P–494 The relationship between the infertility specialist and the patient during the COVID–19 pandemic
Authors: Iordăchescu D 
Published: August 2021

Abstract

Study question
What are the basic elements of the infertility specialist - patient relationship?

Summary answer
For study participants, elements such as empathy, communication, collaboration and trust are important factors in increasing compliance and satisfaction with treatment.

What is known already
In the literature, the doctor-patient relationship is seen as fundamental in the treatment of infertility, due to the emotional implications of fertilization procedures. However, not much data is available specifically for this relationship. Communication and interpersonal skills, empathy, trust, collaboration, compliance and satisfaction are essential elements in this medical context.

Study design, size, duration
A cross-sectional study was conducted between May and June 2020 and follows the methods of a quantitative analysis, the data being collected using questionnaires. The research plan is one specific to the path analysis with mediation effect, in which the hypotheses were tested.

Participants/materials, setting, methods
The research group consists of 151 women diagnosed with infertility, voluntarily recruited through online support communities. Self-reported questionnaires provided socio-demographic information, information related to infertility, as well as information on the relationship of patients with specialists. In order to test the proposed hypotheses, an analysis of structural equations was performed, using the AMOS 20 program.

Main results and the role of chance
According to statistical indicators, CMIN / DF = 2.124, RMSEA = .087 and the p value of the Chi-square is less than 5% significance level, the model proposed is accepted. Based on the reported NFI and CFI values ​​(.777 and .867), as well as the values of ​​RFI = .763, IFI = .868 and TLI = .859, it can be concluded that the model is appropriate for the sample data. The p value of all constructors is less than .05, except for trust in doctor - cognitive empathy and patient satisfaction. All the others paths are significant: the effect of communication on treatment compliance, mediated by trust in specialist and collaboration; the effect on communication on treatment compliance, mediated by affective empathy, trust in specialist and collaboration; the effect on communication on patient satisfaction, mediated by affective empathy and trust in doctor; the direct effect of communication on trust in doctor, as well as the mediated effect by affective empathy. Regarding the relationship with doctor during the COVID–19 pandemic, 33% of the study participants stated that the pandemic affected the relationship with doctor, and 44% discontinued contact with specialist and medical procedures between March and June 2020.

Limitations, reasons for caution
Only infertile, voluntary women participated in this study, which limits the generalizability to other populations. Because the data are cross-sectional and correlational, the direction of causation is not proven. Additional experimental research on larger populations is needed to examine the effects of communication on patient satisfaction and compliance.
Wider implications of the findings: The study draws attention to the importance of basic concepts in the relationship of specialists with infertile patients. Thus, it is necessary for health care providers in assisted human reproduction to participate in programs for the continuous training of empathic communication skills, given the sensitivity of this diagnosis.

Trial registration number
Not applicable