Normalization as a strategy for maintaining quality of life among women undergoing infertility treatments

Abstract

Background: We aimed to develop the concept and a measure of normalization (maintaining normal routine and feeling 'normal') in the context of a long-lasting medical condition and investigate infertility patients' efforts to achieve normalization and their associations with quality of life (QoL). Methods: At the clinic, 180 women undergoing infertility treatment filled in questionnaires assessing normalization-related coping strategies, QoL, and psychological adjustment (distress, wellbeing). Eight months later, 55 women conceived; 55 women who had not conceived completed a second questionnaire. Findings: At baseline, normalization was related to higher QoL and better adjustment. Structural equations modeling showed that QoL was impaired mainly among women who felt different than others, compared and blamed themselves. Over time, normalization was overall unrelated to conception or to changes in adjustment yet was protective against increases in distress among women who already had a child. Discussion: Infertility is highly stressful in a pronatal culture like Israel. It requires treatment yet is not disabling. Patients who manage to maintain normal routines and not feel different than other people their age may experience better QoL and psychological adjustment.