Page 125 - Shared Guideline Development Experiences in Fertility Care

(Guideline-based) indicators for patient-centredness
were recommendations concerning the 10 dimensions of patient-centredness in fertility care according to Dancet et al. (2010) or recommendations provided by a level P [3]. Discrepancies in this division of recommendations were easily solved through discussion. Furthermore, all recommendations regarding the medical- technical quality of care were excluded, since these were not a subject of research of this study. Lastly, in the nal set of indicators a balance was needed between organizational indicators (i.e. coordination and integration of care; physical comfort; transition and continuity of care; access to care; sta s’ competence and technical skills) and non-organizational indicators (i.e. respect for patients’ values, preferences and needs; information, communication and education; emotional support; partner involvement; attitude fertility clinic sta ) for patient-centredness in fertility care. To achieve this, the extracted recommendations were subdivided as described. Level P recommendations, directly formulated by patients through ‘Wikifreya’, represent par excellence patients’ personal needs and are therefore classi ed as non-organizational indicators [21].
Discrepancies in this division of recommendations were again resolved through discussion. Next, all recommendations for patient-centredness (organizational and non-organizational aspects) were formulated into potential indicators (E.B.) and checked and eventually adjusted independently by a second researcher (R.H.). A er reaching consensus on their formulation, the potential indicators were included in a written questionnaire and formulated as follows: ‘ e healthcare provider (e.g. gynaecologist, urologist) should...’ or ‘Patients would like to...’.
Step 2: written questionnaire round 6 e written questionnaire was sent to the members of both panels by post. e rst
part of the questionnaire comprised questions about background characteristics
(e.g. age, sex). Secondly, panel members were asked to rate the relevance of all
potential indicators for patient-centredness on a nine-point Likert-scale ranging from 1 (=completely irrelevant) to 9 (=extremely relevant), with respect to their usefulness as a measure for the quality of patient-centredness in fertility care [11]. Both categories (i.e. organizational and non-organizational) of indicators for patient-centredness were presented separately and according to the structure of the NG following infertile patients’ clinical pathways (e.g. general care by GPs, fertility assessments and treatment by GPs, gynaecologists and urologists as well as a ercare). All potential indicators within the professionals’ questionnaire were supplemented with levels of evidence to facilitate decision-making. e evidence
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