title: Women's experiences of infertility - towards a relational model of care.
abstract: OBJECTIVE
  To consider the effectiveness of current models of patient-centred infertility care.
  
  
  BACKGROUND
  Patient centredness is defined as one of six key dimensions of quality of care. In the field of infertility, a new interaction model of patient-centred infertility care is proposed. Despite positive moves, this model reveals shortcomings in knowledge about the lived experience of infertility and lacks the shift in attitudes and approach that effective patient-centred care requires.
  
  
  METHODS
  The study has a qualitative research design. Nine women living with and through infertility participated in online life-story interviews.
  
  
  METHODS
  Data were analysed using a layered strategy influenced by the voice-centred relational method, emphasising narrative content, form and function.
  
  
  RESULTS
  Women reveal a complex experience. Three key themes were found: Approaching the clinic narratives are infused with personal expectations while deeply reflective of cultural expectations and social norms. Relatedness recognises women's experiences cannot be neatly separated into distinct domains. Liminality and infertility describes women's experiences lost in transition through and beyond infertility treatment.
  
  
  CONCLUSIONS
  The current model of patient-centred infertility care requires further development. Women in this study found themselves lost in transition and irrespective of treatment failure or success. Conceptual development must embrace a relational understanding of patient's experience to ensure that patient-centred infertility care is realistic and relevant to patients, clinical staff and the system as a whole.
  
  
  CONCLUSIONS
  Psychosocial skills are recognised as core competences for fertility nurses. A relational conceptualisation of patient's experiences, living with and through infertility, provides further information for the development of staff and enhanced knowledge and practice skills.
authors.affiliation: School of Nursing, Midwifery and Health, University of Stirling, Stirling, UK.
authors.forename: Nicola
authors.initials: N
authors.lastname: Cunningham
authors.forename: Tom
authors.initials: T
authors.lastname: Cunningham
mesh_terms: D005260:Female; D006801:Humans; D007247:Infertility, Female; D008962:Models, Theoretical; D018802:Patient-Centered Care
keywords: fertility; nurse-patient relationship; nursing education; patient-centred care; quality of care; reproductive health