Patient centred care in infertility health care: direct and indirect associations with wellbeing during treatment.
OBJECTIVE
To investigate whether different dimensions of patient centred care (PCC) were directly associated with wellbeing or indirectly, via lower concerns about medical procedures and/or increased tolerability of treatment.


METHODS
Cross-sectional study with 322 women and 111 men undergoing fertility diagnosis or treatment recruited online and in clinical setting. Participants completed questionnaires that assess PCC (PCQ-Infertility), individual (BSI Anxiety and Depression subscales) and relational wellbeing (FertiQoL Relational Domain), treatment concerns (CART Procedural Concerns scale) and tolerability (FertiQoL Tolerability Domain) and they filled a socio-demographic and fertility data file.


RESULTS
All dimensions of PCC were positively associated with better wellbeing except for organization of care. Information provision and continuity of care were indirectly associated with better individual wellbeing, the first via lower treatment concerns and the second via higher treatment tolerability. Competence, accessibility, continuity and communication were indirectly associated with better relational wellbeing via higher treatment tolerability.


CONCLUSIONS
Patient centred care promotes wellbeing during treatment. PCC is directly associated to wellbeing but also indirectly. The mode of action of the different PCC dimensions on wellbeing varies.


PRACTICAL IMPLICATIONS
To promote patients' wellbeing during treatment clinics should provide treatment related information and allow patients to establish a stable clinical relationship with a trustworthy and competent physician.
['Gameiro|Sofia|S|', 'Canavarro|Maria Cristina|MC|', 'Boivin|Jacky|J|']
D000328:Adult D001007:Anxiety D003142:Communication D003430:Cross-Sectional Studies D003863:Depression D005260:Female D006801:Humans D007246:Infertility D008297:Male D017060:Patient Satisfaction D018802:Patient-Centered Care D010549:Personal Satisfaction D010817:Physician-Patient Relations D057285:Precision Medicine D011569:Psychiatric Status Rating Scales D011788:Quality of Life D027724:Reproductive Techniques, Assisted D011795:Surveys and Questionnaires D055815:Young Adult
Infertility Anxiety Depression FertiQoL Patient centered care Quality of life