Anxiety Inventory (BAI) to assess the level of anxiety. Additionally, a self-structured questionnaire containing the infertility-associated data including the duration and cause of infertility as well as history and the duration of treatment, was completed by the respondents. The subjects were selected through purposive sampling technique. Data analysis was performed using Mann-Whitney U, Kruskal-Wallis, Fisher exact test, regression tests, as well as Spearman’s correlation coefficient in SPSS software, version 16.   Results: The results obtained from BAI showed that 38.4% of the subjects had moderate anxiety. There was a significant relationship between the level of anxiety and age (P=0.001), the cause of infertility (P=0.007), and the duration of treatment (P=0.001). Conclusion: As the level of anxiety was higher in infertile women with younger age, female factor infertility and longer duration of treatment, it is recommended to consider this population more vulnerable and to provide them supportive counseling to be able to overcome their anxiety

Nursing students\' satisfaction and reactions to oral versus written feedback during clinical education

Introduction: Clinical instruction is known as the essence of education in medical sciences, while feedback delivery is a core responsibility of clinical instructors. This study aims to compare the nursing students' satisfaction and reactions to oral versus written feedback during clinical education.  Methods: This is a single blinde, randomized controlled trial. A purposive sample of last semester-nursing students (n=44) was selected and randomly assigned into one of verbal or written feedback groups. Each instructor (n=3) was scheduled to teach two groups, and deliver either verbal or written feedback. Instructors were well attuned to feedback delivery sessions they would hold during their instructional tasks. Instructors were asked to give necessary feedback to the students and document the details of their reaction using the checklists designed for this purpose during the instruction period, daily and during the nine days of instruction. At the end of each instruction period, a questionnaire designed to measure the satisfaction level of feedback delivery sessions was filled out by students. Results: The study did not show difference of satisfaction level between the oral and written feedback groups. The relationship between students' reactions and feedback type at the confidence level of 90% was significant, so that students who received oral feedback showed more severe reactions as compared to written feedback group. Conclusion: Students, satisfaction level in both groups was the same. There is no difference in students' satisfaction between verbal versus written feedback groups. But the number of severe negative reactions in verbal feedback group was significantly higher and this is congruent with previous studies