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Enregistrement W4381619771 · doi:10.1093/humrep/dead093.123

P-577 Understanding how healthcare professionals address the educational and emotional needs of patients seeking fertility care: an assessment of challenges and barriers across eight countries

2023· article· en· W4381619771 sur OpenAlexaff
Monica Augustyniak, M. Kupka, Giovanni Coticchio, Sandro C. Esteves, A.G. Fincham, Patrice Lazure, Sophie Péloquin

Notice bibliographique

RevueHuman Reproduction · 2023
Typearticle
Langueen
DomaineMedicine
ThématiqueReproductive Health and Technologies
Établissements canadiensAxdev Group (Canada)
Organismes subventionnairesnon disponible
Mots-clésThematic analysisFertilityPsychologyHealth careDistressAnxietyQualitative researchReproductive medicineNeeds assessmentMedicineNursingMedical educationFamily medicineClinical psychologyPsychiatryPopulationPregnancyPolitical scienceEnvironmental health

Résumé

récupéré en direct d'OpenAlex

Abstract Study question What are the current challenges and barriers preventing healthcare professionals (HCPs) from optimally addressing patients' educational and emotional needs in fertility care? Summary answer HCPs lack optimal knowledge of patients’ needs/preferences for educational and emotional support, have sub-optimal skills addressing them, and underutilize external resources (e.g., psychologists). What is known already Couples who have difficulty conceiving a child can face a turmoil of emotions, including anxiety and distress, especially when external social pressures are at play. All patients seeking fertility care deserve their educational and emotional needs to be heard and addressed, as advocated by The European Society of Human Reproduction and Embryology (ESHRE) guidelines. Nevertheless, a 2015 educational and behavioural needs assessment found that HCPs involved in reproductive medicine perceive their skills to identify the needs of patients for psychological and emotional support to be less than optimal, especially when discussing sensitive or distressing issues. Study design, size, duration This exploratory mixed-methods study triangulated data from a qualitative phase (76 interviews, June-August 2021) and a quantitative phase (323 surveys, November 2021). Participants included patients (qualitative phase, n = 28), physicians (both phases, n = 249) and laboratory specialists (both phases, n = 122) using assisted reproductive technologies (ART). Participants/materials, setting, methods Countries included Brazil, China, France, Germany, Italy, Mexico, Spain, and UK. Interviews were recorded, transcribed and coded. Thematic analyses were performed. Surveys assessed knowledge, skill, agreement, and task performance frequency using 5-point scales. Knowledge and skill ratings of none (1), basic (2) or intermediate (3), as opposed to advanced (4) or expert (5), were considered a gap. Descriptive analysis and crosstabulations with chi-square tests were performed to explore variations by country and professional role/specialty area. Main results and the role of chance Patient interviews indicated a need to improve HCPs’ ability to set realistic yet encouraging, expectations about conception outcomes. Underlying barriers to fulfilling this need included a lack of optimal knowledge amongst HCPs regarding patients’ preferences, skills addressing their needs, and an under-utilization of resources for psychological support. Survey results indicated 31-36% of physicians and laboratory specialists had a knowledge gap of patients’ preferences and needs for education and emotional support; 11-39% of physicians had a skill gap for a) educating their patients about factors contributing to couples’ infertility and treatments that can optimize chances of conception/pregnancy; b) setting patient expectations about successful fertility outcomes and next steps; and c) providing emotional support to patients/couples experiencing failure to conceive. For laboratory specialists, 23% reported ‘never’, ‘rarely’ or ‘sometimes’ contributing to patient education. When asked how often they “consult references provided by patient organizations regarding the psychological and emotional needs of patients” and “direct patients to support groups or forums (online or in-person)”, an average of 47-49% of surveyed HCPs said ‘never’, ‘rarely’ or ‘sometimes’. Only 49% of surveyed HCPs reported collaborating with psychologists specialized in infertility. The extent to which gaps affected HCPs varied by country and professional role/specialty area. Limitations, reasons for caution Although multiple countries were included in this exploratory mixed-methods study, due to small sample sizes, the likelihood of observing a difference in the frequency of reported challenges, barriers and gaps by country due to chance alone could not be excluded. Wider implications of the findings Several years after the publication of the ESHRE guidelines for psychosocial care, challenges related to providing adequate educational and emotional support to patients remain. This study identified opportunities and direction for continuing professional development to promote routine psychosocial care in fertility clinics. Trial registration number Not applicable for this mixed-methods self-reported educational needs assessment.

Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.

Comment cette classification a été obtenuedéplier

Prédiction distillée sur la base complète

Imitation des enseignants

Ni prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.

score de la tête « metaresearch » (Codex)0,001
score de la tête « metaresearch » (Gemma)0,000
Version: codex-gemma-dda1882f352aStatut de validation: machine_predicted_unvalidated
Catégories candidatesaucune
Catégories consensuellesaucune
DomaineSignal candidat: aucune · Signal consensuel: aucune
Devis d'étudeSignal candidat: Observationnel · Signal consensuel: Observationnel
GenreSignal candidat: Empirique · Signal consensuel: Empirique
Score de désaccord entre enseignants0,035
Score d'incertitude au seuil0,411

Scores Codex et Gemma par catégorie

CatégorieCodexGemma
Métarecherche0,0010,000
Méta-épidémiologie (sens strict)0,0000,000
Méta-épidémiologie (sens large)0,0000,000
Bibliométrie0,0000,000
Études des sciences et des technologies0,0010,001
Communication savante0,0000,000
Science ouverte0,0000,000
Intégrité de la recherche0,0000,000
Charge utile insuffisante (le modèle a refusé de juger)0,0000,000

Scores machine (provisoires)

Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.

Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.

Tête enseignante Opus0,114
Tête enseignante GPT0,418
Écart entre enseignants0,305 · la distance entre les deux têtes enseignantes sur ce seul travail
Statut de validationscore_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découle

Classification

machine, non validée

Prédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.

Les modèles n’ont appliqué aucune catégorie : rien dans la taxonomie ne correspondait à ce travail.
Devis d'étudeObservationnel
Domainenon disponible
GenreEmpirique

Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».

En bref

Citations2
Publié2023
Routes d'admission1
Résumé présentoui

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