Transforming Hope: The Lived Experience of Infertile Women Who Terminated Treatment after in Vitro Fertilization Failure

轉換希望－放棄治療之體外受精治療失敗婦女的生活經驗

蘇燦煮(Tsann-Juu Su)；陳月枝(Yueh-Chih Chen)

轉換希望 ； 不孕症 ； 體外受精 ； 生活經驗 ； 希望 ； transforming hope ； infertility ； in vitro fertilization ； lived experience ； hope

The Journal of Nursing Research

14卷1期（2006 / 03 / 01）

46 - 54

英文

生殖科技帶給不孕者高度的懷孕希望。但是，並非每個人都能實現。本研究目的為探討經歷體外受精治療失敗後並放棄治療的不孕婦女之生活經驗。本研究採質性研究設計，研究情境為台灣北部一所醫學中心。研究對象為曾接受體外受精治療失敗後一年，並已放棄治療的不孕婦女，經其同意，逐一收集，共24人。研究者依據會談指引，採訪談法收集資料，以文字紀錄，經由Benner現象學之解釋性研究的三個策略分析：主題分析、範例分析及典範案例分析。本研究經過該醫學中心倫理委員會審查通過，並獲所有研究對象之同意參與。研究結果：由資料歸類出研究對象之生活經驗的主題為轉換希望；包括三個類目：對不孕事實的接受、對高科技醫療限制的感慨、與對未來生活的重新定位。結論：放棄治療之不孕婦女的醫療諮詢需包括告知治療的完整訊息、持續評估治療的反應及協助患者重新自我定位。

Assisted reproductive treatments provide the hope of pregnancy for infertile women, but do not always turn this hope into reality. The purpose of this study was to explore the lived experience of infertile women who terminated treatment after in vitro fertilization (IVF) failure. Using a qualitative research design, 24 subjects were recruited who had experienced IVF failure and decided to terminate their treatment. Data were collected through interviews, and analyzed using interpretive research strategies of phenomenology. This study protocol was reviewed and approved by the University Review Board for Research. Informed consent was obtained from each subject. The theme of lived experience which emerged from the data was ”transforming hope”. This theme included three categories: (1) accepting the reality of infertility, (2) acknowledging the limitations of treatment involving high technology, and (3) re-identifying one's future. The results illustrated that counseling for these women should involve the provision of both positive and negative information, evaluation of the response to treatment, and assistance in defining their future.

1. Beckman, L. J.,Harvey, S. M.(2005).Current reproductive technologies: Increased access and choice?.Journal of Social Issues,61(1),1-20.
2. Benner, P.(1994).Interpretive phenomenology: Embodiment, caring, and ethics in health and illness.Los Angeles:Sage.
3. Benner, P.(1985).Quality of life: A phenomenological perspective on explanation, prediction, and understanding in nursing science... a Heideggerian approach.Advances in Nursing Science,8(1),1-14.
4. Benzein, E.,Berg, A.(2003).The Swedish version of Herth Hope Index-an instrument for palliative care.Scandinavian Journal of Caring Sciences,17(4),409-415.
5. Boivin, J.,Takefman, J. E.,Tulandi, T.,Brender, W.(1995).Reactions to infertility based on extent of treatment failure.Fertility & Sterility,63(4),801-807.
6. Chao, K. H.,Chen, S. U.,Chen, H. F.,Wu, M. Y.,Yang, Y. S.,Ho, H. N.(1997).Assisted hatching increases the implantation and pregnancy rate of in vitro fertilization (IVF)-embryo transfer (ET), but not that of IVF-tubal ET in patients with repeated IVF failures.Fertility & Sterility,67(5),904-908.
7. Chuang, C. C.,Chen, C. D.,Chao, K. H.,Chen, S. U.,Ho, H. N.,Yang, Y. S.(2003).Age is a better predictor of pregnancy potential than basal follicle-stimulating hormone levels in women undergoing in vitro fertilization.Fertility & Sterility,79(1),63-68.
8. Clarke, D.(2003).Faith and hope.Australasian Psychiatry,11(2),164-168.
9. Creac''h-Le Mer, M. N.,Stoleru, S. G.,Cornet, D.,Zerah, S.,Fermanian, J.,Bimbard, S.(1999).Women's anxiety is a predictor of the implantation step of in vitro fertilisation.Psychosomatic Medicine,61(1),92.
10. Csemiczky, G.,Landgren, B. M.,Collins, A.(2000).The influence of stress and state anxiety on the outcome of IVF-treatment: Psychological and endocrinological assessment of Swedish women entering IVF-treatment.Acta Obstetricia et Gynecologica Scandinavica,79(2),113-118.
11. Dufault, K.,Martocchio, B. C.(1985).Hope: Its spheres and dimensions.Nursing Clinics of North America,20(2),379-391.
12. Facchinetti, F.,Matteo, M. L.,Artini, G. P.,Volpe, A.,Genazzani, A. R.(1997).An increased vulnerability to stress is associated with a poor outcome of in vitro fertilization-embryo transfer treatment.Fertility & Sterility,67(2),309-314.
13. Farran, C. J.,Herth, K. A.,Popovich, J. M.(1995).Hope and hopelessness: Critical clinical constructs.Thousand Oaks, CA:Sage.
14. Gibson, P. R.(1999).Hope in multiple chemical sensitivity: Social support and attitude towards healthcare delivery as predictors of hope.Journal of Clinical Nursing,8(3),275-283.
15. Hjelmstedt, A.,Widstrom, A. M.,Wramsby, H.,Collins, A.(2004).Emotional adaptation following successful in vitro fertilization.Fertility & Sterility,81(5),1254-1264.
16. Holt, J.(2000).Exploration of the concept of hope in the Dominican Republic.Journal of Advanced Nursing,32(5),1116-1125.
17. Jee, B. C.,Ku, S. Y.,Suh, C. S.,Choi, Y. M.,Kim, J. G.,Moon, S. Y.(2004).Cumulative ongoing pregnancy rate in intracytoplasmic sperm injection cycles.Journal of Obstetrics and Gynaecology Research,30(5),372-376.
18. Johansson, M.,Berg, M.(2005).Women's experiences of childlessness 2 years after the end of in vitro fertilization treatment.Scandinavian Journal of Caring Sciences,19(1),58-63.
19. Klinkert, E. R.,Broekmans, F. J.,Looman, C. W.,Te Velde, E. R.(2004).A poor response in the first in vitro fertilization cycle is not necessarily related to a poor prognosis in subsequent cycles.Fertility & Sterility,81(5),1247-1253.
20. LaRossa, R.(1986).Becoming a parent.Los Angeles:Sage.
21. Leonard, V. W.(1989).A Heideggerian phenomenological perspective on the concept of the person.Advances in Nursing Science,11(4),40-55.
22. Li, J. T.(2000).Hope and the medical encounter.Mayo Clinic Proceedings,75(7),765-767.
23. Lincoln, Y.(Eds.),Guba, E.(Eds.)(1985).Naturalistic inquiry.Beverly Hills, CA:Sage.
24. McQuillan, J.,Greil, A. L.,White, L.,Jacob, M. C.(2003).Flustrated fertility: Infertility and psychological distress among women.Journal of Marriage and Family,65,1007-1018.
25. Menning, B. E.(1980).The emotional needs of infertile couples.Fertility & Sterility,34(4),313-319.
26. Miller, K.(2004).Assisted reproduction may change birth intentions.Fertility & Sterility,81(3),572-581.
27. Moore, S. L.(2005).Hope makes a difference.Journal of Psychiatric and Mental Health Nursing,12(1),100-105.
28. Olivius, K.,Friden, B.,Lundin, K.,Bergh, C.(2002).Cumulative probability of live birth after three in vitro fertilization/intracytoplasmic sperm injection cycles.Fertility & Sterility,77(3),505-510.
29. Reame, N.(1999).Informed consent issues in assisted reproduction.Journal of Obstetric, Gynecologic, & Neonatal Nursing,28(3),331-338.
30. Rustoen, T.,Wiklund, I.(2000).Hope in newly diagnosed patients with cancer.Cancer Nursing,23(3),214-219.
31. Ryan, G. L.,Zhang, S. H.,Dokras, A.,Syrop, C. H.,Van Voorhis, B. J.(2004).The desire of infertile patients for multiple births.Fertility & Sterility,81(3),500-504.
32. Schoener, C. J.,Krysa, L. W.(1996).The comfort and discomfort of infertility.Journal of Obstetric, Gynecologic, & Neonatal Nursing,25(2),167-172.
33. Shanner, L.,Nisker, J.(2001).Bioethics for clinicians: 26 assisted reproductive technologies.Canadian Medical Association Journal,164(11),1589-1594.
34. Su, T. J.,Chen, Y. C.,Hung, Y. T.,Yang, Y. S.(2001).Comparative study of daily activities of pregnant and non-pregnant women after in vitro fertilization and embryo transfer.Journal of the Formosan Medical Association,100(4),262-268.
35. Yang, Y. S.(1999).Synopsis of reproductive endocrinology and infertility.Taipei:Health World.
36. Yang, Y. S.,Hwang, J. L.,Ho, H. N.,Lien, Y. R.,Lin, H. R.,Chiu, Y. H.(1991).Translaparoscopic tubal embryo transfer: Preliminary experience at National Taiwan University Hospital.Asia-Oceania Journal of Obstetrics & Gynaecology,17(3),255-259.

1. Okumuş, Hülya,Boz, İlkay(2017).The "Everything About the Existence" Experiences of Turkish Women With Infertility: Solicited Diaries in Qualitative Research.The Journal of Nursing Research,25(4),268-275.
2. 蘇燦煑(2009)。不孕婦女對「自我放鬆訓練」的學習狀況。亞東學報，29，199-206。