Patient-centered care in Israeli IVF units: divergent perceptions of patients and providers

Abstract

Background: Patient-centered care is particularly important for patients undergoing fertility treatment because of their emotional involvement and their constant contact with providers. To the best of our knowledge, to date, there have been no rigorous studies of the discrepancies between the patients' perceptions of the care they received and the providers' perceptions of the care that they provided, in specific dimensions and elements of patient-centered care. Objective: To compare provider and patient perceptions of the extent to which care in Israeli IVF units is patientcentered. Methods: A previously validated survey instrument was used to assess the patient and provider perceptions of ten dimensions of patient-centered care: accessibility of providers, provision of information and of explanations, communication skills of providers, patient involvement in the treatment, respect for patient values and needs, continuity and transition in treatment, professional competence, care organization, physical comfort, and emotional support. The patient survey and the provider survey were conducted in 2016-2017; both surveys were carried out in 8 of 25 hospitalbased IVF units in Israel. Seventy-six providers and 524 patients (response rate 79%) participated in the surveys. Findings: The perceptions of patients and providers were similar regarding seven of the ten dimensions of patientcentered care, although there were some differences in patient vs. provider scores by unit. There were three dimensions with substantial provider-patient score differences: Moderate-sized gaps were found relative to the provision of information and explanations (1.96 vs. 2.38, on a 0-3 scale) and respect for patient values and needs (1.92 vs. 2.47). A large gap was observed relative to emotional support (0.96 vs. 2.54). Conclusions: Providers appear to underestimate the needs of fertility treatment patients for information, respect, and emotional support. The observed differences between what patients feel about their care and what providers assume they provide, especially regarding emotional support, indicates a need for ongoing, specific feedback to providers as to the patient-centeredness of the care they provide. The particularly large patientprovider gap relative to the provision of emotional support highlights the importance of increasing the attention paid to the psychological impact of fertility treatment and of giving patients an opportunity to consult a counselor who is familiar with problems associated with fertility treatments.

Patient-centered care in the Middle East and North African region: a systematic literature review

“…] Dubai To review current patient-centred practices for outpatients in both private clinics and public hospitals in Dubai Patients had appointments in various outpatient departments (OPD) including medical, surgical, and general Independent survey consisting of self-administered questionnaires Manchaiah et al, 2014 [ 82. ] Portugal, India, and Iran To examine and compare audiologists’ preferences for patient-centredness in Portugal, India, and Iran Audiologists Cross sectional Medina-Artom and Adashi, 2020 [ 83. ] Israel To compare provider and patient perceptions of the extent to which care in Israeli IVF units is patient centred Providers and patients Quantitative using questionnaire Mohamed et al, 2013 [ 84.…”

Illness perspectives in patients with primary aldosteronism

“…lack of restrictions after minimally invasive surgery-from the surgeon´s point of view an attractive quality-was perceived as dismissive or ignorant. Differing perceptions of given information and emotional support between patients and health care professionals has been demonstrated earlier [25,26]. Targeted interventions to increase patient's knowledge of their disease and treatment in chronic illness have been shown to improve patient´s health literacy and adherence to treatment [27], hopefully also increasing patient satisfaction.…”

Toward a Personalized Psychological Counseling Service in Assisted Reproductive Technology Centers: A Qualitative Analysis of Couples’ Needs

“…The diagnosis of infertility and ART treatment can have a very strong emotional impact on the person and the couple, which needs adequate support for emotional processing. In this regard, some of the literature has focused on investigating the needs of couples undergoing ART treatment with the aim of giving rise to increasingly patient-centered services (“Patient-Centered Care”) and personalized medicine [ 24 , 28 , 29 , 30 , 31 , 32 , 33 ]. In patient-centered and personalized care approach, patients’ specific health needs and desired health outcomes drive all health care professional decisions, with the aim of individualizing design of care and better aligning it to individual patients' situations [ 34 ].…”

“…In this direction, some studies have shed light on the information regarding the needs of couples facing ART treatment [ 24 , 28 ]. In fact, most infertility patients do not seem to have a deep understanding of the therapeutic treatments and their success rates, which often leads them to develop unrealistic expectations with respect to success and a strong sense of dissatisfaction after treatment failure [ 29 , 30 , 35 ].…”