Determinants of patients' experiences and satisfaction with fertility care

Mourad, Selma; Nelen, W.L.D.M.; Akkermans, Reinier; Vollebergh, Jos H.A.; Grol, Richard; Hermens, Rosella; Kremer, J.A.M.

doi:10.1016/j.fertnstert.2009.07.990

Cited by 54 publications

(54 citation statements)

References 53 publications

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“…Decorrendo de uma perspetiva construtivista, esta abordagem visa apreender a realidade social por meio dos significados que os indivíduos atribuem aos objetos, às suas ações e interações com os outros e com o mundo, através de um processo indutivo de construção de conhecimento baseado na análise e constante comparação, interpretação e concetualização dos dados recolhidos, onde é fulcral a sensibilidade teórica do pesquisador. A análise de conteúdo e a interpretação dos resultados basearam-se numa abordagem qualitativa 36 , explorando a provisão de cuidados de saúde centrados no paciente 27,28 por intermédio da dissecação de um conjunto selecionado de extratos ilustrativos das perceções dos casais entrevistados em torno do consentimento livre e esclarecido na criopreservação de embriões, usando pseudónimos para os identificar. Os dados foram analisados por dois dos autores de forma independente e autónoma e, posteriormente, todas as dúvidas foram resolvidas por discussão conjunta até se obter consenso.…”

Section: Methodsunclassified

“…Assegurar a qualidade das práticas que envolvem a prestação do consentimento para a criopreservação de embriões afigura-se, assim, como 26 . Para esse efeito, importa conhecer as perspetivas dos beneficiários quanto aos fatores organizacionais (por exemplo, provisão de informação, competência, coordenação e integração dos profissionais de saúde, conforto físico e acessibilidade) e humanos (entre outros, atitude e relação com os profissionais de saúde, comunicação, envolvimento dos pacientes, privacidade e suporte emocional) que contextualizam o consentimento 27,28 . Este conhecimento é relevante considerando a ausência de orientações e de guias de prática clínica, em Portugal, com indicações sobre as circunstâncias em que o consentimento deve ser entregue, explicado e assinado 2 .…”

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Consentir na criopreservação de embriões: perceção de casais usuários de medicina da reprodução

Silva

Samorinha

Alves

et al. 2017

Interface (Botucatu)

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Este estudo qualitativo analisou as perceções de casais quanto aos fatores que contextualizam o consentimento livre e esclarecido na criopreservação de embriões, a partir de 34 entrevistas semiestruturadas, em Portugal. Analisaram-se os dados segundo os princípios da grounded theory. Dos resultados emergiram as seguintes necessidades: provisão de informações detalhadas, rigorosas, coerentes e no tempo adequado sobre os custos e duração da criopreservação e o destino dos embriões; reforço da privacidade física; tempo para refletir sobre o destino dos embriões e a divulgação da identidade dos beneficiários. As condições de aplicação do consentimento parecem ameaçar três dos seus elementos fundamentais: informação, voluntarismo e ponderação. Importa desenvolver orientações ético-profissionais que assegurem um consentimento assente em práticas de aconselhamento e prestação de informação adequadas às necessidades e expectativas dos pacientes. This qualitative study analyzed couples' perceptions about the factors that contextualize informed consent regarding embryo cryopreservation, through 34 semi-structured interviews, in Portugal. Data were analyzed according to the principles of grounded theory. The results revealed the following needs: timely provision of detailed, accurate and intelligible information about the costs of cryopreservation, embryo storage limit and embryo disposition; reinforcement of physical privacy; availability of time to reflect about embryo disposition and disclosure of users' identities. The conditions of administration of the informed consent appear to threaten three of its fundamental elements: information, voluntarism and reflection. The development of professional and ethical guidelines is necessary to ensure the implementation of a consent process characterized by practices of counseling and information adapted to patients' needs and expectations.

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Section: Methodsunclassified

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Consentir na criopreservação de embriões: perceção de casais usuários de medicina da reprodução

Silva

Samorinha

Alves

et al. 2017

Interface (Botucatu)

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“…Higher levels of trait anxiety were found among men who were unwilling to donate embryos for research, which can be associated with the fact that individuals with high anxiety levels are more likely to avoid perceived threats, especially future events (Spielberger and Vagg, 1984). Patients who were given extensive information in fertility care services have presented less psychopathological feelings (Mourad et al, 2010). In this context, donation of embryos for research can be perceived as a threat.…”

Section: Article In Pressmentioning

confidence: 99%

Factors associated with willingness to donate embryos for research among couples undergoing IVF

Samorinha

Severo

Alves

et al. 2016

Reproductive BioMedicine Online

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). Her research is focused on patient-centred health care, namely in the field of infertility and assisted reproductive technologies.Abstract Between 2011 and 2012, 213 heterosexual couples undergoing fertility treatments in a Portuguese public fertility centre were systematically recruited to assess factors associated with willingness to donate embryos for research. Data were collected by questionnaire. Most couples (87.3%; 95% CI 82.1 to 91.5) were willing to donate embryos for research, citing benefits for science, health and infertile patients. Almost all couples (94.3%; 95% CI 89.8 to 96.7) reached consensus about the decision. Willingness to donate was more frequent in women younger than 36 years (adjusted OR 3.06; 95% CI 1.23 to 7.61) and who considered embryo research to be very important (adjusted OR: 6.32; 95% CI 1.85 to 21.64), and in Catholic men (adjusted OR 4.16; 95% CI 1.53 to 11.30). Those unwilling to donate reported conceptualizing embryos as children or living beings and a lack of information or fears about embryo research. Men with higher levels of trait anxiety (adjusted OR 0.90; 95% CI 0.84 to 0.96) were less frequently willing to donate. Future research on embryo disposition decision-making should include the assessment of gender differences and psychosocial factors. Ethically robust policies and accurate information about the results of human embryo research are required.

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“…Patient satisfaction is an important and commonly-used indicator for measuring the quality in health care. Although patient satisfaction is multi-dimensional [82][83][84], four indexes are usually used to measure the patient satisfaction in home health care [85]: response time, patient wait time, service quality and service price. In general, response time is affected by factors, such as the level of convenience in contact and the number of medical staff.…”

Section: Comparisons Of Schedules' Qualitymentioning

confidence: 99%

Scheduling Optimization of Home Health Care Service Considering Patients’ Priorities and Time Windows

Liang

Sun

2017

Sustainability

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Abstract:As a new service model, home health care can provide effective health care by adopting door-to-door service. The reasonable arrangements for nurses and their routes not only can reduce medical expenses, but also can enhance patient satisfaction. This research focuses on the home health care scheduling optimization problem with known demands and service capabilities. Aimed at minimizing the total cost, an integer programming model was built in this study, which took both the priorities of patients and constraints of time windows into consideration. The genetic algorithm with local search was used to solve the proposed model. Finally, a case study of Shanghai, China, was conducted for the empirical analysis. The comparison results verify the effectiveness of the proposed model and methodology, which can provide the decision support for medical administrators of home health care.

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Determinants of patients' experiences and satisfaction with fertility care

Cited by 54 publications

References 53 publications

Consentir na criopreservação de embriões: perceção de casais usuários de medicina da reprodução

Consentir na criopreservação de embriões: perceção de casais usuários de medicina da reprodução

Factors associated with willingness to donate embryos for research among couples undergoing IVF

Scheduling Optimization of Home Health Care Service Considering Patients’ Priorities and Time Windows

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