Donor-centred care: the facilitating and constraining factors experienced by gamete donors in a public bank

Abstract

The provision of care that is responsive to the preferences, needs and values of gamete donors is key to improving their recruitment and ensuring the functioning of gamete banks. This qualitative study aimed to explore gamete donors’ experiences about the facilitating and constraining human and system factors to donor-centred healthcare delivery in gamete banks. It is based on 20 semi-structured interviews with oocyte and sperm donors, recruited at the Portuguese Public Bank of Gametes, conducted from November 2017 to February 2019. Deductive content analysis was performed using the software NVivo12, following the patient-centred infertility care model. Interviewees identified facilitating factors mostly related with the human dimension of care (i.e. careful and available attitude and behaviours of health professionals, as well as their good communication skills and emotional support). Constraining factors were predominantly identified at the system level (i.e. insufficient information provision, poor coordination, and integration). Lack of privacy emerged simultaneously as a human and a system constraining factor (i.e. physical discomfort during medical-technical acts or gamete collection). There is room for improving clinical practice and the organisation of healthcare services within a context where the competence and attitude of, and relationship with, the staff are highly valued.

Keywords:

• Patient-centred care
• donor conception
• reproductive techniques, assisted
• health services research
• infertility
• quality of health care

Acknowledgments

The authors thank the health professionals and staff of the Portuguese Public Bank of Gametes who collaborated in the participants’ recruitment; and Ana Moura, Inês Baía, Liliana Abreu and Sandra Pinto da Silva, for the transcription of the interviews.

Author contributions

Samorinha C and Silva S designed the study and carried out data analysis. Samorinha C wrote the first draft of the manuscript and collected the data. All authors gave a substantial contribution to the interpretation of data, critical discussion, and revision of the manuscript, and approved its final version.

Disclosure statement

The authors declare that they have no conflicts of interest to disclose.

Additional information

Funding

This work was supported by national funding from the Foundation for Science and Technology – FCT (Portuguese Ministry of Science, Technology and Higher Education), the Operational Programmes Competitiveness and Internationalization [COMPETE 2020] and Human Capital (POCH), Portugal 2020, and the European Union, through the European Regional Development Fund and the European Social Fund, under the project POCI-01-0145-FEDER-016762, Ref. FCT PTDC/IVC-ESCT/6294/2014, the Unidade de Investigação em Epidemiologia - Instituto de Saúde Pública da Universidade do Porto (EPIUnit) [UIDB/04750/2020], the contract Ref. DL57/2016/CP1336/CT0001 (De Freitas C) and the FCT Investigator contract IF/01674/2015 (Silva S).