Page 14 - Shared Guideline Development Experiences in Fertility Care

Chapter 1
Patient-centredness
Besides safe, e ective, timely, e cient, and equal access to health care, patient- centredness represents one of the six key-dimensions of high-quality care [13]. Among the variously used de nitions for patient-centredness, the Institute of Medicine (IOM) o ers a well-accepted one: ‘providing care that is respectful of and responsive to individual patient preferences, needs and values and ensuring that patients’ values guide all clinical decisions’ [13]. Patient-centredness is a multidimensional and contested concept. According to the framework for patient-centred care created by the Picker Institute, patient-centred fertility care can be divided into 10 organisational and non-organisational dimensions of patient-centredness [14, 15]. Organisational dimensions of patient-centred fertility care include: coordination and integration of care; physical comfort; transition and continuity of care; access to care; and sta competence and technical skills. Non-organisational dimensions of patient-centredness include: respect for patients’ values, preferences, and needs; information, communication, and education; emotional support; partner involvement; and fertility clinic sta attitudes [14]. A number of published articles have stressed the importance of patient-centredness in fertility care. is emphasis is not surprising since infertile patients could especially bene t from patient-centred care for several reasons. Firstly, su ering from infertility is stigmatized and fertility treatments have considerable psychological impact, both of which a ect quality of life. Moreover, the threat of staying childless, which unfortunately overcomes 30% of infertile couples, may mimic reactions seen in serious illness or loss of a relative [16-18]. Secondly, recent reports have con rmed that improvements in several dimensions of patient-centredness could play a major role preventing couples from deciding to drop out from infertility treatments [14, 15, 19-24]. Finally, patient-centred fertility care leads to increased patient satisfaction [25]. us, highly patient-centred fertility care enhances major bene ts for both infertile patients and their caring professionals.
Patient-centred fertility care is increasingly encouraged by the use of innovative tools involving the Internet, which can: promote communication between doctors and infertile couples; enhance information provision, education, and emotional support; and empower infertile couples in their care process [26]. e use of Internet tools to promote patient-centredness seems especially e ective for the clinical area of fertility care, as many patients represent a relatively young patient
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