Perspectives surrounding fertility preservation and posthumous reproduction for adolescent and young adults with terminal cancer: Survey of allied health professionals.
Perspectives surrounding fertility preservation and posthumous reproduction for adolescent and young adults with terminal cancer: Survey of allied health professionals.
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虽然所有生殖年龄的癌症患者都应接受生育力保护（FP）咨询，但对青少年和年轻人（AYA）的最终诊断几乎没有指导，特别是在考虑死后辅助生殖（PAR）时。肿瘤生育卫生专业人员的丰富沟通技能（ECHO/ENRICH）培训专职卫生专业人员（AHPs），以改善与癌症AYA的沟通。对高级专业人员在协助计划生育和方案调整决策方面的作用知之甚少。这是一项针对ECHO/ENRICH学员对晚期癌症AYA患者FP和PAR的态度和经验的横断面调查。有效率为61%（365/601）。虽然69%的人在ECHO/ENRICH培训后与终端AYA讨论FP感到舒适，但85%的人希望继续接受教育。大多数人（88%）同意FP应该是患有癌症的AYA的一种选择，尽管有些人同意提供FP提供虚假的希望（16%）或浪费资源（7%）。大多数人认为，避免讨论FP是常见的做法，特别是在医学上脆弱的晚期疾病或未成年人中。许多人将缺乏对话归因于肿瘤团队的目标。只有9%的人有过PAR的经验。许多人对如何赠送PAR生殖材料以及谁应该被允许使用PAR感到矛盾。有几个人对PAR提出了道德上的担忧，或者对家人提出了不舒服的建议。许多人表达了对额外的PAR特定教育的愿望。ECHO/ENRICH受训者在终末期AYA中暴露于FP的水平不同，PAR经验有限。许多人表示对《巴黎协定》存在不确定性，通过进一步培训和透明的体制政策，这种不确定性可能会得到缓解。作为ECHO/ENRICH受训人员的专职卫生专业人员在患有癌症的晚期青少年和年轻人中暴露于不同程度的生育力保存，并且在死后辅助生殖方面的经验有限。许多人对死后辅助生殖表示了不确定性，通过进一步的培训和透明的体制政策，这种不确定性可能会得到缓解。
While all reproductive‐aged individuals with cancer should be offered fertility preservation (FP) counseling, there is little guidance over offers to adolescent and young adults (AYA) with terminal diagnoses, especially when considering posthumous assisted reproduction (PAR). The Enriching Communication skills for Health professionals in Oncofertility (ECHO/ENRICH) trains Allied Health Professionals (AHPs) to improve communication with AYAs with cancer. Little is known about AHPs' role in assisting in FP and PAR decisions. This is a cross‐sectional survey of ECHO/ENRICH trainees' attitudes and experience with FP and PAR in AYA with terminal cancer. The response rate was 61% (365/601). While 69% felt comfortable discussing FP with terminal AYA after ECHO/ENRICH training, 85% desired further education. The majority (88%) agreed FP should be an option for AYA with cancer, though some agreed offering FP provided false hope (16%) or was a waste of resources (7%). Most shared that avoidance of FP discussions was common practice, especially in the medically fragile, late‐stage disease, or among minors. Many attributed lack of conversations to oncology team goals. Only 9% had prior experience with PAR. Many were conflicted about how PAR reproductive material should be gifted and who should be permitted to use PAR. Several raised moral concerns for PAR, or discomfort advising family. Many voiced desire for additional PAR‐specific education. ECHO/ENRICH trainees had varied levels of exposure to FP in terminal AYA and limited experiences with PAR. Many expressed uncertainties with PAR, which may be alleviated with further training and transparent institutional policies. Allied Health Professionals who were ECHO/ENRICH trainees had varied levels of exposure to fertility preservation in terminally ill adolescent and young adults with cancer and limited experiences with posthumous assisted reproduction. Many expressed uncertainties with posthumous assisted reproduction, which may be alleviated with further training and transparent institutional policies.
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影响因子：
2.4
作者：
Carter, Jeanne;Penson, Richard;Wenzel, Lani
通讯作者：
Wenzel, Lani
影响因子：
3.2
作者：
Schover, Leslie R.
通讯作者：
Schover, Leslie R.
影响因子：
2.1
作者：
Waler, Nicholas J.;Clavijo, Raul I.;Ramasamy, Ranjith
通讯作者：
Ramasamy, Ranjith
DOI：
10.1016/j.suponc.2011.09.006
发表时间：
2012-07
期刊：
The journal of supportive oncology
影响因子：
--
作者：
Quinn GP;Knapp CA;Malo TL;McIntyre J;Jacobsen PB;Vadaparampil ST
通讯作者：
Vadaparampil ST
影响因子：
3.6
作者：
Quinn, Gwendolyn P.;Curci, Meghan Bowman;Vadaparampil, Susan T.
通讯作者：
Vadaparampil, Susan T.