Investigating the Effectiveness of the Psychological Empowerment Program Focusing on Tolerance of Ambiguity Based on the Lived Experience of Infertile Women in the Treatment Process on Psychological Hardiness

Dirmanchi , Niloufar; Kazemian , Somayeh; Khosravi Babadi , Ali Akbar

Volume 15 - Articles-1404 MEJDS (2025) 15: 83 | Back to browse issues page

Ethics code: IR.IAU.CTB.REC.1402.081

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Dirmanchi N, Kazemian S, Khosravi Babadi A A. Investigating the Effectiveness of the Psychological Empowerment Program Focusing on Tolerance of Ambiguity Based on the Lived Experience of Infertile Women in the Treatment Process on Psychological Hardiness. MEJDS 2025; 15 (0) :83-83
URL: http://jdisabilstud.org/article-1-3487-en.html

Investigating the Effectiveness of the Psychological Empowerment Program Focusing on Tolerance of Ambiguity Based on the Lived Experience of Infertile Women in the Treatment Process on Psychological Hardiness

Niloufar Dirmanchi¹

, Somayeh Kazemian ^*²

, Ali Akbar Khosravi Babadi³

1- PhD Student in Counseling, Department of Education and Counseling, Central Tehran Branch, Islamic Azad University, Tehran, Iran
2- Associate Professor, Department of Counseling, Faculty of Psychology and Educational Sciences, Allameh Tabataba'i University, Tehran, Iran
3- Associate Professor, Department of Education and Counseling, Central Tehran Branch, Islamic Azad University, Tehran, Iran

Abstract: (641 Views)

Abstract
Background & Objectives: The psychological stress associated with infertility arises from various factors, such as ambiguity about its causes, the length of treatment, and financial concerns. Ambiguity is something that we face every day in different situations. Tolerating ambiguity is one of the important factors in facing problems. Hardiness is a personality trait that serves as a source of resilience in the face of stressful events. Hardy people involve themselves in life's activities, believing they can influence events, and they view change as natural and stimulating to growth. Since the effort for fertility requires continuity, it is essential to maintain a balance between uncertainty and certainty, as well as to cultivate strength, resilience, and stress management skills.
Additionally, raising awareness and focusing on mental health is crucial, allowing a person to fulfill their responsibilities in the best way possible. Therefore, to strengthen the body and mind of women who have infertility and to achieve the goal, they can be psychologically empowered. Therefore, this study seeks to investigate whether the psychological empowerment program centered on tolerance of ambiguity based on the lived experience of infertile women in the treatment process is effective on the psychological hardiness of infertile women.
Methods: This research employed the single–case study method of an A–B single–subject design. Among the women referred for infertility treatment, 3 infertile women who met the inclusion criteria were selected by the available sampling. The inclusion criteria for the subjects in the study were as follows: primary infertility (confirmed by an obstetrician and gynecologist); being between the ages of 20 and 45; bearing a minimum education level of a high school diploma; having a duration of infertility after 24 months of unprotected sexual intercourse; lacking psychological disorders; not receiving counseling, psychological, or psychiatric services; and having consent to participate in the study. The exclusion criteria were the subject's unwillingness to continue the study, failure to cooperate in treatment sessions, becoming pregnant during the study, and the disappearance of any of the entry conditions. Before the program of psychological empowerment of infertile women, each participant completed the Lang and Goulet Hardiness Scale (LGHS) (Lang et al., 2003) to obtain baseline scores. The intervention program was then administered to the participants over 9 sessions. The researcher made every effort to ensure that the sessions were interactive and engaging. In the fifth and ninth sessions, as well as the follow–up, participants completed the Lang and Goulet Hardiness Scale (LGHS) again to determine post–program scores (Lang et al., 2003). The program of psychological empowerment of infertile women was used, focusing on tolerance of ambiguity in the treatment process. To measure the validity of the program's content, it was approved by 10 experts. The content validity ratio was calculated using the Lavish method and the content validity index. Therefore, the content of the sessions was maintained at a level of more than 0.75. To increase their psychological hardiness, the program was conducted in nine 45–minute sessions and one follow–up session one month later. Additionally, for data analysis, a visual review of graphs (showing the rise and fall of the dependent variable), improvement percentage indicators, variability, and effect size was employed.
Results: The results showed an increase in the psychological hardiness components for the three subjects after treatment. Additionally, the percentage of improvement in the first subject's psychological hardiness components was greater than that of the second and third subjects. Based on the findings, the effect sizes for the three subjects in the control, commitment, and struggle components of the psychological hardiness variable were 4.53, 5.97, and 7.16, respectively.
Conclusion: The findings of the present study showed that the psychological empowerment program based on lived experience is effective in increasing the psychological hardiness of infertile women.

Keywords: Lived experience, Ambiguity tolerance, Psychological empowerment, Infertile women, Psychological hardiness

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Type of Study: Original Research Article | Subject: Counseling

References

1. Zarif Golbar Yazdi H, Aghamohammadian Sharbaf H, Kareshki H, Amirian M. Psychosocial consequences of female infertility in Iran: a meta-analysis. Front Psychiatry. 2020;11:518961. [DOI]

2. Maharlouei N, Morshed Behbahani B, Doryanizadeh L, Kazemi M. Prevalence and pattern of infertility in Iran: a systematic review and meta-analysis study. Women's Health Bull. 2021;8(2):63–71. [DOI]

3. Shabannezhad A, Fazlali M, Mirzaian B. The mediating role of psychological flexibility in the relationship between self-efficacy and health-promoting behaviors in infertile women. EBNESINA. 2021;23(3):52–62. [Persian] [DOI]

4. Thapa N, Verma S, Chander G, Bhat A, Raina DB, Kachroo S, et al. The psychological impact on infertile women – a review. Journal of Reproductive Healthcare and Medicine. 2021;2:10. [DOI]

5. Bagade T, Thapaliya K, Breuer E, Kamath R, Li Z, Sullivan E, et al. Investigating the association between infertility and psychological distress using Australian longitudinal study on women's health (ALSWH). Sci Rep. 2022;12(1):10808. [DOI]

6. Yokota R, Okuhara T, Okada H, Goto E, Sakakibara K, Kiuchi T. Association between stigma and anxiety, depression, and psychological distress among Japanese women undergoing infertility treatment. Healthcare. 2022;10(7):1300. [DOI]

7. Cuppello S, Treglown L, Furnham A. Intelligence, personality and tolerance of ambiguity. J Intell. 2023;11(6):102. [DOI]

8. Gunessee S, Subramanian N. Ambiguity and its coping mechanisms in supply chains lessons from the Covid-19 pandemic and natural disasters. International Journal of Operations & Production Management. 2020;40(7/8):1201–23. [DOI]

9. McLain DL, Kefallonitis E, Armani K. Ambiguity tolerance in organizations: definitional clarification and perspectives on future research. Front Psychol. 2015;6:344. [DOI]

10. Reknes I, Harris A, Einarsen S. The role of hardiness in the bullying–mental health relationship. Occup Med. 2018;68(1):64–6. [DOI]

11. Johnsen BH, Eid J, Pallesen S, Bartone PT, Nissestad OA. Predicting transformational leadership in naval cadets: effects of personality hardiness and training. J Appl Soc Pyschol. 2009;39(9):2213–35. [DOI]

12. Judkins JL, Moorea BA, Collette T. Psychology in the real world. Abingdon, Oxon: Routledge; 2020.

13. Hassan S, Bhatti MI, Habib S, Fatima S, Bhader S, Khan NH, et al. How fear of intimacy affects infertile men's neuropsychological functioning through mental toughness. Front Psychiatry. 2023;14:1049008. [DOI]

14. Bahrami-Kerchi A, Manshaee Gh, Keshtiaray N. The effectiveness of psychological empowerment therapy and dialectical behavior therapy on infertility stress of infertile women in pretreatment stage of in vitro fertilization. Fayz Med Sci. 2020;24(5):554–64. [Persian] [Article]

15. Karaca A, Unsal G. Psychosocial Problems and Coping Strategies among Turkish Women with Infertility. Asian Nurs Res (Korean Soc Nurs Sci). 2015;9(3):243–50. [DOI]

16. Lang A, Goulet C, Amsel R. Lang and Goulet Hardiness Scale: development and testing on bereaved parents following the death of their fetus/infant. Death Stud. 2003;27(10):851-80. [DOI]

17. Roshan R, Shakeri R. The study of the validity and reliability of hardiness scale for university students. Journal of Clinical Psychology & Personality. 2010;8(1):35–52. [Persian] [Article]

18. Modarres M, Abunasri M, Alhani F, Ebrahimi E. The effectiveness of implementing family-centered empowerment model on irrational thoughts of Iranian infertile women: a randomized clinical trial. J Caring Sci. 2022;11(4):224–31. [DOI]

19. Taebi M, Simbar M, Abdolahian S. Psychological empowerment strategies in infertile women: a systematic review. J Edu Health Promot. 2018;7(1):68. [DOI]

20. Allahyari T, Ghorbani B, Alamin SH. Infertility and lack of security in married life. Ministry of Science. 2019;11(3):67–92. [Persian]

21. Garavand H, Sabzian S. The of structural relationship model between dysfunctional attitudes and spiritual intelligence with corona anxiety through mediation role psychological hardiness. Psychological Models and Methods. 2022;13(48):21–38. [Persian] [Article]