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A conceptual framework for patient-centered fertility treatment
Elizabeth A Duthie1, Alexandra Cooper2, Joseph B Davis3
1Center for Patient Care and Outcomes Research, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI, 53226, USA.
Reproductive Health
|September 9, 2017
Summary
This study revises a patient-centered fertility treatment framework based on couples' experiences, incorporating effectiveness, burden, time, cost, risks, and genetic parentage for better decision-making.
Area of Science:
- Reproductive Medicine
- Health Services Research
- Patient-Centered Care
Background:
- Patient-centered care is crucial for individuals undergoing infertility treatment.
- Existing frameworks for fertility treatment decision-making were primarily based on healthcare professionals' perspectives.
- There was a need to revise the conceptual framework using empirical data from patients' lived experiences.
Purpose of the Study:
- To revise and enhance a conceptual framework for patient-centered fertility treatment.
- To incorporate the perspectives and decision-making factors of couples experiencing infertility.
- To develop a more comprehensive model reflecting patient priorities in fertility care.
Main Methods:
- A prospective, longitudinal mixed-methods study involving 37 couples undergoing initial reproductive specialist consultations.
- Data collected via semi-structured qualitative interviews, questionnaires, and medical record reviews at multiple time points.
- Qualitative interview transcripts were content analyzed to identify key treatment dimensions.
Main Results:
- Content analysis identified six key dimensions in fertility treatment decision-making: effectiveness, physical and emotional burden, time, cost, potential risks, and genetic parentage.
- The revised framework includes modifications from the original, notably changing 'safety' to 'potential risks' and adding 'time' and 'genetic parentage'.
- Couples explicitly consider tradeoffs across these dimensions rather than evaluating each in isolation when making treatment decisions.
Conclusions:
- A revised conceptual framework for patient-centered fertility treatment is proposed, grounded in the experiences of couples.
- This framework highlights crucial dimensions patients and partners consider when deciding how to build their families.
- The revised framework can guide patient-centered infertility treatment, research, and the development of decision support tools for patients and providers.
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