Cancer, Fertility and Me: Developing and Testing a Novel Fertility Preservation Patient Decision Aid to Support Women at Risk of Losing Their Fertility Because of Cancer Treatment.
Cancer, Fertility and Me: Developing and Testing a Novel Fertility Preservation Patient Decision Aid to Support Women at Risk of Losing Their Fertility Because of Cancer Treatment.
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DOI：
10.3389/fonc.2022.896939
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发表时间：
2022
影响因子：
4.7
通讯作者：
Anderson, Richard A.
中科院分区：
文献类型：
--
作者：
Jones, Georgina L.;Moss, Rachael H.;Darby, Frances;Mahmoodi, Neda;Phillips, Bob;Hughes, Jane;Vogt, Katharina S.;Greenfield, Diana M.;Brauten-Smith, Grete;Gath, Jacqui;Campbell, Tonia;Stark, Daniel;Velikova, Galina;Snowden, John A.;Baskind, Ellissa;Mascerenhas, Mariano;Yeomanson, Daniel;Skull, Jonathan;Lane, Sheila;Bekker, Hilary L.;Anderson, Richard A.
关键词：
新诊断出癌症的妇女面临着关于旨在保持生育能力的干预措施的复杂决定。决策辅助工具在支持决策方面比传统的信息提供更有效。我们描述了一种新型患者决策辅助工具的开发和现场测试，该工具旨在支持女性在癌症诊断周围做出生育保留治疗决定。一项前瞻性、混合方法、三阶段研究，涉及：1）与包括肿瘤学和生育保健专业人员和患者合作伙伴在内的多学科关键利益相关者小组合作共同开发资源（n=24），2）对过去曾面临生育保留治疗决定的一组癌症患者进行α测试（n=11），和肿瘤学和生育保健专业人员和利益相关者（n=14）和3）β测试的妇女在常规护理谁收到了最近的癌症诊断，并面临着生育保留治疗决定（n=41）和他们的肿瘤学和生育保健专业人员（n=3）。从一个封闭的“现在乳腺癌”Facebook小组和支持小组“英国癌症和生育”招募的10名服务用户也通过在线调查提供了对CFM的反馈。最初开发了一个60页的癌症，生育和我患者决策援助的纸质原型。对该资源的Alpha测试发现，总体而言，癌症患者、医疗保健专业人员和关键利益相关者都可以接受，它被认为是支持生育保留治疗决策的有用资源。然而，医疗保健专业人员认为，患者决策辅助的长度及其内容的元素可能是其使用的障碍。后来，原型减少到40页。在日常护理中对缩短版本进行beta测试期间，接受该资源的妇女描述了其对她们做出生育保留决定的能力的积极影响，并在压力时期支持她们。然而，出现了实际困难，影响了其在临床实践中的更广泛传播，并限制了计划评价的一些要素。在癌症治疗途径中接受决策援助的妇女发现，这有助于她们参与有关生育保护的决策，并与肿瘤学和生育团队制定更明智的、基于价值观的护理计划。需要做更多的工作来解决这一资源的获取和实施，作为常规肿瘤护理途径的一部分。
Women with a new cancer diagnosis face complex decisions about interventions aiming to preserve their fertility. Decision aids are more effective in supporting decision making than traditional information provision. We describe the development and field testing of a novel patient decision aid designed to support women to make fertility preservation treatment decisions around cancer diagnosis. A prospective, mixed-method, three stage study involving: 1) co-development of the resource in collaboration with a multi-disciplinary group of key stakeholders including oncology and fertility healthcare professionals and patient partners (n=24), 2) alpha testing with a group of cancer patients who had faced a fertility preservation treatment decision in the past (n=11), and oncology and fertility healthcare professionals and stakeholders (n=14) and, 3) beta testing with women in routine care who had received a recent diagnosis of cancer and were facing a fertility preservation treatment decision (n=41) and their oncology and fertility healthcare professionals (n=3). Ten service users recruited from a closed Breast Cancer Now Facebook group and the support group Cancer and Fertility UK also provided feedback on CFM via an online survey. A 60-page paper prototype of the Cancer, Fertility and Me patient decision aid was initially developed. Alpha testing of the resource found that overall, it was acceptable to cancer patients, healthcare professionals and key stakeholders and it was considered a useful resource to support fertility preservation treatment decision-making. However, the healthcare professionals felt that the length of the patient decision aid, and elements of its content may be a barrier to its use. Subsequently, the prototype was reduced to 40 pages. During beta testing of the shortened version in routine care, women who received the resource described its positive impact on their ability to make fertility preservation decisions and support them at a stressful time. However, practical difficulties emerged which impacted upon its wider dissemination in clinical practice and limited some elements of the evaluation planned. Women receiving the decision aid within the cancer treatment pathway found it helped them engage with decisions about fertility preservation, and make better informed, values-based care plans with oncology and fertility teams. More work is needed to address access and implementation of this resource as part of routine oncology care pathways.
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影响因子：
3.5
作者：
Bennett, Carol;Graham, Ian D.;O'Connor, Annette M.
通讯作者：
O'Connor, Annette M.
影响因子：
3.6
作者：
Brehaut, JC;O'Connor, AM;Feldman-Stewart, D
通讯作者：
Feldman-Stewart, D
影响因子：
2.9
作者：
Jones, G. L.;Hughes, J.;Bekker, H. L.
通讯作者：
Bekker, H. L.
影响因子：
2.1
作者：
Kirkman, M.;Winship, I.;Fisher, J. R. W.
通讯作者：
Fisher, J. R. W.
影响因子：
3.5
作者：
Mahmoodi, N.;Bekker, H. L.;Jones, G. L.
通讯作者：
Jones, G. L.