Patient-Centered Fertility Care in Kazakhstan: Preliminary Cultural Adaptation of a Fertility-Care Survey and Patient–Staff Perception Gaps in Two Assisted-Reproduction Clinics

A.T. Kushtekova, Maral G. Nogayeva, Lyudmila S. Yermukhanova, Vyacheslav N. Lokshin, Ardak N. Nurbakyt, Aigul Y. Tazhiyeva, Aiman A. Musina, Akmaral Mussakhanova, Alireza Afshar

2026

Full text Open access: Gold Metadata (CSL-JSON)
DOI 10.3390/healthcare14182941
Data confidence 70 medium
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Abstract

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.