title: How patient-centred care relates to patients' quality of life and distress: a study in 427 women experiencing infertility.
abstract: BACKGROUND
  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, R² 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% (=R²) 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.
authors: Department of Obstetrics and Gynaecology, 791,  Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen,  The Netherlands.
authors: J W M
authors: JW
authors: Aarts
authors: A G
authors: AG
authors: Huppelschoten
authors: I W H
authors: IW
authors: van Empel
authors: J
authors: J
authors: Boivin
authors: C M
authors: CM
authors: Verhaak
authors: J A M
authors: JA
authors: Kremer
authors: W L
authors: WL
authors: Nelen
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities; D001007:Anxiety / Q000209:etiology*; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology*; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000523:psychology* / Q000628:therapy*; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D057285:Precision Medicine; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D043762:Reproductive Behavior; D027724:Reproductive Techniques, Assisted / Q000009:adverse effects*; D011795:Surveys and Questionnaires; D055815:Young Adult