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首页> 外文期刊>Human Reproduction >Patients' and professionals' barriers and facilitators of tailored expectant management in subfertile couples with a good prognosis of a natural conception.
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Patients' and professionals' barriers and facilitators of tailored expectant management in subfertile couples with a good prognosis of a natural conception.

机译：在生育能力良好的夫妇中，患者和专业人员的障碍以及对生育能力较弱的夫妇进行量身定制的预期管理的促进因素。

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BACKGROUND: European guidelines on fertility care emphasize that subfertile couples should receive information about their chances of a natural conception and should not be exposed to unnecessary treatments and risks. Prognostic models can help to estimate their chances and select couples with a good prognosis for tailored expectant management (TEM). Nevertheless, TEM is not always practiced. The aim of this study was to identify any barriers or facilitators for TEM among professionals and subfertile couples. METHODS: A qualitative study was performed with semi-structured in-depth interviews of 21 subfertile patients who were counselled for TEM and three focus-group interviews of 21 professionals in the field of reproductive medicine. Two theoretical models were used to guide the interviews and the analyses. The primary outcome was the set of identified barriers and facilitators which influence implementation of TEM. RESULTS: Among the subfertile couples, main barriers were a lack of confidence in natural conception, a perception that expectant management is a waste of time, inappropriate expectations prior to the first consultation, misunderstanding the reason for expectant management and overestimation of the success rates of treatment. Both couples and professionals saw the lack of patient information materials as a barrier. Among professionals, limited knowledge about prognostic models leading to a decision in favour of treatment was recognized as a main barrier. A main facilitator mentioned by the professionals was better management of patients' expectations. CONCLUSIONS: We identified several barriers and facilitators which can be addressed to improve the implementation of TEM. These should be taken into account when designing future implementation strategies.
机译：背景：欧洲关于生育保护的准则强调，未生育夫妇应获得有关其自然受孕机会的信息，并且不应遭受不必要的治疗和风险。预后模型可以帮助估计他们的机会，并选择对预后良好的预期管理（TEM）有良好预后的夫妇。然而，TEM并不总是被实践。这项研究的目的是确定专业人士和不育夫妇中TEM的任何障碍或促进者。方法：定性研究进行了半结构化的深入访谈，对21名接受TEM咨询的可生育患者进行了访谈，并进行了对21名生殖医学领域专家的重点小组访谈。两种理论模型被用来指导访谈和分析。主要结果是确定了影响TEM实施的障碍和促进因素。结果：在生育力较弱的夫妻中，主要障碍是对自然观念的缺乏信心，对预期管理的浪费，对第一次咨询之前的预期不当，误解了预期管理的原因以及对成功率的过高估计的看法。治疗。夫妻和专业人员都认为缺乏患者信息材料是一个障碍。在专业人员中，公认的主要障碍是对预后模型的了解有限，导致无法做出有利于治疗的决定。专业人士提到的一个主要促进因素是更好地管理患者的期望。结论：我们确定了一些障碍和促进者，可以解决这些问题并改善TEM的实施。在设计未来的实施策略时应考虑这些因素。

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