L Borghi1, D Leone2,3, S Poli2, C Becattini4, E Chelo5, M Costa6, L De Lauretis7, A P Ferraretti8, C Filippini9, G Giuffrida10, C Livi5, A Luehwink11, R Palermo12, A Revelli13, G Tomasi10, F Tomei14, E Vegni2,3. 1. Department of Health Sciences, University of Milan, 20142, Milan, Italy. lidia.borghi@unimi.it. 2. Department of Health Sciences, University of Milan, 20142, Milan, Italy. 3. San Paolo University Hospital, Asst-Santi Paolo e Carlo, 20142, Milan, Italy. 4. Futura Assisted Reproductive Center, 50129, Florence, Italy. 5. Demetra Assisted Reproductive Center, 50141, Florence, Italy. 6. Ospedale Evangelico Internazionale, Assisted Reproductive Unit, 16122, Genoa, Italy. 7. Istituto Clinico Città Studi, Assisted Reproductive Center, 20131, Milan, Italy. 8. S.I.S.Me.R. Reproductive Medicine Unit, 40138, Bologna, Italy. 9. Department of Surgical Sciences, University of Turin, 10126, Turin, Italy. 10. CRA, Assisted Reproductive center, 95128, Catania, Italy. 11. Azienda Provinciale per i Servizi Sanitari-Provincia Autonoma di Trento, Assisted Reproductive Unit, 38123, Arco, Italy. 12. Ambra Assisted Reproductive Center, 90138, Palermo, Italy. 13. Gynecology and Obstetrics I, Physiopathology of Reproduction and IVF Unit, Department of Surgical Sciences, S. Anna Hospital, University of Torino, 10126, Torino, Italy. 14. Azienda Ospedaliera Santa Maria degli Angeli, 33170, Pordenone, Italy.
Abstract
PURPOSE: To explore the association between patient-centered communication, patients' satisfaction, and retention in care in assisted reproductive technology (ART) visits. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
PURPOSE: To explore the association between patient-centered communication, patients' satisfaction, and retention in care in assisted reproductive technology (ART) visits. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.