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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.
Hum Reprod 2013; 28(9):2462-72HR

Abstract

STUDY QUESTION

Are positive experiences of different aspects of patient-centred care (PCC) associated with higher intentions to comply with fertility treatment?

SUMMARY ANSWER

Positive experiences regarding information received, respect from staff about values and preferences, continuity in treatment and competence of staff are directly associated with higher compliance intentions, while positive experiences regarding accessibility to and involvement in the treatment and communication with staff are indirectly associated, via associations with less concerns about treatment.

WHAT IS KNOWN ALREADY

The quality of infertility services can influence patients' intentions to comply with treatment. Patients cite negative care experiences as one of the main reasons why they discontinue treatment prematurely. Delivering PCC in routine infertility care is associated with higher quality of life and lower distress during treatment.

STUDY DESIGN, SIZE, DURATION

In this cross-sectional study of 265 women and 83 men, we investigated first, the psychometric properties of the Portuguese version of the Patient-Centredness Questionnaire (PCQ)-Infertility tool, which assesses infertility PCC, and secondly, the associations between PCC and intentions to comply with treatment.

PARTICIPANTS/MATERIALS, SETTING, METHODS

Men and women undergoing fertility diagnostic investigation or treatment at Portuguese fertility clinics were recruited online and in clinical setting. Participants filled out a socio-demographic and fertility data file and other questionnaires to assess PCC (PCQ-Infertility), intentions to comply with treatment (FertiQoL Persistence Scale), wellbeing (Anxiety and Depression subscales of the BSI and FertiQoL), concerns about treatment (CART Scale) and treatment tolerability (FertiQoL Tolerability Domain).

MAIN RESULTS AND THE ROLE OF CHANCE

There were 265 women and 83 men who completed the questionnaires. The confirmatory factor analysis for the PCQ-Infertility indicated a good fit [X² = 479.097; P < 0.001; comparative fit index = 0.929; root mean square error of approximation = 0.058 (0.051-0.065)]. All PCQ-Infertility dimensions showed good internal consistency (α ≥ 0.70, excepting for organization: α = 0.57). Information provision, respect for patients' values, continuity of care and competence of the team were directly associated with higher intentions to comply with treatment (r from 0.13 to 0.23). Greater accessibility, patient involvement and good communication were negatively associated with concerns about treatment (r from -0.14 to -0.16) and less concerns were associated with higher intentions to comply with treatment (r from -0.14 to -0.15).

LIMITATIONS, REASONS FOR CAUTION

Of the sample, 49% were recruited online. Patients recruited online had higher education and were more likely to be undergoing assisted reproduction treatment and this could have influenced the ratings of PCC reported. We did not account for treatment prognosis factors and/or doctor censuring and this may have resulted in underestimation of the strength of associations reported involving compliance intentions. The cross-sectional design of the study does not allow for cause and effect analysis between the study variables.

WIDER IMPLICATIONS OF THE FINDINGS

To promote treatment compliance, clinics should allow patients to establish stable relationships with a reference doctor who is competent and respectful of their interests and values and who provides them with the information they need. Clinics can also alleviate their patients' concerns regarding medical procedures by ensuring that these professionals are easily accessible, have good communication skills, and involve patients in the treatment process and associated decision-making. The Portuguese version of the PCQ-Infertility tool is valid and reliable.

Authors+Show Affiliations

School of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Validation Studies

Language

eng

PubMed ID

23820421

Citation

Pedro, Juliana, et al. "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 (Oxford, England), vol. 28, no. 9, 2013, pp. 2462-72.
Pedro J, Canavarro MC, Boivin J, et al. 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. Hum Reprod. 2013;28(9):2462-72.
Pedro, J., Canavarro, M. C., Boivin, J., & Gameiro, S. (2013). 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 (Oxford, England), 28(9), pp. 2462-72. doi:10.1093/humrep/det259.
Pedro J, et al. 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. Hum Reprod. 2013;28(9):2462-72. PubMed PMID: 23820421.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 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. AU - Pedro,Juliana, AU - Canavarro,Maria Cristina, AU - Boivin,Jacky, AU - Gameiro,Sofia, Y1 - 2013/07/02/ PY - 2013/7/4/entrez PY - 2013/7/4/pubmed PY - 2014/3/22/medline KW - PCQ-Infertility KW - compliance KW - infertility KW - patient-centred care KW - psychometric properties SP - 2462 EP - 72 JF - Human reproduction (Oxford, England) JO - Hum. Reprod. VL - 28 IS - 9 N2 - STUDY QUESTION: Are positive experiences of different aspects of patient-centred care (PCC) associated with higher intentions to comply with fertility treatment? SUMMARY ANSWER: Positive experiences regarding information received, respect from staff about values and preferences, continuity in treatment and competence of staff are directly associated with higher compliance intentions, while positive experiences regarding accessibility to and involvement in the treatment and communication with staff are indirectly associated, via associations with less concerns about treatment. WHAT IS KNOWN ALREADY: The quality of infertility services can influence patients' intentions to comply with treatment. Patients cite negative care experiences as one of the main reasons why they discontinue treatment prematurely. Delivering PCC in routine infertility care is associated with higher quality of life and lower distress during treatment. STUDY DESIGN, SIZE, DURATION: In this cross-sectional study of 265 women and 83 men, we investigated first, the psychometric properties of the Portuguese version of the Patient-Centredness Questionnaire (PCQ)-Infertility tool, which assesses infertility PCC, and secondly, the associations between PCC and intentions to comply with treatment. PARTICIPANTS/MATERIALS, SETTING, METHODS: Men and women undergoing fertility diagnostic investigation or treatment at Portuguese fertility clinics were recruited online and in clinical setting. Participants filled out a socio-demographic and fertility data file and other questionnaires to assess PCC (PCQ-Infertility), intentions to comply with treatment (FertiQoL Persistence Scale), wellbeing (Anxiety and Depression subscales of the BSI and FertiQoL), concerns about treatment (CART Scale) and treatment tolerability (FertiQoL Tolerability Domain). MAIN RESULTS AND THE ROLE OF CHANCE: There were 265 women and 83 men who completed the questionnaires. The confirmatory factor analysis for the PCQ-Infertility indicated a good fit [X² = 479.097; P < 0.001; comparative fit index = 0.929; root mean square error of approximation = 0.058 (0.051-0.065)]. All PCQ-Infertility dimensions showed good internal consistency (α ≥ 0.70, excepting for organization: α = 0.57). Information provision, respect for patients' values, continuity of care and competence of the team were directly associated with higher intentions to comply with treatment (r from 0.13 to 0.23). Greater accessibility, patient involvement and good communication were negatively associated with concerns about treatment (r from -0.14 to -0.16) and less concerns were associated with higher intentions to comply with treatment (r from -0.14 to -0.15). LIMITATIONS, REASONS FOR CAUTION: Of the sample, 49% were recruited online. Patients recruited online had higher education and were more likely to be undergoing assisted reproduction treatment and this could have influenced the ratings of PCC reported. We did not account for treatment prognosis factors and/or doctor censuring and this may have resulted in underestimation of the strength of associations reported involving compliance intentions. The cross-sectional design of the study does not allow for cause and effect analysis between the study variables. WIDER IMPLICATIONS OF THE FINDINGS: To promote treatment compliance, clinics should allow patients to establish stable relationships with a reference doctor who is competent and respectful of their interests and values and who provides them with the information they need. Clinics can also alleviate their patients' concerns regarding medical procedures by ensuring that these professionals are easily accessible, have good communication skills, and involve patients in the treatment process and associated decision-making. The Portuguese version of the PCQ-Infertility tool is valid and reliable. SN - 1460-2350 UR - https://www.unboundmedicine.com/medline/citation/23820421/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_ L2 - https://academic.oup.com/humrep/article-lookup/doi/10.1093/humrep/det259 DB - PRIME DP - Unbound Medicine ER -