Examining decisional needs and contextual factors influencing fertility status assessment among young female survivors of childhood cancer: A sequential mixed methods study protocol.
Examining decisional needs and contextual factors influencing fertility status assessment among young female survivors of childhood cancer: A sequential mixed methods study protocol.
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DOI：
10.1371/journal.pone.0286511
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发表时间：
2023
期刊：
影响因子：
3.7
通讯作者：
中科院分区：
文献类型：
--
作者：
接受促性腺毒性癌症治疗的女性癌症幸存者有卵巢储备严重减少和/或原发性卵巢功能不全导致不孕的风险，这可能与痛苦和生活质量下降有关。尽管优先考虑未来的父母身份，但许多幸存者不确定其治疗对其未来生育能力的影响，对所感知的生殖健康需求和与接受生育状况评估（FSA）相关的因素知之甚少。对于新出现的成年癌症幸存者，缺乏与发育相适应的生殖健康决策支持干预措施。本研究将探讨新兴成年女性儿童癌症幸存者的生殖健康需求，并使用解释性顺序定量到定性混合方法设计确定影响追求生殖健康需求的决策和背景因素。本研究将招募来自美国四个癌症中心的325名女性幸存者（年龄在18至29岁之间，治疗后1年；诊断为癌症< 21岁）。社会人口和发展因素、生殖知识和价值观、决策需要以及获得服务方案将通过网络调查进行评估。根据调查结果，将招募一部分参与者进行定性访谈，以探讨与FSA采用相关的决策因素。临床数据将从病历中提取。将开发多变量逻辑回归模型来确定与金融服务体系相关的因素，定性描述性分析将用于从访谈中开发主题。定量和定性研究结果将通过联合展示合并，以形成综合研究结论并指导未来的介入性研究。
Female cancer survivors who received gonadotoxic cancer treatment are at risk for profound diminished ovarian reserve and/or primary ovarian insufficiency with resulting infertility, which can be associated with distress and decreased quality of life.. Despite prioritizing future parenthood, many survivors are unsure of the impact of their treatment on their future fertility, and little is known about the perceived reproductive health needs and factors associated with receipt of a fertility status assessment (FSA). There is a lack of developmentally appropriate reproductive health decisional support interventions available for emerging adult cancer survivors. This study will explore the perceived reproductive health needs of emerging adult female survivors of childhood cancer and to identify decisional and contextual factors that influence pursuit of FSA using an explanatory sequential quantitative to qualitative mixed methods design. This study will enroll 325 female survivors (aged 18 to 29 years and >1-year post treatment; diagnosed with cancer < age 21 years) from four cancer centers in the United States. Sociodemographic and developmental factors, reproductive knowledge and values, decisional needs, and receipt of an FSA will be assessed through a web-based survey. Informed by survey findings, a subset of participants will be recruited for qualitative interviews to explore decisional factors associated with uptake of an FSA. Clinical data will be abstracted from the medical records. Multivariable logistic regression models will be developed to identify factors associated with FSA and qualitative descriptive analysis will be used to develop themes from the interviews. Quantitative and qualitative findings will be merged using a joint display to develop integrated study conclusions and direct future interventional research.
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