What do patients want? Expectations and perceptions of IVF clinic information and support regarding frozen embryo disposition
What do patients want? Expectations and perceptions of IVF clinic information and support regarding frozen embryo disposition
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DOI：
10.1016/j.fertnstert.2010.02.023
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发表时间：
2010-11-01
影响因子：
6.7
通讯作者：
Becker, Gay
中科院分区：
文献类型：
--
作者：
Nachtigall, Robert D.;Mac Dougall, Kirstin;Becker, Gay
目的：描述冷冻胚胎持有人对体外受精临床信息、支持和储存费用的期望和认知，及其与胚胎处置决策的相关性。设计：定性访谈研究。背景：加州北部三家体外受精。患者(S)：106个家庭(110名女性和74名男性)，平均6个冷冻胚胎储存5年。干预(S)：3次深度访谈(S)：访谈记录的主题分析。结果(S)：尽管胚胎持有人期望试管受精诊所有义务协助处置决策，并将成为他们的主要信息来源，直到胚胎冷冻保存数年后，这些期望才变得明显。患者表达了对信息和支持的时间、格式和内容的各种偏好，从详细的书面信息到可以提供后勤指导和/或心理支持的顾问/倡导者。胚胎持有者认为基础设施不够明确，不利于向其他夫妇捐赠，而向医学研究捐赠被视为不那么复杂，更有可能得到医生和诊所的鼓励和支持。虽然增加的保存费会促使患者做出处置决策，但这可能被解释为强制性的和/或不能反映实际的临床成本。结论(S)：冷冻胚胎保存患者对帮助他们做出处置决策和胚胎捐献的信息和支持的期望表明，IVF诊所可以从回顾他们的冷冻胚胎咨询、保存和处置政策和程序中受益。(Fertil Steril(R)2010；94：2069-72。(C)2010年由美国生殖医学学会公布。)
Objective: To describe frozen embryo holders' expectations and perceptions of IVF clinic information, support, and storage fees and their relevance to embryo disposition decision making.Design: Qualitative interview study.Setting: Three northern California IVF practices.Patient(s): One hundred six families (110 women and 74 men) with an average of six frozen embryos in storage for 5 years.Intervention(s): Three in-depth interviews over 1 year.Main Outcome Measure(s): Thematic analysis of interview transcripts.Result(s): Although embryo holders expected that IVF clinics were under obligation to assist in the disposition decision and would be their main source of information, these expectations did not become manifest until years after embryo cryopreservation. Patients expressed a variety of preferences for the timing, format, and content of information and support, ranging from detailed written information to counselor/advocates that could provide logistical guidance and/or psychologic support. Embryo holders perceived an insufficiently defined infrastructure to facilitate donation to other couples, whereas donating to medical research was seen as less complicated and more likely to be encouraged and supported by physicians and clinics. Although increasing storage fees motivated disposition decision making, they could be interpreted as coercive and/or not reflective of actual clinic costs.Conclusion(s): Frozen embryo-holding patients' expectations of information and support to assist them with disposition decision making and embryo donation suggests that IVF clinics may benefit from a review of their frozen embryo counseling, storage, and disposition policies and procedures. (Fertil Steril (R) 2010;94:2069-72. (C) 2010 by American Society for Reproductive Medicine.)