Influence of illness representations on coping strategies and psychosocial outcomes of infertility: Systematic review and meta-analysis

Abstract

Background: This systematic review and meta-analysis was based on the Common Sense Model, applied to infertility. Aims: The aim was to examine the relationships between cognitive (i.e. cause, coherence, consequences, controllability, identity and timeline) or emotional representations of infertility and both coping (i.e. maladaptive and adaptive) and psychosocial outcomes (i.e. distress, anxiety, depressive symptoms, social isolation, low well-being and poor quality of life), reporting followed PRISMA guidelines. Materials & Methods: Five databases (PubMed, PsycINFO, PsycARTICLES, PubPsych and CINAHL) were searched, and 807 articles were initially identified. Results: Seven cross-sectional studies (N = 1208 participants) were retained in qualitative and quantitative analyses. These studies assessed the associations of seven types of representations with either maladaptive or adaptive coping (20 effect sizes), or with psychosocial outcomes (131 effect sizes). A multivariate meta-analysis revealed that none (0/2) of the associations between the sole type of representation considered (i.e. controllability) and coping strategies were statistically significant, whereas three (3/7) of the associations between representations of infertility and psychosocial outcomes were statistically significant. Regardless of p-values, pooled estimates ranged from low (r =.03) to very high (r =.59). Discussion: Future studies should validate specific measurement tools for measuring cognitive and emotional representations of infertility. Conclusion: Our results highlight the influence of representations of infertility (particularly cognitive representations of consequences and emotional representations) on the psychosocial outcomes of infertility.