O-113 Recent research on fertility staff emotions
Authors: Fedele F 
Published: June 2023

Infertility-related psychological research is traditionally oriented more at analysing the wellbeing of couples undergoing Assisted Reproductive Technologies (ART), than to studying the job-related effects on the healthcare fertility staff.

The unfulfilled desire for a child can cause an emotional crisis for couples: they may experience high levels of stress with physical, emotional, social and financial concerns related to infertility and ART treatment.

Little is known instead about the emotional reaction of healthcare members to infertility and treatment delivery. In fact, it is well documented that patients with infertility problems may challenge usual approaches to care, leading to potential difficulties in the therapeutic relationship: patients undergoing ART are often dissatisfied with the level of empathy and attention received by the healthcare staff. Besides, patients may be experienced as manipulative, emotionally dependent, self-destructive, non-compliant and with a hostile attitude, thus raising negative feelings of frustration, anxiety, and dislike among healthcare professionals.

This is the aim of the research titled “What about fertility staff emotions? An explorative analysis of healthcare professionals’ subjective perspective”, aimed at understanding the subjective perspective of the fertility professionals and their emotional dynamics in relationship with patients. An in-depth explorative research study was conducted on 12 healthcare professionals working in the fertility clinic of a public healthcare hospital of Rome. Structured interviews with open-ended questions were conducted and Emotional Text Analysis was carried out to analyse the transcripts of their interviews. Five thematic domains were detected that describe the staff’s emotions about their professional experience, as follows: performance anxiety (Cluster 1), ambivalence between omnipotence and powerlessness (Cluster 2), care burden (Cluster 3), feeling of duty (Cluster 4), and sense of interdependence (Cluster 5). This study suggests that the professionals’ awareness about the implicitly emotional meanings, beliefs, values, referred to the professional function and therapeutic relationship may facilitate team work and care relationship.

For this reason, the Italian National ART Register of the National Institute of Health and the Department of Dynamic Clinical and Health Psychology of La Sapienza University carried out a research to examine the characteristics of psychological services in Italian ART centres. A questionnaire consisting in 26 questions was sent to the physicians in charge of 341 ART centres active in Italy.

The overall picture was rather disappointing in that only half of the responding centres (47%) have a psychologist permanently on staff and psychological intervention seems to be considered as targeting the inner world of the individual or the couple and not their relationship with the ART context. Moreover, relatively few couples (10-20%) resort to counselling in 70% of the responding centres. Referrals did not seem to be regulated by specific policies and procedures in 60% of the cases and in 70% of centres the fee for psychological counselling was not included in the ART treatment fee. Furthermore, 30% of the responding centres worked with an independent psychologist who is called in upon request.

It is possible to hypothesise instead that health professionals in the field of reproductive medicine could offer their care on an ongoing basis during the course of treatment with an integrated and collaborative approach that also involves:

1. education, training, and support of the fertility clinic staff to help reduce staff stress, prevent burnout, and improve overall patient care.

2. offer support to adopt an emotional accompanying function into the healthcare relationship, through attempts at restitution, clinical supervision, joint listening setting (physician, psychologist, patients), analysis and sharing of the emotional dimensions involved in the Centre's activity, in order to improve the care experience of the patient and of the carers in relation to each other.

This approach may represent a real multidisciplinary model of caretaking.