Page 144 - Shared Guideline Development Experiences in Fertility Care

Chapter 7
General discussion
is thesis focused on our rst experiences with the participation of Dutch infertile couples in ‘shared guideline development’.
First, we explored the added value of patients to various phases of the guideline development process (i.e. de ning the guideline’s scope, formulating the guideline’s recommendations, and de ning performance measurements). Next, we introduced a novel network approach to multidisciplinary guideline development, in which the infertile couple plays a crucial role. Finally, this thesis described the development, evaluation, and potentials for wider implementation of an online participatory tool for patients in guideline development.
In the rst part of this nal chapter, we present answers to the research questions as posed in the general introduction. Next, the main ndings from the studies included in this thesis are discussed in the light of available literature and recent policy. en some methodological considerations are addressed and discussed. Finally, this chapter concludes with recommendations for future research, implications for practice, and an overall conclusion.
Answers to the research questions:
e following answers to the research questions posed in Chapter 1 can be formulated from the studies described in this thesis.
1. What value do patients add to the scope of a Dutch multidisciplinary guideline on infertility when comparing perceived key clinical issues between professionals and patients? (Chapter 3)
Including patients in the scoping phase of the guideline development process leads to valuable additional main key clinical issues (de ned as care aspects that need improvement) for the next step of a multidisciplinary guideline development process. Infertile couples broadened the scope of the guideline by adding eight main key clinical issues regarding patient-centred (e.g. information provision not meeting expectations) and organizational (e.g. poor care alignment) aspects of care. Infertile patients and professionals mentioned only two main key clinical issues collectively: the lack of emotional support and the lack of respect and autonomy. Nevertheless, patients posed di erent interpretations of these issues than professionals, which resulted in more patient-centred care aspects to be addressed in a multidisciplinary guideline on infertility.
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