The Development of an International Oncofertility Competency Framework: A Model to Increase Oncofertility Implementation
The Development of an International Oncofertility Competency Framework: A Model to Increase Oncofertility Implementation
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DOI：
10.1634/theoncologist.2019-0043
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发表时间：
2019-12-01
期刊：
影响因子：
5.8
通讯作者：
Ledger, William
中科院分区：
文献类型：
--
作者：
Anazodo, Antoinette;Laws, Paula;Ledger, William
背景尽管有关于生育力保持（FP）的国际证据，但仍有一些障碍阻碍了公平的FP实践的实施。目前，不存在肿瘤生育能力。本研究的目的是开发一个肿瘤生育能力框架，该框架定义了肿瘤生育护理的关键组成部分，开发了一个优先服务发展的模型，并定义了卫生保健专业人员（HCP）扮演的角色。与来自16个国家（12个高收入国家和4个中等收入国家）的HCP以及患者和家庭倡导团体（PFA）一起查询和综合关于肿瘤生育护理声明的意见。声明包括HCP的角色以及十个领域服务开发护理的优先事项（沟通、肿瘤生育决策辅助工具、适龄护理、转诊途径、文件、肿瘤生育培训、生殖生存护理和与生育相关的心理社会支持、支持性护理，和伦理框架），代表了33个不同的护理要素。结果第一份问卷由457名参与者完成（332名HCP和125名PFA）。138名参与者完成了第二份问卷（122名HCP和16名PFA）。就108项肿瘤生育能力和HCP在肿瘤生育护理中应发挥的作用达成共识。提出了一个三层服务发展模式，逐步实施不同的护理组成部分。共有92.8%的108个商定的能力也有协议之间的高和中等收入的participator.Conclusion FP指南建立最佳实践，但不考虑的技能和要求，以实施这些准则。的能力框架给HCP和服务的培训HCP和实施护理的结构，以及定义一个模型，优先考虑oncofertility服务development.Implications实践尽管国际证据生育保存（FP），一些障碍仍然阻止公平FP实践的实施。能力框架提供了108项能力，这些能力将使医疗保健专业人员（HCP）和服务机构能够建立一个发展肿瘤生育护理的结构，并定义HCP在提供护理和支持方面的作用。该框架还提出了一个三级肿瘤生育服务发展模式，该模式将肿瘤生育护理的组成部分优先发展为基本服务、增强服务和专家服务，并为服务发展提出了明确的建议。能力框架将加强计划生育指导方针的实施，改善公平获得医疗和心理治疗的机会。
Background Despite international evidence about fertility preservation (FP), several barriers still prevent the implementation of equitable FP practice. Currently, oncofertility competencies do not exist. The aim of this study was to develop an oncofertility competency framework that defines the key components of oncofertility care, develops a model for prioritizing service development, and defines the roles that health care professionals (HCPs) play.Materials and Method A quantitative modified Delphi methodology was used to conduct two rounds of an electronic survey, querying and synthesizing opinions about statements regarding oncofertility care with HCPs and patient and family advocacy groups (PFAs) from 16 countries (12 high and 4 middle income). Statements included the roles of HCPs and priorities for service development care across ten domains (communication, oncofertility decision aids, age-appropriate care, referral pathways, documentation, oncofertility training, reproductive survivorship care and fertility-related psychosocial support, supportive care, and ethical frameworks) that represent 33 different elements of care.Results The first questionnaire was completed by 457 participants (332 HCPs and 125 PFAs). One hundred and thirty-eight participants completed the second questionnaire (122 HCPs and 16 PFAs). Consensus was agreed on 108 oncofertility competencies and the roles HCPs should play in oncofertility care. A three-tier service development model is proposed, with gradual implementation of different components of care. A total of 92.8% of the 108 agreed competencies also had agreement between high and middle income participants.Conclusion FP guidelines establish best practice but do not consider the skills and requirements to implement these guidelines. The competency framework gives HCPs and services a structure for the training of HCPs and implementation of care, as well as defining a model for prioritizing oncofertility service development.Implications for Practice Despite international evidence about fertility preservation (FP), several barriers still prevent the implementation of equitable FP practice. The competency framework gives 108 competencies that will allow health care professionals (HCPs) and services a structure for the development of oncofertility care, as well as define the role HCPs play to provide care and support. The framework also proposes a three-tier oncofertility service development model which prioritizes the development of components of oncofertility care into essential, enhanced, and expert services, giving clear recommendations for service development. The competency framework will enhance the implementation of FP guidelines, improving the equitable access to medical and psychological oncofertility care.