Effect of Individual Counseling Intervention on Weight Management Based on Stages of Change Model Conducted on Infertile Women

Öz

Objective: Evaluate the effect of individual counseling intervention on weight management based on Stages of Change Model conducted on infertile women Methods: This study consisted of two stages: counseling and follow-up. The research population consisted of 146 infertile women who applied to the in vitro fertilization center of a state hospital in İzmir between January 4, 2019, and June 22, 2019. Among the 104 infertile women who met the inclusion criteria and declared their willingness to participate in the study, 51 women constituted the intervention group, and 53 women constituted the control group. While an individual counseling program based on Stages of Change Model was conducted on the initiative group, the control group was followed routinely. Research data were analyzed using SPSS 22.0 software. Results: Most recent follow-up anthropometric values of infertile women in the intervention group were lower compared to the pre-follow-up values. The difference between these two data was statistically significant (p = 0.000). Infertile women in the intervention group tended to increase their consumption of daily milk and dairy products and vegetable and fruits in their most recent follow-up stage compared to that in the pre-follow-up stage, whereas their consumption of and daily calories from meat products, sugary products, fats, cereals, and bread decreased. The difference between these two data was statistically significant (p = 0.000). Conclusion: Individual counseling intervention based on Stages of Change Model aiming to evaluate the weight management caused infertile women to adopt healthy behaviors in terms of physical activity and nutritional habits.

Anahtar Kelimeler

• Infertility
• Women
• Counseling
• Nurse
• Weight management

İnfertil Kadınlara Değişim Aşamaları Modeli ile Yapılan Bireysel Danışmanlık Girişiminin Kilo Yönetimine Etkisi

Öz

Amaç: İnfertil kadınlarda Değişim Aşaması Modeli ile yapılan bireysel danışmanlık girişiminin kilo yönetimine etkisini değerlendirmektir. Yöntem: Bu çalışma danışmanlık ve takip olmak üzere iki aşamadan oluşmaktadır. Araştırmanın evrenini, 4 Ocak 2019 ile 22 Haziran 2019 tarihleri arasında İzmir'de bir devlet hastanesinin tüp bebek merkezine başvuran 146 infertil kadın oluşturmaktadır. Dahil edilme kriterlerini karşılayan ve araştırmaya katılmak istediğini beyan eden 104 infertil kadından 51'i müdahale grubunu, 53'ü kontrol grubunu oluşturdu. Girişim grubuna Değişim Aşamaları Modeline dayalı bireysel psikolojik danışma programı uygulanırken, kontrol grubu rutin olarak takip edildi. Araştırma verileri SPSS 22.0 programı kullanılarak analiz edilmiştir. Bulgular: Girişim grubu infertil kadınların ön izleme göre son izlem antropometrik değerlerinde azalma göstermiş, istatistiksel olarak anlamlı fark saptanmıştır (p=0.000). Çalışmada girişim grubu infertil kadınların ön izleme kıyasla son izlemde günlük süt grubu, sebze ve meyve grubu tüketiminde artış olmuş, et grubu, şeker grubu, yağ grubu, tahıl grubu ve ekmek grubu tüketiminde ve günlük kalori azalma olmuş, istatistiksel olarak anlamlı fark saptanmıştır (p=0.000). Sonuç: Kilo yönetimine ilişkin Değişim Aşamaları Modeline dayalı verilen bireysel danışmanlık girişimi infertil kadınlarda fiziksel aktivite ve beslenme alışkanlıklarında sağlıklı davranış değişimine neden olmuştur.

Anahtar Kelimeler

• İnfertilite
• Kadın
• Danışmanlık
• Hemşire
• Kilo Yönetimi

Kaynakça

1. 1. Karlıdere, T., Bozkurt, A., & Yetkin, S. (2007). Is there a gender difference in infertile couples without an axis I psychiatric disorder in the context of emotional symptoms, social support, and sexual function?. Turkish Journal of Psychiatry, 18(4), 1–11.
2. 2. Ramazanzadeh, F., Noorbala, A.A., Abedinia, N., & Naghizadeh, M.M. (2009). Emotional adjustment in infertile couples: systematic review article. Iran J Reprod Med, 7, 97–103.
3. 3. Goldman, M.B., Missmer, S.A., & Barbieri, R.L. (2000). Woman and Health. In: MB Goldman, MC Hatch (Ed.), İnfertility. (ss. 196–215). California: Academic Press.
4. 4. Robinson, G.E., & Stewart, D.E. (2001). Infertility and new reproductive technologies. Review of Psychiatry, 14, 1994–1997.
5. 5. Kırca, N., & Pasinlioğlu, T. (2013). Psychosocial problems in infertility treatment. Current Approaches in Psychiatry, 5, 162-178.
6. 6. Luke, B., Brown, M.B., Missmer, S.A., Bukulmez, O., Leach, R., & Stern, J.E. (2011). The effect of increasing obesity on the response to and outcome of assisted reproductive technology: a national study. Fertil Steril, 96(4), 820–825.
7. 7. Vahratian, A., & Smith, Y.R. (2009). Should access to fertility-related services be conditional on body mass index?. Hum Reprod, 24(7), 1532–1537.
8. 8. Gesink Law, D.C., Maclehose, R.F., & Longnecker, M.P. (2007). Obesity and time to pregnancy. Hum Reprod, 22(2), 414–420.

9. 9. Barbieri, R.L. (2001). The initial fertility consultation: recommendations concerning cigarette smoking, body mass index, and alcohol and caffeine consumption. Am J Obstet Gynecol, 185(5), 1168–1173.
10. 10. Potdar, N., Ojidu, J., & Odukoya, O. (2002). Anthropometric variation in ovulatory and anovulatory infertility. Fertil Steril, 78, 155–156.
11. 11. Glazer, N.L., Hendrickson, A.F., Schellenbaum, G.D., & Mueller, B.A. (2004). Weight change and the risk of gestational diabetes in obese women. Epidemiology, 15(6), 733–737.
12. 12. Gillett, W.R., Putt, T., & Farquhar., C.M. (2006). Prioritising for fertility treatments the effect of excluding women with a high body mass index. BJOG, 113(10), 1218–1221.
13. 13. Öge, A., & Gönen, S. (2006). Obesity and type 2 diabetes mellitus: obesity and diabetes. Obesity Research Association of Turkey, 6(1), 12–38.
14. 14. Nelson, S.M., & Fleming, R.F. (2007). The preconceptual contraception paradigm: obesity and infertility. Hum Reprod, 22(4), 912–915.
15. 15. Bellver, J., Martínez-Conejero, J.A., Labarta, E., Alama, P., Barreto Melo, M.A., Remohi, J., et al. (2011). Endometrial gene expression in the window of implantation is altered in obese women especially in association with polycystic ovary syndrome. Fertil Steril, 95, 2335-2340.
16. 16. Karaca, A., & Ünsal, G. (2012). The effects of infertility on women's mental health and the role of the psychiatric nurse. Journal of Psychiatric Nursing, 3(2), 80-85.
17. 17. Şengün, F., Üstün, B., & Bademli, K. (2013). A review of theory/model-based nursing research in Turkey. Anatolian Journal of Nursing and Health Sciences, 16(2), 132–139.
18. 18. Ocakçı, A.F., & Ecevit, A.Ş. (2013). Concept, theory and model examples in nursing. Istanbul: Istanbul Medical Bookstore.
19. 19. Özkan, A.H. (2014). Philosophy and Care in Nursing: and historical development process of conceptual and theoretical studies in nursing. Istanbul: Fundamentals of Science Academy Press and Publishing.
20. 20. Tümer, A., Arslan, A.S., Pehlivan, Ç., Sunna, E., & Koç, O. (2013). Investigation of Adult Exercise Behavior According to the Transtheoretical Model. Health and Society, 23(1), 24–31.
21. 21. Moran, L., Tsagareli, V., Norman, R., & Noakes, M. (2011). Diet and IVF pilot study: short-term weight loss improves pregnancy rates in overweight/obese women undertaking IVF. Aust N Z J Obstet Gynaecol, 51(5), 455-459.
22. 22. Daşıkan, Z. (2012). The effect of theory-based individual counseling intervention on weight management in pregnancy. (Doctoral thesis). Ege University Institute of Health Sciences, IZMIR.
23. 23. Dilek, O., Senay, U. A., & Fatih, C. (2022). Impact of the individual counseling program for polycystic ovarya syndrome management among university students: A prospective randomized controlled trial. Nigerian Journal of Clinical Practice, 25(6), 809–816.
24. 24. Wise, L.A., Rothman, K.J., Mikkelsen, E.M., Sørensen, H.T., Riis, A., & Hatch, E.E. (2010). An internet-based prospective study of body size and time-to-pregnancy. Hum Reprod, 25(1), 253–264.
25. 25. Grodstein, F., Goldman, M.B., & Cramer, D.W. (1994). Body mass index and ovulatory infertility. Epidemiology, 5(2), 247–250.
26. 26. Karsten, M.D.A., Van Oers, A.M., Groen, H., Mutsaerts, M.A.Q., van Poppel, M.N.M., Geelen, A., et al. (2019). Determinants of successful lifestyle change during a 6-month preconception lifestyle intervention in women with obesity and infertility. The LIFEstyle study group. Eur J Nutr, 58(6), 2463–2475.
27. 27. Vujkovic, M., de Vries, J.H., Lindemans, J., Macklon, N.S., van der Spek, P.J., Steegers, et al. (2010). The preconception Mediterranean dietary pattern in couples undergoing in vitro fertilization/intracytoplasmic sperm injection treatment increases the chance of pregnancy. Fertil Steril, 94(6), 2096–2101.
28. 28. Toledo, E., Lopez-del Burgo, C., Ruiz-Zambrana, A., Donazar, M., Navarro-Blasco, I., Martínez-González, M.A., et al. (2011). Dietary patterns and difficulty conceiving: a nested case-control study. Fertil Steril, 96(5), 1149– 1153.
29. 29. Chavarro, J.E., Rich-Edwards, J.W., Rosner, B.A., & Willett, W.C. (2007). Diet and lifestyle in the prevention of ovulatory disorder infertility. Obstet Gynecol, 110(5), 1050–1058.
30. 30. Chavarro, J.E., Rich-Edwards, J.W., Rosner, B.A., & Willett, W.C. (2009). A prospective study of dietary carbohydrate quantity and quality in relation to risk of ovulatory infertility. Eur J Clin Nutr, 63(1), 78–86.
31. 31. Braga, D.P., Halpern, G., Setti, A.S., Figueira, R.C.S., Iaconelli, Jr, V., & Borges, Jr, E. (2015). The impact of food intake and social habits on embryo quality and the likelihood of blastocyst formation. Reprod Biomed Online, 31(1), 30–38.
32. 32. Twigt, J.M., Bolhuis, M.E., Steegers, E.A., Hammiche, F., van Inzen, W.G., Laven, J.S.E., et al. (2012). The preconception diet is associated with the chance of ongoing pregnancy in women undergoing IVF/ICSI treatment. Human Reprod, 27(8), 2526–2531.
33. 33. Prochaska, J.O., & Velicer, W.F. (1997). The transtheoretical model of health behavior change. Am J Health Promot, 12(1), 38–48.
34. 34. Prochaska, J.O., Redding, C.O., & Evers, K.E. (2008). Health behavior and health education. In: Glanz K, Rimer BK, Viswanat K, (ed,). The transtheoretical model and stages of change. (ss.97–117). San Francisco: Jossey-Bass.