Impact of treatment decision making preference on mental health outcomes: a longitudinal study with infertile women undergoing in vitro fertilization treatment

Abstract

BACKGROUND: Patient participation in healthcare decisions has been increasingly encouraged. This study investigate relationship between treatment decision making (TDM) preference, decision conflict (DC) and their consequence on mental health in women undergoing fertility treatments. METHODS: A longitudinal study was conducted at a public hospital. Women undergoing in vitro fertilization treatments were asked to indicate TDM preference on recruitment (T0), DC when making the decision (T1) and regret 3 months later (T2). Depression scores were collected at all time points. FINDINGS: 151 of 246 women completed 3 questionnaires (attrition: 39%). On average, their age was 37.2 (SD=3.5) and experienced 1.12 cycles. 82.4% of them resumed a passive TDM role. Although TDM preference did not significantly affect DC or regret, relationship between DC and mood was mediated by regret. Unstandardized direct effect between DC and mood was .071 (p<.001). Indirect effect through mediation of regret was found to be moderated by TDM preference (unstandardized indirect effect=.0002 and .0167 for passive and active TDM preference respectively). IMPLICATIONS: This study showed TDM preference has mental health consequences among women undergoing infertility treatment. Healthcare professionals should encourage discussion of TDM conflict and regret with clients.