Patient-centred infertility care: a qualitative study to listen to the patient's voice

Dancet, Eline; Empel, I.W.H. van; Rober, Peter; Nelen, W.L.D.M.; Kremer, J.A.M.; D’Hooghe, Thomas

doi:10.1093/humrep/der022

Cited by 150 publications

(153 citation statements)

References 46 publications

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“…2,3 Multiple strategies to promote public involvement in the development of health policies on assisted reproductive technologies need to be used such as arts-based approaches and traditional consultation like consensus panels. 1 Users' empowerment in decision-making processes may be reinforced through more inclusive priority-setting processes including participation in councils on assisted reproductive technologies with at least one member representing IVF couples; and the government should promote increased awareness of infertility through local research projects aiming to address the medical, legal, ethical, social, cultural, psychological and political dimensions of infertility treatment.…”

Section: Discussionmentioning

confidence: 99%

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Perspectives on access to in vitro fertilization in Portugal

Silva

Barros

2012

Rev. Saúde Pública

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OBJECTIVE:To analyze users' reasons for choosing in vitro fertilization treatment in public or private services and to identify their suggestions for improving fertility treatment. METHODS:A qualitative study using an interpretative approach was conducted. Fifteen semi-structured interviews were conducted with patients undergoing in vitro fertilization treatment (nine women, one man and fi ve couples) at home or at their workplace in the districts of Viana do Castelo, Braga, Porto and Lisbon, Portugal, between July 2005 and February 2006. RESULTS:Users evaluated access to in vitro fertilization treatment in public and private services based mainly on their individual experiences and called for more access to less costly, faster and friendlier care with suitable facilities, appropriate time management and caring medical providers. These perceptions were also associated with views on the need for fi ghting stigmatization of infertility, protecting children's rights and guaranteeing sustainability of health care system. Interviewees sought to balance reduced waiting time and more attentive care with costs involved. The choice of services depended on the users' purchase power and place of residence and availability of attentive care. CONCLUSIONS:Current national policies on in vitro fertilization treatment meet user's demands of promoting access to, and quality, availability and affordability of in vitro fertilization treatment. However, their focus on legal regulation and technical-scientifi c aspects contrasts with the users' emphasis on reimbursement, insurance coverage and focus on emotional aspects of the treatment. The study showed these policies should ensure insurance coverage, participation of user representatives in the National Council for Assisted Reproductive Technology, promotion of infertility research and certifi cation of fertility laboratories. The World Health Organization (WHO) established as a global goal for the new millennium to improve women's access to infertility treatment, and availability and affordability of infertility services, 6 which can contribute to the delivery of optimal infertility care. Portugal has taken this directive to task and medically assisted reproduction is a major issue in the recent structural reforms of the Portuguese health sector. MÉTODOS:Estudo qualitativo e interpretativo, baseado em 15 entrevistas semiestruturadas com pessoas que tentaram conceber por meio de técnicas de procriação medicamente assistida em Portugal (nove mulheres, um homem e cinco casais). As entrevistas foram realizadas entre julho de 2005 e fevereiro de 2006 nos distritos de Viana do Castelo, Braga, Porto e Lisboa, em casa ou no local de trabalho dos entrevistados. RESULTADOS:Os usuários avaliaram o acesso aos tratamentos de fertilidade no serviço público ou privado sobretudo com base nas suas experiências individuais, reclamando acesso mais barato, rápido e amigável, em espaços adequados, com gestão apropriada dos tempos de espera e serviços médicos atenciosos. Tais percepções fora...

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Section: Discussionmentioning

confidence: 99%

“…2,3,9 This study aimed to evaluate users' reasons for choosing public or private IVF treatment and to identify their suggestions for improving infertility treatment.…”

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confidence: 99%

Perspectives on access to in vitro fertilization in Portugal

Silva

Barros

2012

Rev. Saúde Pública

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“…Participants also felt that communication with clinics was better than in the UK, often with direct and readily available access to the clinician leading their care. Many of these factors have been identified as key components of 'patient-centred fertility care' generally (Dancet et al, 2010;Dancet et al, 2011;Redshaw, Hockley, & Davidson, 2007;Schmidt et al, 2003). A systematic review of patients' perspectives of fertility care concluded that fertility patients 'want to be treated like human beings with a need for: medical skills, respect, coordination, accessibility, information, comfort, support, partner involvement and a good attitude of and relationship with fertility clinic staff' (Dancet et al, 2010, p. 467).…”

Section: It Was a Bit More Daunting There's The Language And Cyrillimentioning

confidence: 99%

Cross-border-assisted reproduction: a qualitative account of UK travellers’ experiences

et al. 2016

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Surveys on patients' experiences of cross-border fertility treatment have reported a range of positive and challenging features. However, the number of such studies is limited, and there is no detailed qualitative account of the experiences of UK patients who travel overseas for fertility treatment. The present study used a cross-sectional, qualitative design and in-depth interviews. Fifty-one participants (41 women and 10 men, representing 41 treatment 'cases') participated in semi-structured interviews. The experiences reported were broadly positive with a large proportion of participants (39 cases, 95%) citing a favourable overall experience with only two cases (5%) reporting a more negative experience. Thematic analysis revealed 6 major categories and 20 sub-categories, which described the positive and challenging aspects of cross-border fertility travel. The positive aspects were represented by the categories: 'access', 'control' and 'care and respect'. The more challenging aspects were categorized as 'logistics and coordination of care', 'uncertainty' and 'cultural dissonance'. The study confirms findings from others that despite some challenges, there is a relatively high level of patient satisfaction with cross-border treatment with participants able to extend the boundaries of their fertility-seeking trajectories and in some cases, regain a sense of control over their treatment.

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“…Regarding patient centeredness, it is surprising that half of the final indicators relate to emotional support provided by counsellors as these concerns only 1 out of 10 dimensions of patient-centred infertility care (Dancet et al, 2011b. However, the need for all staff members to address patients from a psychosocial besides a medical perspective during routine care (Boivin et al, 2001;Dancet et al, 2011b) was addressed by the other two indicators.…”

Section: The Multidimensional Quality Indicator Set For Infertility Carementioning

confidence: 99%

Quality indicators for all dimensions of infertility care quality: consensus between professionals and patients

Dancet¹,

D’Hooghe²,

Spiessens³

et al. 2013

Human Reproduction

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study question: What is the relative importance of the six dimensions of quality of care according to different stakeholders and can a quality indicator set address all six quality dimensions and incorporate the views from professionals working in different disciplines and from patients?summary answer: Safety, effectiveness and patient centeredness were the most important quality dimensions. All six quality dimensions can be assessed with a set of 24 quality indicators, which is face valid and acceptable according to both professionals from different disciplines and patients.what is known already: To our knowledge, no study has weighted the relative importance of all quality dimensions to infertility care. Additionally, there are very few infertility care-specific quality indicators and no quality indicator set covers all six quality dimensions and incorporated the views of professionals and patients. study design, size and duration: A three-round iterative Delphi survey including patients and professionals from four different fields, conducted in two European countries over the course of 2011 and 2012. participants/materials, settings and methods: Dutch and Belgian gynaecologists, embryologists, counsellors, nurses/midwifes and patients took part (n ¼ 43 in round 1 and finally 30 in round 3). Respondents ranked the six quality dimensions twice for importance and their agreement was evaluated. Furthermore, in round 1, respondents gave suggestions, which were subsequently uniformly formulated as quality indicators. In rounds 2 and 3, respondents rated the quality indicators for preparedness to measure and for importance (relation to quality and prioritization for benchmarking). Providing feedback allowed selecting indicators based on consensus between stakeholder groups. Measurable indicators, important to all stakeholder groups, were selected for each quality dimension.main results: All stakeholder groups and most individuals agreed that safety, effectiveness and patient centeredness were the most important quality dimensions. A total of 498 suggestions led to the development of 298 indicators. Professionals were sufficiently prepared to measure 204 of these indicators. Based on importance, 52 (7-15 per dimension; round 2) and finally 24 (4 per dimension; round 3) quality indicators were selected.limitations, reasons for caution: The final quality indicator set does not cover the entire care process, but rather takes a 'sample' of each quality dimension. Although the quality indicators are face valid and acceptable, their psychometric characteristics need to be tested by further research.wider implications of the findings: Quality management should focus on safety, effectiveness and patient centeredness of care. Clinics can use the quality indicator set to assess all quality dimensions of their care.

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Patient-centred infertility care: a qualitative study to listen to the patient's voice

Cited by 150 publications

References 46 publications

Perspectives on access to in vitro fertilization in Portugal

Perspectives on access to in vitro fertilization in Portugal

Cross-border-assisted reproduction: a qualitative account of UK travellers’ experiences

Quality indicators for all dimensions of infertility care quality: consensus between professionals and patients

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