Exploring patient-centred care and help-seeking behaviour among infertile females in Jeddah governorate, Saudi Arabia: a mixed method approach

This thesis aims to explore the concept of PCIC, to develop and validate an instrument to measure it, and to determine the relationship of PCIC with the helpseeking behaviour (HSB) among Arab infertile women. It was conducted in Jeddah Governorate, Saudi Arabia in three phases from January 2017 t...

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Main Author: Webair, Hana Hasan Mohammed
Format: Thesis
Language:English
Published: 2023
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Online Access:http://eprints.usm.my/60342/1/HANA%20HASAN%20MOHAMMED%20WEBAIR-FINAL%20THESIS%20P-UD001016%28R%29-E.pdf
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spelling my-usm-ep.603422024-04-18T04:54:31Z Exploring patient-centred care and help-seeking behaviour among infertile females in Jeddah governorate, Saudi Arabia: a mixed method approach 2023-10 Webair, Hana Hasan Mohammed R Medicine RA440-440.87 Study and teaching. Research RC870-923 Diseases of the genitourinary system. Urology This thesis aims to explore the concept of PCIC, to develop and validate an instrument to measure it, and to determine the relationship of PCIC with the helpseeking behaviour (HSB) among Arab infertile women. It was conducted in Jeddah Governorate, Saudi Arabia in three phases from January 2017 to December 2022 using mixed-method approach. Phase I was a qualitative study that explored the concept of PCIC among infertile women who received medical care within the last six months. Women were recruited purposefully until saturation was reached. Fourteen in-depth interviews were conducted and analysed by inductive-deductive thematic analysis. Phase II was a validation study to develop and validate a Patient-Centred Infertility Questionnaire for Female clients (PCIQ-F). PCIC-F was formulated in the light of the results of the qualitative study and literature review. A pilot study was then carried out on an online convenience sample of 201 infertile women to define PCIQ-F latent constructs using exploratory factor analysis. Furthermore, a field study was undertaken on 316 infertile women to test PCIQ-F psychometric properties and to produce the final version. Phase III was a cross-sectional online survey which examined the relationship of HSB with the PCIC during the last six months by logistic regression and path analysis in structural equation modelling. The moderation effect of the type of infertility treatment on this relationship was tested by multi-group analysis. The tool was PCIQ-F with added questions about the concurrent use of non-medical treatment during infertility medical care. A total of 466 women were included. Phase I identified nine PCIC dimensions valued by Arab women; accessibility; minimising costs; staff attitude and communication; information and education; physical comfort; privacy; staff competence; psychological and emotional support; and continuity and coordination of care. PCIQ-F comprises four sections: introduction, background characteristics, PCIC, and overall quality assessment. PCIC section is divided into four domains (24 items): comprehensiveness of care, communication and information; patient education and support; patient empowerment; and physical comfort. Statistical analysis proved the validity and reliability of PCIQ-F. Phase III found no significant effect of PCIC on seeking non-medical care (p=0.078, AOR 0.86, 95%CI 0.73, 1.02). However, patient empowerment and physical comfort showed a significant effect, p=0.023, 0.032 AOR 1.20, 0.83 95%CI 1.02,1.41; 0.71,0.99, respectively. Furthermore, PCIC, patient empowerment, and physical comfort showed direct negative effect on the number of sources seen for infertility with p=0.001 for all, beta –1.29, -0.534,–0.257, S.E.0.128, 0.071,0.042, respectively. The type of infertility treatment partially moderated the relationship between PCIC and HSB. In conclusion, the concept of PCIC from Arab women’s perspectives embraces nine dimensions. Based on these dimensions, a valid and reliable tool (PCIQ-F) was developed. PCIC has a negative effect on seeking non-medical care, which is moderated by the treatment type. We recommend implementing PCIC in health facilities and measuring its implementation using PCIQ-F, which could improve women's HSB. 2023-10 Thesis http://eprints.usm.my/60342/ http://eprints.usm.my/60342/1/HANA%20HASAN%20MOHAMMED%20WEBAIR-FINAL%20THESIS%20P-UD001016%28R%29-E.pdf application/pdf en public phd doctoral Universiti Sains Malaysia Pusat Pengajian Sains Perubatan
institution Universiti Sains Malaysia
collection USM Institutional Repository
language English
topic R Medicine
R Medicine
R Medicine
spellingShingle R Medicine
R Medicine
R Medicine
Webair, Hana Hasan Mohammed
Exploring patient-centred care and help-seeking behaviour among infertile females in Jeddah governorate, Saudi Arabia: a mixed method approach
description This thesis aims to explore the concept of PCIC, to develop and validate an instrument to measure it, and to determine the relationship of PCIC with the helpseeking behaviour (HSB) among Arab infertile women. It was conducted in Jeddah Governorate, Saudi Arabia in three phases from January 2017 to December 2022 using mixed-method approach. Phase I was a qualitative study that explored the concept of PCIC among infertile women who received medical care within the last six months. Women were recruited purposefully until saturation was reached. Fourteen in-depth interviews were conducted and analysed by inductive-deductive thematic analysis. Phase II was a validation study to develop and validate a Patient-Centred Infertility Questionnaire for Female clients (PCIQ-F). PCIC-F was formulated in the light of the results of the qualitative study and literature review. A pilot study was then carried out on an online convenience sample of 201 infertile women to define PCIQ-F latent constructs using exploratory factor analysis. Furthermore, a field study was undertaken on 316 infertile women to test PCIQ-F psychometric properties and to produce the final version. Phase III was a cross-sectional online survey which examined the relationship of HSB with the PCIC during the last six months by logistic regression and path analysis in structural equation modelling. The moderation effect of the type of infertility treatment on this relationship was tested by multi-group analysis. The tool was PCIQ-F with added questions about the concurrent use of non-medical treatment during infertility medical care. A total of 466 women were included. Phase I identified nine PCIC dimensions valued by Arab women; accessibility; minimising costs; staff attitude and communication; information and education; physical comfort; privacy; staff competence; psychological and emotional support; and continuity and coordination of care. PCIQ-F comprises four sections: introduction, background characteristics, PCIC, and overall quality assessment. PCIC section is divided into four domains (24 items): comprehensiveness of care, communication and information; patient education and support; patient empowerment; and physical comfort. Statistical analysis proved the validity and reliability of PCIQ-F. Phase III found no significant effect of PCIC on seeking non-medical care (p=0.078, AOR 0.86, 95%CI 0.73, 1.02). However, patient empowerment and physical comfort showed a significant effect, p=0.023, 0.032 AOR 1.20, 0.83 95%CI 1.02,1.41; 0.71,0.99, respectively. Furthermore, PCIC, patient empowerment, and physical comfort showed direct negative effect on the number of sources seen for infertility with p=0.001 for all, beta –1.29, -0.534,–0.257, S.E.0.128, 0.071,0.042, respectively. The type of infertility treatment partially moderated the relationship between PCIC and HSB. In conclusion, the concept of PCIC from Arab women’s perspectives embraces nine dimensions. Based on these dimensions, a valid and reliable tool (PCIQ-F) was developed. PCIC has a negative effect on seeking non-medical care, which is moderated by the treatment type. We recommend implementing PCIC in health facilities and measuring its implementation using PCIQ-F, which could improve women's HSB.
format Thesis
qualification_name Doctor of Philosophy (PhD.)
qualification_level Doctorate
author Webair, Hana Hasan Mohammed
author_facet Webair, Hana Hasan Mohammed
author_sort Webair, Hana Hasan Mohammed
title Exploring patient-centred care and help-seeking behaviour among infertile females in Jeddah governorate, Saudi Arabia: a mixed method approach
title_short Exploring patient-centred care and help-seeking behaviour among infertile females in Jeddah governorate, Saudi Arabia: a mixed method approach
title_full Exploring patient-centred care and help-seeking behaviour among infertile females in Jeddah governorate, Saudi Arabia: a mixed method approach
title_fullStr Exploring patient-centred care and help-seeking behaviour among infertile females in Jeddah governorate, Saudi Arabia: a mixed method approach
title_full_unstemmed Exploring patient-centred care and help-seeking behaviour among infertile females in Jeddah governorate, Saudi Arabia: a mixed method approach
title_sort exploring patient-centred care and help-seeking behaviour among infertile females in jeddah governorate, saudi arabia: a mixed method approach
granting_institution Universiti Sains Malaysia
granting_department Pusat Pengajian Sains Perubatan
publishDate 2023
url http://eprints.usm.my/60342/1/HANA%20HASAN%20MOHAMMED%20WEBAIR-FINAL%20THESIS%20P-UD001016%28R%29-E.pdf
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