title: What is the role of nephrologists and nurses of the dialysis department in providing fertility care to CKD patients? A questionnaire study among care providers.
abstract: OBJECTIVE
  This study evaluated current fertility care for CKD patients by assessing the perspectives of nephrologists and nurses in the dialysis department.
  
  
  METHODS
  Two different surveys were distributed for this cross-sectional study among Dutch nephrologists (N = 312) and dialysis nurses (N = 1211).
  
  
  RESULTS
  Response rates were 50.9% (nephrologists) and 45.4% (nurses). Guidelines on fertility care were present in the departments of 9.0% of the nephrologists and 15.6% of the nurses. 61.7% of the nephrologists and 23.6% of the nurses informed ≥50% of their patients on potential changes in fertility due to a decline in renal function. Fertility subjects discussed by nephrologists included "wish to have children" (91.2%), "risk of pregnancy for patients' health" (85.8%), and "inheritance of the disease" (81.4%). Barriers withholding nurses from discussing FD were based on "the age of the patient" (62.6%), "insufficient training" (55.2%), and "language and ethnicity" (51.6%). 29.2% of the nurses felt competent in discussing fertility, 8.3% had sufficient knowledge about fertility, and 75.7% needed to expand their knowledge. More knowledge and competence were associated with providing fertility health care (p < 0.01).
  
  
  CONCLUSIONS
  In most nephrology departments, the guidelines to appoint which care provider should provide fertility care to CKD patients are absent. Fertility counseling is routinely provided by most nephrologists, nurses often skip this part of care mainly due to insufficiencies in self-imposed competence and knowledge and barriers based on cultural diversity. The outcomes identified a need for fertility guidelines in the nephrology department and training and education for nurses on providing fertility care.
authors.affiliation: Department of Urology, Leiden University Medical Center, Albinusdreef 2, PO Box 9600, 2300 RC, Leiden, The Netherlands. G.F.van_Ek@lumc.nl.
authors.forename: Gaby F
authors.initials: GF
authors.lastname: van Ek
authors.affiliation: Department of Urology, Leiden University Medical Center, Albinusdreef 2, PO Box 9600, 2300 RC, Leiden, The Netherlands.
authors.forename: Esmée M
authors.initials: EM
authors.lastname: Krouwel
authors.affiliation: Department of Urology, Leiden University Medical Center, Albinusdreef 2, PO Box 9600, 2300 RC, Leiden, The Netherlands.
authors.forename: Melianthe P J
authors.initials: MPJ
authors.lastname: Nicolai
authors.affiliation: Department of Medical and Clinical Psychology and Centre of Research on Psychological and Somatic Disorders, Tilburg University, Tilburg, The Netherlands.
authors.forename: Brenda L
authors.initials: BL
authors.lastname: Den Oudsten
authors.affiliation: Saxion, University of Applied Sciences, Enschede, The Netherlands.
authors.forename: Marjolein E M
authors.initials: MEM
authors.lastname: Den Ouden
authors.affiliation: Department of Gynecology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Sandra W M
authors.initials: SWM
authors.lastname: Dieben
authors.affiliation: Department of Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Hein
authors.initials: H
authors.lastname: Putter
authors.affiliation: Department of Urology, Leiden University Medical Center, Albinusdreef 2, PO Box 9600, 2300 RC, Leiden, The Netherlands.
authors.forename: Rob C M
authors.initials: RCM
authors.lastname: Pelger
authors.affiliation: Department of Urology, Leiden University Medical Center, Albinusdreef 2, PO Box 9600, 2300 RC, Leiden, The Netherlands.
authors.forename: Henk W
authors.initials: HW
authors.lastname: Elzevier
mesh_terms: D000328:Adult; D000368:Aged; D002983:Clinical Competence; D003144:Communication Barriers; D003430:Cross-Sectional Studies; D054521:Cultural Competency; D004501:Education, Medical; D004506:Education, Nursing; D005260:Female; D005298:Fertility; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007802:Language; D008297:Male; D008875:Middle Aged; D009398:Nephrology / Q000193:education; D009426:Netherlands; D024802:Nurse's Role; D010044:Outpatient Clinics, Hospital; D010353:Patient Education as Topic; D010819:Physician's Role; D017410:Practice Guidelines as Topic; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000503:physiopathology* / Q000628:therapy; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Chronic kidney disease; Fertility care; Practice patterns; Questionnaires; Renal care providers