Fertility preservation consultation for women with cancer: are we helping patients make high-quality decisions?
Fertility preservation consultation for women with cancer: are we helping patients make high-quality decisions?
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DOI：
10.1016/j.rbmo.2013.03.004
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发表时间：
2013-07-01
影响因子：
4
通讯作者：
Mersereau, Jennifer E.
中科院分区：
文献类型：
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作者：
Kim, Jayeon;Deal, Allison M.;Mersereau, Jennifer E.
为了调查当前保留生育力咨询过程对患者决策的有效性以及可能影响患者决策的社会人口和认知因素，在大学试管婴儿中心进行了一项前瞻性试点调查，纳入了2009年4月至2010年12月期间接受生育力保留的18-43岁女性。测量了患者对保留生育力咨询和决策的看法。在完成调查的 52 名女性中，超过一半 (52%) 要求咨询。所有患者均表示咨询是一种有用的信息来源，73%的患者在咨询后做出了治疗决定。强烈认为自己在咨询期间有机会提问的患者决策冲突较低（P = 0.001），而那些报告费用对治疗决策有很大影响的患者（P < 0.001）和未接受治疗的患者（P < 0.001）决策冲突较高。尽管会诊似乎在患者保留生育力的决策中发挥着关键作用，但肿瘤科医生的会诊转诊率仍然很低。当患者面临财务问题以及感觉提问的机会不够时，决策似乎会受到严重影响。 (C) 2013 年，Reproductive Healthcare Ltd. 由 Elsevier Ltd 出版。保留所有权利。
To investigate the efficacy of the current fertility preservation consultation process in patients' decision-making and socio-demographic and cognitive factors that may affect patients' decision-making, a prospective pilot survey was conducted at university-based IVF centres and included women aged 18-43 years seen for fertility preservation between April 2009 and December 2010. Patients' views on consultation and decision-making about fertility preservation were measured. Among 52 women who completed the survey, more than half (52%) requested their consultation. All patients answered that consultation was a helpful resource of information, and 73% made their decision about treatment after consultation. Decisional conflict was lower in patients who felt strongly that they were given opportunities to ask questions during the consultation (P = 0.001) and higher those who reported that cost was strongly influential in the treatment decision (P < 0.001) and who did not receive treatment (P < 0.001). Although consultation appeared to play a critical role in patients' decision-making about fertility preservation, the referral rate for consultation by oncologists is still poor. Decision-making appears to be significantly impaired in patients grappling with financial concerns and when the opportunity to ask questions is not felt to be sufficient. (C) 2013, Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.