1
|
Woods BM, Bray LA, Campbell SB, Holland A, Mrug S, Ladores S. A phenomenological exploration of the mental health experiences of young women with diminished ovarian reserve. Res Nurs Health 2024; 47:220-233. [PMID: 37837429 DOI: 10.1002/nur.22347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/30/2023] [Accepted: 09/30/2023] [Indexed: 10/16/2023]
Abstract
Infertility is a reproductive disease affecting one in six individuals that renders an individual unable to conceive. One cause of infertility is diminished ovarian reserve (DOR), which reduces the quantity and/or quality of a female's oocyte pool. Although typically indicating normal ovarian aging during the late 30s and early 40s, DOR can also impact younger women, increasing their risk for psychological distress from an unexpected diagnosis of infertility. A phenomenological approach examined the mental health experiences and perceptions of infertility-related mental health care of young women with DOR. Women diagnosed with DOR by age 35 in the United States who experienced emotional distress during infertility were recruited from infertility-specific social media and via snowball sampling. Participants completed a demographic survey and semi-structured individual interview that was audio-recorded, transcribed verbatim, and analyzed using a phenomenological approach. Ten women ages 27-41 completed the study. On average, participants were 30 years of age at the time of DOR diagnosis (age range 25-35), primarily Caucasian (90%), and married (90%). Two main themes were found: (1) Young women with DOR feel like a "forgotten community" coping with an invisible disease; and (2) Not all fertility clinics are created equal. Participants perceived their diagnosis as devastating and hopeless and urged others to find a provider with ample experience treating patients with DOR. This study helped to understand how young women with DOR perceive their mental health and identified a significant need for advancing towards more holistic infertility healthcare that encompasses both physical and mental health.
Collapse
Affiliation(s)
- Brittany M Woods
- Department of Family, Community and Health Systems, University of Alabama at Birmingham School of Nursing, Birmingham, Alabama, USA
| | - Leigh Ann Bray
- Capstone College of Nursing, University of Alabama, Tuscaloosa, Alabama, USA
| | - Sukhkamal B Campbell
- Division of Reproductive Endocrinology & Infertility, University of Alabama at Birmingham Medicine, Birmingham, Alabama, USA
| | - Aimee Holland
- Department of Family, Community and Health Systems, University of Alabama at Birmingham School of Nursing, Birmingham, Alabama, USA
| | - Sylvie Mrug
- Department of Psychology, University of Alabama at Birmingham College of Arts and Sciences, Birmingham, Alabama, USA
| | - Sigrid Ladores
- Department of Family, Community and Health Systems, University of Alabama at Birmingham School of Nursing, Birmingham, Alabama, USA
| |
Collapse
|
2
|
van der Kolk L, Smit E, Bloemer J, van Wijk LM. The PCQ-Infertility Revised: A New Digital Instrument to Measure Treatment Satisfaction of Fertility Patients. Patient Relat Outcome Meas 2023; 14:223-234. [PMID: 37483866 PMCID: PMC10362858 DOI: 10.2147/prom.s416182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 06/23/2023] [Indexed: 07/25/2023] Open
Abstract
Background One of the key dimensions of healthcare quality is patient-centeredness, which represents how well healthcare is geared towards patients' needs and wishes. Many questionnaires that measure the patient-centeredness are long and complicated, eliciting non-response or careless responding. Moreover, responses to some commonly used questionnaires are difficult to interpret. The Patient-Centeredness Questionnaire-Infertility (PCQ-Infertility) is used to measure the patient's experience of fertility healthcare quality. The aim of this study was to improve the PCQ-Infertility to allow large-scale clinical implementation. Methods The study was performed in three parts. First, shortcomings of the original PCQ-Infertility were identified by evaluation of expert opinions. Second, the number of items were reduced, and items were rescaled and rephrased. Third, 844 patients filled in the original PCQ-Infertility and 260 patients filled in the revised PCQ-Infertility and reliability analyses were performed. In addition, a confirmatory factor analysis was performed on the revised PCQ-Infertility. Results The number of items in the revised questionnaire was reduced by 24% (from 51 to 39 items), which increased the internal consistency and reliability. The reliability analyses and confirmatory factor analysis indicated high consistency and convergent validity in all seven dimensions (accessibility, information, communication, patient involvement, respect for patient's values, continuity and transition, and competence) of the revised PCQ-Infertility. Conclusion The revised PCQ-Infertility is a more valid and reliable instrument than the original PCQ-Infertility, easier to interpret and shorter. Therefore, large-scale clinical implementation and data analysis are now possible, giving the opportunity for fertility care professionals to evaluate and improve their healthcare.
Collapse
Affiliation(s)
- Lotte van der Kolk
- Institute for Management Research, Radboud University, Nijmegen, the Netherlands
| | - Ellen Smit
- Ferring B.V., Hoofddorp, the Netherlands
| | - Josée Bloemer
- Institute for Management Research, Radboud University, Nijmegen, the Netherlands
| | | |
Collapse
|
3
|
Schreurs AMF, Dancet EAF, Apers S, Kuchenbecker WKH, van de Ven PM, Maas JWM, Lambalk CB, Nelen WLDM, van der Houwen LEE, Mijatovic V. The Relation between Patient-Centered Care and Quality of Life in Women with Endometriosis. Gynecol Obstet Invest 2023; 88:249-256. [PMID: 37231934 DOI: 10.1159/000531063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 04/24/2023] [Indexed: 05/27/2023]
Abstract
OBJECTIVE The objective of this study was to examine the hypothesis that experiences with patient-centered endometriosis care are related to the endometriosis-specific quality of life dimensions "emotional well-being" and "social support." DESIGN A secondary regression analysis of two cross-sectional studies was conducted. Participants/Materials: In total, data from 300 women were eligible for analysis. The participating women all had surgically proven endometriosis. SETTING The study was conducted in one secondary and two tertiary endometriosis clinics in the Netherlands. Questionnaires were disseminated between 2011 and 2016. METHODS Both included studies investigated patient-centeredness of endometriosis care and endometriosis-specific quality of life using, respectively, the ENDOCARE questionnaire (ECQ) and the Endometriosis Health Profile 30 (EHP-30). To increase power, the regression analysis focused on the previously found relation between the ten dimensions of the ECQ and the EHP-30 domains "emotional well-being" and "social support" rather than all five EHP-30 domains. After the Bonferroni correction to limit type 1 errors, the adjusted p value was 0.003 (0.05/20). RESULTS The participating women had a mean age of 35.7 years and had predominantly been diagnosed with moderate to severe endometriosis. None of the relations between patient-centered endometriosis care and the EHP-30 domain "emotional well-being" were significant. Three dimensions of patient-centered endometriosis care proved to be significantly related to the EHP-30 domain "social support": "information, communication, and education" (p < 0.001, beta = 0.436), "coordination and integration of care" (p = 0.001, beta = 0.307), and "emotional support and alleviation of fear and anxiety" (p = 0.002, beta = 0.259). LIMITATIONS This cross-sectional study identified relations rather than proving causality between experiencing less patient-centeredness of care and having lower quality of life. Nevertheless, it is very tangible that some causality exists, either directly or indirectly (e.g., through empowerment) and that by improving patient-centeredness, quality of life might be improved as well. CONCLUSION "Information, communication, and education"; "coordination and integration of care"; and "emotional support and alleviation of fear and anxiety" as dimensions of patient-centered endometriosis care are related to the quality of life domain "social support" of women with endometriosis. Improving the patient-centeredness of endometriosis care was already considered an important goal, but even more so given its relation with women's quality of life, which is increasingly considered the ultimate measure of health care quality. Quality improvement projects focusing on "information, communication, and education" are expected to impact women's quality of life the most.
Collapse
Affiliation(s)
- Anneke M F Schreurs
- Department of Reproductive Medicine, Endometriosis Center Amsterdam UMC, Research Institute Amsterdam Reproduction & Development, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Eline A F Dancet
- Department of Development and Regeneration, KU Leuven, University of Leuven, Leuven, Belgium
| | - Silke Apers
- Department of Development and Regeneration, KU Leuven, University of Leuven, Leuven, Belgium
| | | | - Peter M van de Ven
- Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universtiteit Amsterdam, Amsterdam, The Netherlands
| | - Jacques W M Maas
- Department of Obstetrics and Gynaecology, Maastricht UMC+ and Grow - School for Oncology and Developmental Biology, Maastricht, The Netherlands
| | - Cornelis B Lambalk
- Department of Reproductive Medicine, Endometriosis Center Amsterdam UMC, Research Institute Amsterdam Reproduction & Development, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Willianne L D M Nelen
- Department of Obstetrics and Gynaecology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Lisette E E van der Houwen
- Department of Reproductive Medicine, Endometriosis Center Amsterdam UMC, Research Institute Amsterdam Reproduction & Development, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Velja Mijatovic
- Department of Reproductive Medicine, Endometriosis Center Amsterdam UMC, Research Institute Amsterdam Reproduction & Development, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
4
|
Woods BM, Bray LA, Campbell S, Holland A, Mrug S, Ladores S. A review of the psychometric properties and implications for the use of the fertility quality of life tool. Health Qual Life Outcomes 2023; 21:45. [PMID: 37173669 PMCID: PMC10182698 DOI: 10.1186/s12955-023-02125-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 05/02/2023] [Indexed: 05/15/2023] Open
Abstract
OBJECTIVES To analyze and synthesize the reported psychometric properties of the Fertility Quality of Life (FertiQoL) instrument and describe its implications for use in practice and research in men and women with infertility. METHODS A systematic literature search was performed to identify all articles using the FertiQoL tool. PubMed, CINAHL, and PsycINFO were searched from September 2006 through May 2022. Studies were eligible for inclusion if they reported psychometric data on the original FertiQoL tool using a sample population of individuals with infertility. Sample size, country of origin, and psychometric data were documented for each study. RESULTS The initial search revealed 153 articles that had utilized the FertiQoL. Following abstract, title, and full-text screenings, 53 articles reported psychometric data and met criteria for inclusion. The FertiQoL is a sound measurement with satisfactory reliability and validity. Studies indicated adequate reliability in the overall scale ([Formula: see text]), as well as the core Emotional, Mind/Body, Social, and Relational scales ([Formula: see text]) and two optional Tolerability and Environment fertility treatment subscales ([Formula: see text]). Although the Relational subscale exhibited slightly lower reliability in several studies, the internal consistency for the measurement as a whole was satisfactory. Results also indicate adequate: 1) face and content validity with extensive professional and patient feedback during development; 2) convergent validity with general quality of life, depression, and anxiety measurements; and 3) structural validity using both confirmatory and exploratory factor analyses. CONCLUSION The FertiQoL tool is the most commonly used instrument to measure the impact of fertility issues on quality of life in men and women with infertility. Understanding the impact of infertility on quality of life provides valuable insight into the areas of infertility-related care that need to be prioritized, such as mental health or relational stressors. While the instrument has been used in different patient populations with infertility and available in multiple translations, it is necessary to understand the updated psychometric properties and the implications for its use. This review shows that the FertiQoL is reliable and valid for cross-cultural use among individuals with various etiologies of infertility.
Collapse
Affiliation(s)
- Brittany M Woods
- University of Alabama at Birmingham School of Nursing, 1720 2nd Avenue South, NB482, AL, 35294-1210, Birmingham, USA.
| | - Leigh Ann Bray
- University of Alabama Capstone College of Nursing, Office 3160, Box 870358, Tuscaloosa, AL, 35487, USA
| | - Sukhkamal Campbell
- Fertility Preservation Services, University of Alabama at Birmingham Medicine, 1700 6Th Ave South, Women and Infants Center 10390, Birmingham, AL, 35233, USA
| | - Aimee Holland
- Graduate Clinical Education, University of Alabama at Birmingham School of Nursing, 1720 2nd Avenue South, NB 406A, Birmingham, AL, 35294-1210, USA
| | - Sylvie Mrug
- University of Alabama at Birmingham, 1720 2nd Ave South, CH415, Birmingham, AL, 35294-1170, USA
| | - Sigrid Ladores
- University of Alabama at Birmingham School of Nursing, 1720 2nd Avenue South, NB422, Birmingham, AL, 35294-1210, USA
| |
Collapse
|
5
|
Dura-Ferrandis E, Bonilla-Campos A, Alhambra-Borras T. Psychometric properties of the Spanish version of the FertiQoL measure in couples undergoing infertility treatment. J Reprod Infant Psychol 2023:1-15. [PMID: 36814063 DOI: 10.1080/02646838.2023.2180623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 02/10/2023] [Indexed: 02/24/2023]
Abstract
BACKGROUND Both the diagnosis and the process of undergoing fertility treatment have a considerable negative effect on a person's quality of life (QoL). The evaluation of this effect is essential to offer comprehensive and high-quality care. The FertiQoL questionnaire is the most widely used instrument to evaluate QoL in people with fertility issues. OBJECTIVE This study is aimed at examining the dimensionality, validity and reliability of the Spanish version of the FertiQoL questionnaire in a sample of Spanish heterosexual couples undergoing fertility treatment. METHODS FertiQoL was administered to 500 people (50.2% women; 49.8% men; average age 36.1 years) recruited from a public Assisted Reproduction Unit in Spain. In this cross-sectional study, Confirmatory Factor Analysis (CFA) was used to analyse the dimensionality, validity and reliability of FertiQoL. Discriminant and convergent validity were assessed using the Average Variance Extracted (AVE), and model reliability was shown by Composite Reliability (CR) and Cronbach's alpha. RESULTS CFA's results support the 6-factor solution of the original FertiQoL (RMSEA and SRMR <0.09; CFI and TLI >0.9). However, several items had to be eliminated due to their low factorial weights - in particular, items Q4, Q5, Q6, Q11, Q14, Q15 and Q21. Moreover, FertiQoL showed good reliability (CR >0.7) and validity (AVE >0.5). CONCLUSION The Spanish version of FertiQoL is a reliable and valid instrument in measuring QoL in heterosexual couples undergoing fertility treatment. The CFA confirms the original 6-factors model but indicates that by eliminating some items the psychometric properties could improve. However, further research is recommended to address some of the measurement issues.
Collapse
Affiliation(s)
| | - Amparo Bonilla-Campos
- Department of Personality, Assessment, and Psychological Treatments, University of Valencia, Valencia, Spain
| | | |
Collapse
|
6
|
Scaravelli G, Fedele F, Spoletini R, Monaco S, Renzi A, Di Trani M. Toward a Personalized Psychological Counseling Service in Assisted Reproductive Technology Centers: A Qualitative Analysis of Couples' Needs. J Pers Med 2022; 13:jpm13010073. [PMID: 36675734 PMCID: PMC9867277 DOI: 10.3390/jpm13010073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/22/2022] [Accepted: 12/26/2022] [Indexed: 12/30/2022] Open
Abstract
Infertility may have a very strong emotional impact on individuals, requiring adequate support, but few studies on patients' demands toward psychological support have been conducted. This study aims to explore the emotions related to the infertility and to the Assisted Reproductive Technology (ART) procedure for which patients consider useful a psychological support. A total of 324 women completed a sociodemographic and clinical questionnaire and an open-ended questionnaire on emotional needs for psychological support. The written texts were explored by the Linguistic Inquiry and Word Count (LIWC) programme and linguistic characteristics were related to sociodemographic and anamnestic variables. Specific linguistic features were connected to several individual characteristics. More specifically, differences in linguistic processes emerged comparing women with an age over or under 40 years, women undergoing their first attempts versus more attempts, women undergoing ART with or without gamete donation, and women undergoing ART for male or unknown causes, as well as those undergoing ART for female or both partners' problems. These differences seem to confirm that older age, more attempts, gamete donation, and ART for unknown or male causes are risk factors that may worsen women's psychological well-being. This study contributes to increase the knowledge about the emotional needs of patients undergoing an ART procedure to develop specific psychological intervention programs.
Collapse
Affiliation(s)
- Giulia Scaravelli
- ART Italian National Register, National Centre for Diseases Prevention and Health Promotion, Italian National Health Institute, Viale Regina Elena 299, 00161 Rome, Italy
| | - Fabiola Fedele
- ART Italian National Register, National Centre for Diseases Prevention and Health Promotion, Italian National Health Institute, Viale Regina Elena 299, 00161 Rome, Italy
| | - Roberta Spoletini
- ART Italian National Register, National Centre for Diseases Prevention and Health Promotion, Italian National Health Institute, Viale Regina Elena 299, 00161 Rome, Italy
| | - Silvia Monaco
- Department of Dynamic and Clinical Psychology and Health Studies, “Sapienza” University of Rome, Via degli Apuli 1, 00185 Rome, Italy
- Correspondence:
| | - Alessia Renzi
- Department of Dynamic and Clinical Psychology and Health Studies, “Sapienza” University of Rome, Via degli Apuli 1, 00185 Rome, Italy
| | - Michela Di Trani
- Department of Dynamic and Clinical Psychology and Health Studies, “Sapienza” University of Rome, Via degli Apuli 1, 00185 Rome, Italy
| |
Collapse
|
7
|
Tavousi SA, Behjati M, Milajerdi A, Mohammadi AH. Psychological assessment in infertility: A systematic review and meta-analysis. Front Psychol 2022; 13:961722. [PMID: 36389481 PMCID: PMC9650266 DOI: 10.3389/fpsyg.2022.961722] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 10/03/2022] [Indexed: 11/23/2022] Open
Abstract
Infertility is a prevalent worldwide health issue and is defined by the World Health Organization (WHO) as a global health problem. Considering the importance of the psychological dimensions of infertility, various measurement tools have been used to measure the variables involved in infertility, of which the most widely used are the following: the Symptom Checklist 90 (SCL90), the Brief Symptom Inventory (BSI), the State-Trait Anxiety Inventory Form (STAI), and the Depression Anxiety Stress Scale (DASS). Therefore, given the problems of infertile people in terms of psychological dimensions, the aim of this meta-analysis was to assess the psychological assessment score in infertility. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol, we applied an online database with no time restriction. Data were gathered using a random-effect model to estimate the standard mean difference (SMD) for the evaluation of the strength of association analyses. Our data demonstrated a significant higher SCL90 score (CISCL90: 0.96, 0.34–1.57, heterogeneity: 94%, pheterogeneity < 0.001), and a non-significant higher DASS score (CIAnxiety: 0.82, -0.14 to 1.79; CIDepression: 0.8, -0.28 to 1.87; and CIStress: 0.82, -0.24 to 1.88). It is essential to seek for strategies to help infertile patients overcome their infertility-related psychological problems.
Collapse
Affiliation(s)
| | - Mohaddeseh Behjati
- Cellular, Molecular and Genetics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Milajerdi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran
| | - Amir Hossein Mohammadi
- Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran
- *Correspondence: Amir Hossein Mohammadi,
| |
Collapse
|
8
|
Pu DF, Rodriguez CM, Dimperio MD. Factors Distinguishing Reciprocal Versus Nonreciprocal Intimate Partner Violence Across Time and Reporter. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP13654-NP13684. [PMID: 33840301 PMCID: PMC8502788 DOI: 10.1177/08862605211001475] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Although intimate partner violence (IPV) is often conceptualized as occurring unilaterally, reciprocal or bidirectional violence is actually the most prevalent form of IPV. The current study assessed physical IPV experiences in couples and evaluated risk and protective factors that may be differentially associated with reciprocal and nonreciprocal IPV concurrently and over time. As part of a multi-wave longitudinal study, women and men reported on the frequency of their IPV perpetration and victimization three times across the transition to parenthood. Participants also reported on risk factors related to personal adjustment, psychosocial resources, attitudes toward gender role egalitarianism, and sociodemographic characteristics at each wave. Participants were classified into one of four IPV groups (reciprocal violence, male perpetrators only, female perpetrators only, and no violence) based on their self-report and based on a combined report, which incorporated both partners' reports of IPV for a maximum estimate of violence. Women and men were analyzed separately, as both can be perpetrators and/or victims of IPV. Cross-sectional analyses using self-reported IPV data indicated that IPV groups were most consistently distinguished by their levels of couple satisfaction, across gender; psychological distress also appeared to differentiate IPV groups, although somewhat less consistently. When combined reports of IPV were used, sociodemographic risk markers (i.e., age, income, and education) in addition to couple functioning were among the most robust factors differentiating IPV groups concurrently, across gender. In longitudinal analyses, sociodemographic vulnerabilities were again among the most consistent factors differentiating subsequent IPV groups over time. Several gender differences were also found, suggesting that different risk factors (e.g., women's social support and men's emotion regulation abilities) may need to be targeted in interventions to identify, prevent, and treat IPV among women and men.
Collapse
Affiliation(s)
- Doris F. Pu
- University of Alabama at Birmingham, Birmingham, AL, USA
| | | | | |
Collapse
|
9
|
Zhu H, Shi L, Wang R, Cui L, Wang J, Tang M, Qian H, Wei M, Wang L, Zhou H, Xu W. Global Research Trends on Infertility and Psychology From the Past Two Decades: A Bibliometric and Visualized Study. Front Endocrinol (Lausanne) 2022; 13:889845. [PMID: 35903282 PMCID: PMC9317298 DOI: 10.3389/fendo.2022.889845] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 06/13/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives The aim of this study was to evaluate the global scientific output of research on infertility and psychology; explore the current status and trends in this field through the cooperation of authors, countries, and institutions; shed light on the direction of clinical infertility research in the future, and provide inspiration for targeted diagnosis and treatment of infertility. Methods Research publications on infertility and psychology from the past two decades were retrieved from the Web of Science Core Collection (WoSCC). Bibliometric analyses were performed using VOSviewer software and the bibliometrix R package. Network maps were generated to evaluate the collaborations between different authors, countries, institutions, and keywords. Results A total of 151 articles related to the study of infertility and psychology were identified. We observed a gradual increase in the number of publications from 2001 to 2021, and the trend has been relatively stable in the past eight years. Human Reproduction (England), as the leading journal publishing the most papers (29 articles), was cited in the most journals (1208 times). Boivin J was the most prolific author (16 articles), with the largest number of citations (890 times) and the highest h-index (14) during the past decades. Boivin J was also the leader with the highest publication frequency and more active cooperation with other top authors. The United Kingdom (34 papers) and Cardiff University (25 articles) contributed the most publications and were the leading contributors in this field. Active cooperation between countries and between institutions was observed, and analyses of articles and references were also shown. The main hot topics included matters related to women (39 times), in-vitro salt (31 times), infertility (30 times), couples (25 times), and impact (24 times). Conclusion Our study results provide a comprehensive overview of the development of scientific literature, allowing relevant authors and research teams to recognize the current research status in this field. At the same time, infertility and psychology may soon become hotspots and should be closely monitored.
Collapse
Affiliation(s)
- Hongkun Zhu
- Nanjing University of Chinese Medicine, Nanjing, China
| | - Lingli Shi
- Department of Reproduction, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Rong Wang
- Department of Laboratory Medicine, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Lijuan Cui
- Department of Pathology, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Jiahui Wang
- Department of Reproduction, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Mengyu Tang
- Department of Reproduction, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Haiqing Qian
- Department of Reproduction, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Minggang Wei
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Lihong Wang
- Department of Reproduction, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Huifang Zhou
- Department of Gynaecology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Wenting Xu
- Nanjing University of Chinese Medicine, Nanjing, China
- Department of Reproduction, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| |
Collapse
|
10
|
Hassan SUN, Zahra A, Parveen N, Iqbal N, Mumtaz S, Batool A. Quality of Infertility Care Services and Emotional Health of South Asian Women. Psychol Res Behav Manag 2022; 15:1131-1146. [PMID: 35586700 PMCID: PMC9109899 DOI: 10.2147/prbm.s357301] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 04/26/2022] [Indexed: 11/23/2022] Open
Abstract
Background Treatment tolerability and treatment environment are two major spheres of infertility care that may associate with women’s emotional health and coping mechanisms. Aim The present study aimed at assessing the relationship between infertility treatment quality and various aspects of emotion-focus coping, problem-focus coping, and avoidance coping mechanisms. Method The study was completed by using standardized tools and data from this descriptive, cross-sectional, correlational study were collected from 350 women undergoing infertility treatments in private reproductive healthcare centers in Quetta, Pakistan. Findings Treatment tolerability was found to be positively associated with positive reframing (p < 0.02) and negatively associated with the use of emotional support (p < 0.03); acceptance (p < 0.01); humor (p < 0.03); behavioral disengagement (p < 0.01) and venting (p < 0.01). The quality of the treatment environment demonstrated a negative correlation between religious coping (p < 0.02) and behavioral disengagement (p < 0.01), whereas it showed a positive correlation with active coping (p < 0.03) and planning (p < 0.02). The linear regression analysis demonstrated that treatment tolerability significantly increased with positive reframing (R2 = 0.118, F(304) = 2.22, p < 0.03). Behavioral disengagement significantly decreased with better treatment environment (R2 = 0.111, F(304) = 2.09, p < 0.02). Discussion We discussed the findings keeping in view the role of social, cultural, and economic factors related to infertility care in the context South-Asian culture, and recommendations are made to promote women’s mental health and coping by improving some specific aspects of infertility treatment quality. Conclusions High treatment tolerability may associate with some useful aspects of emotion-focus coping, such as positive reframing, whereas low treatment tolerability may associate with avoidance coping, such as behavioral disengagement and venting. Besides, the quality of the infertility treatment environment enables women to use problem-focus coping mechanisms, such as planning and active coping.
Collapse
Affiliation(s)
- Sehar-un-Nisa Hassan
- Department of Public Health, College of Public Health and Health Informatics, University of Ha’il, Ha’il, 81451, Kingdom of Saudi Arabia
- Department of Behavioral Sciences, School of Social Sciences and Humanities, National University of Sciences and Technology (NUST), Islamabad, Pakistan
- Correspondence: Sehar-un-Nisa Hassan, Department of Public Health, College of Public Health and Health Informatics, University of Ha’il, Ha’il, 81451, Kingdom of Saudi Arabia, Tel +966 5576 629 275, Email ;
| | - Aqeela Zahra
- Department of Family and Community Medicine, College of Medicine, University of Ha’il, Ha’il, 81451, Kingdom of Saudi Arabia
| | - Nuzhat Parveen
- Department of Obstetrics and Gynecology, College of Medicine, University of Ha’il, Ha’il, 81451, Kingdom of Saudi Arabia
- Nuzhat Parveen, Department of Obstetrics and Gynecology, College of Medicine, University of Ha’il, Ha’il, 81451, Kingdom of Saudi Arabia, Email
| | - Naveed Iqbal
- Department of Obstetrics and Gynecology, College of Medicine, University of Ha’il, Ha’il, 81451, Kingdom of Saudi Arabia
| | - Sarwat Mumtaz
- Department of Health Management, College of Public Health and Health Informatics, University of Ha’il, Ha’il, 81451, Kingdom of Saudi Arabia
| | - Asma Batool
- Obstetrics and Gynecology, Maternity and Children Hospital Ha’il, Ha’il, Kingdom of Saudi Arabia
| |
Collapse
|
11
|
Missmer SA, Tu F, Soliman AM, Chiuve S, Cross S, Eichner S, Antunez Flores O, Horne A, Schneider B, As-Sanie S. Impact of endometriosis on women's life decisions and goal attainment: a cross-sectional survey of members of an online patient community. BMJ Open 2022; 12:e052765. [PMID: 35477879 PMCID: PMC9047767 DOI: 10.1136/bmjopen-2021-052765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES To examine women's perceptions of endometriosis-associated disease burden and its impact on life decisions and goal attainment. DESIGN An anonymous online survey was distributed in October 2018 through the social media network MyEndometriosisTeam.com. PARTICIPANTS Women aged 19 years and older living in several English-speaking countries who self-identified as having endometriosis. OUTCOME MEASURES Patients' perspectives on how endometriosis has affected their work, education, relationships, overall life decisions and attainment of goals. Subanalyses were performed for women who identified as 'less positive about the future' (LPAF) or had 'not reached their full potential' (NRFP) due to endometriosis. RESULTS 743 women completed the survey. Women reported high levels of pain when pain was at its worst (mean score, 8.9 on severity scale of 0 (no pain) to 10 (worst imaginable pain)) and most (56%, n=415) experienced pain daily. Women reported other negative experiences attributed to endometriosis, including emergency department visits (66%, n=485), multiple surgeries (55%, n=406) and prescription treatments for symptoms of endometriosis (72%, n=529). Women indicated that they believed endometriosis had a negative impact on their educational and professional achievements, social lives/relationships and overall physical health. Most women 'somewhat agreed'/'strongly agreed' that endometriosis caused them to lose time in life (81%, n=601), feel LPAF (80%, n=589) and feel they had NRFP (75%, n=556). Women who identified as LPAF or NRFP generally reported more negative experiences than those who were non-LPAF or non-NRFP. CONCLUSIONS Women who completed this survey reported pain and negative experiences related to endometriosis that were perceived to negatively impact major life-course decisions and attainment of goals. Greater practitioner awareness of the impact that endometriosis has on a woman's life course and the importance of meaningful dialogue with patients may be important for improving long-term management of the disease and help identify women who are most vulnerable.
Collapse
Affiliation(s)
- Stacey A Missmer
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Boston Center for Endometriosis, Boston, Massachusetts, USA
- Department of Obstetrics, Gynecology, and Reproductive Biology, Michigan State University, Grand Rapids, Michigan, USA
| | - Frank Tu
- Department of Obstetrics and Gynecology, NorthShore University Health System, Evanston, Illinois, USA
- Department of Obstetrics and Gynecology, Pritzker School of Medicine, University of Chicago, Evanston, Illinois, USA
| | | | | | | | | | | | - Andrew Horne
- Medical Research Council Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK
| | | | - Sawsan As-Sanie
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan, USA
| |
Collapse
|
12
|
Leyser-Whalen O, Bombach B, Mahmoud S, Greil AL. From generalist to specialist: A qualitative study of the perceptions of infertility patients. REPRODUCTIVE BIOMEDICINE & SOCIETY ONLINE 2022; 14:204-215. [PMID: 35036590 PMCID: PMC8753058 DOI: 10.1016/j.rbms.2021.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 08/02/2021] [Accepted: 10/26/2021] [Indexed: 06/14/2023]
Abstract
Few studies explore in-depth accounts of women's and men's experiences with, and transitions between, obstetrician/gynaecologists (OB/GYNs) and reproductive endocrinologists during infertility diagnostic and treatment processes. This study examined this subject matter with data from qualitative, in-depth, semi-structured interviews. Between April 2007 and March 2008, the first author interviewed 20 women and eight men from a large midwestern metropolitan area in the USA who had used, or were in the process of using, any fertility treatment in the 5 years preceding the interview. Six couples and 16 individuals were interviewed, resulting in narratives of 22 distinct infertility journeys. The main complaints made by respondents about OB/GYNs were that they were insufficiently concerned with providing timely treatment and that they paid insufficient attention to male partners. Women felt that their concerns were taken more seriously by reproductive endocrinologists, but complained of insensitivity, depersonalization and misinformation, and were suspicious of a profit orientation.
Collapse
Affiliation(s)
- Ophra Leyser-Whalen
- Department of Sociology and Anthropology, University of Texas El Paso, El Paso, TX, USA
| | - Brianne Bombach
- Department of Sociology and Anthropology, University of Texas El Paso, El Paso, TX, USA
| | - Sara Mahmoud
- Department of Sociology and Anthropology, University of Texas El Paso, El Paso, TX, USA
| | - Arthur L. Greil
- Division of Social Sciences, Alfred University, Alfred, NY, USA
| |
Collapse
|
13
|
Verkerk EW, Rake EA, Braat DDM, Nelen WLDM, Aarts JWM, Kremer JAM. The Tell me tool: The development and feasibility of a tool for person-centred infertility care. Health Expect 2022; 25:1081-1093. [PMID: 35218288 PMCID: PMC9122469 DOI: 10.1111/hex.13455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 02/01/2022] [Accepted: 02/07/2022] [Indexed: 11/30/2022] Open
Abstract
Background An important—and often missing—element of person‐centred care is the inclusion of individual patients' values and preferences. This is challenging but especially important for high‐burden fertility treatments. We describe the development of a clinical tool that aims to facilitate the delivery of person‐centred fertility care by giving insight into the patients' values and preferences. Methods We developed the Tell me tool following the three principles of user‐centred design: (1) early and continual focus on users; (2) iterative design; (3) measurement of user behaviour. Accordingly, our methods consisted of three phases: (1) conducting semi‐structured interviews with 18 couples undergoing fertility treatment, followed by a consensus meeting with relevant stakeholders; (2) performing seven iterative improvement rounds; (3) testing the feasibility of the tool in 10 couples. Results The Tell me tool consists of a ranking assignment of 13 themes and two open‐ended questions. These themes relate to the couples' wellbeing and experience of the treatment, such as mental health and shared decision making. The open‐ended questions ask them to write down what matters most to them. The field test showed variation between the individual patients' answers. The tool proved to highlight what is important to the individual patient and gives insight into patients' personal contexts. Conclusions We developed a tool that gives insight into the values and preferences of the individual patient. The tool seems feasible for facilitating person‐centred fertility care. Patient or Public Contribution The tool was developed with a user‐centred design that strongly involved patients.
Collapse
Affiliation(s)
- Eva W Verkerk
- Department of IQ Healthcare, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Ester A Rake
- Department of IQ Healthcare, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands.,Knowledge Institute of Medical Specialists, Utrecht, The Netherlands
| | - Didi D M Braat
- Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Willianne L D M Nelen
- Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Johanna W M Aarts
- Department of Obstetrics and Gynecology, Amsterdam UMC, Amsterdam, The Netherlands
| | - Jan A M Kremer
- Department of IQ Healthcare, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| |
Collapse
|
14
|
Handley SC, Passarella M, Martin AE, Lorch SA, Srinivas SK, Nembhard IM. Development and Testing of a Survey Measure of Organizational Perinatal
Patient‐Centered
Care Culture. Health Serv Res 2022; 57:806-819. [PMID: 35128641 PMCID: PMC9264452 DOI: 10.1111/1475-6773.13949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 01/14/2022] [Accepted: 01/18/2022] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To develop and test a measure of patient-centered care (PCC) culture in hospital-based perinatal care. DATA SOURCES Data were obtained from US perinatal hospitals: one provided survey development data and 14 contributed data for survey testing. STUDY DESIGN We used qualitative and quantitative methods to develop the mother-infant centered care (MICC) culture survey. Qualitative methods included observation, focus group, interviews, and expert consultations to adapt items from other settings and create new items capturing dimensions of PCC articulated by The Commonwealth Fund. We quantitatively assessed survey psychometric properties using reliability (Cronbach's α and Pearson correlation coefficients) and validity (exploratory and confirmatory factor analysis [CFA]) statistics, and refined the survey. After confirming aggregation suitability (ICCs), we calculated "MICC culture scores" at the individual, unit, and hospital level and assessed associations between scores and survey-collected, staff-reported outcomes to evaluate concurrent validity. DATA COLLECTION Survey development included 12 site-visit observations, one semi-structured focus group (five participants), two semi-structured interviews, five cognitive interviews, and three expert consultations. Survey testing used online surveys administered to obstetric and neonatal unit staff (N = 316). PRINCIPAL FINDINGS Using responses from 10 hospitals with ≥4 responses from both units (n = 240), the 20-item MICC culture survey demonstrated reliability (Cronbach's α = 0.95) while capturing all PCC dimensions (subscale Cronbach's α = 0.72-0.87). CFA showed validity through goodness-of-fit (overall chi-square = 214 [p-value = 0.012], SRMR = 0.056, RMSEA = 0.041, CFI = 0.97, and TLI = 0.96). Aggregation statistics (ICCs < 0.05) justify unit- and hospital-level aggregation. Demonstrating preliminary validity, individual-, unit-, and hospital-level MICC culture scores were associated with all outcomes (satisfaction with care provided, within-unit team effectiveness, and relational coordination [RC] between units) (p-values < 0.05), except for neonatal unit scores and RC (p-value = 0.11). CONCLUSIONS The MICC culture survey is a psychometrically sound measure of PCC culture for hospital-based perinatal care. Survey scores are associated with staff-reported outcomes. Future studies with patient outcomes will aid identification of improvement opportunities in perinatal care.
Collapse
Affiliation(s)
- Sara C. Handley
- Division of Neonatology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine‐University of Pennsylvania Philadelphia Pennsylvania
- Leonard Davis Institute of Health Economics University of Pennsylvania Philadelphia PA
| | - Molly Passarella
- Department of Pediatrics Children’s Hospital of Philadelphia Philadelphia PA
| | - Ashley E. Martin
- Department of Pediatrics Children’s Hospital of Philadelphia Philadelphia PA
| | - Scott A. Lorch
- Division of Neonatology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine‐University of Pennsylvania Philadelphia Pennsylvania
- Leonard Davis Institute of Health Economics University of Pennsylvania Philadelphia PA
| | - Sindhu K. Srinivas
- Leonard Davis Institute of Health Economics University of Pennsylvania Philadelphia PA
- Department of Obstetrics and Gynecology Perelman School of Medicine‐University of Pennsylvania Philadelphia Pennsylvania
| | - Ingrid M. Nembhard
- Leonard Davis Institute of Health Economics University of Pennsylvania Philadelphia PA
- The Wharton School University of Pennsylvania Philadelphia PA
| |
Collapse
|
15
|
Mahoney DE, Russell CL. Women's Reports of Barriers to and Facilitators of Oral Medication Adherence During Ovarian Stimulation: A Mixed Methods Pilot Study. J Reprod Infertil 2021; 22:184-200. [PMID: 34900639 PMCID: PMC8607872 DOI: 10.18502/jri.v22i3.6719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 08/03/2020] [Indexed: 11/24/2022] Open
Abstract
Background: Adherence to lifestyle modification recommendations remains problematic for women undergoing fertility treatment, raising concerns about the extent to which women adhere to prescribed medication regimens. Limited data have shown suboptimal oral medication adherence rates of 19% to 74%. The objective of this study was to explore what women perceive as barriers to and facilitators of oral medication adherence during fertility treatment cycles. Methods: An exploratory mixed methods pilot study was conducted among a sample of 30 women who were actively taking one to two cycles of letrozole or clomiphene citrate for ovarian stimulation in conjunction with intrauterine insemination cycles. Medication adherence barriers were measured using a 20-item survey. Medication adherence facilitators and personal experiences with fertility treatment were assessed with structured interviews. Medication adherence was assessed with electronic event monitoring. Results: The overall medication adherence median was 0.97 with a range of 0.75 to 1.00, and nine women (50%) demonstrated perfect adherence. The most commonly reported barriers were recently feeling sad, down, or blue (53%), and taking medication more than once per day (40%). Women with higher barrier scores had significantly lower medication adherence scores (p=0.02) compared to women with lower total barrier scores. Facilitators included using physical aides as reminders (60%) and establishing a daily routine (50%). No significant correlation was found between medication adherence scores and facilitators. Conclusion: The dynamic interplay between perceived barriers and facilitators and women’s medication-taking patterns could influence whether or not medication regimens are followed correctly.
Collapse
Affiliation(s)
- Diane E Mahoney
- School of Nursing, University of Kansas Medical Center, Kansas, US
| | | |
Collapse
|
16
|
Mori A, Nishii O, Takai Y, Momoeda M, Kamisawa E, Shimizu K, Nozawa M, Takemura Y, Fujimoto A. Influence of a patient education and care program on women undergoing non-assisted reproductive technology fertility treatment. Reprod Med Biol 2021; 20:513-523. [PMID: 34646080 PMCID: PMC8499593 DOI: 10.1002/rmb2.12406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/20/2021] [Accepted: 07/29/2021] [Indexed: 12/02/2022] Open
Abstract
PURPOSE To determine the influence of a patient education and care program on the quality of life (QOL) of female patients undergoing non-assisted reproductive technology (ART) fertility treatment. METHODS Participants completed the MOS 36-Item Short-Form Health Survey and fertility QOL (FertiQoL) questionnaires at baseline and at 3, 6, and 12 months of treatment. The responses of patients who underwent three sessions of the program (at baseline, 3 months, and 6 months of treatment) were compared with those of patients who did not receive the program. RESULTS This study compared 69 patients who received an additional care program with 104 patients in the control group, all from 13 facilities. Treatment FertiQoL responses (p = 0.004) and treatment tolerability (p = 0.043) differed between the program and control groups at 3 months using the repeated measures mixed model. The cost of treatment per pregnancy was lower in the program group than in the control group. CONCLUSION The patient education and care program provided by reproductive fertility specialists or fertility nurses during non-ART fertility programs improves patient satisfaction.
Collapse
Affiliation(s)
- Akiko Mori
- Department of NursingSchool of NursingShonan Kamakura University of Medical SciencesKanagawaJapan
| | - Osamu Nishii
- Department of Obstetrics and GynecologyTeikyo University School of Medicine Hospital MizonokuchiKanagawaJapan
| | - Yasushi Takai
- Department of Obstetrics and GynecologySaitama Ika Daigaku Sogo Iryo CenterSaitamaJapan
| | - Mikio Momoeda
- Center for Advanced ReproductionSt. Luke's International UniversityHospital, TokyoJapan
| | - Etsuko Kamisawa
- Graduate School of NursingKyoto Tachibana UniversityKyotoJapan
| | - Kiyomi Shimizu
- Department of NursingSchool of NursingJosai International UniversityChibaJapan
| | - Mieko Nozawa
- Department of NursingTokyo University of Technology School of Health SciencesTokyoJapan
| | | | - Akihisa Fujimoto
- Department of Obstetrics and GynecologyTeikyo University School of Medicine Hospital MizonokuchiKanagawaJapan
| |
Collapse
|
17
|
Domar A, Vassena R, Dixon M, Costa M, Vegni E, Collura B, Markert M, Samuelsen C, Guiglotto J, Roitmann E, Boivin J. Barriers and factors associated with significant delays to initial consultation and treatment for infertile patients and partners of infertile patients. Reprod Biomed Online 2021; 43:1126-1136. [PMID: 34756644 DOI: 10.1016/j.rbmo.2021.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 08/09/2021] [Accepted: 09/02/2021] [Indexed: 11/28/2022]
Abstract
RESEARCH QUESTION What are the key drivers and barriers for infertile patients and their partners to see an infertility specialist and initiate treatment? DESIGN An online, international, 30-minute quantitative survey collected data from 1944 respondents from nine countries. Respondents were infertile patients (n = 1037) or partners of infertile patients (n = 907; but not necessarily partners of the patient sample), at different stages of the treatment journey. RESULTS The overall average times were 3.2 years to receiving a medical infertility diagnosis, 2.0 years attempting to achieve pregnancy without assistance before treatment, and 1.6 years of treatment before successful respondents achieved pregnancy. The most common driver for considering treatment after a consultation (n = 1025) was an equal desire within the couple to have a child (40.8%). Of the partners (n = 356), 29.8% reported that transparency of information from healthcare professionals about treatment expectations was important. A significantly higher proportion of respondents seeking treatment reported that healthcare professionals offered supportive services (61.2%) and mental health services (62.0%), than of the 207 respondents who did not seek treatment (32.4% and 36.7%, respectively; P < 0.001). Perceived cost was the most commonly reported barrier for respondents not seeking a consultation (37.5% of n = 352) or treatment (42.0% of n = 207). Of the 95 respondents who discontinued treatment, 34.7% discontinued due to the financial impact. CONCLUSIONS Respondents reported significant delays to seeking treatment, probably negatively impacting the chances of achieving pregnancy. Motivational coherence within couples was a key driver and cost of treatment was the main barrier. Reported supportive service offerings by healthcare professionals were significantly associated with continuation of the treatment journey.
Collapse
Affiliation(s)
- Alice Domar
- Boston IVF, Domar Center for Mind/Body Health, Waltham, MA and Harvard Medical School, Boston MA, USA.
| | | | - Marjorie Dixon
- ANOVA Fertility and Reproductive Health, University of Toronto, Toronto ON, Canada
| | - Mauro Costa
- Reproductive Medicine, International Evangelical Hospital, Genova, Italy
| | - Elena Vegni
- Department of Health Sciences, Università Statale di Milano, Milan, Italy
| | - Barbara Collura
- RESOLVE: The National Infertility Association, McClean, Virginia, USA
| | - Marie Markert
- Ferring Pharmaceuticals, Health Economics & Outcomes Research, Copenhagen, Denmark
| | - Carl Samuelsen
- Ferring Pharmaceuticals, Health Economics & Outcomes Research, Copenhagen, Denmark
| | | | | | - Jacky Boivin
- School of Psychology, Cardiff University, Cardiff, UK
| |
Collapse
|
18
|
Timmers T, Keijsers M, Kremer JAM, Janssen L, Smeenk J. Supporting Women Undergoing IVF Treatment With Timely Patient Information Through an App: Randomized Controlled Trial. JMIR Mhealth Uhealth 2021; 9:e28104. [PMID: 34448725 PMCID: PMC8433853 DOI: 10.2196/28104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 06/02/2021] [Accepted: 07/02/2021] [Indexed: 11/13/2022] Open
Abstract
Background Since the introduction of assisted reproductive technologies in 1978, over 2 million in vitro fertilization (IVF) babies have been born worldwide. Patients play a vital role in the success of this treatment. They are required to take fertility medication (hormone injections) to activate the ovaries to produce a sufficient number of oocytes. Later, they need to take medication to increase the chance of the embryo surviving inside the uterus. Patients are educated during an intake consultation at the start of the treatment to minimize the emotional burden and reduce noncompliance. The consultation lasts about 30 to 45 minutes and covers all essential subjects. Even though ample time and energy is spent on patient education, patients still feel anxious, unknowledgeable, and unsupported. As such, electronic health utilizing a smartphone or tablet app can offer additional support, as it allows health care professionals to provide their patients with the correct information at the right time by using push notifications. Objective This randomized controlled trial aimed to evaluate the capacity of an app to support IVF patients throughout the different phases of their treatment and assess its effectiveness. The study's primary outcome was to determine the patients’ level of satisfaction with the information provided. The secondary outcomes included their level of knowledge, ability to administer the medication, overall experienced quality of the treatment, health care consumption, and app usage. Methods This study was performed at a specialized fertility clinic of the nonacademic teaching hospital Elisabeth-TweeSteden Ziekenhuis in Tilburg, the Netherlands. Patients who were scheduled for IVF or intracytoplasmic sperm injection treatments between April 2018 and August 2019 were invited to participate in a physician-blinded, randomized controlled trial. Results In total, 54 patients participated (intervention group: n=29). Patients in the intervention group demonstrated a higher level of satisfaction on a 0 to 10 scale (mean 8.43, SD 1.03 vs mean 7.70, SD 0.66; P=.004). In addition, they were more knowledgeable about the different elements of the treatment on a 7 to 35 scale (mean 27.29, SD 2.94 vs mean 23.05, SD 2.76; P<.001). However, the difference disappeared over time. There were no differences between the two patient groups on the other outcomes. In total, 25 patients in the intervention group used the app 1425 times, an average of 57 times per patient. Conclusions Our study demonstrates that, in comparison with standard patient education, using an app to provide patients with timely information increases their level of satisfaction. Furthermore, using the app leads to a higher level of knowledge about the steps and procedures of IVF treatment. Finally, the app’s usage statistics demonstrate patients’ informational needs and their willingness to use an electronic health application as part of their treatment. Trial Registration Netherlands Trial Register (NTR) 6959; https://www.trialregister.nl/trial/6959
Collapse
Affiliation(s)
- Thomas Timmers
- IQ healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands.,Interactive Studios, Rosmalen, Netherlands
| | - Manouk Keijsers
- Department of Obstetrics and Gynaecology, Elisabeth-TweeSteden Hospital, Tilburg, Netherlands
| | - Jan A M Kremer
- IQ healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | | | - Jesper Smeenk
- Department of Obstetrics and Gynaecology, Elisabeth-TweeSteden Hospital, Tilburg, Netherlands
| |
Collapse
|
19
|
Samorinha C, de Freitas C, Silva S. Donor-centred care: the facilitating and constraining factors experienced by gamete donors in a public bank. HUM FERTIL 2021:1-12. [PMID: 34355619 DOI: 10.1080/14647273.2021.1962987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The provision of care that is responsive to the preferences, needs and values of gamete donors is key to improving their recruitment and ensuring the functioning of gamete banks. This qualitative study aimed to explore gamete donors' experiences about the facilitating and constraining human and system factors to donor-centred healthcare delivery in gamete banks. It is based on 20 semi-structured interviews with oocyte and sperm donors, recruited at the Portuguese Public Bank of Gametes, conducted from November 2017 to February 2019. Deductive content analysis was performed using the software NVivo12, following the patient-centred infertility care model. Interviewees identified facilitating factors mostly related with the human dimension of care (i.e. careful and available attitude and behaviours of health professionals, as well as their good communication skills and emotional support). Constraining factors were predominantly identified at the system level (i.e. insufficient information provision, poor coordination, and integration). Lack of privacy emerged simultaneously as a human and a system constraining factor (i.e. physical discomfort during medical-technical acts or gamete collection). There is room for improving clinical practice and the organisation of healthcare services within a context where the competence and attitude of, and relationship with, the staff are highly valued.
Collapse
Affiliation(s)
- Catarina Samorinha
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates.,EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Cláudia de Freitas
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.,Centro de Investigação e Estudos de Sociologia (CIES-IUL), Instituto Universitário de Lisboa (ISCTE-IUL), Lisbon, Portugal
| | - Susana Silva
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| |
Collapse
|
20
|
Fata S, Aluş Tokat M. Communication between infertile women and nurses: facilitators, barriers and requirements for improving. PSYCHOL HEALTH MED 2021; 27:1704-1714. [PMID: 33855913 DOI: 10.1080/13548506.2021.1916959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Nurses working in infertility clinics need to know effective ways of communicating with infertile women to help them experience their treatment period comfortably. However, they can face various stressors which can reduce the motivation. Therefore, the aim of this study was to evaluate communication between nurses in infertility clinics and infertile women from the perspective of both groups. The qualitative study was conducted in an InVitroFertilization clinic, in Turkey with five nurses and seven female patients. Data obtained from semi-structured interviews were thematically analyzed. Three main themes were identified: facilitators of communication (verbal and nonverbal facilitator), barriers to communication (related to nurses and women), and requirements for improving communication. Factors such as appropriate tone of voice, smiling, provide eye-to-eye contact are expressed by women and/or nurses as facilitators. The high tone of voice, yelling, etc. for women, stress and the low education level of women for nurses were barriers. The requirements expressed by women were nurses receiving training to improve their communication skills, and not having prejudice, while requirements for nurses were enough time, women being sincere, taking psychological support. This paper may provide nurses recognize facilitators and barriers to effective communication with women and include in their care plans.
Collapse
Affiliation(s)
- Sevcan Fata
- Gynecology&Obstetrics Nursing Department, Dokuz Eylul University Nursing Faculty, Izmir, Turkey
| | - Merlinda Aluş Tokat
- Gynecology&Obstetrics Nursing Department, Dokuz Eylul University Nursing Faculty, Izmir, Turkey
| |
Collapse
|
21
|
Pozza A, Dèttore D, Coccia ME. Quality of life and infertility stress in homologous and heterologous medically assisted reproduction: The role of common and specific psychopathological traits. Perspect Psychiatr Care 2021; 57:717-725. [PMID: 32776595 DOI: 10.1111/ppc.12603] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 07/03/2020] [Accepted: 08/02/2020] [Indexed: 11/28/2022] Open
Abstract
PURPOSE This study compared the quality of life/stress between individuals undergoing homologous and heterologous medically assisted reproduction (MAR) and explored the role of psychopathological traits. DESIGN AND METHODS Two hundred and twenty-six participants in homologous (52.2%) and heterologous MAR (47.8%) completed Symptom Checklist 90-R, Fertility Problem Inventory, and Fertility Quality of Life. FINDINGS The homologous group showed higher depressive/anxious and obsessive-compulsive traits, hostility and interpersonal detachment, and worse quality of life/stress than the heterologous one. In the homologous pathway, those with higher interpersonal detachment showed worse quality of life, in the heterologous one those with greater paranoid traits had greater stress. PRACTICE IMPLICATIONS Psychiatric nursing support should focus on interpersonal detachment in homologous and paranoid traits in heterologous MAR.
Collapse
Affiliation(s)
- Andrea Pozza
- Department of Medical Sciences, Surgery, and Neurosciences, University of Siena, Siena, Italy
| | - Davide Dèttore
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Maria E Coccia
- Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy
| |
Collapse
|
22
|
Mosconi L, Crescioli G, Vannacci A, Ravaldi C. Communication of Diagnosis of Infertility: A Systematic Review. Front Psychol 2021; 12:615699. [PMID: 33815202 PMCID: PMC8015870 DOI: 10.3389/fpsyg.2021.615699] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 02/02/2021] [Indexed: 11/22/2022] Open
Abstract
Background: When infertility is diagnosed, physicians have the difficult task to break bad news. Their communication skills play a central role in improving patients' coping abilities and adherence to infertility treatments. However, specific guidelines and training courses on this topic are still lacking. The aim of the present study is to provide some practical advice for improving breaking bad news in infertility diagnosis through a systematic literature review of qualitative and quantitative studies. Methods: Electronic searches were performed in the MEDLINE, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Psychology and Behavioral Sciences Collection databases. All articles focusing on the communication of the diagnosis of infertility were included. The main findings of each included article were then summarized. Results: Literature search identified 11,838 references that were screened for eligibility. Full texts of 81 articles were retrieved, and their analysis led to the inclusion of 4 articles, which treated the theme of communication of infertility only partially. The main addressed aspects concerning the communication of the infertility diagnosis were the following: (i) the value that patients give to healthcare professionals' communication skills; (ii) the importance of giving clear information on diagnostic procedures and treatments in order to decrease patients' anxiety; and (iii) the importance of involving both partners. Conclusions: This review pointed out that the communication of the infertility diagnosis is still underinvestigated. Specific guidelines are currently not available, but other protocols could be used. Taking into account the principal aspects of communication highlighted with this review, in this study, we suggested an adaptation of the original SPIKES protocol that could be used by healthcare professionals for the communication of the infertility status.
Collapse
Affiliation(s)
- Laura Mosconi
- CiaoLapo Foundation for Perinatal Health, Prato, Italy
| | - Giada Crescioli
- Perinatal Research Laboratory (PeaRL), University of Florence, Florence, Italy.,Section of Pharmacology and Toxicology, Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Alfredo Vannacci
- CiaoLapo Foundation for Perinatal Health, Prato, Italy.,Perinatal Research Laboratory (PeaRL), University of Florence, Florence, Italy.,Section of Pharmacology and Toxicology, Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Claudia Ravaldi
- CiaoLapo Foundation for Perinatal Health, Prato, Italy.,Perinatal Research Laboratory (PeaRL), University of Florence, Florence, Italy.,Section of Pharmacology and Toxicology, Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| |
Collapse
|
23
|
Sylvest R, Stormlund S, Koert E, Freiesleben NLC, Løssl K, Ziebe S, Schmidt L, Pinborg A. A qualitative study on couples' attitudes and concerns regarding a freeze all strategy in ART treatment. HUM FERTIL 2021; 25:697-705. [PMID: 33673786 DOI: 10.1080/14647273.2021.1893838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The freeze all strategy has become a promising alternative to fresh embryo transfer in fertility treatment almost eliminating late ovarian hyperstimulation syndrome (OHSS) in the segmented cycle. There is a lack of in-depth knowledge regarding patients' attitudes towards the freeze all strategy. The aim of this study was to explore the attitudes towards a freeze all strategy compared with fresh embryo transfer in assisted reproductive technology (ART) treatment among couples in a public health care setting. We conducted semi-structured qualitative interviews with ten couples already participants in a randomised controlled trial (RCT) and undergoing ART treatment. The couple's responses showed five themes: (i) Starting treatment provides needed relief; (ii) Treatment must be provided with humanity; (iii) Provision of information instigates positive attitudes towards treatment; (iv) Fresh treatment - 'The normal way'; and (v) Freeze all treatment - 'The new black'. When thorough information about treatment procedures and safety aspects regarding both the freeze all and fresh embryo transfer strategy is given prior to initiation of treatment, couples feel secure and content, regardless of which treatment strategy is finally applied. This qualitative study found that starting treatment could prompt longed-for relief, as professionals would now 'take over' and assist in meeting the couple's family building goals.
Collapse
Affiliation(s)
- Randi Sylvest
- Department of Obstetrics and Gynaecology, Fertility Clinic Section 455, Hvidovre University Hospital, Copenhagen, Denmark
| | - Sacha Stormlund
- Department of Obstetrics and Gynaecology, Fertility Clinic Section 455, Hvidovre University Hospital, Copenhagen, Denmark
| | - Emily Koert
- Department of Public Health, Faculty of Medical and Health Sciences, University of Copenhagen, Copenhagen K, Denmark
| | - Nina la Cour Freiesleben
- Department of Obstetrics and Gynaecology, Fertility Clinic Section 455, Hvidovre University Hospital, Copenhagen, Denmark
| | - Kristine Løssl
- The Fertility Clinic, Section 4071, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Søren Ziebe
- The Fertility Clinic, Section 4071, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Lone Schmidt
- Department of Public Health, Faculty of Medical and Health Sciences, University of Copenhagen, Copenhagen K, Denmark
| | - Anja Pinborg
- The Fertility Clinic, Section 4071, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| |
Collapse
|
24
|
Handley SC, Bell S, Nembhard IM. A Systematic Review of Surveys for Measuring Patient-centered Care in the Hospital Setting. Med Care 2021; 59:228-237. [PMID: 33229897 PMCID: PMC7878319 DOI: 10.1097/mlr.0000000000001474] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Patient-centered care (PCC) is a core component of quality care and its measurement is fundamental for research and improvement efforts. However, an inventory of surveys for measuring PCC in hospitals, a core care setting, is not available. OBJECTIVE To identify surveys for assessing PCC in hospitals, assess PCC dimensions that they capture, report their psychometric properties, and evaluate applicability to individual and/or dyadic (eg, mother-infant pairs in pregnancy) patients. RESEARCH DESIGN We conducted a systematic review of articles published before January 2019 available on PubMed, Web of Science, and EBSCO Host and references of extracted papers to identify surveys used to measure "patient-centered care" or "family-centered care." Surveys used in hospitals and capturing at least 3 dimensions of PCC, as articulated by the Picker Institute, were included and reviewed in full. Surveys' descriptions, subscales, PCC dimensions, psychometric properties, and applicability to individual and dyadic patients were assessed. RESULTS Thirteen of 614 articles met inclusion criteria. Nine surveys were identified, which were designed to obtain assessments from patients/families (n=5), hospital staff (n=2), and both patients/families and hospital staff (n=2). No survey captured all 8 Picker dimensions of PCC [median=6 (range, 5-7)]. Psychometric properties were reported infrequently. All surveys applied to individual patients, none to dyadic patients. CONCLUSIONS Multiple surveys for measuring PCC in hospitals are available. Opportunities exist to improve survey comprehensiveness regarding dimensions of PCC, reporting of psychometric properties, and development of measures to capture PCC for dyadic patients.
Collapse
Affiliation(s)
- Sara C. Handley
- Division of Neonatology, Department of Pediatrics, The Children’s Hospital of Philadelphia, Philadelphia, PA
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
| | - Sydney Bell
- The Wharton School, University of Pennsylvania, Philadelphia, PA
| | - Ingrid M. Nembhard
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
- The Wharton School, University of Pennsylvania, Philadelphia, PA
| |
Collapse
|
25
|
Holter H, Bergh C, Gejervall AL. Lost and lonely: a qualitative study of women's experiences of no embryo transfer owing to non-fertilization or poor embryo quality. Hum Reprod Open 2021; 2021:hoaa062. [PMID: 33501383 PMCID: PMC7814295 DOI: 10.1093/hropen/hoaa062] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 11/18/2020] [Indexed: 11/26/2022] Open
Abstract
STUDY QUESTION What are the experiences of women undergoing IVF who could not receive an embryo transfer because of failed fertilization or poor embryo development? SUMMARY ANSWER No embryo transfer because of failed embryo development is associated with considerable emotional suffering and the need for an early appointment with a physician to obtain information on what went wrong and new alternatives. WHAT IS KNOWN ALREADY The psychological and emotional impact of IVF treatments as experienced by IVF patients is well known, particularly following the failure to achieve pregnancy. STUDY DESIGN, SIZE, DURATION A qualitative study running from January 2018 to April 2019 was carried out at one public and one private IVF clinic. The invitation to participate was sent to women within 1 month after the cycle failed. PARTICIPANTS/MATERIALS, SETTING, METHODS The women undergoing IVF were diverse in terms of cause of infertility, age, number of previous cycles, country of birth and educational level. Nineteen of the 41 invited women who had experienced no embryo transfer because of non-fertilization or poor embryo development took part in a semi-structured interview. Data were analysed by thematic content analysis. MAIN RESULTS AND THE ROLE OF CHANCE The master theme was identified as: ‘Lost and lonely’ organized in two main themes ‘Experience of the event’ and ‘Perception of needs from healthcare providers’. Considerable emotional suffering was recognized after no embryo transfer. The need for support was expressed as to be offered an early appointment with a physician for information about what went wrong, looking at new alternatives and, for many women, providing information about counselling. LIMITATIONS, REASONS FOR CAUTION Only women participated, not partners. Of the women invited, 46% participated. Several declined to participate because of high levels of emotional stress. WIDER IMPLICATIONS OF THE FINDINGS Patients undergoing IVF and not achieving embryo transfer due to poor embryo development are a vulnerable group. They need early feedback concerning reasons for failure and future alternatives. They also require psychological support. This ought to be offered by IVF clinics. STUDY FUNDING/COMPETING INTEREST(S) The study was financed by grants from the Swedish state under the agreement between the Swedish government and the county councils, the ALF-agreement (ALFGBG-70940). It was also financed by the Local Research and Development Board for Gothenburg and Södra Bohuslän (VGFOUGSB-866771) and by Hjalmar Svensson’s research foundation (HJSV-2017012). None of the authors declares any conflicts of interest. LARGE SCALE DATA N/A.
Collapse
Affiliation(s)
- Herborg Holter
- Department of Obstetrics and Gynaecology, Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg University, Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg SE-41345, Sweden
| | - Christina Bergh
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg SE-41345, Sweden
| | - Ann-Louise Gejervall
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg SE-41345, Sweden
| |
Collapse
|
26
|
Fata S, Tokat MA. Does Hypnofertility-Based Nursing Care Affect Cortisol Levels, Fertility Preparedness, and Pregnancy Outcomes in Women Undergoing In Vitro Fertilization? A Randomized Controlled Trial. Biol Res Nurs 2020; 23:418-429. [PMID: 33297757 DOI: 10.1177/1099800420976916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study used Hypnofertility-based interventions to determine whether these interventions would lead to increased fertility preparedness and pregnancy outcomes and decreased cortisol levels in women undergoing In Vitro Fertilization (IVF) treatment. This randomized, controlled, prospective study was conducted from November 2017 through March 2019 in 61 Turkish women with unexplained infertility (intervention group: 30, control group: 31). Hypnofertility-based nursing care included affirmations, visualization, imagination, and relaxation from the first day of treatment until the day of the pregnancy test. The Fertility Preparedness Scale, a saliva sample for cortisol level, and the pregnancy test results were used for data collection. Hypnofertility-based nursing care decreased the cortisol levels of women in the intervention group compared to that in the control group (p = 0.00). Though fertility preparedness was higher in the intervention group, the difference was not statistically significant (p = 0.13). Although interventions relieved the women during the treatment process, there was no anticipated effect on pregnancy outcomes (p = 0.75). Hypnofertility-based nursing care significantly reduce the cortisol levels, suggesting that the intervention helped women relax.
Collapse
Affiliation(s)
- Sevcan Fata
- 37508Dokuz Eylul University Nursing Faculty, Gynecology & Obstetrics Nursing Department, Izmir, Turkey
| | - Merlinda Aluş Tokat
- 37508Dokuz Eylul University Nursing Faculty, Gynecology & Obstetrics Nursing Department, Izmir, Turkey
| |
Collapse
|
27
|
Bayrami R, Janghorban R, Effati-Daryani F, Hajshafiha M. Supportive care: men's expectations who undergoing in vitro fertilization treatment. BMC Res Notes 2020; 13:552. [PMID: 33287902 PMCID: PMC7720556 DOI: 10.1186/s13104-020-05407-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 11/28/2020] [Indexed: 11/28/2022] Open
Abstract
Objective Infertile couples perceive some needs and expectations during treatment. Most studies have focused on infertile women’s needs. The study was done to explore the expectations of men who undergoing in in vitro fertilization (IVF) treatment. Participants were men whose wives undergo IVF treatment in the IVF clinic of Shahid Motahhri hospital in Urmia. Purposive sampling was performed and data collection was done through in-depth semi-structured interviews until data saturation. Results “Supportive care” was emerged as the main theme consisted of two categories. The first category was “to be treated with attention in healthcare setting” which included three subcategories: Receiving couple based care, establishing counseling centers, and continuous care. The second category was “to be welcomed in the society” which included two subcategories: Financial support from community and close family, and changing community views about IVF treatment. Expectations of men undergoing IVF focuses on supportive care. They seek to receive the kind of care from health care setting and society. A deep understanding of the needs could help practitioners to consider men’s expectations, and assist policy makers and researchers to design and implement interventions and programs in infertility clinics which enhance the partnership of infertile men and fulfill their expectations.
Collapse
Affiliation(s)
- Roghieh Bayrami
- Department of Midwifery, Reproductive Health Research Center, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Roksana Janghorban
- Department of Midwifery, School of Nursing and Midwifery, Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, 7193613119, Shiraz, Iran.
| | - Fatemeh Effati-Daryani
- Department of Midwifery, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Masoumeh Hajshafiha
- Department of Obstetrics and Gynecology, School of Medicine, Reproductive Health Research Center, Urmia University of Medical Sciences, Urmia, Iran
| |
Collapse
|
28
|
Stormlund S, Schmidt L, Bogstad J, Løssl K, Prætorius L, Zedeler A, Pinborg A. Patients' attitudes and preferences towards a freeze-all strategy in ART treatment. Hum Reprod 2020; 34:679-688. [PMID: 30811549 DOI: 10.1093/humrep/dez006] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 12/24/2018] [Accepted: 01/16/2019] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION What are the attitudes towards different aspects of a freeze-all strategy and elective frozen embryo transfer (eFET) in comparison with fresh embryo transfer in assisted reproductive technology treatment among female and male patients before and after their first ART treatment cycle in a public health care setting? SUMMARY ANSWER Despite concerns about the delay in embryo transfer associated with eFET, nearly 60% of the participants were in favor of eFET compared with fresh embryo transfer assuming that the clinical pregnancy rate was equivalent. WHAT IS KNOWN ALREADY Vitrification and blastocyst transfer have considerably improved success rates after FET with ongoing pregnancy rates in frozen cycles approaching those seen in fresh treatment cycles. Furthermore, the risk of ovarian hyperstimulation syndrome (OHSS) is essentially eliminated in FET cycles, and FET may be beneficial to the endometrial and fetal development because a hormonal environment mirroring the natural cycle is enabled. However, the freeze-all strategy is not yet implemented as standard care. One reason is the presumption of negative patient attitudes towards a freeze-all embryo strategy. So far, no data regarding patients' attitudes on a freeze-all strategy have been published. STUDY DESIGN, SIZE, DURATION This study was designed as a descriptive cross-sectional study including 165 fertility patients referred for their first ART treatment from December 2014 to June 2016. PARTICIPANTS/MATERIALS, SETTING, METHODS All newly referred patients participating in a mandatory meeting before initiating ART treatment at the Fertility Clinic, Hvidovre Hospital, Copenhagen, Denmark were requested to fill in an online web-based questionnaire separately for men and women covering attitudes towards a freeze-all strategy, socio-demographic data and reproductive history. The patients were informed about both conventional fresh embryo transfer strategy and the freeze-all strategy prior to answering the questionnaire. MAIN RESULTS AND THE ROLE OF CHANCE The total response rate was 77.1% (n = 165), and for women and men respectively 85.8 versus 66.0%. The female respondents were significantly more likely to consider the postponement of embryo transfer difficult compared to the male population (78.6 versus 35.5%; P < 0.001) and they were significantly more willing to accept a risk in treatment on own health to achieve a pregnancy than were the male respondents on their partners health (82.5 versus 96.8%; P = 0.025). However, 59.2% of the women and 59.7% of the men agreed that they would choose eFET over fresh embryo transfer if the chance of pregnancy were the same. Most of the patients furthermore agreed that the health of the mother and their baby was of highest importance. In the adjusted analyses we found no significant predictive factors for preferences towards a freeze-all strategy apart from a negative attitude towards delay of transfer in case of previous unsuccessful ART attempts. LIMITATIONS, REASONS FOR CAUTION Selection bias cannot be excluded, as the total response rate was 77.1%. The hypothetical nature of the items may furthermore limit the validity of the results. In addition, the participants were from a single Fertility Clinic in the Capital Region of Denmark and may therefore not be representative for all fertility patients. WIDER IMPLICATIONS OF THE FINDINGS In a clinical setting with similar pregnancy rates for eFET and fresh embryo transfer, these results indicate that patients, when given access to information on advantages and disadvantages of both fresh embryo transfer and eFET, are less prone to opt for fresh embryo transfer. This may be ground breaking for a patient-centered paradigm shift in routine ART treatment with a wider implementation of a freeze-all and eFET-strategy eliminating the risk of OHSS. STUDY FUNDING/COMPETING INTEREST(S) The Danish Council for Independent Research and Merck Serono supported the study. The study is part of the Reprounion Collaborative study, co-financed by the European Union, Interreg V ÖKS. No competing interests exist.
Collapse
Affiliation(s)
- S Stormlund
- Department of Obstetrics and Gynaecology, Fertility Clinic Section 455, Hvidovre University Hospital, Hvidovre, Copenhagen, Denmark
| | - L Schmidt
- Department of Public Health, Faculty of Medical and Health Sciences, University of Copenhagen, Copenhagen K, Denmark
| | - J Bogstad
- The Fertility Clinic, Section 4071, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - K Løssl
- The Fertility Clinic, Section 4071, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - L Prætorius
- Department of Obstetrics and Gynaecology, Fertility Clinic Section 455, Hvidovre University Hospital, Hvidovre, Copenhagen, Denmark
| | - A Zedeler
- Department of Obstetrics and Gynaecology, Fertility Clinic Section 455, Hvidovre University Hospital, Hvidovre, Copenhagen, Denmark
| | - A Pinborg
- Department of Obstetrics and Gynaecology, Fertility Clinic Section 455, Hvidovre University Hospital, Hvidovre, Copenhagen, Denmark
| |
Collapse
|
29
|
Shandley LM, Hipp HS, Anderson-Bialis J, Anderson-Bialis D, Boulet SL, McKenzie LJ, Kawwass JF. Patient-centered care: factors associated with reporting a positive experience at United States fertility clinics. Fertil Steril 2020; 113:797-810. [DOI: 10.1016/j.fertnstert.2019.12.040] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 12/05/2019] [Accepted: 12/09/2019] [Indexed: 12/13/2022]
|
30
|
Lamvu G, Antunez-Flores O, Orady M, Schneider B. Path to diagnosis and women’s perspectives on the impact of endometriosis pain. JOURNAL OF ENDOMETRIOSIS AND PELVIC PAIN DISORDERS 2020. [DOI: 10.1177/2284026520903214] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Introduction: Endometriosis is a burdensome chronic disease that can be difficult to diagnose, yet few studies examine experiences along the continuum of disease state. We sought to explore women’s journeys to an endometriosis diagnosis, experience with endometriosis pain, and interactions with healthcare practitioners. Methods: An anonymous 23-question online survey was distributed to women (aged >19 years) who self-identified as having a surgical or nonsurgical diagnosis of endometriosis and living in seven English-speaking countries through the social media network MyEndometriosisTeam.com . Results: From January through April 2018, 317 women in the United States and 134 women outside the United States completed the survey. More than 50% of the women waited 6 or more years for a diagnosis of endometriosis. Overall, 54.3% experienced endometriosis-related pain daily. Respondents (US/non-US) reported a significant impairment in quality of life that interfered with their family (45.7%/45.5%) and social life (40.1%/44.0%), education/career (42.9%/46.3%), and sexual function (68.1%/70.1%). Women reported their disease led to other conditions, including fatigue (93.6%), gastrointestinal issues (91.8%), and difficulty sleeping (87.4%). Many women were not satisfied with their practitioner’s ability to listen to concerns and felt that their practitioner’s treatment recommendations lacked consistency with their own goals/needs. Conclusion: Women still experience long delays and difficult journeys to an endometriosis diagnosis. Disease-associated pain is pervasive and has direct and indirect impacts on quality of life. Women are frequently not satisfied with disease-management options presented to them by their practitioners. These results suggest a need for improved medical education on disease state for both patients and practitioners.
Collapse
Affiliation(s)
- Georgine Lamvu
- Gynecology Division, Department of Surgery, Orlando VA Medical Center, Orlando, FL, USA
| | | | | | | |
Collapse
|
31
|
Grunberg P, Miner S, Zelkowitz P. Infertility and perceived stress: the role of identity concern in treatment-seeking men and women. HUM FERTIL 2020; 25:117-127. [DOI: 10.1080/14647273.2019.1709667] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Paul Grunberg
- Department of Psychology, McGill University, Montreal, Canada
| | - Skye Miner
- Department of Sociology, McGill University, Montreal, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
| | - Phyllis Zelkowitz
- Department of Psychology, McGill University, Montreal, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
- Department of Psychiatry, McGill University, Montreal, Canada
| |
Collapse
|
32
|
Barrière P, Avril C, Benmahmoud-Zoubir A, Bénard N, Dejager S. Patient perceptions and understanding of treatment instructions for ovarian stimulation during infertility treatment. REPRODUCTIVE BIOMEDICINE & SOCIETY ONLINE 2019; 9:37-47. [PMID: 31993512 PMCID: PMC6976931 DOI: 10.1016/j.rbms.2019.08.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 07/25/2019] [Accepted: 08/19/2019] [Indexed: 06/10/2023]
Abstract
The impact of patient-physician communication and levels of understanding of treatment on patient knowledge and compliance has been studied in patients undergoing their first cycle of infertility treatment. This observational, real-life, longitudinal study involved 488 patients from 28 infertility centres in France. Data on communication quality, understanding of treatment instructions, patient knowledge and compliance to treatment protocol were collected through questionnaires administered before treatment initiation (V1) and at oocyte retrieval (V2). At V1, patients were very satisfied with their levels of understanding of the injection and monitoring schedules, the information given by the medical team, and the way of receiving instructions, with average ratings on a scale of 0-100% of > 75%. They rated their understanding of possible treatment side-effects as satisfactory (average score 71.1%). Gaps in patient knowledge about their treatment, revealed by discrepancies between physician and patient reports, were observed in 20.5% of patients (n = 79/386), and most commonly resulted from confusion about the units and dose of gonadotropin. Anxiety about performing self-injections and a lack of confidence in their ability to self-inject correctly were each observed in approximately one-third of patients. Patient self-assessment of compliance at V2 revealed that 27% of patients (n = 83/305) did not comply with or had doubts about the injection schedule or dose injected. Meanwhile physicians reported high levels of patient compliance (94.3%; n = 350/371). In conclusion, even when patient-physician relationships appear to be satisfactory, patient miscomprehension and non-compliance during infertility treatment may be underestimated. Further interventions are required to improve these outcomes.
Collapse
Affiliation(s)
- Paul Barrière
- CRTI, U 1064, Service de biologie et médecine de la reproduction, Centre Hospitalier Universitaire, Nantes, France
| | - Catherine Avril
- Clinique Mathilde – Service de médecine de la reproduction, Rouen, France
| | | | | | | |
Collapse
|
33
|
Pastore LM, Cordeiro Mitchell CN, Rubin LR, Nicoloro-SantaBarbara J, Genoff Garzon MC, Lobel M. Patients' preimplantation genetic testing decision-making experience: an opinion on related psychological frameworks. Hum Reprod Open 2019; 2019:hoz019. [PMID: 31598567 PMCID: PMC6777985 DOI: 10.1093/hropen/hoz019] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 06/24/2019] [Accepted: 07/01/2019] [Indexed: 12/18/2022] Open
Abstract
The process of deciding whether to pursue preimplantation genetic testing (PGT) of an embryo is highly stressful for individuals and couples and has adverse emotional consequences (e.g. distress and uncertainty). PGT influences patients’ lives in both positive and negative ways and is experienced at an individual level, as a dyadic unit, as a family member and as part of the society. Here, we argue that providing a conceptual framework with which to understand the `experience of decision making’ about PGT for monogenic disease (PGT-M) testing specifically, as well as the factors contributing to `decisional distress’ and `uncertainty’ that patients endure as a result—apart from what decision they make—is crucial to optimizing patient counseling, satisfaction and outcomes in the field of ART. Derived from psychological theory, the framework proposed here identifies three categories of contributing factors to decisional distress and uncertainty in considering PGT-M; namely, ‘intraindividual’, ‘interpersonal’ and ‘situational’ factors. We reviewed evidence from the PGT literature to inform our framework. Well-accepted theories of stress and health decision making were also reviewed for their relevance to PGT-M decision making, focusing on potential distress and uncertainty. Our novel conceptual framework can be used to inform clinical practice, to advance research and to aid the development of interventions for individuals and couples who are deciding whether or not to use PGT-M. Alleviating emotional distress and uncertainty can improve patients’ well-being during their reproductive journey.
Collapse
Affiliation(s)
- L M Pastore
- Department of Obstetrics, Gynecology and Reproductive Medicine, Stony Brook Medicine, Stony Brook, NY, USA
| | - C N Cordeiro Mitchell
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - L R Rubin
- Department of Psychology, The New School for Social Research, New York, NY, USA
| | | | - M C Genoff Garzon
- Department of Psychology, The New School for Social Research, New York, NY, USA
| | - M Lobel
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| |
Collapse
|
34
|
Braga DPDAF, Melamed RMM, Setti AS, Zanetti BF, Figueira RDCS, Iaconelli A, Borges E. Role of religion, spirituality, and faith in assisted reproduction. J Psychosom Obstet Gynaecol 2019; 40:195-201. [PMID: 29873289 DOI: 10.1080/0167482x.2018.1470163] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
Purpose: The purpose of this study is to evaluate the impact of the patient's faith, religion, and spirituality on the outcomes of intracytoplasmic sperm injection (ICSI) cycles. Materials and methods: Eight hundred and seventy-seven patients received a questionnaire containing information on faith, religiosity, and spirituality and the results of the questionnaires were correlated with ICSI outcomes. Patients stated to be Catholic (n = 476), spiritists (n = 93), Evangelical (n = 118), and other religion (n = 32), and 78 did not identify with any religious group. Results: A significant increase in fertilization, high-quality embryos, and pregnancy rate was found among Spiritists and Evangelicals. Patients who included the infertility diagnosis and treatment in their prayers showed an increased pregnancy rate, and those who reported their faith to be affected by the infertility diagnosis presented a decreased high-quality embryos rate. The high-quality embryos rate was increased among patients who answered that their faith contributed to their decision to undergo infertility treatment. The cycle's cancelation was negatively correlated with the frequency of religious meetings, and the frequency of prayers was positively correlated with the response to ovarian stimulation. Finally, belief in treatment success positively influenced the embryo quality. Conclusion: The findings suggest that spirituality plays a role in adjusting the psychological aspects of an infertile patient.
Collapse
Affiliation(s)
- Daniela Paes de Almeida Ferreira Braga
- a Fertility Medical Group , São Paulo , SP , Brazil.,b Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Assistida , São Paulo , SP , Brazil
| | | | - Amanda Souza Setti
- a Fertility Medical Group , São Paulo , SP , Brazil.,b Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Assistida , São Paulo , SP , Brazil
| | - Bianca Ferrarini Zanetti
- b Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Assistida , São Paulo , SP , Brazil
| | | | - Assumpto Iaconelli
- a Fertility Medical Group , São Paulo , SP , Brazil.,b Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Assistida , São Paulo , SP , Brazil
| | - Edson Borges
- a Fertility Medical Group , São Paulo , SP , Brazil.,b Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Assistida , São Paulo , SP , Brazil
| |
Collapse
|
35
|
Koert E, Takefman J, Boivin J. Fertility quality of life tool: update on research and practice considerations. HUM FERTIL 2019; 24:236-248. [PMID: 31387469 DOI: 10.1080/14647273.2019.1648887] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The 36-item Fertility Quality of Life (FertiQoL) tool is increasingly used in research and practice. It measures quality of life in four personal domains (emotional, social, relational, mind/body) and two treatment domains (tolerability, environment). A literature review of published empirical research using FertiQoL was undertaken to provide an overview of this research base. Five databases were searched using 'FertiQoL' and its variant. In total, 41 published articles from 35 independent samples in 23 countries involving 16,315 participants, mainly in clinical settings, were reviewed. FertiQoL was used for three main purposes: (i) to assess quality of life and FertiQoL measurement properties (especially Core FertiQoL) using cross-sectional designs; (ii) to identify correlates, predictors, and consequences of fertility quality of life (some of which included international comparisons); (iii) to assess the effect of psychological interventions on fertility quality of life. The range of median FertiQoL Core, Treatment and subscale (scaled) scores in 31 samples was between 60 and 75. Poorer fertility quality of life was consistently associated with being a woman, longer duration of infertility, poorer psychological functioning and lower patient-centred care. Some FertiQoL subscale scores improved after psychological interventions. Future research should address measurement issues and examine reported associations with fertility quality of life.
Collapse
Affiliation(s)
- Emily Koert
- a Department of Educational and Counselling Psychology and Special Education, University of British Columbia , Vancouver , Canada
| | - Janet Takefman
- b Departments of Obstetrics/Gynecology and Psychology, McGill University Health Centre Reproductive Centre , Montreal , Canada
| | - Jacky Boivin
- c Cardiff Fertility Studies Research Group, School of Psychology, Cardiff University , Cardiff , UK
| |
Collapse
|
36
|
Langberg EM, Dyhr L, Davidsen AS. Development of the concept of patient-centredness - A systematic review. PATIENT EDUCATION AND COUNSELING 2019; 102:1228-1236. [PMID: 30846206 DOI: 10.1016/j.pec.2019.02.023] [Citation(s) in RCA: 104] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 02/21/2019] [Accepted: 02/22/2019] [Indexed: 05/10/2023]
Abstract
OBJECTIVE Patient-centredness is often linked to high-quality patient care, but the concept is not well-defined. This study aims to provide an overview of how patient-centredness has been defined in the literature since Mead and Bower's review in 2000, and to provide an updated definition of the concept. METHOD & DESIGN We performed a systematic literature search in PubMed to identify original articles with a sufficient definition of patient-centredness. We analysed extracted data defining patient-centredness. RESULTS Eighty articles were included. The dimensions "biopsychosocial", "patient-as-person", "sharing power and responsibility" and "therapeutic alliance" corresponded to four of five dimensions described by Mead and Bower. "Coordinated care" was a new dimension. CONCLUSION The identified dimensions are encompassed by three elements: the patient, the doctor-patient relationship and the framework of care i.e. the health care system. The additional focus on coordinated care could reflect increasing complexity of the health care system. PRACTICE IMPLICATIONS Narrowing down the understanding of patient-centredness to these three focus areas, viz. 1) understanding of the patients' experience of the illness in their life situation, 2) the professional's relationship with the patient, and 3) coordination of care in the system, could make the operationalisation and implementation of a patient-centred approach more manageable.
Collapse
Affiliation(s)
- Emil Mørup Langberg
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen K, Denmark.
| | - Lise Dyhr
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen K, Denmark.
| | - Annette Sofie Davidsen
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen K, Denmark.
| |
Collapse
|
37
|
Borghi L, Leone D, Poli S, Becattini C, Chelo E, Costa M, De Lauretis L, Ferraretti AP, Filippini C, Giuffrida G, Livi C, Luehwink A, Palermo R, Revelli A, Tomasi G, Tomei F, Vegni E. Patient-centered communication, patient satisfaction, and retention in care in assisted reproductive technology visits. J Assist Reprod Genet 2019; 36:1135-1142. [PMID: 31077010 DOI: 10.1007/s10815-019-01466-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 04/28/2019] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To explore the association between patient-centered communication, patients' satisfaction, and retention in care in assisted reproductive technology (ART) visits. METHODS ART visits at eight Italian clinics were videotaped and coded using the Roter Interaction Analysis System, which includes a Patient-Centered Index (PCI), a summary "patient-centered communication" ratio. After the visit, patients completed a satisfaction questionnaire (SATQ). After 3 months, patients were asked about their retention in care. Spearman correlations and Mann-Whitney tests were used to test associations between the study variables; the open-ended item of SATQ was analyzed through content analysis. RESULTS Eighty-five visits were videotaped (involving 28 gynecologists and 160 patients). PCI score (μ = 0.51 ± 0.28) revealed a more disease-oriented communication during the visit. Patients reported high levels of satisfaction with the visit and identified in the information provision or in the doctor's humanity or kindness the main reasons of satisfaction. At the follow-up, the majority of the couples declared to have followed the clinicians' recommendations and to have remained related to the ART center. No associations were found among the study variables, except for a lower male satisfaction among couples who declared to have changed ART clinic. CONCLUSIONS Contrary to what was expected, the style of physician-patient communication was not found to be associated with patient satisfaction and retention in care. However, patients were highly satisfied and engaged. The actual meaning of a communication that is "patient-centered" in the ART context might be wider, including the couples' need for information, as suggested by qualitative findings.
Collapse
Affiliation(s)
- L Borghi
- Department of Health Sciences, University of Milan, 20142, Milan, Italy.
| | - D Leone
- Department of Health Sciences, University of Milan, 20142, Milan, Italy
- San Paolo University Hospital, Asst-Santi Paolo e Carlo, 20142, Milan, Italy
| | - S Poli
- Department of Health Sciences, University of Milan, 20142, Milan, Italy
| | - C Becattini
- Futura Assisted Reproductive Center, 50129, Florence, Italy
| | - E Chelo
- Demetra Assisted Reproductive Center, 50141, Florence, Italy
| | - M Costa
- Ospedale Evangelico Internazionale, Assisted Reproductive Unit, 16122, Genoa, Italy
| | - L De Lauretis
- Istituto Clinico Città Studi, Assisted Reproductive Center, 20131, Milan, Italy
| | - A P Ferraretti
- S.I.S.Me.R. Reproductive Medicine Unit, 40138, Bologna, Italy
| | - C Filippini
- Department of Surgical Sciences, University of Turin, 10126, Turin, Italy
| | - G Giuffrida
- CRA, Assisted Reproductive center, 95128, Catania, Italy
| | - C Livi
- Demetra Assisted Reproductive Center, 50141, Florence, Italy
| | - A Luehwink
- Azienda Provinciale per i Servizi Sanitari-Provincia Autonoma di Trento, Assisted Reproductive Unit, 38123, Arco, Italy
| | - R Palermo
- Ambra Assisted Reproductive Center, 90138, Palermo, Italy
| | - A Revelli
- Gynecology and Obstetrics I, Physiopathology of Reproduction and IVF Unit, Department of Surgical Sciences, S. Anna Hospital, University of Torino, 10126, Torino, Italy
| | - G Tomasi
- CRA, Assisted Reproductive center, 95128, Catania, Italy
| | - F Tomei
- Azienda Ospedaliera Santa Maria degli Angeli, 33170, Pordenone, Italy
| | - E Vegni
- Department of Health Sciences, University of Milan, 20142, Milan, Italy
- San Paolo University Hospital, Asst-Santi Paolo e Carlo, 20142, Milan, Italy
| |
Collapse
|
38
|
Bedrick BS, Anderson K, Broughton DE, Hamilton B, Jungheim ES. Factors associated with early in vitro fertilization treatment discontinuation. Fertil Steril 2019; 112:105-111. [PMID: 31043233 DOI: 10.1016/j.fertnstert.2019.03.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 03/02/2019] [Accepted: 03/04/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To investigate factors associated with early IVF treatment discontinuation. DESIGN Retrospective cohort study. SETTING Academic medical center. PATIENT(S) Six hundred sixty-nine first-attempt IVF patients who did not have a live birth. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Treatment discontinuation and time to return for a second IVF cycle. RESULT(S) Women without IVF insurance coverage were more likely to discontinue treatment than women with insurance coverage (adjusted odds ratio [aOR] = 3.12; 95% confidence interval [CI], 2.22-4.40). African-American women were more likely to discontinue treatment (aOR = 2.95; 95% CI, 1.54-5.66) and returned for treatment more slowly (adjusted hazard ratio [aHR] = 0.44; 95% CI, 0.28-0.71) than non-Hispanic white women, regardless of IVF insurance coverage or income. Women with a poor prognosis were more likely to discontinue treatment than women with a good prognosis. Older women with IVF insurance coverage or a good prognosis had a shorter time to return for a second IVF cycle than older women without IVF insurance coverage or with a poor prognosis. Estimated income, distance to clinic, fertility diagnosis, number of oocytes retrieved, and history of previous live birth were not associated with treatment discontinuation or time to return for a second IVF cycle after adjustment for covariates. CONCLUSION(S) IVF insurance coverage, race, age, and future treatment prognosis are associated with IVF treatment discontinuation and time to return.
Collapse
Affiliation(s)
- Bronwyn S Bedrick
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Washington University School of Medicine, St. Louis, Missouri
| | - Kelsey Anderson
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Washington University School of Medicine, St. Louis, Missouri
| | - Darcy E Broughton
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Washington University School of Medicine, St. Louis, Missouri; Pacific NW Fertility, Seattle, Washington
| | - Barton Hamilton
- Olin School of Business, Washington University in St. Louis, St. Louis, Missouri
| | - Emily S Jungheim
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Washington University School of Medicine, St. Louis, Missouri.
| |
Collapse
|
39
|
Palmer-Wackerly AL, Voorhees HL, D'Souza S, Weeks E. Infertility patient-provider communication and (dis)continuity of care: An exploration of illness identity transitions. PATIENT EDUCATION AND COUNSELING 2019; 102:804-809. [PMID: 30527731 DOI: 10.1016/j.pec.2018.12.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 11/21/2018] [Accepted: 12/02/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To identify how and why infertility patients' communication with health care providers relates to their continuity of care within infertility treatment. METHOD A grounded theory analysis was conducted for 25 in-depth interviews across three coding phases, where we remained open to all themes present in the data, narrowed to most prominent themes, and found the connections between the themes. RESULTS Based on our identified themes, we created a conceptual model that explains why infertility patients (dis)continued care with one or more clinician. Through this model, we describe two infertility identity transitions for patients: Transition 1: "Infertility as Temporary" to "Infertility as Enduring"; and Transition 2: "Infertility as Enduring" to "Infertility as Integrated." CONCLUSION The study explains how and why patients' view of their infertility affects their communication, and thus their continuity of care, with clinicians. PRACTICE IMPLICATIONS To provide patient-centered care within infertility treatment, providers can recognize how patients' view of their infertility, and thus their needs, goals, and expectations, shift throughout their infertility experience.
Collapse
Affiliation(s)
| | - Heather L Voorhees
- Department of Communication Studies, The University of Nebraska-Lincoln, USA
| | - Sarah D'Souza
- Department of Biobehavioral Health, Pennsylvania State University, USA
| | - Edward Weeks
- School of Communication, The Ohio State University, USA
| |
Collapse
|
40
|
Mourad SM, Curtis C, Gudex G, Merrilees M, Peek J, Sadler L. Measuring patient-centredness in publicly funded fertility care: A New Zealand validation and international comparison of the Patient-Centred Questionnaire-Infertility. Aust N Z J Obstet Gynaecol 2018; 59:265-271. [PMID: 30101455 DOI: 10.1111/ajo.12869] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 06/26/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND The Patient-Centred Questionnaire-Infertility (PCQ-Infertility) has proven to be a reliable instrument to assess the extent of patient-centredness of fertility care in European countries. AIMS To validate the PCQ-Infertility in New Zealand (NZ) and to compare results with international experience. MATERIALS AND METHODS A cross-sectional 46-item questionnaire study among 409 women undergoing publicly funded fertility care (intrauterine insemination or in vitro fertilisation / intracytoplasmic sperm injection) in three fertility clinics in the Northern Auckland region was performed between October 2015 and September 2016. Inclusion of eligible participants was both retro- and prospective. The questionnaire was distributed by email link and women were asked to complete it with their partner. Internal consistency and construct validity were determined and correction for case mix was performed. Mean dimension scores, adjusted for 'current pregnancy', 'educational level' and 'treatment type', were calculated for each dimension of the PCQ-Infertility. NZ results were compared with PCQ-Infertility results from five countries. RESULTS Of 409 invited women, 255 questionnaires were submitted (response rate 62%), of which 216 (53%) were analysable. The dimension 'Care organization' had poor internal consistency, but overall the questionnaire had high internal consistency (Cronbach's α = 0.93). Construct validity was also good. International comparison showed NZ to have the second highest overall score. In New Zealand, the lowest scoring domain was 'Continuity and transition'. CONCLUSIONS The NZ version of the PCQ-infertility proved a valid instrument for the assessment of patient-centredness of publicly funded fertility care. Future research should focus on international inequities in patient-centred fertility care and use of the tool for quality improvement. Local use of the PCQ-Infertility is encouraged.
Collapse
Affiliation(s)
- Selma M Mourad
- Department of Obstetrics and Gynaecology, Radboudumc, Nijmegen, The Netherlands
| | - Cate Curtis
- School of Psychology, University of Waikato, Hamilton, New Zealand
| | | | | | - John Peek
- Fertility Associates, Auckland, New Zealand
| | | |
Collapse
|
41
|
Geukens E, Apers S, Meuleman C, D'Hooghe T, Dancet E. Patient-centeredness and endometriosis: Definition, measurement, and current status. Best Pract Res Clin Obstet Gynaecol 2018; 50:11-17. [DOI: 10.1016/j.bpobgyn.2018.01.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 01/23/2018] [Indexed: 01/24/2023]
|
42
|
Glujovsky D, Sueldo CE, Coscia A, De Carvalho P, Lancuba S, Martinez G, Ciapponi A. Physicians and patients' motivations to perform elective single or double-embryo transfers: A nationwide survey. PATIENT EDUCATION AND COUNSELING 2018; 101:945-950. [PMID: 29249597 DOI: 10.1016/j.pec.2017.12.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 12/05/2017] [Accepted: 12/11/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES To evaluate motivations to perform an elective single embryo transfer (e-SET). METHODS Cross-sectional surveys to reproductive medicine specialists and to infertile patients undergoing assisted reproductive treatments. RESULTS In the physician's survey (n = 278), we found that the main reasons for not offering e-SET were the physicians' belief that patients prefer optimizing the pregnancy rates regardless of the potential complications (57.1%). Regarding the decision making process, 76.7% of physicians thought that patients and doctors should make these decisions together and 93.3% would like to have a more formal decision-aid to help with counseling. In the patients' survey (n = 100), 21.3% chose e-SET, while 33% mentioned that complications associated to multiple pregnancies were insufficiently discussed. Among those patients, none chose to have e-SET, while 30% of those who had a full discussion selected e-SET (p = 0.05). CONCLUSIONS Most physicians did not offer e-SET based on potential patients' negative feelings. Also, almost 30% take important decisions without the patient's participation. Patients that discussed more thoroughly this topic, more frequently selected e-SET. Almost all the physicians surveyed agreed that decision-aids could help in this important shared-decision process. PRACTICE IMPLICATIONS Decision aids about e-SET vs DET are needed to help patients in the decision making process.
Collapse
Affiliation(s)
- Demian Glujovsky
- Center for Studies in Genetics and Reproduction (CEGYR), Reproductive Medicine Department, Buenos Aires, Argentina; Argentine Cochrane Centre, Institute for Clinical Effectiveness and Health Policy (IECS-CONICET), Buenos Aires, Argentina.
| | - Carlos E Sueldo
- University of California San Francisco-Fresno, OB-GYN Dept., Fresno, CA, United States
| | - Andrea Coscia
- Argentine Cochrane Centre, Institute for Clinical Effectiveness and Health Policy (IECS-CONICET), Buenos Aires, Argentina
| | - Paula De Carvalho
- Argentine Cochrane Centre, Institute for Clinical Effectiveness and Health Policy (IECS-CONICET), Buenos Aires, Argentina
| | - Stella Lancuba
- Argentinian Society of Reproductive Medicine (SAMeR), Buenos Aires, Argentina
| | - Gustavo Martinez
- Argentinian Society of Reproductive Medicine (SAMeR), Buenos Aires, Argentina
| | - Agustín Ciapponi
- Argentine Cochrane Centre, Institute for Clinical Effectiveness and Health Policy (IECS-CONICET), Buenos Aires, Argentina
| |
Collapse
|
43
|
Webair HH, Ismail TAT, Ismail SB. Patient-centered infertility care from an Arab perspective: A review study. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2018. [DOI: 10.1016/j.mefs.2017.10.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
44
|
Apers S, Dancet EA, Aarts JW, Kluivers KB, D'Hooghe TM, Nelen WL. The association between experiences with patient-centred care and health-related quality of life in women with endometriosis. Reprod Biomed Online 2018; 36:197-205. [DOI: 10.1016/j.rbmo.2017.10.106] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 08/02/2017] [Accepted: 10/13/2017] [Indexed: 01/24/2023]
|
45
|
Patel A, Sharma PSVN, Kumar P. Role of Mental Health Practitioner in Infertility Clinics: A Review on Past, Present and Future Directions. J Hum Reprod Sci 2018; 11:219-228. [PMID: 30568350 PMCID: PMC6262662 DOI: 10.4103/jhrs.jhrs_41_18] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
A large body of literature has emerged over the past four decades which highlights the need to address emotional needs in infertility and integrates psychological services within routine fertility care. Evidenced-based guidelines in most countries propagate that the mental health expert (MHP) plays a vital role as a team member in reducing the impact of infertility on the lives of patients, across all stages of treatment. In accordance with these global developments, inclusion of psychosocial care in fertility treatments is an upcoming trend in our nation. This review article brings forth the traditional role of MHP in infertility, compares patient-centered care with counseling, and elaborates on the guidelines on determinants of patient needs and suitability for structured psychological interventions. It also highlights the evidence-based studies on the application of psychotherapy in infertility.
Collapse
Affiliation(s)
- Ansha Patel
- Department of Psychiatry, Kasturba Medical College, Manipal, Karnataka, India
| | - P S V N Sharma
- Department of Psychiatry, Kasturba Medical College, Manipal, Karnataka, India
| | - Pratap Kumar
- Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal, Karnataka, India
| |
Collapse
|
46
|
Holter H, Gejervall AL, Borg K, Sandin-Bojö AK, Wikland M, Wilde-Larsson B, Bergh C. In vitro fertilization healthcare professionals generally underestimate patients' satisfaction with quality of care. Acta Obstet Gynecol Scand 2017; 96:302-312. [PMID: 27990625 DOI: 10.1111/aogs.13080] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 12/11/2016] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Previous studies have mainly compared professionals' and patients' ratings of the importance of different care aspects, finding poor agreement between the groups concerning patient-centered quality of care. There is still little known about professionals' knowledge of how patients experience the quality of care they receive during in vitro fertilization (IVF) treatments. The aim of this study was to investigate how IVF healthcare professionals estimate patients' experience of patient-centered quality of care and if certain factors influenced the IVF professionals' perceptions and IVF patients' experience of quality of care. MATERIAL AND METHODS All 16 IVF public and private clinics in Sweden participated in this cross-sectional study. A total of 268 IVF healthcare professionals and 3298 patients (women and men) undergoing IVF treatment between January and May 2015 participated by answering the validated questionnaire "Quality from the patients' perspective of in vitro fertilization treatment" (QPP-IVF). RESULTS Healthcare professionals significantly underestimated patients' satisfaction with the patient-centered quality of care they received in all aspects measured. Both patients and professionals rated the most deficient factors to be "responsibility/continuity", "participation" and "availability". Healthcare professionals and patients belonging to private clinics evaluated patient-centered care as significantly better than professionals and patients at public clinics in almost all aspects measured. CONCLUSION The results of this study will increase the professionals' understanding of the patients' experiences during IVF treatment and provide additional knowledge when identifying areas to prioritize to improve quality of care.
Collapse
Affiliation(s)
- Herborg Holter
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ann-Louise Gejervall
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Kia Borg
- Fertility Center Scandinavia, Gothenburg, Sweden
| | - Ann-Kristin Sandin-Bojö
- Department of Health Sciences, Nursing Sciences, Faculty of Health, Science and Technology, Karlstad University, Karlstad, Sweden
| | | | - Bodil Wilde-Larsson
- Department of Health Sciences, Nursing Sciences, Faculty of Health, Science and Technology, Karlstad University, Karlstad, Sweden.,Department of Health Studies, Faculty of Public Health, Hedmark University of Applied Sciences, Elverum, Norway
| | - Christina Bergh
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| |
Collapse
|
47
|
Fernández-Sola C, Martínez-Caba MI, Hernández-Padilla JM, Carmona-Samper E, Granero-Molina J. Experiences of Spanish women undergoing hysterosalpingography as part of the infertility process: a phenomenological study. J Clin Nurs 2016; 25:494-504. [PMID: 26818374 DOI: 10.1111/jocn.13077] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2015] [Indexed: 12/16/2022]
Abstract
AIMS AND OBJECTIVES To describe and understand the experiences and perceptions of women who undergo hysterosalpingography as part of the infertility process. BACKGROUND Nurses and midwives should conduct research into the emotional aspects of caring for patients undergoing infertility treatment. The hysterosalpingography is considered to be the most feared test in the infertility process and the one about which very little is known. DESIGN A phenomenological qualitative study. METHODS Ten Spanish women who had undergone hysterosalpingography participated in this study. In-depth interviews were carried out between October 2012-May 2013. Data analysis was performed with the help of atlas.ti software to identify emerging themes. RESULTS The experience of the participants who underwent hysterosalpingography during the infertility process is represented by the following three themes: (1) becoming a mother to feel complete as a person and as a woman, with the subthemes 'maternity as a life objective' and 'maternity in terms of gender identity'; (2) infertility--an intimate experience which provokes negative feelings, with the subthemes 'negative feelings regarding own infertility' and 'infertility as an experience that is little shared with others'; (3) Undergoing hysterosalpingography, with the subthemes 'feelings regarding hysterosalpingography', 'treatment by medical providers' and 'areas for improvement regarding the service given by the providers'. CONCLUSION For women who undergo hysterosalpingography, maternity may be seen as a life objective that could identify them as women. Results suggest that although infertility is experienced with negative feelings such as anxiety, frustration and sadness, hysterosalpingography seems to be related with both hope and fear when facing the test. RELEVANCE TO CLINICAL PRACTICE Knowing the experiences of these women could help nurses, midwives and physicians to provide better patient-centred care.
Collapse
Affiliation(s)
- Cayetano Fernández-Sola
- Department of Nursing Science, Physiotherapy and Medicine, University of Almeria, Almeria, Spain.,Faculty of Health Sciences, Universidad Autónoma de Chile, Temuco, Chile
| | | | | | - Esther Carmona-Samper
- Department of Nursing Science, Physiotherapy and Medicine, University of Almeria, Almeria, Spain.,Torrecardenas Hospital, Almeria, Spain
| | - José Granero-Molina
- Department of Nursing Science, Physiotherapy and Medicine, University of Almeria, Almeria, Spain.,Faculty of Health Sciences, Universidad Autónoma de Chile, Temuco, Chile
| |
Collapse
|
48
|
Jafarzadeh-Kenarsari F, Ghahiri A, Zargham-Boroujeni A, Habibi M. Exploration of the counseling needs of infertile couples: A qualitative study. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2015; 20:552-9. [PMID: 26457091 PMCID: PMC4598900 DOI: 10.4103/1735-9066.164506] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Identification of the main needs of infertile patients is essential to provision of appropriate supportive services and care based on their needs. Thus, the present study aims to explore infertile couples' counseling needs. MATERIALS AND METHODS This study was carried out with an inductive qualitative content analysis approach during 2012-2013. The participants of this study included 26 Iranian infertile couples and 7 medical personnel (3 gynecologists and 4 midwives). The infertile couples were selected through purposive sampling and considering maximal variation from patients attending state-run and private infertility treatment centers as well as infertility specialists, offices in Isfahan and Rasht, Iran. Unstructured in-depth interviews and field notes were utilized for data gathering and replying to this research main question, "What are the counseling needs of infertile couples?" The data from medical personnel was collected through semi-structured interviews. Data analysis was carried out through conventional content analysis. RESULTS Data analysis revealed two main themes. The first theme was "a need for psychological counseling," which included four subthemes: Emotional distress management, sexual counseling, marital counseling, and family counseling. The second theme was "a need for guidance and information throughout treatment process," which included three subthemes: Treatment counseling, financial counseling, and legal counseling. CONCLUSIONS The counseling needs of infertile couples are varied, and they require various psychosocial support and counseling interventions. The participants of this study identified clearly the significance of psychological counseling and information throughout the long and onerous journey of infertility and its treatment.
Collapse
Affiliation(s)
- Fatemeh Jafarzadeh-Kenarsari
- Department of Reproductive Health and Midwifery, Nursing and Midwifery Student Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran, Faculty Member at Guilan University of Medical Sciences, Rasht, Iran
| | - Ataollah Ghahiri
- Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Zargham-Boroujeni
- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mojtaba Habibi
- Department of Family Therapy, Family Research Institute, Shahid-Beheshti University, G.C. Evin, Tehran, Iran
| |
Collapse
|
49
|
Gameiro S, Boivin J, Dancet E, de Klerk C, Emery M, Lewis-Jones C, Thorn P, Van den Broeck U, Venetis C, Verhaak CM, Wischmann T, Vermeulen N. ESHRE guideline: routine psychosocial care in infertility and medically assisted reproduction-a guide for fertility staff. Hum Reprod 2015; 30:2476-85. [PMID: 26345684 DOI: 10.1093/humrep/dev177] [Citation(s) in RCA: 159] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 06/11/2015] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION Based on the best available evidence in the literature, what is the optimal management of routine psychosocial care at infertility and medically assisted reproduction (MAR) clinics? SUMMARY ANSWER Using the structured methodology of the Manual for the European Society of Human Reproduction and Embryology (ESHRE) Guideline Development, 120 recommendations were formulated that answered the 12 key questions on optimal management of routine psychosocial care by all fertility staff. WHAT IS ALREADY KNOWN The 2002 ESHRE Guidelines for counselling in infertility has been a reference point for best psychosocial care in infertility for years, but this guideline needed updating and did not focus on routine psychosocial care that can be delivered by all fertility staff. STUDY, DESIGN, SIZE, DURATION This guideline was produced by a group of experts in the field according to the 12-step process described in the ESHRE Manual for Guideline Development. After scoping the guideline and listing a set of 12 key questions in PICO (Patient, Intervention, Comparison and Outcome) format, thorough systematic searches of the literature were conducted; evidence from papers published until April 2014 was collected, evaluated for quality and analysed. A summary of evidence was written in a reply to each of the key questions and used as the basis for recommendations, which were defined by consensus within the guideline development group (GDG). Patient and additional clinical input was collected during the scoping and the review phase of the guideline development. PARTICIPANTS/MATERIALS, SETTING, METHODS The guideline group, comprising psychologists, two medical doctors, a midwife, a patient representative and a methodological expert, met three times to discuss evidence and reach consensus on the recommendations. MAIN RESULTS AND THE ROLE OF CHANCE THE GUIDELINE PROVIDES 120 recommendations that aim at guiding fertility clinic staff in providing optimal evidence-based routine psychosocial care to patients dealing with infertility and MAR. The guideline is written in two sections. The first section describes patients' preferences regarding the psychosocial care they would like to receive at clinics and how this care is associated with their well-being. The second section of the guideline provides information about the psychosocial needs patients experience across their treatment pathway (before, during and after treatment) and how fertility clinic staff can detect and address these. Needs refer to conditions assumed necessary for patients to have a healthy experience of the fertility treatment. Needs can be behavioural (lifestyle, exercise, nutrition and compliance), relational (relationship with partner if there is one, family friends and larger network, and work), emotional (well-being, e.g. anxiety, depression and quality of life) and cognitive (treatment concerns and knowledge). LIMITATIONS, REASONS FOR CAUTION We identified many areas in care for which robust evidence was lacking. Gaps in evidence were addressed by formulating good practice points, based on the expert opinion of the GDG, but it is critical for such recommendations to be empirically validated. WIDER IMPLICATIONS OF THE FINDINGS The evidence presented in this guideline shows that providing routine psychosocial care is associated with or has potential to reduce stress and concerns about medical procedures and improve lifestyle outcomes, fertility-related knowledge, patient well-being and compliance with treatment. As only 45 (36.0%) of the 125 recommendations were based on high-quality evidence, the guideline group formulated recommendations to guide future research with the aim of increasing the body of evidence.
Collapse
Affiliation(s)
- S Gameiro
- Cardiff Fertility Studies Research Group, School of Psychology, Cardiff University, CF10 3AT Cardiff, UK
| | - J Boivin
- Cardiff Fertility Studies Research Group, School of Psychology, Cardiff University, CF10 3AT Cardiff, UK
| | - E Dancet
- Leuven University Fertility Centre, University Hospitals Leuven, 3000 Leuven, Belgium Center for Reproductive Medicine, Women's and Children's Hospital, Academic Medical Center, University of Amsterdam, Amsterdam 1105 AZ, The Netherlands
| | - C de Klerk
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC University Medical Centre, Rotterdam 3000 CA, The Netherlands
| | - M Emery
- Centre for Medically Assisted Procreation-CPMA, CH-1003 Lausanne, Switzerland
| | | | - P Thorn
- Practice for Couple and Family Therapy, 64546 Moerfelden, Germany
| | - U Van den Broeck
- Leuven University Fertility Centre, University Hospitals Leuven, 3000 Leuven, Belgium
| | - C Venetis
- Women's and Children's Health, St George Hospital, University of New South Wales, NSW 2217 Sydney, Australia
| | - C M Verhaak
- Department of Psychology, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands
| | - T Wischmann
- Institute of Medical Psychology, Centre for Psychosocial Medicine, Heidelberg University Hospital, 69115 Heidelberg, Germany
| | - N Vermeulen
- European Society for Human Reproduction and Embryology, 1852 Grimbergen, Belgium
| |
Collapse
|
50
|
Boivin J, Gameiro S. Evolution of psychology and counseling in infertility. Fertil Steril 2015; 104:251-9. [PMID: 26092131 DOI: 10.1016/j.fertnstert.2015.05.035] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 05/20/2015] [Accepted: 05/28/2015] [Indexed: 11/29/2022]
Abstract
Five key paradigm shifts are described to illustrate the evolution of psychology and counseling in infertility. The first paradigm shift was in the 1930s when psychosomatic concepts were introduced in obstetrics and gynecology as causal factors to explain why some couples could not conceive despite the absence of organic pathology. In the second shift, the nurse advocacy movement of the 1970s stimulated the investigation of the psychosocial consequences of infertility and promoted counseling to help couples grieve childlessness when medical treatments often could not help them conceive. The third shift occurred with the advent of IVF, which created a demand for mental health professionals in fertility clinics. Mental health professionals assessed the ability of couples to withstand the demands of this new high technology treatment as well as their suitability as potential parents. The fourth shift, in the 1990s, saw reproductive medicine embrace the principles of evidence-based medicine, which introduced a much more rigorous approach to medical practice (effectiveness and safety) that extended to psychosocial interventions. The most recent paradigm shift, in the new millennium, occurred with the realization that compliance with protracted fertility treatment depended on the adoption of an integrated approach to fertility care. An integrated approach could reduce treatment burden arising from multiple sources (i.e., patient, clinic, and treatment). This review describes these paradigm shifts and reflects on future clinical and research directions for mental health professionals.
Collapse
Affiliation(s)
- Jacky Boivin
- Cardiff Fertility Studies Research Group, School of Psychology, Cardiff University, Cardiff, Wales, United Kingdom.
| | - Sofia Gameiro
- Cardiff Fertility Studies Research Group, School of Psychology, Cardiff University, Cardiff, Wales, United Kingdom
| |
Collapse
|