176 Chapter 8 Table 1. Examples of questions per FertiQoL domain. Domain Example 1. Mind-body Do you feel drained or worn out because of your fertility problems? 2. Relational Have fertility problems had a negative impact on your relationship with your partner? 3. Social Are you socially isolated because of fertility problems? 4. Emotional Do you feel sad and depressed about your fertility problems? 5. Environment Are you satisfied with the quality of services available to you to address your emotional needs? 6. Tolerability Are you bothered by the effect of treatment on your daily or work related activities? The ECQ is a validated questionnaire evaluating the patient-centeredness of endometriosis care (8, 9). It contains 38 aspects that are assessed using a 4-point Likert scale. Both performance and the importance of the care aspects are rated. The 38 aspects can be divided into 10 categories of patient-centred care: (i) respect for patients’ values, preferences and expressed needs; (ii) coordination and integration of care; (iii) information and communication; (iv) physical comfort; (v) emotional support and alleviation of fear and anxiety; (vi) involvement of the significant other; (vii) continuity and transition; (viii) access to care; (ix) technical skills; and (x) endometriosis clinic staff (Table 2). The outcomes are converted to scores ranging from 0 to 100 for each category. The patient-centeredness scores from the same university hospital obtained by Schreurs and colleagues are used as a reference population (10). The healthcare provider questionnaire consisted of two different subsections: (i) demographics and (ii) assessment of virtual care. The questions used mirrored the questions in the patient questionnaires on virtual care (Supplementary information). When respondents did not complete the full questionnaire but did complete one or more sections, the completed sections were included in the analysis. Timeline of COVID-19 restrictions From 16 March 2020 the Netherlands was in the first lockdown and all elective and non-essential care was paused at that point. Fertility treatments that had started before the 16th of March were completed, but new or subsequent cycles were cancelled. Endometriosis consultations, investigations and surgeries were all cancelled, and only emergency consultations in cases of severe pain or bleeding were possible. From midMay 2020 planned care was able to slowly restart in the Netherlands.
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