난임은 큰 스트레스로 작용하며, 난임을 겪는 당사자들은 무력감과 상실감, 통제불능감, 정체성의 혼란, 미래에 대한 무망감 등과 함께 사회적 고립과 부부관계의 어려움을 경험한다. 난임상담은 난임 및 난임치료에서 발생하는 정서적 고통과 심리적 문제들을 돕고, 난임당사자들의 삶의 질을 개선하기 위한 심리적 개입으로 그 중요성이 점점 부각되어 왔다. 본고에서는 난임문제를 가지고 있는 개인이나 부부가 경험하는 문제를 간략하게 기술하고, 난임상담의 목적과 난임상담에서 다뤄야할 내용에 대해 기술하였다. 다음으로 근거기반 실무(evidence-based practice)로서 난임상담이 제공되기 위해 난임상담 효과에 대한 근거를 검토하였다. 이제까지 발표된 난임상담 효과에 대한 메타연구 결과를 개관하고, 난임상담의 효과에 영향을 미치는 요인들을 살펴보았다. 마지막으로 근거기반 실무를 구현하는데 중요한 요건인 전문가로서 난임상담사의 자격과 훈련을 살펴보았다. 이를 위해 영국, 독일, 호주, 미국과 일본에서 난임상담을 제공하는 전문가의 자격과 교육 및 실습 과정을 파악하고, 난임상담사의 역할을 기술하였다. 앞으로 우리나라에서 난임상담이 근거기반실무로 자리 잡기 위해서는 상담 전후에 수량화 가능한 평가를 통해 효과성에 대한 근거 자료를 마련하고, 난임상담 전문인력을 체계적으로 육성해야 할 것이다.
Given the high percentage of women who experience mental health problems and the great demand for infertility counseling, there is an urgent need to develop infertility counseling as evidence-based practice in Korea in near future. The purpose of this study was to review the current status of infertility counseling as evidence-based practice and provide suggestions and policy directions for infertility counseling in Korea. First, psychological distress and mental health status of infertile women or couples were briefly reviewed. Second, the purposes and content of infertility counseling were presented. Third, the empirical evidence of the efficacy of infertility counseling was reviewed. Forth, the requirements and training of infertility counselors in countries where infertility counseling has been integrated as a necessary component of infertility treatment such as UK, Germany, and Australia were reviewed. We need to develop cost-effective infertility counseling to meet the needs of Korean women and couples and monitor outcomes of the counseling which will be used as evidence and utilized to improve the efficacy of infertility counseling.
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