Managing emotions and therapeutic alliance in Advanced fertility care: a qualitative study

It is scientifically recognized that fertility treatment is a source of stress and suffering for infertile patients, but less is known about the effects of the couples’ emotional experiences on the well-being of fertility staff. An interest regarding stress, job satisfaction and emotional health of fertility staff has only recently developed. An in-depth explorative research study was conducted on the health professionals of an Italian fertility hospital clinic (n=12). The interviewed group consisted of 3 gynecologists, 4 resident gynecologists, 2 embryologists, 2 nurses, and 1 midwife. A structured interview - created ad hoc for this study - was administered to the staff in order to explore the operators’ deepest feelings about their professional role and relationship with patients. Emotional text analysis, through aid of the T-Lab software, was conducted to analyze the corpus of their interviews, allowing the identification of five domains (clusters). They refer to the following emotional dimensions: the reference to the treatment’s technical aspects as a strategy aimed at perceiving control and reducing anxiety (cluster 1), great emotional investment on the treatment’s result (cluster 2), being completely in charge of patients (cluster 3), reference to the public identity of the fertility center (cluster 4), and self-definition as a symbolic incubator in which the couple and their desire are contained (cluster 5). Overall, the discursive factors seem to refer to adaptive strategies used by the specialists to face and contain the intense emotional involvement that derives from being the ones in charge of the couples’ procreative goals. In conclusion, the study suggests the importance of an integrative approach in fertility clinics, providing a space for the staff to express themselves and also obtain support in positively handling the complex relationship with their patients.