Women more vulnerable than men when facing risk for treatment-induced infertility: A qualitative study of young adults newly diagnosed with cancer
Women more vulnerable than men when facing risk for treatment-induced infertility: A qualitative study of young adults newly diagnosed with cancer
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DOI：
10.3109/0284186x.2014.948573
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发表时间：
2015-02-01
期刊：
影响因子：
3.1
通讯作者：
Lampic, Claudia
中科院分区：
文献类型：
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作者：
Armuand, Gabriela M.;Wettergren, Lena;Lampic, Claudia
背景被诊断患有癌症不仅对健康构成直接威胁，而且癌症治疗也可能对生育能力产生负面影响。回顾性研究表明，许多幸存者后悔没有收到生育相关的信息，并在诊断时提供生育保留。本定性研究调查了新诊断的癌症患者的生育相关的沟通的经验，以及他们如何对未来不孕的风险的原因。在一所大学医院的三个癌症病房招募了告密者。11名新诊断为癌症的女性和10名男性参加了单独的半结构化访谈，重点关注三个领域：生育相关的沟通经验，有关生育保护的决策，以及对可能不孕症风险的想法和感受。采用定性内容分析法对数据进行分析。分析产生了三个分主题，“了解”，“对风险的反应”和“处理不确定性”，以及一个主题“妇女在面临不育风险时更脆弱”，表明妇女报告了更多与癌症治疗生育相关方面的患者-提供者沟通有关的负面经历，以及对不孕风险的负面情绪反应和与处理未来生育不确定性有关的挑战。被调查者描述了在接受可能影响生育的治疗时的痛苦，并使用不同的策略来处理不孕症的风险，例如依靠生育力保护或考虑其他方法来实现父母身份。女性受访者报告的负面经历可能与以下事实有关：几乎所有的男性都没有接受过有关生育的信息并使用过生育辅助措施。新诊断为癌症的妇女在面临治疗引起的不孕症风险时似乎特别脆弱。缺乏关于未来生育的共同决策可能会导致痛苦，因此有必要改善针对女性癌症患者的生育相关沟通。
Background. Being diagnosed with cancer constitutes not only an immediate threat to health, but cancer treatments may also have a negative impact on fertility. Retrospective studies show that many survivors regret not having received fertility-related information and being offered fertility preservation at time of diagnosis. This qualitative study investigates newly diagnosed cancer patients' experiences of fertility-related communication and how they reason about the risk of future infertility.Material and methods. Informants were recruited at three cancer wards at a university hospital. Eleven women and 10 men newly diagnosed with cancer participated in individual semi-structured interviews focusing on three domains: experiences of fertility-related communication, decision-making concerning fertility preservation, and thoughts and feelings about the risk of possible infertility. Data was analyzed through qualitative content analysis.Results. The analysis resulted in three sub-themes, 'Getting to know', 'Reacting to the risk' and 'Handling uncertainty', and one main theme 'Women more vulnerable when facing risk for infertility', indicating that women reported more negative experiences related to patient-provider communication regarding fertility-related aspects of cancer treatment, as well as negative emotional reactions to the risk of infertility and challenges related to handling uncertainty regarding future fertility. The informants described distress when receiving treatment with possible impact on fertility and used different strategies to handle the risk for infertility, such as relying on fertility preservation or thinking of alternative ways to achieve parenthood. The negative experiences reported by the female informants may be related to the fact that none of the women, but almost all men, had received information about and used fertility preservation.Conclusions. Women newly diagnosed with cancer seem to be especially vulnerable when facing risk for treatment-induced infertility. Lack of shared decision-making concerning future fertility may cause distress and it is therefore necessary to improve the fertility-related communication targeted to female cancer patients.