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以患者为中心的护理如何与患者的生活质量和困扰相关:一项对 427 名不孕女性的研究。

How patient-centred care relates to patients' quality of life and distress: a study in 427 women experiencing infertility.

机构信息

Department of Obstetrics and Gynaecology, 791, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands.

出版信息

Hum Reprod. 2012 Feb;27(2):488-95. doi: 10.1093/humrep/der386. Epub 2011 Nov 22.

Abstract

BACKGROUND

The aim of this study was to investigate to what extent patients' experiences with fertility care are associated with their quality of life (QoL), and levels of anxiety and depression.

METHODS

We performed a cross-sectional questionnaire study within 29 Dutch fertility clinics, including women with fertility problems. Through multilevel regression analyses, associations between patients' QoL (FertiQoL) and distress [anxiety and depression; Hospital Anxiety and Depression Scale (HADS)] and their experiences with fertility care [patient-centredness questionnaire (PCQ)-infertility] were determined. For all multilevel models, R² and intra-cluster correlation coefficients were calculated.

RESULTS

This study included 427 non-pregnant patients who filled out the FertiQoL, HADS and PCQ-infertility (response rate 76%). Multilevel regression analysis showed significant associations between the PCQ total scale, the total FertiQoL scale (B = 0.25), and HADS subscales (B = -0.22 and -0.18). Of the variance in patients' experiences, 13% (=R²) could be explained by their perceived QoL, 12% by their level of anxiety and 10% by their level of depression.

CONCLUSIONS

Patient-centredness in fertility care and the patients' QoL and anxiety and depression scores are related. Paying attention to these variables could lead to positive care experiences and improved patient-centredness of care. Future research should focus on identifying causal relationships among these variables.

摘要

背景

本研究旨在探讨患者对生育护理的体验在何种程度上与其生活质量(QoL)、焦虑和抑郁水平相关。

方法

我们在 29 家荷兰生育诊所进行了一项横断面问卷调查研究,纳入了有生育问题的女性。通过多级回归分析,确定了患者的 QoL(FertiQoL)和困扰[焦虑和抑郁;医院焦虑和抑郁量表(HADS)]与其生育护理体验[以患者为中心的问卷(PCQ)-不孕]之间的关联。对于所有多级模型,计算了 R² 和组内相关系数。

结果

本研究纳入了 427 名未怀孕的填写了 FertiQoL、HADS 和 PCQ-不孕(应答率为 76%)的患者。多级回归分析显示,PCQ 总量表、总 FertiQoL 量表(B = 0.25)和 HADS 子量表(B = -0.22 和 -0.18)之间存在显著关联。在患者体验的变异性中,可由患者感知的 QoL 解释 13%(=R²),由焦虑水平解释 12%,由抑郁水平解释 10%。

结论

生育护理中的以患者为中心以及患者的 QoL 和焦虑抑郁评分是相关的。关注这些变量可能会带来积极的护理体验和改善以患者为中心的护理。未来的研究应集中于确定这些变量之间的因果关系。

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