Parent-Adolescent Concordance Regarding Fertility Perspectives and Sperm Banking Attempts in Adolescent Males With Cancer.
Parent-Adolescent Concordance Regarding Fertility Perspectives and Sperm Banking Attempts in Adolescent Males With Cancer.
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关于患有癌症的青少年男性的生育力观点和精子库尝试的父母-青少年一致性。
DOI：
10.1093/jpepsy/jsab069
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发表时间：
2021
影响因子：
3.6
通讯作者：
Gerhardt,CynthiaA
中科院分区：
文献类型：
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作者：
Nahata,Leena;Olsavsky,Anna;Dattilo,TaylorM;Lipak,KeaganG;Whiteside,Stacy;Yeager,NicholasD;Audino,Anthony;Rausch,Joseph;Klosky,JamesL;O'Brien,SarahH;Quinn,GwendolynP;Gerhardt,CynthiaA
目的：大约一半的男性儿童癌症幸存者经历了生育能力受损，但生育能力保存（FP）仍未得到充分利用。虽然父母的建议影响青少年的决策，但父母可能不确定和/或低估了儿子的为人父母目标。本研究评估了父母-青少年和家庭层面关于青少年生育观点（即价值观、目标）的一致性以及与计划生育尝试的关联。方法一项前瞻性试点研究考察了以家庭为中心的价值观澄清工具（FAST）对新诊断为癌症的有不育风险的青春期男性的银行尝试的影响。FAST评估了青少年和父母对青少年生育价值和目标的看法（即，对不育的感知威胁，对银行的感知利益/障碍）。父母-青少年的一致性和家庭层面对生育观点的一致性，以及与银行尝试和显著人口因素的关联进行了研究。结果来自32个家庭的98名参与者（32名12-20岁的青少年，37名母亲，29名父亲）在治疗开始前完成了FAST。在大约一半的回答上，父母和青少年是一致的。银行尝试与更高的家庭层面的感知利益一致性相关，r(32) = .40,p= .02。青少年年龄越大，家庭层面的威胁感知一致性越高，r(31) = .37,p=。r(32) = .40,p= .03。父亲的教育程度与较高的家庭层面障碍一致性相关，r(21) = .53,p= .01。结论：当父母认同儿子的生育价值观和目标，特别是他们认为的好处时，青少年更有可能尝试计划生育。临床医生应在癌症治疗前促进家庭内生育观点的分享，特别是与较年轻的青少年。建议对面临计划生育决定的家庭提供心理社会支持，并在诊断时和整个护理过程中提供支持。
ObjectiveApproximately half of male childhood cancer survivors experience impaired fertility, yet fertility preservation (FP) remains underutilized. Although parent recommendation influences adolescents’ decision-making, parents may be uncertain and/or underrate their sons’ parenthood goals. This study assessed parent–adolescent and family-level concordance regarding adolescent fertility perspectives (i.e., values, goals) and associations with FP attempts.MethodsA prospective pilot study examined the impact of a family-centered values clarification tool (FAST) on banking attempts among adolescent males newly diagnosed with cancer at risk for infertility. The FAST assessed adolescent and parent perceptions of adolescents’ fertility values and goals (i.e., perceived threat of infertility, perceived benefits/barriers to banking). Parent–adolescent concordance and family-level concordance on fertility perspectives were examined, along with associations with banking attempts and salient demographic factors.ResultsNinety-eight participants (32 adolescents aged 12–20, 37 mothers, 29 fathers) from 32 families completed the FAST before treatment initiation. Parent–adolescent dyads were concordant on approximately one-half of responses. Banking attempts were associated with higher family-level concordance regarding perceived benefits,r(32) = .40,p= .02. Older adolescent age was associated with higher family-level concordance regarding perceived threat,r(31) = .37,p= .04, and benefits,r(32) = .40,p= .03. Fathers’ education was associated with higher family-level concordance regarding barriers,r(21) = .53,p= .01.ConclusionsWhen parents were concordant with their son’s fertility values and goals, particularly perceived benefits, adolescents were more likely to attempt FP. Clinicians should facilitate sharing of fertility perspectives within families before cancer treatment, especially with younger adolescents. Psychosocial support for families facing FP decisions is recommended at diagnosis and across the care continuum.