Page 32 - Shared Guideline Development Experiences in Fertility Care

Chapter 2
Key clinical issues
Overall, 32 key clinical issues among infertile couples (Table 3) and 23 key clinical issues among professionals (Table 4) were identi ed. e main key clinical issues (suggested by at least two di erent professionals in both focus groups or in more than three quarters of the infertile couples) are presented separately and per domain (i.e. key clinical issues at the level of actual guidelines (I) and at professional (II), patients (III) and organizational (IV) level). e presented main key clinical issues are accompanied by verbatim quotes taken from the interviews (Table 3).
Infertile couples’ key clinical issues:
Domain I: guidelines (Table 3) -
Domain II: professionals
Lack of respect and autonomy. All participants mentioned their healthcare professionals’ attitude or behaviour as a key clinical issue, for example impersonal, uninterested or not serious.
... it is all really very impersonal, you feel no more than a number.
Furthermore, the lack of partner involvement (male for GP and gynaecologist, female for urologist) was mentioned.
... everything was concentrated on her, it o en felt like I did not matter.
Insu cient information provision. Information provided by professionals was mostly on a medical-technical level and lacked attention for non-medical issues. Treatment alternatives were not proposed and explanations were unclear, resulting in obscure treatment plans.
... our GP could have explained more to us, but she did not. I heard everything from the gynaecologist, I think that is a pity because our GP could have done a part of that.
Lack of emotional support. A lack of emotional support was mentioned as a key clinical issue for fertility care, delivered by both the GP and the gynaecologist. Although the need for emotional support di ers among patients, it was rarely discussed in the consulting room. Furthermore, patients mentioned that the possibility of a referral to a psychologist is not enough: they clearly prefer emotional support to be embedded within daily care.
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