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.