Quality of Patient-Centered Care from the Viewpoint of Infertile Clients in the ART Centers of the Hospitals of Shahid Beheshti University of Medical Sciences

Document Type : Original Article

Authors

1 M.Sc. student in Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

2 Assistant Professor, Department of Internal Surgery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

3 Associate Professor, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

4 Associate Professor, Department of Obstetrics and Gynecology, Gynecologic Diseases Prevention Research Center, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

5 Assistant Professor, Department of Biostatistics, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Abstract

Introduction: Paying attention to the needs of infertile couples and involving them in the treatment program allows them to deal with this problem more effectively. The patient-centered care is based on the principle that all resources and activities of the organization should be organized around the patient. This study was performed with aim to evaluate the quality of patient-centered care from the viewpoints of infertile clients.
Methods: This descriptive study was performed in 2019 on 200 infertile clients referring to the assisted reproductive centers of Shahid Beheshti selected hospitals. Data were collected using a patient-centered questionnaire in infertile clients. This questionnaire consists of 50 questions in 8 areas including: access, information, communication, patient participation, respect for patient values, patient's continuity and support, staff's competence and care organization area; the minimum score in each area is zero and maximum is 3. Data were analyzed using SPSS software (version 18) and descriptive and regression tests.
Results: According to the results, the most infertility factor was related to female factor with 132 cases (66.0%) and then the common factor of male and female with 62 cases (31.0%). The mean duration of infertility was 5.35±3.67 years. The results of this study showed that in the score range between 0 and 3, the mean focus of patients in infertility treatment was 1.50. The lowest patient-centered score was related to access area (0.37 from 3) and the highest was related to care organization area (2.40 from 3).
Conclusion: According to the results of the study, the quality of patient-centered care has been obtained moderate-level (1.5) from the desired level (3). It is necessary to reform the infrastructure of the country's health system and the patient-centered approach be widely trained and implemented in the country. In order to make this important, we should identify the influencing factors on patient-centered care.

Keywords


  1. Direkvand Moghadam A, Delpisheh A, Sayehmiri K. The prevalence of infertility in Iran, a systematic review. Iran J Obstet Gynecol Infertil 2013; 16(81):1-7.
  2. Sajjadi MJ. Investigating the Risk Factors of Infertility in Men Visiting Infertility Clinics in Bandar Abbas[Persian]: Hormozgan University of Medical Sciences; 2017.
  3. Khodakarami N, Hashemi S, Seddigh S, Hamdiyeh M, Taheripanah R. Life experience with infertility; a phenomenological study. Journal of Reproduction & Infertility 2010; 10(4).
  4. Akhondi MM, Kamali K, Ranjbar F, Shirzad M, Shafeghati S, Ardakani ZB, et al. Prevalence of primary infertility in Iran in 2010. Iranian journal of public health 2013; 42(12):1398.
  5. Delaney LJ. Patient-centred care as an approach to improving health care in Australia. Collegian 2018; 25(1):119-23.
  6. Ibrahim J, Majoor J. Corruption in the health care system: the circumstantial evidence. Australian Health Review 2002; 25(2):20-6.
  7. Berwick DM. What ‘patient-centered’should mean: confessions of an extremist: A seasoned clinician and expert fears the loss of his humanity if he should become a patient. Health affairs 2009; 28(Suppl1):w555-65.
  8. Cunningham N, Cunningham T. Women's experiences of infertility–towards a relational model of care. Journal of clinical nursing 2013; 22(23-24):3428-37.
  9. Dancet EA, Van Empel IW, Rober P, Nelen WL, Kremer JA, D'Hooghe TM. Patient-centred infertility care: a qualitative study to listen to the patient's voice. Human Reproduction 2011; 26(4):827-33.
  10. Peddie VL, van Teijlingen E, Bhattacharya S. A qualitative study of women's decision-making at the end of IVF treatment. Human Reproduction 2005; 20(7):1944-51.
  11. Porter M, Bhattacharya S. Helping themselves to get pregnant: a qualitative longitudinal study on the information-seeking behaviour of infertile couples. Human reproduction 2008; 23(3):567-72.
  12. Vosough taghi dizaj A, Ezabadi Z, Takbiri A, Baniasadi A. Infertility care in royan institute: a p atient centeredness analysis. Payesh 2016; 15(3):325-32.
  13. Pedro J, Canavarro MC, Boivin J, Gameiro S. Positive experiences of patient-centred care are associated with intentions to comply with fertility treatment: findings from the validation of the Portuguese version of the PCQ-Infertility tool. Human Reproduction 2013; 28(9):2462-72.
  14. Schmidt L, Holstein BE, Boivin J, Tjørnhøj‐Thomsen T, Blaabjerg J, Hald F, et al. High ratings of satisfaction with fertility treatment are common: findings from the Copenhagen Multi‐centre Psychosocial Infertility (COMPI) Research Programme. Human Reproduction 2003; 18(12):2638-46.
  15. Beattie PF, Pinto MB, Nelson MK, Nelson R. Patient satisfaction with outpatient physical therapy: instrument validation. Physical therapy 2002; 82(6):557-65.
  16. van Empel IW, Nelen WL, Tepe ET, van Laarhoven EA, Verhaak CM, Kremer JA. Weaknesses, strengths and needs in fertility care according to patients. Human Reproduction 2010; 25(1):142-9.
  17. Dancet EA, Van Empel IW, Rober P, Nelen WL, Kremer JA, D'Hooghe TM. Patient-centred infertility care: a qualitative study to listen to the patient's voice. Human Reproduction 2011; 26(4):827-33.
  18. Haggerty JL, Reid RJ, Freeman GK, Starfield BH, Adair CE, McKendry R. Continuity of care: a multidisciplinary review. Bmj 2003; 327(7425):1219-21.
  19. MacPhail LH, Neuwirth EB, Bellows J. Coordination of diabetes care in four delivery models using an electronic health record. Medical care 2009: 993-9.
  20. Dancet EA, D'Hooghe TM, Sermeus W, Van Empel I, Strohmer H, Wyns C, et al. Patients from across Europe have similar views on patient-centred care: an international multilingual qualitative study in infertility care. Human Reproduction 2012; 27(6):1702-11.
  21. Ezabadi Z, Mollaahmadi F, Sazvar S, Vesali S, Omani-Samani R. Satisfaction with information provided to infertile patients who undergo assisted reproductive treatment. International journal of fertility & sterility 2019; 12(4):324.
  22. Farhadfar AH, Nasiripour AA, Haji Nabi K. A Comprehensive Review of Patient-Centered Care in the Hospitals. Journal of healthcare management 2019; 9(4):91-8.
  23. Pasch LA, Holley SR, Bleil ME, Shehab D, Katz PP, Adler NE. Addressing the needs of fertility treatment patients and their partners: are they informed of and do they receive mental health services?. Fertility and sterility 2016; 106(1):209-15.
  24. den Breejen EM, Nelen WL, Schol SF, Kremer JA, Hermens RP. Development of guideline-based indicators for patient-centredness in fertility care: what patients add. Human reproduction 2013; 28(4):987-96.
  25. Starr JS, Mobley E, Roy V, Wade J. Improving hospital consumer assessment of healthcare providers and systems (HCAHPS) scores in bone marrow transplant inpatient setting. Pain 2014; 69(39):95-9.