Page 155 - Shared Guideline Development Experiences in Fertility Care

Study design
is thesis consists of mainly qualitative exploratory and feasibility studies. In Chapter 2, we used qualitative research methods and data analysis to explore and compare patients’ and professionals’ perceived key clinical issues. e value of qualitative methods has been widely proven in exploratory studies [68]. In our rst study, for practical reasons, we used two types of qualitative research methods, namely semi-structured interviews with infertile couples and focus group interviews among professionals involved in fertility care. Research has been previously suggested that social desirability plays an important role in focus group discussions, which could have restricted the number of and variety in key clinical issues [69]. Nevertheless, various key clinical issues were addressed.
In Chapters 3, 4, and 5 we performed feasibility studies. e term ‘feasibility study’ is still a contested term that refers to the exploration of new methodologies or interventions [70]. Traditionally part of feasibility studies, experience with a new approach or intervention, barriers and facilitators, and suggestions for improvement are important outcome measures and input for further study [70]. In this thesis, we used a mixed-method evaluation. Mixed methods are frequently used to quantify prede ned qualitative outcome data and are therefore highly applicable to our described studies. However, potential disadvantages of this methodology regarding our studies include potential sampling bias and the low response rates on the written questionnaires described in Chapter 5. Furthermore, we used interviews as input for designing a written questionnaire while saturation of data was not reached.
In Chapter 6 we described the development of guideline-based quality indicators
for patient-centredness using a RAND modi ed Delphi method. is method has
been widely used in the development of quality indicators in healthcare [66,71].
While this method is a useful approach to facilitating consensus, the in uence of
the panel composition and type of feedback on the legitimacy of the results have
been questioned regularly [66,72–74]. However, in our study, a balanced group of 7 stakeholders mandated by their professional societies participated. Furthermore,
the panel members received written feedback instead of face-to-face feedback, which may have minimized intimidation factors while selecting potential indicators [73,74].
Outcome
e main goal of developing quality instruments is monitoring and nally improving the quality of care. However, there is still no direct, su cient evidence that patient
Discussion
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