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09-01-2023

Evaluating health-related quality of life and subjective wellbeing among infertility patients: a cross-sectional study in mainland China

Auteurs: Zhao Shi, Hongwei Nie, Ling Geng, Xuewen Wang, Gang Chen, Shunping Li

Gepubliceerd in: Quality of Life Research | Uitgave 5/2023

Abstract

Purpose

This study aimed to explore the health-related quality of life (HRQoL) and subjective wellbeing (SWB) of infertility patients in mainland China and to investigate the relationships between HRQoL and SWB instruments in infertility patients.

Methods

We conducted this cross-sectional study in the Hospital for Reproductive Medicine Affiliated of Shandong University between April 2019 and November 2019. Participants self-completed the five-level EQ-5D (EQ-5D-5L) questionnaire, the Assessment of Quality of Life (AQoL)-8D, and the WHO-5 wellbeing index (WHO-5). The agreements between EQ-5D-5L and AQoL-8D were assessed employing intraclass correlation coefficient (ICC) and Bland-Altman plots. Exploratory factor analysis (EFA) was conducted to examine the difference in descriptive systems among the three instruments.

Results

We analyzed a valid sample of 618 infertility patients (84.4%). The mean scores of the total EQ-5D-5L, AQoL-8D, and WHO-5 were 0.96 (95%CI 0.96, 0.96), 0.80 (95%CI 0.79, 0.81), and 16.92 (95%CI 16.52, 17.31), respectively. Patients diagnosed with primary infertility had significantly lower HRQoL and SWB than those with secondary infertility. The ICC of EQ-5D-5L and AQoL-8D was 0.14. The AQoL-8D (r = 0.625) was more strongly correlated with WHO-5 than with the EQ-5D-5L (r = 0.262). The EFA results indicated that HRQoL instruments and the WHO-5 instruments were complementary rather than substitutable.

Conclusions

Poorer HRQoL and SWB were found that primary than secondary infertility patients. There exists a poor agreement between EQ-5D-5L and AQoL-8D and the difference in the psychosocial components may explain the difference. Measuring both HRQoL and SWB could provide complementary information for infertility patients.

vorige artikel Lived experience of patients with sleep apnea: a systematic synthesis of qualitative evidence

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Zegers-Hochschild, F., Adamson, G. D., Dyer, S., Racowsky, C., de Mouzon, J., Sokol, R., et al. (2017). The international glossary on infertility and fertility care, 2017. Human Reproduction, 32(9), 1786–1801. https://doi.org/10.1016/j.fertnstert.2017.06.005CrossRefPubMedPubMedCentral

Qiao, J., Wang, Y., Li, X., Jiang, F., Zhang, Y., Ma, J., et al. (2021). A Lancet Commission on 70 years of women’s reproductive, maternal, newborn, child, and adolescent health in China. Lancet, 397(10293), 2497–2536. https://doi.org/10.1016/S0140-6736(20)32708-2CrossRefPubMed

Zhou, Z., Zheng, D., Wu, H., Li, R., Xu, S., Kang, Y., et al. (2017). Epidemiology of infertility in China: A population-based study. BJOG, 125(4), 432–441. https://doi.org/10.1111/1471-0528.14966CrossRefPubMed

China's infertility rate reached 12–15 percent (in chinese) [Internet]. Beijing: The Beijing News. 2018 Oct, 30. Chinese. Retrieved December 12, 2022, from http://epaper.bjnews.com.cn/html/2018-10/30/content_736104.htm?div=-1.

Omani-Samani, R., Ghaheri, A., Navid, B., Sepidarkish, M., & Maroufizadeh, S. (2018). Prevalence of generalized anxiety disorder and its related factors among infertile patients in Iran: A cross-sectional study. Health and Quality of Life Outcomes. https://doi.org/10.1186/s12955-018-0956-1CrossRefPubMedPubMedCentral

Ramezanzadeh, F., Aghssa, M. M., Abedinia, N., Zayeri, F., Khanafshar, N., Shariat, M., et al. (2004). A survey of relationship between anxiety, depression and duration of infertility. BMC Women’s Health. https://doi.org/10.1186/1472-6874-4-9CrossRefPubMedPubMedCentral

Schmidt, L. (2006). Psychosocial burden of infertility and assisted reproduction. Lancet, 367(9508), 379–380. https://doi.org/10.1016/S0140-6736(06)68117-8CrossRefPubMed

Wang, K., Li, J., Zhang, J. X., Zhang, L., Yu, J., & Jiang, P. (2007). Psychological characteristics and marital quality of infertile women registered for in vitro fertilization-intracytoplasmic sperm injection in China. Fertility and Sterility, 87(4), 792–798. https://doi.org/10.1016/j.fertnstert.2006.07CrossRefPubMed

Monga, M., Alexandrescu, B., Katz, S. E., Stein, M., & Ganiats, T. (2004). Impact of infertility on quality of life, marital adjustment, and sexual function. Urology, 63(1), 126–130. https://doi.org/10.1016/j.urology.2003.09.015CrossRefPubMed

10.

Luk, B.H.-K., & Loke, A. Y. (2015). The impact of infertility on the psychological well-being, marital relationships, sexual relationships, and quality of life of couples: A systematic review. Journal of Sex & Marital Therapy, 41(6), 610–625. https://doi.org/10.1080/0092623X.2014.958789CrossRef

11.

Lau, J. T. F., Wang, Q. S., Cheng, Y. M., Kim, J. H., Yang, X. L., & Tsui, H. Y. (2008). Infertility-related perceptions and responses and their associations with quality of life among rural Chinese infertile couples. Journal of Sex & Marital Therapy, 34(3), 248–267. https://doi.org/10.1080/00926230701866117CrossRef

12.

Food and drug administration (FDA). (2009). Guidance for Industry Patient-Reported Outcome Measures: Use in Medical Product Development to Support Labeling Claims. Retrieved December 12, 2021, from https://www.fda.gov/regulatory-information/search-fda-guidance-documents/patient-reported-outcome-measures-use-medical-product-development-support-labeling-claims.

13.

Brazier, J., Ratcliffe, J., Salomon, J., & Tsuchiya, A. (2017). Measuring and valuing health benefits for economic evaluation (2nd ed.). Oxford University Press.

14.

Kitchen, H., Aldhouse, N., Trigg, A., Palencia, R., & Mitchell, S. (2017). A review of patient-reported outcome measures to assess female infertility-related quality of life. Health and Quality of Life Outcomes, 15(1), 86. https://doi.org/10.1186/s12955-017-0666-0CrossRefPubMedPubMedCentral

15.

Mousavi, S. A., Masoumi, S. Z., Keramat, A., Pooralajal, J., & Shobeiri, F. (2013). Assessment of questionnaires measuring quality of life in infertile couples: A systematic review. Journal of Reproduction & Infertility, 14(3), 110–119.

16.

Hubens, K., Arons, A. M. M., & Krol, M. (2018). Measurement and evaluation of quality of life and well-being in individuals having or having had fertility problems: A systematic review. European Journal of Contraception and Reproductive Health Care, 23(6), 441–450. https://doi.org/10.1080/13625187.2018.1539161CrossRefPubMed

17.

Krol, M., Nap, A., Michels, R., Veraart, C., & Goossens, L. (2019). Health state utilities for infertility and subfertility. Reproductive Health, 16, 47. https://doi.org/10.1186/s12978-019-0706-9CrossRefPubMedPubMedCentral

18.

Diener, E., Suh, E. M., Lucas, R. E., & Smith, H. L. (1999). Subjective well-being: Three decades of progress. Psychological Bulletin, 125(2), 276–302. https://doi.org/10.1037//0033-2909.125.2.276CrossRef

19.

Lee, H., Vlaev, I., King, D., Mayer, E., Darzi, A., & Dolan, P. (2013). Subjective well-being and the measurement of quality in healthcare. Social Science & Medicine, 99, 27–34. https://doi.org/10.1016/j.socscimed.2013.09.027CrossRef

20.

Wang, Y., Fu, Y., Ghazi, P., Gao, Q., Tian, T., Kong, F., et al. (2022). Prevalence of intimate partner violence against infertile women in low-income and middle-income countries: A systematic review and meta-analysis. The Lancet. Global health, 10(6), e820–e830. https://doi.org/10.1016/S2214-109X(22)00098-5CrossRefPubMedPubMedCentral

21.

Chachamovich, J. R., Chachamovich, E., Ezer, H., Fleck, M. P., Knauth, D., & Passos, E. P. (2010). Investigating quality of life and health-related quality of life in infertility: A systematic review. Journal of Psychosomatic Obstetrics & Gynecology, 31(2), 101–110. https://doi.org/10.3109/0167482X.2010.481337CrossRef

22.

Bockerman, P., Johansson, E., & Saarni, S. I. (2011). Do established health-related quality-of-life measures adequately capture the impact of chronic conditions on subjective well-being? Health Policy, 100(1), 91–95. https://doi.org/10.1016/j.healthpol.2010.10.008CrossRefPubMed

23.

Richardson, J., Chen, G., Khan, M. A., & Iezzi, A. (2015). Can multi-attribute utility instruments adequately account for subjective well-being? Medical Decision Making, 35(3), 292–304. https://doi.org/10.1177/0272989X14567354CrossRefPubMed

24.

Albornoz, S. C. D., & Chen, G. (2021). Relationship between health-related quality of life and subjective wellbeing in asthma. Journal of Psychosomatic Research, 142, 110356. https://doi.org/10.1016/j.jpsychores.2021.110356CrossRefPubMed

25.

Cubi-Molla, P., de Vries, J., & Devlin, N. (2014). A study of the relationship between health and subjective well-being in Parkinson’s disease patients. Value in Health, 17(4), 372–379. https://doi.org/10.1016/j.jval.2014.03.002CrossRefPubMed

26.

Liu, L., Li, S., Zhao, Y., Zhang, J., & Chen, G. (2018). Health state utilities and subjective well-being among psoriasis vulgaris patients in mainland China. Quality of Life Research, 27(5), 1323–1333. https://doi.org/10.1007/s11136-018-1819-2CrossRefPubMed

27.

Walters, S. (2009). Quality of life outcomes in clinical trials and health-care evaluation. New York: Wiley.CrossRef

28.

Herdman, M., Gudex, C., Lloyd, A., Janssen, M. F., Kind, P., Parkin, D., et al. (2011). Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Quality of Life Research, 20(10), 1727–1736. https://doi.org/10.1007/s11136-011-9903-xCrossRefPubMedPubMedCentral

29.

Janssen, M. F., Bonsel, G. J., & Luo, N. (2018). Is EQ-5D-5L better than EQ-5D-3L? A head-to-head comparison of descriptive systems and value sets from seven countries. PharmacoEconomics, 36(6), 675–697. https://doi.org/10.1007/s40273-018-0623-8CrossRefPubMedPubMedCentral

30.

Scalone, L., Ciampichini, R., Fagiuoli, S., Gardini, I., Fusco, F., Gaeta, L., et al. (2013). Comparing the performance of the standard EQ-5D-3L with the new version EQ-5D-5L in patients with chronic hepatic diseases. Quality of Life Research, 22(7), 1707–1716. https://doi.org/10.1007/s11136-012-0318-0CrossRefPubMed

31.

Luo, N., Li, M. H., Liu, G. G., Lloyd, A., de Charro, F., & Herdman, M. (2013). Developing the Chinese version of the new 5-level EQ-5D descriptive system: The response scaling approach. Quality of Life Research, 22(4), 885–890. https://doi.org/10.1007/s11136-012-0200-0CrossRefPubMed

32.

Luo, N., Chew, L. H., Fong, K. Y., Koh, D. R., & Thumboo, J. (2003). Do English and Chinese EQ-5D versions demonstrate measurement equivalence? An exploratory study. Health and Quality of Life Outcomes, 1(1), 7. https://doi.org/10.1186/1477-7525-1-7CrossRefPubMedPubMedCentral

33.

Zhou, T., Guan, H., Wang, L., Zhang, Y., Rui, M., & Ma, A. (2021). Health-related quality of life in patients with different diseases measured with the EQ-5D-5L: A systematic review. Frontiers in Public Health. https://doi.org/10.3389/fpubh.2021.675523CrossRefPubMedPubMedCentral

34.

Luo, N., Liu, G., Li, M. H., Guan, H. J., Jin, X. J., & Rand-Hendriksen, K. (2017). Estimating an EQ-5D-5L value set for China. Value in Health, 20(4), 662–669. https://doi.org/10.1016/j.jval.2016.11.016CrossRefPubMed

35.

Richardson, J., Iezzi, A., Khan, M. A., & Maxwell, A. (2014). Validity and reliability of the Assessment of Quality of Life (AQoL)-8D multi-attribute utility instrument. The Patient-Patient Centered Outcomes Research, 7(1), 85–96. https://doi.org/10.1007/s40271-013-0036-xCrossRefPubMed

36.

Richardson, J., Mckie, J., & Bariola, E. (2014). Multiattribute utility instruments and their use. Encyclopedia of Health Economics, 2, 341–357.

37.

Si, L., Tu, L., Xie, Y., Chen, G., Hiligsmann, M., Yang, M., et al. (2020). Evaluating health related quality of life in older people at risk of osteoporotic fracture: A head-to-head comparison of the EQ-5D-5L and AQoL-6D. Social Indicators Research, 160(2–3), 809–824. https://doi.org/10.1007/s11205-020-02414-8CrossRef

38.

Si, Y., Li, S., Xu, Y., & Chen, G. (2021). Validation and comparison of five preference-based measures among age-related macular degeneration patients: Evidence from mainland China. Quality of Life Research, 31(5), 1561–1572. https://doi.org/10.1007/s11136-021-03047-1CrossRefPubMed

39.

Richardson, J., Sinha, K., Iezzi, A., & Khan, M. A. (2014). Modelling utility weights for the Assessment of Quality of Life (AQoL)-8D. Quality of Life Research, 23(8), 2395–2404. https://doi.org/10.1007/s11136-014-0686-8CrossRefPubMed

40.

WHO. (1998). Wellbeing measures in primary health care/The Depcare Project. WHO Regional Office for Europe.

41.

About the WHO-5. Retrieved December 12, 2022, from https://www.psykiatri-regionh.dk/who-5/who-5-questionnaires/Pages/default.aspx.

42.

Topp, C. W., Ostergaard, S. D., Sondergaard, S., & Bech, P. (2015). The WHO-5 Well-Being Index: A systematic review of the literature. Psychotherapy and Psychosomatics, 84(3), 167–176. https://doi.org/10.1159/000376585CrossRefPubMed

43.

Reuvers, S. H. M., Korfage, I. J., Scheepe, J. R., & Blok, B. F. M. (2017). The urinary-specific quality of life of multiple sclerosis patients: Dutch translation and validation of the SF-Qualiveen. Neurourology and Urodynamics, 36(6), 1629–1635. https://doi.org/10.1002/nau.23168CrossRefPubMed

44.

Terwee, C. B., Bot, S. D. M., de Boer, M. R., van der Windt, D. A. W. M., Knol, D. L., Dekker, J., et al. (2007). Quality criteria were proposed for measurement properties of health status questionnaires. Journal of Clinical Epidemiology, 60(1), 34–42. https://doi.org/10.1016/j.jclinepi.2006.03.012CrossRefPubMed

45.

Fayers, P., & Machin, D. (2016). Quality of life: The assessment, analysis and interpretation of patient-reported outcomes. Wiley Blackwell.

46.

Cohen, J. (1992). A power primer. Psychological Bulletin, 112(1), 155–159. https://doi.org/10.1037//0033-2909.112.1.155CrossRefPubMed

47.

Ratner, B. (2009). The correlation coefficient: Its values range between +1/1, or do they? Journal of Targeting Measurement & Analysis for Marketing, 17(2), 139–142.CrossRef

48.

Helter, T. M., Coast, J., Laszewska, A., Stamm, T., & Simon, J. (2022). Comparison of capability and health-related quality of life instruments in capturing aspects of mental well-being in people with schizophrenia and depression. BJPsych Open. https://doi.org/10.1192/bjo.2022.514CrossRefPubMedPubMedCentral

49.

Laszewska, A., Schwab, M., Leutner, E., Oberrauter, M., Spiel, G., & Simon, J. (2019). Measuring broader wellbeing in mental health services: Validity of the German language OxCAP-MH capability instrument. Quality of Life Research, 28(8), 2311–2323. https://doi.org/10.1007/s11136-019-02187-9CrossRefPubMedPubMedCentral

50.

Engel, L., Mortimer, D., Bryan, S., Lear, S. A., & Whitehurst, D. G. T. (2017). An investigation of the overlap between the ICECAP-A and five preference-based health-related quality of life instruments. PharmacoEconomics, 35(7), 741–753. https://doi.org/10.1007/s40273-017-0491-7CrossRefPubMed

51.

Chen, G., Ratcliffe, J., Kaambwa, B., McCaffrey, N., & Richardson, J. (2018). Empirical comparison between capability and two health-related quality of life measures. Social Indicators Research, 140(1), 175–190. https://doi.org/10.1007/s11205-017-1788-9CrossRef

52.

Williams, B., Brown, T., & Onsman, A. (2010). Exploratory factor analysis: A five-step guide for novices. Australasian Journal of Paramedicine, 8(3), 1–13. https://doi.org/10.33151/ajp.8.3.93CrossRef

53.

Timmerman, M. E., & Lorenzo-Seva, U. (2011). Dimensionality assessment of ordered polytomous items with parallel analysis. Psychological Methods, 16(2), 209–220. https://doi.org/10.1037/a0023353CrossRefPubMed

54.

FACTOR. Retrieved December 12, 2022, from https://psico.fcep.urv.cat/utilitats/factor/Download.html.

55.

Yang, Z. H., Busschbach, J., Liu, G., & Luo, N. (2018). EQ-5D-5L norms for the urban Chinese population in China. Health and Quality of Life Outcomes, 16, 210. https://doi.org/10.1186/s12955-018-1036-2CrossRefPubMedPubMedCentral

56.

Karabulut, A., Ozkan, S., & Oguz, N. (2013). Predictors of fertility quality of life (FertiQoL) in infertile women: Analysis of confounding factors. European Journal of Obstetrics & Gynecology and Reproductive Biology, 170(1), 193–197. https://doi.org/10.1016/j.ejogrb.2013.06.029CrossRef

57.

Epstein, Y. M., & Rosenberg, H. S. (2005). Depression in primary versus secondary infertility egg recipients. Fertility and Sterility, 83(6), 1882–1884. https://doi.org/10.1016/j.fertnstert.2005.01.098CrossRefPubMed

58.

Newton, C. R., Sherrard, W., & Glavac, I. (1999). The Fertility Problem Inventory: Measuring perceived infertility-related stress. Fertility and Sterility, 72(1), 54–62. https://doi.org/10.1016/s0015-0282(99)00164-8CrossRefPubMed

59.

Raque-Bogdan, T. L., & Hoffman, M. A. (2015). The relationship among infertility, self-compassion, and well-being for women with primary or secondary infertility. Psychology of Women Quarterly, 39(4), 484–496. https://doi.org/10.1177/0361684315576208CrossRef

60.

Dhillon, R., Cumming, C. E., & Cumming, D. C. (2000). Psychological well-being and coping patterns in infertile men. Fertility and Sterility, 74(4), 702–706. https://doi.org/10.1016/s0015-0282(00)01511-9CrossRefPubMed

61.

Chen, G., & Olsen, J. A. (2020). Filling the psycho-social gap in the EQ-5D: The empirical support for four bolt-on dimensions. Quality of Life Research, 29(11), 3119–3129. https://doi.org/10.1007/s11136-020-02576-5CrossRefPubMedPubMedCentral

62.

Payakachat, N., Ali, M. M., & Tilford, J. M. (2015). Can the EQ-5D detect meaningful change? A systematic review. Pharmacoeconomics, 33(11), 1137–1154. https://doi.org/10.1007/s40273-015-0295-6CrossRefPubMedPubMedCentral

63.

Dolan, P., Lee, H., King, D., & Metcalfe, R. (2009). Valuing health directly. BMJ-British Medical Journal, 339, b2577. https://doi.org/10.1136/bmj.b2577CrossRef

64.

Song, D., Li, X., Yang, M., Wang, N., Zhao, Y., Diao, S., et al. (2021). Fertility quality of life (FertiQoL) among Chinese women undergoing frozen embryo transfer. BMC Women’s Health. https://doi.org/10.1186/s12905-021-01325-1CrossRefPubMedPubMedCentral

65.

Ni, Y., Tong, C., Huang, L., Zhou, W., & Zhang, A. (2021). The analysis of fertility quality of life and the influencing factors of patients with repeated implantation failure. Health and Quality of Life Outcomes. https://doi.org/10.1186/s12955-021-01666-3CrossRefPubMedPubMedCentral

66.

Wang, J. Y., Lv, X. Q., Wu, J. M., Tang, W. Q., Luo, G. Y., Liang, C. M., et al. (2022). Sexual function, self-esteem, and quality of life in infertile couples undergoing in vitro fertilization: A dyadic approach. Psychology Research And Behavior Management, 15, 2449–2459. https://doi.org/10.2147/PRBM.S378496DovePressCrossRefPubMedPubMedCentral

67.

Fu, B., Qin, N., Cheng, L., Tang, G. X., Cao, Y., Yan, C. L., et al. (2015). Development and validation of an Infertility Stigma Scale for Chinese women. Journal of Psychosomatic Research, 79(1), 69–75.CrossRefPubMed

68.

Liu, Y., Luo, J., & Tan, H. (2015). Happiness of infertile patients and its related influence factors (in chinese). China Journal of Modern Medicine, 25(21), 92–95.

69.

Yafen, H., Wang, K., Zhou, Y., Wang, H., Huo, K., & Zhou, M. (2016). Relationship between pressure of infertility patients from social concern andmental health and subjective well-being: Moderating effect of tradition-modernity (in chinese). Chinese General Practice, 19(31), 3861–3865. https://doi.org/10.3969/j.issn.1007-9572.2016.31.021CrossRef

70.

Richardson, J., Iezzi, A., & Khan, M. A. (2015). Why do multi-attribute utility instruments produce different utilities: The relative importance of the descriptive systems, scale and ‘micro-utility’ effects. Quality of Life Research, 24(8), 2045–2053. https://doi.org/10.1007/s11136-015-0926-6CrossRefPubMedPubMedCentral

Titel: Evaluating health-related quality of life and subjective wellbeing among infertility patients: a cross-sectional study in mainland China
Auteurs: Zhao Shi
Hongwei Nie
Ling Geng
Xuewen Wang
Gang Chen
Shunping Li
Publicatiedatum: 09-01-2023
Uitgeverij: Springer International Publishing
Gepubliceerd in: Quality of Life Research / Uitgave 5/2023
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI: https://doi.org/10.1007/s11136-022-03330-9

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