Patient-Centered Fertility Care in Kazakhstan: Preliminary Cultural Adaptation of a Fertility-Care Survey and Patient–Staff Perception Gaps in Two Assisted-Reproduction Clinics
Background: Patient-centered care is particularly important in assisted reproductive technology, where treatment is clinically demanding and emotionally intensive. This study documented a preliminary cultural and linguistic adaptation of a fertility-care survey for Kazakhstan and evaluated patient–staff perception gaps, item-level priorities, preliminary reliability, and exploratory associations with global care ratings. Methods: A cross-sectional survey was conducted in two assisted-reproduction clinics in Almaty. The analytic workbook contained 273 patient and 74 staff records; 173 patient response patterns were unique and 100 records matched an earlier exact pattern. Group-level patient–staff comparisons between independent respondent samples used prespecified harmonized indices, Welch tests, false-discovery-rate correction, clinic-stratified analyses, and one-pattern-per-record sensitivity analyses. Importance–experience differences were calculated within respondents with both values available. Global-rating regressions used HC3 robust inference and were treated as exploratory. Results: Staff rated cost, attitude and communication, information and education, and participation more favorably, whereas patients rated privacy, emotional support, and continuity more favorably. Accessibility and competence showed little difference. Clinic-stratified and one-pattern-per-record analyses preserved the principal contrast directions, although the Physical Comfort proxy was not robust. Several indices showed weak or negative internal consistency. Global ratings had a marked ceiling, with 79.1% at 10/10, and the HC3 joint test for the added care-index block was not significant (p = 0.080). Conclusions: This exploratory survey identified substantial, bidirectional group-level patient–staff differences and concrete item-level priorities, but the scoring and psychometric evidence are insufficient to interpret the domain indices as established measurement scales. Source-codebook verification and broader structural validation are required.
Authors
- Maral G. Nogayeva
- Alireza Afshar (ORCID: https://orcid.org/0000-0002-8618-5872)
- Aiman Musina
- Akmaral Mussakhanova (ORCID: https://orcid.org/0000-0002-0399-5045)
- Ardak Nurbakyt (ORCID: https://orcid.org/0000-0002-4854-6809)
- Lyudmila S. Yermukhanova
- Aigerim T. Kushtekova
- Vyacheslav N. Lokshin
- Aigul Y. Tazhiyeva
Institutions
- Kazakh National Medical University (KZ)
- National Academy of Sciences of the Republic of Kazakhstan (KZ)
- West Kazakhstan Marat Ospanov State Medical University (KZ)
- Astana Medical University (KZ)
- Bushehr University of Medical Sciences (IR)
Publication Details
- Journal
- Healthcare
- Published
- 2026-09-10
- DOI
- https://doi.org/10.3390/healthcare14182941
- Primary Topic
- Reproductive Health and Technologies
- Type
- article
- Field-Weighted Citation Impact
- 0.00