| 1. |
- Holter, Herborg, 1960, et al.
(författare)
-
In vitro fertilization health care professionals generally underestimate patients’ satisfaction with quality of care
- 2017
-
Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : John Wiley & Sons. - 0001-6349 .- 1600-0412. ; 96:3, s. 302-312
-
Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Previous studies have mainly compared professionals' and patient's ratings of the importance of different care aspects, finding poor agreement between the groups concerning patient-centered quality of care. There is still little known about the professionals' knowledge of how patients' experience the quality of care they receive during in vitro fertilization (IVF) treatments. The aim of this study was to investigate how IVF health care professionals estimate patients' experience of patient-centered quality of care and if certain factors influenced the IVF professionals' perceptions and IVF patients' experience of quality of care.MATERIAL AND METHODS: All 16 IVF public and private clinics in Sweden participated in this cross sectional study. A total of 268 IVF health care professionals and 3298 patients (women and men) undergoing IVF treatment between January and May 2015 participated by answering the validated questionnaire "Quality from the patient's perspective of in vitro fertilization treatment" (QPP-IVF).RESULTS: Healthcare professionals significantly underestimated patients' satisfaction with the patient-centered quality of care they received in all aspects measured. Both patients and professionals rated the most deficient factors to be 'responsibility/continuity', 'participation' and 'availability'. Healthcare professionals and patients belonging to private clinics evaluated patient-centered care as significantly better than professionals and patients at public clinics in almost all aspects measured.CONCLUSION: The results of this study will increase the professionals understanding of the patients' experiences during IVF treatment and provide additional knowledge when identifying areas to prioritize in order to improve quality of care.
|
|
| 2. |
- Holter, Herborg, 1960, et al.
(författare)
-
Patient-centred quality of care in an IVF programme evaluated by men and women.
- 2014
-
Ingår i: Human reproduction (Oxford, England). - : Oxford University Press (OUP). - 1460-2350 .- 0268-1161. ; 29:12, s. 2695-2703
-
Tidskriftsartikel (refereegranskat)abstract
- Do men and women value the same aspects of quality of care during IVF treatment when measuring rates of importance by the validated instrument, quality from the patient's perspective of in vitro fertilization (QPP-IVF)?
|
|
| 3. |
|
|
| 4. |
- Cerne, Anna, et al.
(författare)
-
Pre-ovarian block versus paracervical block for oocyte retrieval.
- 2006
-
Ingår i: Human reproduction (Oxford, England). - : Oxford University Press (OUP). - 0268-1161 .- 1460-2350. ; 21:11, s. 2916-21
-
Tidskriftsartikel (refereegranskat)abstract
- A pre-ovarian block (POB) technique can be used for pain relief during oocyte retrieval in IVF. The local anaesthetic is deposited in the vaginal wall and between the vaginal wall and the peritoneal surface near the ovary using ultrasound guidance. The aim of this study was to test whether analgesia with POB resulted in improved pain relief compared to paracervical block (PCB).
|
|
| 5. |
- Gejervall, Ann-Louise, 1963, et al.
(författare)
-
Effect of alfentanil dosage during oocyte retrieval on fertilization and embryo quality.
- 2010
-
Ingår i: European journal of obstetrics, gynecology, and reproductive biology. - : Elsevier BV. - 1872-7654 .- 0301-2115. ; 150:1, s. 66-71
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: A possible negative effect of pain-relieving analgesics used during oocyte retrieval on fertilization and embryo development has been discussed. This study examines whether alfentanil dosage adversely affects fertilization and/or embryo quality. STUDY DESIGN: In a retrospective observational study the effect of different doses of alfentanil on two primary endpoints, fertilization rate and good quality embryo (GQE) rate, were compared in 663 women. RESULTS: In group A (0.5mg alfentanil) mean fertilization rate was 0.6+/-0.3 versus 0.6+/-0.2 (P=0.678, adjusted P=0.937, 95% CI for the difference -0.041; 0.044) and mean GQE rate was 0.6+/-0.3 versus 0.5+/-0.3 (P=0.207, adjusted P=0.179, 95% CI for the difference -0.015; 0.078), respectively. A paired comparison of 65 women who underwent repeated IVF cycles found that, compared with 0.5mg alfentanil had no adverse effects on fertilization rate (mean difference 0.05+/-0.3, P=0.231, 95% CI -0.02; 0.12) or GQE rate (mean difference -0.02+/-0.4, P=0.970, 95% CI -0.12; 0.09). CONCLUSION: The amount of alfentanil is not associated with adverse effects on fertilization rate, embryo development, or clinical pregnancy rate, which is reassuring and indicates that women can be offered adequate pain relief.
|
|
| 6. |
- Gejervall, Ann-Louise, 1963, et al.
(författare)
-
Electro-acupuncture versus conventional analgesia: a comparison of pain levels during oocyte aspiration and patients' experiences of well-being after surgery
- 2005
-
Ingår i: Hum Reprod. ; 20:3, s. 728-35
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The primary aims were to compare the pain-relieving effect and post-operative well-being between electro-acupuncture analgesia (EA) and conventional analgesia (CA) comprising opiates. Further aims were to compare time for mobilization, and costs for time and drug consumption. METHODS: In all, 160 women undergoing IVF were randomized, according to a computer-generated list, to EA or CA. Well-being was evaluated with the State Trait Anxiety Inventory (STAI). Pain and subjective expectations and experiences were recorded on a visual analogue scale (VAS). Time and drug consumption were recorded. RESULTS: Although VAS pain ratings were significantly higher at oocyte aspiration (P < 0.0001) and after retrieval (P < 0.01) in the EA than in the CA group, they were similar 60 min after surgery. Both groups had similar STAI well-being scores. The EA group was significantly less tired and confused than the CA group after oocyte aspiration. No significant differences in time and costs for drug consumption were noted. CONCLUSION: EA cannot generally be recommended as a pain-relieving method at oocyte aspiration but might be an alternative for women desiring a non-pharmacological method. An advantage of EA is less post-operative tiredness and confusion compared with CA.
|
|
| 7. |
- Gejervall, Ann-Louise, 1963, et al.
(författare)
-
Pain aspects in oocyte aspiration for IVF.
- 2007
-
Ingår i: Reproductive biomedicine online. - 1472-6483. ; 14:2, s. 184-90
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this observational two-centre study was to investigate different aspects of pain in oocyte aspiration in conjunction with IVF, whether the preoperative information to women was sufficient, and which factor(s) influenced a woman's sense of security. The study group comprised 124 women who underwent IVF treatment. The visual analogue scale (VAS) was used to measure pain, and multiple-choice questions were used to evaluate satisfaction and sense of security. The women rated expected pain significantly higher than mean pain during surgery (P < 0.0001). They would have accepted significantly more pain than they experienced (P < 0.0001). In a stepwise linear regression analysis, total dose of alfentanil was the only variable that was independently associated with mean pain. Satisfaction with the preoperative information was high. Women considered staff competence to be important for their sense of security. In conclusion, women rated oocyte aspiration to be less painful than they expected before surgery. This is important information for women who are about to start IVF treatment, since it might reduce apprehension about the level of pain that could be expected during oocyte aspiration.
|
|
| 8. |
- Gejervall, Ann-Louise, 1963
(författare)
-
Women's experience of pain and pain relief in assisted reproductive technology
- 2008
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis was to evaluate and compare different methods for pain relief during oocyte retrieval and to study women’s expectations and experiences of pain during oocyte retrieval in conjunction with in vitro fertilization. Paper I, an open prospective randomized controlled trial, including 160 women had the primary aims of comparing the pain relieving effects of electro-acupuncture and conventional analgesia, comprising opiates, in conjunction with oocyte retrieval, and to compare post-operative well-being between groups. For measurements of pain the Visual Analogue Scale (VAS) was used and post-operative well-being was assessed using the State Trait Anxiety Inventory test. Our findings showed that women who used electro-acupuncture had significantly more pain during surgery than women who received conventional analgesia. Well-being between groups was comparable. In paper II, a prospective single blinded randomized multicentre study with a total of 183 women two techniques for local anesthesia were compared; pre-ovarian block and paracervical block, in combination with conscious sedation. VAS and the McGill Pain Questionnaire were used for pain ratings. No significant difference between paracervical block and pre-ovarian block was found in terms of pain relieving effects. No differences in fertilization and embryo development were observed. Study III, an observational two-centre study of 124 women, evaluated women’s expectations regarding pain before oocyte retrieval and whether their experienced pain was in accordance with the expected pain. VAS and multiple choice questions of our own construction were used for measurements. It was found that women experienced significantly less pain during oocyte retrieval than they expected before surgery. Study IV was a retrospective study evaluating the effects of analgesic drugs used at oocyte retrieval, in particular different doses of alfentanil, on fertilization rate and/or embryo quality. A total of 663 women were included. Data was collected from the clinical database at Reproductive Medicine, Sahlgrenska University Hospital and from the women’s hospital records. No differences in fertilization rate or embryo quality were observed in relation to the amount of drug used for analgesia. In conclusion, the results of these studies showed that electro-acupuncture cannot generally be recommended as a general pain relief method for oocyte retrieval, but might be used as an alternative for women desiring a non-pharmacological method (Paper I). One advantage of electro-acupuncture was significantly less tiredness and confusion compared with conventional analgesia. Both pre-ovarian block and paracervical block offered good pain relief and were considered safe methods with rapid recovery and ease of administration and monitoring (Paper II). Since women experienced significantly less pain in conjunction with oocyte retrieval than they expected before surgery, this is important information for women who are about to start IVF. It might reduce their apprehension about pain levels during the procedure (Paper III). High doses of alfentanil compared to low doses were not associated with any adverse effects on fertilization rate, embryo development or clinical pregnancy rate, assuring that women can be offered adequate pain relief (Paper IV).
|
|
| 9. |
- Holter, Herborg, 1960, et al.
(författare)
-
Lost and lonely: a qualitative study of women's experiences of no embryo transfer owing to non-fertilization or poor embryo quality
- 2021
-
Ingår i: Human Reproduction Open. - : Oxford University Press (OUP). - 2399-3529. ; 2021:1
-
Tidskriftsartikel (refereegranskat)abstract
- STUDY QUESTION: What are the experiences of women undergoing IVF who could not receive an embryo transfer because of failed fertilization or poor embryo development? SUMMARY ANSWER: No embryo transfer because of failed embryo development is associated with considerable emotional suffering and the need for an early appointment with a physician to obtain information on what went wrong and new alternatives. WHAT IS KNOWN ALREADY: The psychological and emotional impact of IVF treatments as experienced by IVF patients is well known, particularly following the failure to achieve pregnancy. STUDY DESIGN, SIZE, DURATION: A qualitative study running from January 2018 to April 2019 was carried out at one public and one private IVF clinic. The invitation to participate was sent to women within 1month after the cycle failed. PARTICIPANTS/MATERIALS, SETTING, METHODS: The women undergoing IVF were diverse in terms of cause of infertility, age, number of previous cycles, country of birth and educational level. Nineteen of the 41 invited women who had experienced no embryo transfer because of non-fertilization or poor embryo development took part in a semi-structured interview. Data were analysed by thematic content analysis. MAIN RESULTS AND THE ROLE OF CHANCE: The master theme was identified as: 'Lost and lonely' organized in two main themes 'Experience of the event' and 'Perception of needs from healthcare providers'. Considerable emotional suffering was recognized after no embryo transfer. The need for support was expressed as to be offered an early appointment with a physician for information about what went wrong, looking at new alternatives and, for many women, providing information about counselling. LIMITATIONS, REASONS FOR CAUTION: Only women participated, not partners. Of the women invited, 46% participated. Several declined to participate because of high levels of emotional stress. WIDER IMPLICATIONS OF THE FINDINGS: Patients undergoing IVF and not achieving embryo transfer due to poor embryo development are a vulnerable group. They need early feedback concerning reasons for failure and future alternatives. They also require psychological support. This ought to be offered by IVF clinics.
|
|
| 10. |
|
|
| 11. |
- Svanberg, Agneta Skoog, et al.
(författare)
-
Gamete donors' satisfaction; Gender differences and similarities among oocyte and sperm donors in a national sample
- 2013
-
Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 92:9, s. 1049-1056
-
Tidskriftsartikel (refereegranskat)abstract
- Objective To explore oocyte and sperm donors' emotional stress, experiences of care and satisfaction after donation. Design Prospective multicenter study. Settings All fertility clinics performing gamete donation in Sweden during the period 2005 to 2008. Population Of 220 eligible oocyte donors who were approached, 181 agreed to complete the first questionnaire and 165 completed the second questionnaire 2 months after oocyte donation. Of 156 eligible sperm donors 119 accepted to complete the first questionnaire before donation. Eighty-nine participants completed the second questionnaire 2 months after sperm donation. Methods Standardized and study-specific questionnaires. Main outcome measures Satisfaction with the donation, respondents' mental health and overall care. Results A larger percentage of sperm donors (97.8%) were satisfied with their overall experience of being a donor than oocyte donors (85.9%, p = 0.003). Some oocyte and sperm donors did not receive sufficient information about practical issues (9.1% and 13.5%, respectively) and future consequences (12.8% and 3.4%, respectively, p = 0.014). The donors' symptoms of anxiety and depression did not show any differences in relation to negative or positive perceptions of satisfaction. The donors who did not indicate ambivalence before treatment were on average almost five times more satisfied compared with those who did indicate ambivalence (odds ratio 4.71; 95% CI 1.34-16.51). Conclusions Most donors were satisfied with their contribution after the donation. Oocyte and sperm donors who expressed ambivalence before donation were less satisfied after donation. In vitro fertilization staff fulfilled most of the donors' needs for information and care. © 2013 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons on behalf of Nordic Federation of Societies of Obstetrics and Gynecology.
|
|
