Date of Award

5-2024

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Program

Health Outcomes and Policy Research

Track

Health Policy

Research Advisor

J. Carolyn Graff, PhD

Committee

Erica C. Kaye, MD; Courtnee Melton-Fant, PhD; Simonne S. Nouer, MD; Janet Tucker, PhD; Shelley White-Means, PhD

Keywords

Advocacy;Health policy;Infertility;Patient support;Patient-centered care;Well-being

Abstract

While the effect of age and stress on fertility is widely known, those wishing to conceive children after career attainment or lengthy training programs are not adequately prepared with the knowledge or tools to mitigate the effects of these factors. Physicians and nurses, though trained to provide healthcare to others, are not immune to this struggle. In part due to the high prevalence of infertility in the United States (US), the lack of uniform policies to support this population, and the higher rates of infertility experienced by those in the healthcare field when compared to the general population, research focused on physicians and nurses is essential.

Given the high costs of treatment for infertility, as well as the increases in demand for assisted reproductive technologies (ART), such as in vitro fertilization (IVF), egg freezing, and fertility medications, the identification of appropriate support mechanisms that can reduce the burden of the disease is critical. Using a qualitative descriptive approach, this study examined the experiences of physicians and nurses affected by infertility in the state of Tennessee (TN). Semi-structured interviews and a demographic survey were used to generate thick, deep descriptions of the phenomenon, as well as to pinpoint stressors, actionable factors influencing the satisfaction of physicians and nurses seeking infertility care, and participant-proposed support resources. Data analysis from 30 individual interviews of physicians (n=13) and nurses (n=17) revealed three sub-themes for physicians: (1) physicians and the role of knowledge, (2) physician modes of communication, and (3) physicians and the function of externalities, two sub-themes for nurses: (1) nurses and interpersonal factors, and (2) external motivators for nurses, and three sub-themes shared between the two groups: (1) physicians, nurses, and individual identity, and (2) partnerships and marriages, which were then compressed into three overarching themes, (1) understanding, (2) relationships, and (3) support.

Overall, this research aims to fill an essential gap in understanding what stressors are experienced as a result of infertility, how they uniquely affect physicians and nurses working in TN, and what policy changes can be made to better support physicians and nurses with infertility. This study is one of the first to explore the lived experiences of physicians and nurses in TN affected by infertility. Additional work is needed to capture the experiences of healthcare providers with infertility working across the US and to examine the effects of adopting policies and programs to support those with infertility.

Declaration of Authorship

Declaration of Authorship is included in the supplemental files.

ORCID

0000-0002-7016-9800

DOI

10.21007/etd.cghs.2024.0655

Additional Files
2024-004-Clayton-DOA.pdf (164 kB)
Download

Available for download on Wednesday, May 06, 2026

Share

COinS