Healthcare professionals' views on discussing fertility preservation with young cancer patients: a mixed method systematic review of the literature.
Healthcare professionals' views on discussing fertility preservation with young cancer patients: a mixed method systematic review of the literature.
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医疗保健专业人员对与年轻癌症患者讨论保留生育能力的看法：对文献的混合方法系统回顾。
DOI：
10.1002/pon.4092
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发表时间：
2017
期刊：
影响因子：
3.6
通讯作者：
Lubker,IreneMachowa
中科院分区：
文献类型：
--
作者：
Vindrola-Padros,Cecilia;Dyer,KarenE;Cyrus,John;Lubker,IreneMachowa
目的尽管努力保证患者充分了解其生育力丧失的风险并提供生育力保留（FP）治疗，但先前的研究报告称，这一话题并未经常与患者讨论，尤其是年轻患者群体。我们进行了一项混合方法系统评价，以探讨影响癌症儿童（0-15 岁）和青少年/年轻人（16-24 岁）讨论 FP 的因素。方法使用与癌症和生育力相关的关键词和受控词汇/主题标题的组合独立搜索了六个数据库。纳入标准包括：(a) 在同行评审期刊上发表，(b) 关注医疗保健专业人员 (HCP) 关于癌症患者生育问题的信念、态度或做法，(c) 从 HCP 收集主要数据，以及 (d) 关注为年轻患者提供服务的 HCP。在搜索中确定的 6276 篇文章中，最终综述中纳入了介绍 14 项研究结果的 16 篇文章。结果各研究报告的共同主题表明，影响 HCP 与年轻癌症患者讨论 FP 的五个主要因素：(a) HCP 的知识，(b) HCP 的舒适感，(c) 患者因素（即性成熟度、预后、伴侣状态以及他们是否发起对话），(d) 父母因素（即 HCP 对其参与程度的看法），以及 (e) 教育材料的可用性。结论未来的工作应确保 HCP 掌握癌症相关 FP 的知识，并确保他们接受关于如何与年轻患者及其父母同意和讨论信息的充分培训。
ObjectiveIn spite of efforts to guarantee patients are adequately informed about their risk of fertility loss and offered treatment for fertility preservation (FP), previous studies have reported that this topic is not routinely discussed with patients, especially with younger patient populations. A mixed method systematic review was undertaken to explore the factors shaping the discussion of FP with children (0–15 years) and adolescents/young adults (16–24 years) with cancer.MethodsSix databases were searched independently using a combination of keywords and controlled vocabulary/subject headings relating to cancer and fertility. Inclusion criteria consisted of: (a) being published in a peer‐reviewed journal, (b) a focus on healthcare professionals' (HCPs') beliefs, attitudes, or practices regarding fertility issues in cancer patients, (c) primary data collection from HCPs, and (d) a focus on HCPs who provide services to young patients. Of the 6276 articles identified in the search, 16 articles presenting the results of 14 studies were included in the final review.ResultsCommon themes reported across studies indicate that five main factors influence HCPs' discussion of FP with young cancer patients: (a) HCPs' knowledge, (b) HCPs' sense of comfort, (c) patient factors (i.e., sexual maturity, prognosis, partnership status, and whether or not they initiate the conversation), (d) parent factors (i.e., HCPs' perception of the extent of their involvement), and (e) availability of educational materials.ConclusionsFuture work should ensure that HCPs possess knowledge of cancer‐related FP and that they receive adequate training on how to consent and discuss information with young patients and their parents.