Patient identified factors influencing decisions to seek fertility care: adaptation of a wellness model.
Patient identified factors influencing decisions to seek fertility care: adaptation of a wellness model.
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患者确定了影响寻求生育护理决策的因素：健康模式的适应。
DOI：
10.1080/02646838.2019.1705263
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发表时间：
2021
影响因子：
2.5
通讯作者：
Ryan,GinnyL
中科院分区：
文献类型：
--
作者：
WhittierOlerich,Kelsey;Summers,Karen;Lewis,AdamM;Stewart,Kathleen;Ryan,GinnyL
目的：适应生育保健健康模式。背景：尽管有一系列不孕不育的诊断和治疗服务，但许多人在实现活产之前没有寻求护理或停止护理。健康模型可以为研究患者寻求和继续生育护理的决定提供信息，因为在健康方面有许多障碍和驱动因素。方法：对135名在美国经历过不孕症的育龄患者进行了一项混合方法的在线调查。结果包括寻求或继续生育护理的驱动因素和障碍。使用卡方检验和Fisher精确检验比较治疗史中确定的因素。通过传统的内容分析，在对6个开放式回答项目的174个回答中确定了主题和模式。结果：专题分析揭示了寻求护理决定的实际（环境、财务和身体）和情感（情感、社会和精神）方面的健康因素（67%），情感因素在决定返回护理时更为突出（78%）。结论：治疗失败后寻求生育护理和返回的决定综合了经济、身体、环境、情感、社会和精神健康等方面的现实和情感理由。应考虑这些维度内的驱动因素和障碍，以鼓励求医和提高患者保留率。
Objective: To adapt a fertility care wellness model.Background: Despite availability of a range of diagnostic and therapeutic services for infertility, many do not seek care or discontinue care prior to achieving a live birth. Wellness models can inform research on patient decisions to seek and continue fertility care, as many barriers and drivers are represented within the dimensions of wellness.Methods: A mixed-methods online survey was completed by 135 people of reproductive age who experienced infertility in the USA. Outcomes included drivers and barriers to seeking or continuing fertility care. Identified factors were compared by treatment history using chi-square and Fisher’s exact tests. Themes and patterns were identified within 174 responses to 6 open-response items through conventional content analysis.Results: Thematic analysis revealed practical (environmental, financial, and physical) and affective (emotional, social and spiritual) dimensions of wellness in decisions to seek care (67%), with affective rationales more prominent in decisions to return for care (78%).Conclusion: Decisions to seek fertility care and return after failed treatment integrate practical and affective rationales from financial, physical, environmental, emotional, social and spiritual wellness dimensions. Drivers and barriers within these dimensions should be considered to encourage care seeking and improve patient retention.