SCREENIVF English version Introduction for patients going to start fertility treatment
Screening on distress in fertility treatment
Fertility treatments are intensive treatment forms, which could affect all parts of your life. We would like to support couples during treatment in the best possible way, which is why we have developed a short screening questionnaire. The information you provide by filling in this questionnaire will help us to determine the possible emotional impact of the treatment for you. We will then be able to advise you as to whether you might benefit from additional support from a counselor (psychologist or social worker). You will receive the results of the screening questionnaire by [just indicate who will provide the result: by mail or by letter or via your doctor or nurse]. If you have any questions or concerns, please contact [just indicate your policy: e.g. a member of the reproductive team or our psychosocial team]. © Verhaak CM 2016 Radboud University Medical Center Nijmegen the Netherlands.
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Anxiety Below you can find a couple of statements that people use to describe themselves. Read every item carefully and encircle the number next to the statement that most closely matches with how you felt during the last week. There are no right or wrong answers. Don’t think too much, your first impression is usually best. So it is about how you felt during the last week.
Nearly never 1 1 1 1 1 1 1 1 1
sometimes
I feel fine * 2 I feel satisfied * 2 I worry too much about not really important things 2 I am happy * 2 I am troubled by disturbing thoughts 2 I feel safe * 2 I am pleased * 2 There are thoughts that keep haunting me 2 I take disappointments so seriously that I cannot get 2 them out of my mind I get very nervous and worried when thinking about 1 2 my current troubles * reverse scoring, see instruction. Do not indicate asterisks on patient form
often 3 3 3 3 3 3 3 3 3
Nearly always 4 4 4 4 4 4 4 4 4
3
4
Depression The next questionnaire consists of statements in a cluster together. Read every statement carefully. In each cluster select that statement that most closely matches with how you felt during the last week. Encircle the number before the line of the statement you chose. Be sure that you carefully read each statement before making a choice. So it is about how you felt during the last week. 0 1 2 3 0 1 2 3
0 1 2 3
I do not feel sad. I feel sad. I am sad all the time and I can’t snap out of it. I am so sad and unhappy that I can’t stand it. I am not particularly discouraged about the future. I feel discouraged about the future. I feel I have nothing to look forward to. I feel the future is hopeless and that things cannot improve. I do not feel like a failure. I feel I have failed more than the average person. As I look back on my life, all I can see is a lot of failures. I feel I am a complete failure as a person.
0 1 2 3 0 1 2 3 0 1 2 3 0 1 2 3
I get as much satisfaction out of things as I used to. I don’t enjoy things the way I used to. I don’t get real satisfaction out of anything anymore. I am dissatisfied or bored with everything. I don’t feel disappointed in myself. I am disappointed in myself. I am disgusted with myself. I hate myself. I don’t feel I am any worse than anybody else. I am critical of myself for my weaknesses or mistakes. I blame myself all the time for my faults. I blame myself for everything bad that happens. I don’t have any thoughts about killing myself. I have thoughts about killing myself, but I would not carry them out. I would like to kill myself. I would like to kill myself if I had the chance.
Social support These statements are about your social relationships. We ask you to encircle the number of items that most closely match with how you feel about your social relationships. The questions refer to how you felt about your social relationships the last six months. When I feel tense or nervous, there is someone to help me When I experience some nice things, there is someone with whom to talk about it When I am in pain there is someone to comfort me When I am sad there is someone with whom to talk about it When I need help with a job I cannot carry out alone there is someone to help me
Nearly never 1
sometimes
regularly
often
2
3
4
1
2
3
4
1 1
2 2
3 3
4 4
1
2
3
4
Cognitions regarding fertility problems The next items are statements from people with fertility problems. We ask you to indicate to what extent you agree with the statements. You can do that by encircling the number next to the statement that most closely matches with what you think about the statement. Do not think too deeply, your first impression is usually best.
Do not agree 1. Because of my fertility problems I miss things that 1 are most important for me 2. I can deal with the consequences of my fertility 1 problems 3. I have learned to live with my fertility problems 1 4. My fertility problems control my life 1 5. My fertility problems sometimes give me the 1 feeling of being useless 6. My fertility problems make my life incomplete 1 7. I have learned to accept my fertility problems 1 8. My fertility problems affect everything that is 1 important for me 9. I can accept my fertility problems 1 10. I think I can cope with my fertility problems, 1 even if they are not solved 11. I often feel helpless because of my fertility 1 problems 12. I can cope well with my fertility problems 1
Agree a little bit 2
agree 3
Strongly agree 4
2
3
4
2 2 2
3 3 3
4 4 4
2 2 2
3 3 3
4 4 4
2 2
3 3
4 4
2
3
4
2
3
4
Defining at risk SCREENIVF is a screening instrument developed for the Dutch population of fertility patients. For English readers we developed an English version, however this version is not validated. SCREENIVF consists of 5 items on state anxiety, 5 items on trait anxiety, 7 items on depression, 5 items on social support and 12 items on cognitions regarding fertility problems. Patients were defined as at risk when their scores on one of the five risk factors showed clinically relevant problems. Scoring anxiety subscale by recoding items 1, 2, 4, 6, 7 by reverse them: 1=4; 2=3; 3=2; 4=1; then counting the numbers circled on all items. Cutt off =24 and above. Scoring depression scale : Answer categories are 0 1 2 and 3. Counting the scores on each item. Cut off: 4 or above following Beck et al. 1997. The social support subscale is scored by counting the numbers circled. The subscale cognitions consists of two subscales: Helplessness: count the numbers on items 1, 4, 5, 6, 8, 11Acceptance: Count the numbers on items 2, 3, 7, 9, 10, 12. For the scores of helplessness, acceptance and social support, no norm scores were available. The cut off scores were based on one standard deviation above the mean scores of IVF-patients in a previous study (Verhaak et al. 2005), resulting in a cut off of 14 and above for helplessness, 11 and less for acceptance and 15 and less for social support. Accordingly, SCREENIVF resulted in dichotomous scores on each of the five risk factors: score 0 if the patient scored below the cut off, and score 1 when scoring above or equal to the cut off score. The score range on SCREENIVF is 0 to 5: 0 indicating no risk factors and 5 indicating 5 risk factors.
References Beck AT, Guth D, Steer RA, Ball R. Screening for major depression disorders in medical inpatients with the Beck Depression Inventory for primary care. Behav Res Ther 1997;35;785-91. van Dongen AJ, Kremer JA, Van Sluisveld N, Verhaak CM, Nelen WL. Feasibility of screening patients for emotional risk factors before in vitro fertilization in daily clinical practice: a process evaluation. Hum Reprod. 2012 Dec;27(12):3493-501. Gameiro S, Boivin J, Dancet E, de Klerk C, Emery M, Lewis-Jones C, Thorn P, Van den Broeck U, Venetis C, Verhaak CM, Wischmann T, Vermeulen N. ESHRE guideline: routine psychosocial care in infertility and medically assisted reproduction-a guide for fertility staff. Hum Reprod. 2015 Nov;30(11):2476-85. Huppelschoten AG, van Dongen AJ, Verhaak CM, Smeenk JM, Kremer JA, Nelen WL. Differences in quality of life and emotional status between infertile women and their partners. Hum Reprod. 2013 Aug;28(8):2168-76. Lopes V, Canavarro MC, Verhaak CM, Boivin J, Gameiro S. Are patients at risk for psychological maladjustment during fertility treatment less willing to comply with treatment? Results from the Portuguese validation of the SCREENIVF. Hum Reprod. 2014 Feb;29(2):293-302. Verhaak CM, Smeenk JM, Evers AW, van Minnen A, Kremer JA, Kraaimaat FW. Predicting emotional response to unsuccessful fertility treatment: a prospective study. J Behav Med 2005;28;181-90.
Verhaak CM, Lintsen AM, Evers AW, Braat DD. Who is at risk of emotional problems and how do you know? Screening of women going for IVF treatment. Hum Reprod. 2010;25:1234-40..
