Priorities for family building among patients and partners seeking treatment for infertility.
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2017-04-05
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BACKGROUND: Infertility treatment decisions require people to balance multiple priorities. Within couples, partners must also negotiate priorities with one another. In this study, we assessed the family-building priorities of couples prior to their first consultations with a reproductive specialist. METHODS: Participants were couples who had upcoming first consultations with a reproductive specialist (N = 59 couples (59 women; 59 men)). Prior to the consultation, couples separately completed the Family-Building Priorities Tool, which tasked them with ranking from least to most important 10 factors associated with family building. We describe the highest (top three) and lowest (bottom three) priorities, the alignment of priorities within couples, and test for differences in prioritization between men and women within couples (Wilcoxon signed rank test). RESULTS: Maintaining a close and satisfying relationship with one's partner was ranked as a high priority by majorities of men and women, and in 25% of couples, both partners ranked this factor as their most important priority for family building. Majorities of men and women also ranked building a family in a way that does not make infertility obvious to others as a low priority, and in 27% of couples, both partners ranked this factor as the least important priority for family building. There were also differences within couples that involved either men or women ranking a particular goal more highly than their partners. More women ranked two factors higher than did their partners: 1) that I become a parent one way or another (p = 0.015) and 2) that I have a child in the next year or two (p < 0.001), whereas more men ranked 4 factors higher than their partners: 1) that our child has [woman's] genes (p = 0.025), 2) that our child has [man's] genes (p < 0.001), 3) that I maintain a close relationship with my partner (p = 0.034), and 4) that I avoid side effects from treatment (p < 0.001). CONCLUSIONS: Clinicians who support patients in assessing available family-building paths should be aware that: (1) patients balance multiple priorities as a part of, or beside, becoming a parent; and (2) patients and their partners may not be aligned in their prioritization of achieving parenthood. For infertility patients who are in relationships, clinicians should encourage the active participation of both partners as well as frank discussions about each partner's priorities for building their family.
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Duthie, Elizabeth A, Alexandra Cooper, Joseph B Davis, Jay Sandlow, Katherine D Schoyer, Estil Strawn and Kathryn E Flynn (2017). Priorities for family building among patients and partners seeking treatment for infertility. Reprod Health, 14(1). p. 52. 10.1186/s12978-017-0311-8 Retrieved from https://hdl.handle.net/10161/14244.
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Alexandra Cooper
Alexandra Cooper serves as Associate Director for Evaluation and Assessment within the Purpose Project in the Kenan Institute for Ethics. She supports the Project in making question of character, purpose and meaning signature features of the Duke community by gathering evidence about the Project's programs and their effects and by working with Project team members to examine and understand what that evidence shows us about what the Project does and can accomplish.
Prior to joining the Purpose Project she worked at Duke's Social Science Research Institute, first as its Administrative Director and subsequently as its Associate Director for Education and Training. She has guided and directed a wide range of collaborative educational programming and services and devoted effort to a wide range of research projects, supporting both quantitative and qualitative data collection, management, analysis, and reporting. Prior to coming to Duke, she held faculty positions at Lafayette College and the University of North Carolina - Charlotte. She holds a B.A. in Political and Social Thought and in French from the University of Virginia and a Ph.D. in Political Science from the University of North Carolina - Chapel Hill.
Kathryn Eve Flynn
Kathryn E. Flynn, PhD, is an adjunct assistant professor in psychiatry and behavioral sciences at the Duke University School of Medicine. She works primarily at the Duke Clinical Research Institute.
Dr. Flynn was trained in sociology and population health sciences at the University of Wisconsin, where she worked with Maureen Smith on the development and fielding of new survey instruments to assess health care access and utilization in the near elderly as part of the Wisconsin Longitudinal Study, a long-term cohort study with over 10,000 participants. In 2005, Dr. Flynn was awarded an R36 dissertation grant from the Agency for Healthcare Research and Quality to use the Wisconsin Longitudinal Study to examine preferences for health care decision making among older adults. Findings from this research have been published in Social Science and Medicine and the Journal of General Internal Medicine. As a postdoctoral fellow at the Duke Clinical Research Institute, Dr. Flynn trained under Kevin Weinfurt, gaining experience in the design and analysis of patient-reported outcomes in clinical trials.
Dr. Flynn's research interests include shared medical decision making; patient-provider relationships, including communication, trust, and technology; quality of medical care; patient-reported outcomes in clinical trials; and quantitative and qualitative methods in behavioral research.
Areas of Expertise: Health Measurement, Health Services Research, and Health Behavior
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