Abstract：
BACKGROUND: While there is a recognized role of optimizing lifestyle (diet and physical activity) behaviours in the management of infertility, the best practice remains unknown and factors influencing the lifestyle of people with infertility are not well understood.
OBJECTIVE: This systematic review evaluated barriers and enablers to a healthy lifestyle in people with infertility, from the perspectives of people with infertility and health professionals, in order to inform optimal behavioural change strategies.
METHODS: Ovid MEDLINE(R), PsycINFO, EMBASE, EBM Reviews, and CINAHL were searched from inception to 28 August 2023. Eligible studies were qualitative and quantitative primary studies that explored barriers and/or enablers to lifestyle for infertility management. Quality assessment was performed using the Centre for Evidence-Based Management Critical Appraisal of a Survey Tool and the Critical Appraisal Skills Programme Qualitative Checklist. Data were analysed by thematic analysis with themes mapped to the Capability, Opportunity, Motivation and Behaviour (COM-B) model and Theoretical Domains Framework (TDF).
RESULTS: After screening 12 326 abstracts and 99 full-texts, 27 studies were included (12 quantitative, 6 qualitative and 9 mixed-methods) with 22 studies of women with infertility (n = 2524), 11 studies of men with infertility (n = 1407), and 6 studies of health professionals (n = 372). We identified barriers and enablers relating to capability (e.g. strategies for behaviour change), opportunity (e.g. limited time, resources, and money), and motivation (e.g. interplay between lifestyle and emotional state). Based on the identified themes, suggested intervention components to integrate into lifestyle management of infertility include facilitating development of self-management skills to support lifestyle change (e.g. self-monitoring, action planning, and goal setting) and incorporating mental health strategies (e.g. providing information about the benefits of healthy lifestyle behaviours for mental health and encouraging patients to reframe healthy lifestyle behaviours as self-care strategies).
CONCLUSIONS: The findings have identified important factors that influence lifestyle management in people with infertility and have suggested relevant intervention components to consider when designing interventions. Given the paucity of qualitative studies identified, more research is needed to further understand the complex and interacting factors that shape lifestyle during the fertility journey.
OBJECTIVE: This systematic review evaluated barriers and enablers to a healthy lifestyle in people with infertility, from the perspectives of people with infertility and health professionals, in order to inform optimal behavioural change strategies.
METHODS: Ovid MEDLINE(R), PsycINFO, EMBASE, EBM Reviews, and CINAHL were searched from inception to 28 August 2023. Eligible studies were qualitative and quantitative primary studies that explored barriers and/or enablers to lifestyle for infertility management. Quality assessment was performed using the Centre for Evidence-Based Management Critical Appraisal of a Survey Tool and the Critical Appraisal Skills Programme Qualitative Checklist. Data were analysed by thematic analysis with themes mapped to the Capability, Opportunity, Motivation and Behaviour (COM-B) model and Theoretical Domains Framework (TDF).
RESULTS: After screening 12 326 abstracts and 99 full-texts, 27 studies were included (12 quantitative, 6 qualitative and 9 mixed-methods) with 22 studies of women with infertility (n = 2524), 11 studies of men with infertility (n = 1407), and 6 studies of health professionals (n = 372). We identified barriers and enablers relating to capability (e.g. strategies for behaviour change), opportunity (e.g. limited time, resources, and money), and motivation (e.g. interplay between lifestyle and emotional state). Based on the identified themes, suggested intervention components to integrate into lifestyle management of infertility include facilitating development of self-management skills to support lifestyle change (e.g. self-monitoring, action planning, and goal setting) and incorporating mental health strategies (e.g. providing information about the benefits of healthy lifestyle behaviours for mental health and encouraging patients to reframe healthy lifestyle behaviours as self-care strategies).
CONCLUSIONS: The findings have identified important factors that influence lifestyle management in people with infertility and have suggested relevant intervention components to consider when designing interventions. Given the paucity of qualitative studies identified, more research is needed to further understand the complex and interacting factors that shape lifestyle during the fertility journey.
摘要：
背景：虽然在不孕症的管理中优化生活方式（饮食和身体活动）行为具有公认的作用，最佳实践仍然未知，影响不孕症患者生活方式的因素也没有得到很好的理解。
目的：本系统综述评估了不孕症患者健康生活方式的障碍和促成因素，从不孕症患者和健康专业人士的角度来看，以告知最佳的行为改变策略。
方法：OvidMEDLINE(R)，PsycINFO,EMBASE,EBM评论,和CINAHL从开始到2023年8月28日进行了搜索。合格的研究是定性和定量的主要研究，探讨了不孕症管理生活方式的障碍和/或推动者。质量评估是使用循证管理中心关键评估调查工具和关键评估技能计划定性清单进行的。数据通过主题分析进行分析，主题映射到能力，机会,动机和行为(COM-B)模型和理论域框架(TDF)。
结果：在筛选12.326摘要和99篇全文后，纳入27项研究(12项定量，6种定性方法和9种混合方法），对22例不孕症女性进行了研究（n=2524），11项男性不育研究（n=1407），和6项卫生专业人员的研究（n=372）。我们确定了与能力相关的障碍和促成因素(例如行为改变策略)，机会(例如，有限的时间，资源,和金钱），和动机(例如生活方式和情绪状态之间的相互作用)。根据确定的主题，建议将干预措施纳入不孕症的生活方式管理，包括促进自我管理技能的发展，以支持生活方式的改变(例如自我监测，行动计划,和目标设定）并纳入心理健康策略（例如，提供有关健康生活方式行为对心理健康的益处的信息，并鼓励患者将健康生活方式行为重新构建为自我护理策略）。
结论：研究结果确定了影响不孕症患者生活方式管理的重要因素，并提出了设计干预措施时要考虑的相关干预因素。鉴于定性研究的缺乏，需要更多的研究来进一步了解在生育过程中塑造生活方式的复杂和相互作用的因素。
目的：本系统综述评估了不孕症患者健康生活方式的障碍和促成因素，从不孕症患者和健康专业人士的角度来看，以告知最佳的行为改变策略。
方法：OvidMEDLINE(R)，PsycINFO,EMBASE,EBM评论,和CINAHL从开始到2023年8月28日进行了搜索。合格的研究是定性和定量的主要研究，探讨了不孕症管理生活方式的障碍和/或推动者。质量评估是使用循证管理中心关键评估调查工具和关键评估技能计划定性清单进行的。数据通过主题分析进行分析，主题映射到能力，机会,动机和行为(COM-B)模型和理论域框架(TDF)。
结果：在筛选12.326摘要和99篇全文后，纳入27项研究(12项定量，6种定性方法和9种混合方法），对22例不孕症女性进行了研究（n=2524），11项男性不育研究（n=1407），和6项卫生专业人员的研究（n=372）。我们确定了与能力相关的障碍和促成因素(例如行为改变策略)，机会(例如，有限的时间，资源,和金钱），和动机(例如生活方式和情绪状态之间的相互作用)。根据确定的主题，建议将干预措施纳入不孕症的生活方式管理，包括促进自我管理技能的发展，以支持生活方式的改变(例如自我监测，行动计划,和目标设定）并纳入心理健康策略（例如，提供有关健康生活方式行为对心理健康的益处的信息，并鼓励患者将健康生活方式行为重新构建为自我护理策略）。
结论：研究结果确定了影响不孕症患者生活方式管理的重要因素，并提出了设计干预措施时要考虑的相关干预因素。鉴于定性研究的缺乏，需要更多的研究来进一步了解在生育过程中塑造生活方式的复杂和相互作用的因素。
