Relationship between quality of life and distress in infertility: a validation study of the Dutch FertiQoL

BACKGROUND: This study examined the relationship between emotional distress as measured by the Hospital Anxiety and Depression Scale (HADS) and the Fertility Quality of Life (FertiQoL) questionnaire. METHODS: The FertiQoL and HADS were distributed to a random sample of 785 patients attending 29 Dutch clinics for medically assisted reproduction. FertiQoL was psychometrically tested for reliability. Pearson's correlations were calculated between subscales of FertiQoL and HADS. Using an independent t-test, differences between patient subgroups were computed for both instruments. The threshold for clinically meaningful depression/anxiety on the HADS subscales was used to ascertain the critical threshold for high distress on the FertiQoL scales. RESULTS: FertiQoL and HADS were completed by 583 patients (response 74%). Reliability of FertiQoL scales was high (reliability coefficient between 0.72 and 0.91). Significant negative correlations were found between FertiQoL subscales and HADS scores for anxiety and depression, ranging from -0.29 to -0.71. Means on FertiQoL scales and HADS scales of couples undergoing an assisted reproductive technology (ART) treatment and a non-ART treatment did not differ significantly. Patients scoring above the HADS threshold for pathology on anxiety had an average FertiQoL score of 58.8, whereas patients exceeding the HADS depression threshold had a FertiQoL total score of 51.9 (range 0-100). CONCLUSIONS: Our study confirms the expected negative relation between quality of life as measured by FertiQoL and anxiety and depression. The data support that FertiQoL reliably measures QoL in women facing infertility. FertiQoL enables clinicians to tailor care more specifically to the patient in a comprehensive way

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

Item does not contain fulltextBACKGROUND: 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, R(2) 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% (=R(2)) 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.1 februari 201

Patients from across Europe have similar views on patient-centred care: an international multilingual qualitative study in infertility care.

The PCIC-model is the first patient-centred care (PCC) model based on the patients' perspective to be validated in an international setting. Although health-care organization and performance differ, the similarities between countries in the infertile patients' perspective were striking, as were the similarities with PCC models from other clinical conditions. A non-condition specific international PCC model and a European instrument for the patient centredness of infertility care could be developed. European professionals can learn from each other on how to provide PCC