Effects of comprehensive care on mood and quality of life in infertile patients

Objective: To evaluate the effects of a comprehensive care management program on bad mood and quality of life (QoL) in infertile patients. Methods: Three hundred and sixty infertile patients were recruited in this study. The psychological status of the patients was evaluated by the Symptom Check-List-90 (SCL-90) scale. The recruited patients were randomized into the control group or the study group. The patients in the control group were assigned to receive usual care, whereas those in the study group underwent a comprehensive care management program in addition to usual care. The overall satisfaction with care, the incidence of pregnancy, and the time to pregnancy were compared between the two groups. Additionally, the Hamilton Rating Scale for Depression (HRSD), the Zung Self-Rating Anxiety Scale (SAS), the medical coping modes questionnaire (MCMQ) and the Generic Quality of Life Inventory-74 (GQOLI-74) were utilized to evaluate the psychological status of the patients. Changes in sexual hormones and ovulation of patients in the two groups were monitored, and the effects of comprehensive care were assessed based on changes in endocrine hormone levels of the patients. Results: Comparison of the SCL-90 scores of all patients with national normal values revealed that the major psychological problems of infertile patients were somatization, depression, anxiety, hostility and interpersonal sensitivity. After comprehensive care, satisfaction with care, incidence of pregnancy and time to pregnancy were strikingly improved in the study group as compared with those in the control group (all P<0.05). Before intervention, the scores on the HRSD, SAS, FPI, MCMQ and GQOLI-74 differed insignificantly between the two groups (all P>0.05). Conversely, after intervention, the HRSD, SAS and FPI scores in the study group were substantially lower than those of the control group (all P<0.05). As for the MCMQ scores, the score of confrontation (a coping mode) was remarkably higher in the study group than in the control group (P<0.05), whereas the scores of submission and avoidance were markedly lower in the study group (both P<0.05). The QoL of the study group was significantly better than that of the control group (P<0.05). The follicle stimulating hormone (FSH), luteinizing hormone (LH), progesterone (P), and prolactin (PRL) levels in the study group were strikingly higher than those in the control group (all P<0.05), but the disparities in the estradiol (E2) and testosterone (T) levels were mild (both P>0.05). A remarkably higher rate of ovulation was noted in the study group (P<0.05). Conclusion: The addition of a comprehensive care management program to usual care for infertility results in greater improvements in the bad mood, the QoL, and physiological status of patients, which is worthy of clinically wide use.