Department of Health Sciences, University of Milan, 20142, Milan, Italy.
San Paolo University Hospital, Asst-Santi Paolo e Carlo, 20142, Milan, Italy.
J Assist Reprod Genet. 2019 Jun;36(6):1135-1142. doi: 10.1007/s10815-019-01466-1. Epub 2019 May 10.
To explore the association between patient-centered communication, patients' satisfaction, and retention in care in assisted reproductive technology (ART) visits.
ART visits at eight Italian clinics were videotaped and coded using the Roter Interaction Analysis System, which includes a Patient-Centered Index (PCI), a summary "patient-centered communication" ratio. After the visit, patients completed a satisfaction questionnaire (SATQ). After 3 months, patients were asked about their retention in care. Spearman correlations and Mann-Whitney tests were used to test associations between the study variables; the open-ended item of SATQ was analyzed through content analysis.
Eighty-five visits were videotaped (involving 28 gynecologists and 160 patients). PCI score (μ = 0.51 ± 0.28) revealed a more disease-oriented communication during the visit. Patients reported high levels of satisfaction with the visit and identified in the information provision or in the doctor's humanity or kindness the main reasons of satisfaction. At the follow-up, the majority of the couples declared to have followed the clinicians' recommendations and to have remained related to the ART center. No associations were found among the study variables, except for a lower male satisfaction among couples who declared to have changed ART clinic.
Contrary to what was expected, the style of physician-patient communication was not found to be associated with patient satisfaction and retention in care. However, patients were highly satisfied and engaged. The actual meaning of a communication that is "patient-centered" in the ART context might be wider, including the couples' need for information, as suggested by qualitative findings.
探讨辅助生殖技术(ART)就诊中以患者为中心的沟通与患者满意度和就诊保留率之间的关系。
对意大利 8 家诊所的 ART 就诊进行录像,并使用 Roter 互动分析系统进行编码,该系统包括患者为中心指数(PCI)和一个概括的“以患者为中心的沟通”比例。就诊结束后,患者完成满意度问卷(SATQ)。3 个月后,询问患者就诊保留率。采用 Spearman 相关分析和 Mann-Whitney 检验来检验研究变量之间的关联;通过内容分析对 SATQ 的开放性项目进行分析。
共录像 85 次就诊(涉及 28 名妇科医生和 160 名患者)。PCI 评分(μ=0.51±0.28)显示就诊期间沟通更倾向于疾病导向。患者对就诊非常满意,并将信息提供或医生的人道或善良视为满意度的主要原因。在随访中,大多数夫妇表示已遵循临床医生的建议,并与 ART 中心保持联系。研究变量之间没有关联,但在报告已更换 ART 诊所的夫妇中,男性满意度较低。
与预期相反,医患沟通方式与患者满意度和就诊保留率之间没有关联。然而,患者非常满意并积极参与。ART 背景下以患者为中心的沟通的实际意义可能更广泛,包括夫妇对信息的需求,这一点在定性研究结果中得到了提示。