Infertility has a stressful impact on both partners, with adverse effects on the quality of life of infertile couples. Spirituality is a meaning-based strategy that can protect couples against infertility's negative impact on quality of life, but analysis of this mediator relationship in infertile couples has not been reported. We adopted a dyadic approach and used the actor-partner interdependence mediation model to examine whether and how women's and men's spirituality was associated with their own and their partners' infertility-related stress and quality of life. In 2014, 152 infertile couples starting their first fertility treatment at a private clinic in Brazil were recruited and completed self-reports of spirituality, infertility-related stress, and quality of life. Results indicated that women's and men's level of spirituality was positively associated with their own quality of life directly and indirectly, by reducing their own infertility-related stress. Their spirituality was associated with an increase in their partners' quality of life only indirectly, by reducing their partners' infertility-related stress. Findings highlight the importance of assessing and promoting spirituality as a coping resource that infertile women and men might use to deal with the stress of infertility and reduce its adverse effects on quality of life.

No abstract

This study adopted a dyadic approach to explore the associations between social support and stress as mediated by coping among infertile couples. All these variables were infertility-specific. A total of 201 couples starting their first assisted reproductive technology (ART) treatment completed self-reports of infertility-specific support from spouse and from social network, infertility-related coping with four strategies (active-avoidance, active-confronting, passive-avoidance, and meaning-based), and infertility stress. The actor-partner interdependence model was applied. Results indicated that dyadic associations between support and stress were either direct or mediated by individual or partner coping, with differences based on gender, source of support, and coping strategy. For both genders, greater support from spouse was associated with lower individual and partner stress directly and indirectly, through lower partner's use of active-avoidance coping. In men, the relationship between support from spouse and stress was also mediated by individual/partner avoidance coping strategies. As for support from social network, greater levels were directly associated with a lower partner stress in women and with higher individual stress in men. For both genders, the relationship between support from social network and stress was also mediated by active-confronting coping, which was associated with higher individual and partner stress. The findings suggest a potential protective role of support from spouse and an adverse effect of that from people outside the dyad. Interventions for couples starting ART treatment should focus on promoting infertility-related communication and support within the couple, which might help to reduce the use of infertility-specific maladaptive coping strategies.

No abstract

Background: The quality of life (QoL) of patients with endometriosis and infertility was assessed in different stages and correlated with the clinical features of the cases. Methods: The present study was a cross-sectional study; 106 women were included, divided in two endometriosis groups (Grade I/II, 26 women, and Grade II/IV, 74 women). All participants attended the Endometriosis and Infertility

ObjectivesTo explore and compare the perspectives of junior doctors in Brazil and Ireland regarding transition and professional socialisation during the COVID-19 pandemic, with the purpose of identifying better ways to support doctors as they assume their new professional role.Design27 semistructured interviews. Transcripts were analysed using qualitative thematic analysis. Cruess’ framework of professional socialisation in medicine supported the interpretation of these data.SettingPublic health hospitals across four Brazilian states (Santa Catarina, São Paulo, Ceará, Paraíba) and County Cork in the South of Ireland.ParticipantsTwenty-seven male and female medical junior doctors who had graduated between November 2019 and April 2020.ResultsFourteen Brazilian and 13 Irish junior doctors were interviewed for this study. Entry to clinical practice during the pandemic had a significant impact on factors influencing the professional socialisation of junior doctors. This impact was reflected across the following six thematic areas: lack of preparedness; disrupted trajectory of role adaptation; fewer opportunities for experiential learning; solidarity and isolation; altered interactions with patients; challenges to health and well-being.ConclusionsTransition to clinical practice is an important stage in junior doctors’ professional socialisation and identity formation. The COVID-19 pandemic created the opportunity for medical graduates to enter the workforce earlier than usual. Entering the workforce during this period created a lack of confidence among junior doctors concerning the boundaries of their new role and responsibilities, while simultaneously disrupting their social integration. Priorities to mitigate the impact of COVID-19 and future pandemics on this transition are presented.

No abstract

Background Communication of bad news plays a critical role in the physician-patient relationship, and a variety of consensus guidelines have been developed to this purpose, including the SPIKES protocol. However, little is known about physicians’ attitudes towards breaking bad news and to be trained to deliver it. This study aimed to develop and validate a self-report questionnaire to assess physicians’ attitudes towards principles of the SPIKES protocol and training on them. Methods The Breaking Bad News Attitudes Scale (BBNAS) was administered to 484 pediatricians and 79 medical students, recruited at two scientific conferences and two medical schools in Brazil. The questionnaire structural validity, reliability, and associations with other variables were tested. Results The BBNAS showed adequate validity and good reliability, with two factors measuring attitudes towards the SPIKES strategy for braking bad news (α = 0.81) and the possibility to be trained on it (α = 0.77), respectively. Conclusion The novel questionnaire is a psychometrically sound measure that provides information on physicians’ agreement with the SPIKES protocol. The BBNAS can provide useful information for planning training and continuing education programs for clinicians on communication of bad news using the SPIKES as a framework.