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Afulani PA, Nakphong MK, Sudhinaraset M. Person-centred sexual and reproductive health: A call for standardized measurement. Health Expect 2023; 26:1384-1390. [PMID: 37232021 PMCID: PMC10349248 DOI: 10.1111/hex.13781] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 04/26/2023] [Accepted: 05/14/2023] [Indexed: 05/27/2023] Open
Abstract
Person-centred sexual and reproductive health (PCSRH) care refers to care that is respectful of and responsive to people's preferences, needs, and values, and which empowers them to take charge of their own sexual and reproductive health (SRH). It is an important indicator of SRH rights and quality of care. Despite the recognition of the importance of PCSRH, there is a gap in standardized measurement in some SRH services, as well as a lack of guidance on how similar person-centred care measures could be applied across the SRH continuum. Drawing on validated scales for measuring person-centred family planning, abortion, prenatal and intrapartum care, we propose a set of items that could be validated in future studies to measure PCSRH in a standardized way. A standardized approach to measurement will help highlight gaps across services and facilitate efforts to improve person-centred care across the SRH continuum. PATIENT OR PUBLIC CONTRIBUTION: This viewpoint is based on a review of validated scales that were developed through expert reviews and cognitive interviews with services users and providers across the different SRH services. They provided feedback on the relevance, clarity, and comprehensiveness of the items in each scale.
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Affiliation(s)
- Patience A. Afulani
- Departments of Epidemiology and Biostatistics and Obstetrics, Gynecology, and Reproductive Sciences, School of MedicineUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Michelle K. Nakphong
- Department of Community Health Sciences, Jonathan and Karin Fielding School of Public HealthUniversity of California, Los AngelesLos AngelesCaliforniaUSA
| | - May Sudhinaraset
- Department of Community Health Sciences, Jonathan and Karin Fielding School of Public HealthUniversity of California, Los AngelesLos AngelesCaliforniaUSA
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van der Kolk L, Smit E, Bloemer J, van Wijk LM. The PCQ-Infertility Revised: A New Digital Instrument to Measure Treatment Satisfaction of Fertility Patients. Patient Relat Outcome Meas 2023; 14:223-234. [PMID: 37483866 PMCID: PMC10362858 DOI: 10.2147/prom.s416182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 06/23/2023] [Indexed: 07/25/2023] Open
Abstract
Background One of the key dimensions of healthcare quality is patient-centeredness, which represents how well healthcare is geared towards patients' needs and wishes. Many questionnaires that measure the patient-centeredness are long and complicated, eliciting non-response or careless responding. Moreover, responses to some commonly used questionnaires are difficult to interpret. The Patient-Centeredness Questionnaire-Infertility (PCQ-Infertility) is used to measure the patient's experience of fertility healthcare quality. The aim of this study was to improve the PCQ-Infertility to allow large-scale clinical implementation. Methods The study was performed in three parts. First, shortcomings of the original PCQ-Infertility were identified by evaluation of expert opinions. Second, the number of items were reduced, and items were rescaled and rephrased. Third, 844 patients filled in the original PCQ-Infertility and 260 patients filled in the revised PCQ-Infertility and reliability analyses were performed. In addition, a confirmatory factor analysis was performed on the revised PCQ-Infertility. Results The number of items in the revised questionnaire was reduced by 24% (from 51 to 39 items), which increased the internal consistency and reliability. The reliability analyses and confirmatory factor analysis indicated high consistency and convergent validity in all seven dimensions (accessibility, information, communication, patient involvement, respect for patient's values, continuity and transition, and competence) of the revised PCQ-Infertility. Conclusion The revised PCQ-Infertility is a more valid and reliable instrument than the original PCQ-Infertility, easier to interpret and shorter. Therefore, large-scale clinical implementation and data analysis are now possible, giving the opportunity for fertility care professionals to evaluate and improve their healthcare.
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Affiliation(s)
- Lotte van der Kolk
- Institute for Management Research, Radboud University, Nijmegen, the Netherlands
| | - Ellen Smit
- Ferring B.V., Hoofddorp, the Netherlands
| | - Josée Bloemer
- Institute for Management Research, Radboud University, Nijmegen, the Netherlands
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Webair HH, Ismail TAT, Ismail SB, Khaffaji AJ, Hussain NHN, Kadir AA, Muhamad R, Bakar FAA, Ismail NR, Badri N. Patient-centered infertility questionnaire for female clients (PCIQ-F): part I: questionnaire development. BMC Med Res Methodol 2021; 21:188. [PMID: 34544388 PMCID: PMC8454158 DOI: 10.1186/s12874-021-01376-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 08/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patient-centered care is an essential component of health care quality. To achieve patient-centered care, health care authorities should have a clear definition and an applicable tool to measure the extent of its application. The real concept of patient centeredness should be developed by the patients themselves. We aimed to demonstrate a way to develop a draft Arabic patient-centered infertility care (PCIC) questionnaire for females clients following practical steps that address women with infertility. METHODS An iterative process of questionnaire development was undertaken by combining two approaches: the steps proposed by Robert F. DeVellis for scale development and the recommended practices for questionnaire development and testing in the European statistical system. We attempted to develop the draft questionnaire that involved conceptualization and operationalization, generation of an item pool, development of the questionnaire format, review of the initial item pool by experts, and consideration of validation items for inclusion. RESULTS We generated an item pool from in-depth interviews with 14 women who sought infertility care within 6 months before the interview time. We then added more items from a literature review. The item pool contained 123 items distributed through 10 domains. Ten women with infertility were included for face validation. Then, experts with backgrounds in Obstetrics and Gynecology, Family Medicine, and Public Health reviewed the item pool using content validation (n = 10 professors and/or specialists). The item pool was finally reduced to 57 items. We developed the draft Arabic patient-centered infertility care questionnaire for female clients (PCIQ-F) with three sections, including 66 items: background variables, PCIC experience variables, and a general question about the quality of infertility care in the health facility. The draft questionnaire was further reviewed and edited last by experts in preparation for part 2, which will test the questionnaire and prepare the final version. CONCLUSION The PCIQ-F questionnaire development is a multi-step iterative process started and ended by the target users as experts. Experts' participation in infertility care and in questionnaire format development had a great impact on questionnaire development and conflict resolution. We recommend this transparent and replicable approach for new instrument developers; it is likely to generate a questionnaire that is valid and acceptable to target users. The draft PCIQ-F questionnaire is ready for testing of its psychometric properties before the final version to measure the PCIC level in health facilities.
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Affiliation(s)
- Hana Hasan Webair
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150, Kubang Kerian, Kelantan, Malaysia. .,Department of Family Medicine, Hadhramout University, College of Medicine, PO Box 50512, Mukalla, Hadhramaut, Yemen. .,International Medical Center, Jeddah, Saudi Arabia.
| | - Tengku Alina Tengku Ismail
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150, Kubang Kerian, Kelantan, Malaysia
| | - Shaiful Bahari Ismail
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150, Kubang Kerian, Kelantan, Malaysia
| | - Azza Jameel Khaffaji
- Obstetrics and Gynaecology Department, Ministry of Health, King Abdulaziz Hospital, P.O.Box 31467, Jeddah, 21497, Saudi Arabia
| | - Nik Hazlina Nik Hussain
- Women's Health Development Unit, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150, Kubang Kerian, Kelantan, Malaysia
| | - Azidah Abdul Kadir
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150, Kubang Kerian, Kelantan, Malaysia
| | - Rosediani Muhamad
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150, Kubang Kerian, Kelantan, Malaysia
| | | | - Nur Raihan Ismail
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150, Kubang Kerian, Kelantan, Malaysia
| | - Nagwa Badri
- International Medical Center, Jeddah, Saudi Arabia
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Medina-Artom TR, Adashi EY. Patient-centered care in Israeli IVF units: divergent perceptions of patients and providers. Isr J Health Policy Res 2020; 9:39. [PMID: 32762771 PMCID: PMC7409630 DOI: 10.1186/s13584-020-00395-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 07/15/2020] [Indexed: 01/21/2023] Open
Abstract
Background Patient-centered care is particularly important for patients undergoing fertility treatment because of their emotional involvement and their constant contact with providers. To the best of our knowledge, to date, there have been no rigorous studies of the discrepancies between the patients’ perceptions of the care they received and the providers’ perceptions of the care that they provided, in specific dimensions and elements of patient-centered care. Objective To compare provider and patient perceptions of the extent to which care in Israeli IVF units is patient-centered. Methods A previously validated survey instrument was used to assess the patient and provider perceptions of ten dimensions of patient-centered care: accessibility of providers, provision of information and of explanations, communication skills of providers, patient involvement in the treatment, respect for patient values and needs, continuity and transition in treatment, professional competence, care organization, physical comfort, and emotional support. The patient survey and the provider survey were conducted in 2016–2017; both surveys were carried out in 8 of 25 hospital-based IVF units in Israel. Seventy-six providers and 524 patients (response rate 79%) participated in the surveys. Findings The perceptions of patients and providers were similar regarding seven of the ten dimensions of patient-centered care, although there were some differences in patient vs. provider scores by unit. There were three dimensions with substantial provider-patient score differences: Moderate-sized gaps were found relative to the provision of information and explanations (1.96 vs. 2.38, on a 0–3 scale) and respect for patient values and needs (1.92 vs. 2.47). A large gap was observed relative to emotional support (0.96 vs. 2.54). Conclusions Providers appear to underestimate the needs of fertility treatment patients for information, respect, and emotional support. The observed differences between what patients feel about their care and what providers assume they provide, especially regarding emotional support, indicates a need for ongoing, specific feedback to providers as to the patient-centeredness of the care they provide. The particularly large patient – provider gap relative to the provision of emotional support highlights the importance of increasing the attention paid to the psychological impact of fertility treatment and of giving patients an opportunity to consult a counselor who is familiar with problems associated with fertility treatments. Policy recommendations Efforts to improve the patient-centeredness in FT should begin by establishing a national ongoing feedback mechanism, involving all 25 IVF units operating in Israel working in collaboration with the Ministry of Health. The findings from this joint effort should be shared with the public. In addition, we recommended appointing one professional in each IVF unit to be in charge of promoting improvements in the patient-centered care for that unit. Assigning a mental health professional (psychologist or social worker) to each and every IVF unit is also of crucial importance.
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Affiliation(s)
- Tamar R Medina-Artom
- Myers-JDC Brookdale Institute, PO Box 3886, 91037, Jerusalem, Israel. .,The Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel.
| | - Eli Y Adashi
- The Warren Alpert Medical School, Brown University, RI 02906, Providence, USA
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