Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
Department of Geographical and Sustainability Sciences, University of Iowa, Iowa City, IA, USA.
J Reprod Infant Psychol. 2021 Jul;39(3):263-275. doi: 10.1080/02646838.2019.1705263. Epub 2019 Dec 20.
: To adapt a fertility care wellness model.: 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.: 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.: 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%).: 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.
：为适应生育保健综合模式：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并未寻求或停止治疗。综合模式可以为研究患者寻求和继续生育保健的决策提供信息，因为许多障碍和驱动因素都存在于综合模式的各个维度中：一项混合方法的在线调查由 135 名经历过美国不孕不育的育龄人士完成。调查结果包括寻求或继续生育保健的驱动因素和障碍。使用卡方和 Fisher 精确检验比较了根据治疗史确定的因素。通过对 6 项开放式回复项目的 174 项回复进行常规内容分析，确定了主题和模式：主题分析揭示了在寻求治疗（67%）的决策中存在实际（环境、财务和身体）和情感（情感、社会和精神）维度的健康，在决定继续治疗的决策中，情感推理更为突出（78%）。寻求生育保健的决策和在治疗失败后返回的决策整合了来自财务、身体、环境、情感、社会和精神健康维度的实际和情感推理。应考虑这些维度内的驱动因素和障碍，以鼓励寻求治疗并提高患者保留率。
