P–467 Emotions, Thoughts, and Coping Strategies of Women with Infertility Problems on Changes in Treatment during Covid–19 Pandemic: A Qualitative Study

Abstract

Study question: What are the emotions, thoughts and coping strategies of women with infertility problems on changes in treatment during the COVID-19 pandemic? Summary answer: Treatment-related procedures keep changing directions, exposing the women to high level of uncertainty. Changes in treatments may be perceived as threats to achieving parenting goals. What is known already: Both infertility and the treatment process constitute a stressful experience. Literature reports that couples describe infertility as the most difficult challenge to overcome in their lives. In addition, it has been reported that women experience more anxiety, stress, and depression than men during this period. Societies and individuals affected by large-scale disasters, such as global pandemics, can develop stress-related disorders. Current data indicate that closure of fertility clinic during the COVID-19 pandemic was associated with a sharp increase in the prevalence of anxiety and depression among patients undergoing fertility treatments and was perceived as an uncontrollable and stressful event. Study design, size, duration: The research was designed as a qualitative study. The data were collected from two Internet forums between October - December 2020. Blogs most frequently used by women with infertility in Turkey were simultaneously selected. The comments of 30 women were included. Participants/materials, setting, methods: Data were screened by using the directed qualitative content analysis. After selecting the blog, emotions, thoughts, and coping strategies expressed by 30 women whose treatment was canceled due to the Covid-19 pandemic or who continued treatment during this period were included in the analysis. The themes created were adapted to Lazarus and Folkman's Transactional Model of Stress and Coping. Main results and the role of chance: The thematic analysis of the expression of women with infertility problems in accordance with the Transactional Model of Stress and Coping stages of Lazarus and Folkman resulted in 4 themes: psychological changes, cognitive changes, changes in social life, and coping strategies. Some women perceived changes in treatments positively, and stopping the treatments due to the uncertainty of the pandemic and its effect on pregnancy and the baby made them feel safe. The majority of women appraised the closure of fertility clinics negatively impacted their lives. They experienced despair, uncertainty, disappointment, anxiety, anger, sadness, and exhaustion from waiting. Also, some participants did not find it right to delay the treatments and felt that the healthcare personnel postponed the treatments to avoid infection. Women experienced feelings of anger, distrust, and threats toward the health authorities. Moreover, the women in our study stated that they were always at home due to the pandemic, far from friends and family, and therefore did did not feel need for self-care and considered themselves ugly. The expressions of women mostly include emotion-based coping strategies. They used activities such as praying, exercising, distracting, noticing the positive side of postponing, and stopping treatments during the pandemic, accepting, and meditating. Limitations, reasons for caution: Clinics closed due to the pandemic or limited procedures caused fewer women to come to the clinics. At the same time, it is not accepted for anyone other than working in the clinic to come to the clinics for scientific studies. Therefore, comments of women have been reached through blogs. Wider implications of the findings: It is believed that approaches based on Lazarus and Folkman's model helped the health professionals to determine potential stressors for women with infertility during the pandemic, and identified areas that required strengthening and improved personal coping strategies.