Conectar
Many studies have identified the negative psychological impact of in vitro fertilisation and embryo transfer (IVF-ET) on couples with infertility, but there remains a paucity of research clarifying both positive and negative effects within the context of Chinese culture.
To explore the dynamic psychosocial experiences and underlying mechanisms of couples in the whole process of IVF-ET, and to construct a theoretical framework that elucidates this phenomenon within the context of Chinese social-culture.
A grounded theory study.
Guided by constructivist grounded theory methodology, semi-structured face-to-face interviews were conducted in the reproductive medicine outpatient department of a tertiary-level hospital located in northwest China between January and October 2023. Purposive and theoretical sampling methods were used to recruit couples undergoing IVF-ET. Data were analysed through three iterative steps: initial coding, focused coding, and theoretical coding, utilising constant comparative methods and reflective memo-writing. The study is reported using the COREQ checklist.
Theoretical saturation was achieved after interviewing 22 couples. The substantive theory was synthesised into one core category: ‘forward or backward’, which captured the ambivalent psychosocial experiences of couples undergoing IVF-ET within the context of Chinese culture. This theory described three overarching stages: making the decision, undergoing the treatment, and facing the result, with each stage linked to specific promoting and hindering factors.
This study establishes a theoretical foundation for further implementation of comprehensive reproductive health management within the Chinese sociocultural context. It is crucial for healthcare providers and policymakers to focus on the dyad of couples undergoing IVF-ET, pay attention to both negatively and positively psychosocial fluctuations, and enhance both medical care and sociocultural support systems accordingly.
No patient or public contribution.
The study investigated the influence of quality of discharge teaching (QDT) on readiness for hospital discharge (RHD) and pathways involved in patients with first-episode stroke, aiming to provide a theoretical framework for enhancing RHD levels and reducing readmission rates.
Cross-sectional study.
A total of 372 inpatients completed the Quality of Discharge Teaching Scale, Readiness for Hospital Discharge Scale, Chronic Disease Self-efficacy Scale and Southampton Stroke Self-Management Questionnaire. Structural equation modelling and Pearson's correlation analysis were utilised to elucidate relationships and action pathways among these variables.
The correlation analysis demonstrated significant positive pairwise correlations between QDT, RHD, self-efficacy and self-management (r = 0.376–0.678, p < 0.01). The final model exhibited a good fit with the following indices: χ 2/df = 3.286, RMSEA = 0.078, SRMR = 0.0303, GFI = 0.984, AGFI = 0.926, CFI = 0.991 and TLI = 0.970. The impact of QDT on RHD in patients with first-episode stroke was observed through one direct and three indirect pathways: (1) QDT exerted a direct influence on RHD (p < 0.001); (2) QDT indirectly influenced RHD via self-efficacy (p < 0.001); (3) QDT indirectly affected RHD through self-management (p < 0.001); and (4) QDT had an indirect effect on RHD via both self-efficacy and self-management (p < 0.05).
QDT was found to directly influence RHD in patients with first-episode stroke and also exerted indirect effects through self-efficacy and self-management, either independently or in combination. Early screening of RHD levels in patients before discharge is recommended, along with the enhancement of QDT through the development of tailored guidance plans according to different disease stages, ultimately improving RHD levels and facilitating a safer transition from hospital to home or community.
Healthcare professionals should assess both QDT and RHD levels to provide targeted interventions. The establishment of transitional care teams and implementation of long-term poststroke management are essential for reducing stroke recurrence and mortality rates.
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