"Looking at future cancer survivors, give them a roadmap": addressing fertility and family-building topics in post-treatment cancer survivorship care.
"Looking at future cancer survivors, give them a roadmap": addressing fertility and family-building topics in post-treatment cancer survivorship care.
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DOI：
10.1007/s00520-020-05731-3
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发表时间：
2021-04
期刊：
影响因子：
--
通讯作者：
Ford JS
中科院分区：
文献类型：
--
作者：
Benedict C;Nieh JL;Hahn AL;McCready A;Diefenbach M;Ford JS
生育是青少年和年轻成年女性（AYA-F）癌症幸存者的一个重要问题。本研究调查了AYA-F幸存者未满足的需求和治疗后幸存者生育/家庭建设护理建议。半结构化访谈（45-60分钟）探讨了与癌症后生育和家庭建设有关的主题。基于扎根理论方法推导编码类别。主题是通过编码和审查的迭代过程确定的。参与者（N=25）平均年龄29岁（SD=6.2；范围15-39），主要是受过良好教育的白人，平均治疗后5.81年（SD=5.43）；32%的人接受了生育能力保存（癌前或癌后）。确定了改善护理的六项建议：解决患者与提供者的沟通，需要提供信息，情感和同伴支持，财务信息和决策支持。aya - f认为，了解资源的最佳方式是通过在线平台或医生发起的讨论。人们普遍认为远程保健选择和数字资源是可以接受的。当aya -f预计会有直接的问题或痛苦的情绪，以及对互联网安全的担忧时，面对面的交流更受欢迎。因此，最好采取一种综合办法，即首先提供信息（通过网络通信），并在需要时进行后续亲自访问和转诊。需要信息和支持服务，以更好地教育患者关于性腺毒素的影响和癌症治疗完成后生育的选择。未来的工作应该评估如何最好地支持肿瘤提供者满足幸存者对生育和家庭建设的需求，包括转诊到临床专科和支持性资源。
Fertility is an important issue among adolescent and young adult female (AYA-F) cancer survivors. This study examined AYA-F survivors’ unmet needs and recommendations for care to address fertility/family-building in post-treatment survivorship. Semi-structured interviews (45–60 minutes) explored themes related to fertility and family-building after cancer. Coding categories were derived based on grounded theory methods. Themes were identified through an iterative process of coding and review. Participants (N=25) averaged 29 years old (SD=6.2; range, 15–39), were primarily White and well educated, and averaged 5.81 years post-treatment (SD=5.43); 32% had undergone fertility preservation (pre- or post-cancer). Six recommendations for improving care were identified: addressing patient-provider communication, need to provide informational, emotional, and peer support, financial information, and decision-making support. AYA-Fs believed the best way to learn about resources was through online platforms or doctor-initiated discussions. Telehealth options and digital resources were generally considered acceptable. Face-to-face interactions were preferred for in-depth information, when AYA-Fs anticipated having immediate questions or distressing emotions, and with concerns about Internet security. Thus, a combined approach was preferred such that information (via web-based communication) should be provided first, with follow-up in-person visits and referral when needed. Informational and support services are needed to better educate patients about gonadotoxic effects and options to have children after cancer treatment is completed. Future work should evaluate how to best support oncology providers in meeting the needs of survivors concerned about fertility and family-building including referral to clinical specialties and supportive resources.
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