A mixed methods approach to examining decisional needs and contextual factors influencing fertility status assessment outcomes among young female survivors of childhood cancer.

项目总结/摘要 接受性腺毒性癌症治疗的儿童癌症女性幸存者有接受治疗的风险- 与不孕症有关潜在的不育是年轻癌症幸存者最关心的问题，但许多幸存者 妇女不确定自己的生育状况，这种不确定性加剧了与生育有关的痛苦。很少有人知道的 与接受生育状况评估相关的生殖健康需求和因素 在女性癌症幸存者中，这一差距将在拟议的研究中得到解决。成年期（EARLY ADULATION） （从青春期到成年的过渡期）是计划生育的成熟发展时期， 生殖健康需求。缺乏与发育相适应的生殖健康和与生育有关的 为新出现的成年癌症幸存者提供心理教育和决策支持干预。的 本研究的目的是探讨新出现的成年女性癌症患者的生殖健康需求 幸存者，并确定决策和背景因素，影响追求FSA使用顺序 解释性混合方法设计这项研究将招募325名女性幸存者（目前年龄为18至29岁， 治疗后>1年;诊断患有癌症<21岁），来自美国的四个癌症中心， 完成定量调查;一部分参与者将参加定性访谈。具体目标 本研究的目的是：（1）建立一个年轻人生殖健康需求的知识库 成年癌症幸存者，并确定相关因素与FSA，（2）阐明患者的经验与FSA 和偏好的决策支持干预，（3）探索决策满意度作为一个结果， 未来的干预。这项以患者为导向的研究的长期目标是为一项 对FSA感兴趣的幸存者进行决策支持干预。这项研究的重点与 国家护理研究所的研究重点是“改善慢性病患者的生活质量” 通过支持女性癌症幸存者谁是治疗相关的不孕症和生育相关的风险， 痛苦候选人的长期职业目标是成为一名独立的调查员， 研究的重点是改善癌症幸存者的生殖健康成果。的辅导下 埃默里大学和亚特兰大儿童保健中心的癌症生存国际领导者， 候选人将实现她的短期目标，扩大癌症幸存者生殖健康的专业知识， 获得混合方法研究的培训，并获得团队科学的经验。拟议的培训目标 包括有重点跨学科指导、教学课程和有组织的学习活动 这将丰富候选人的研究知识和技能，为她的职业生涯奠定坚实的基础， 独立调查员

PROJECT SUMMARY/ABSTRACT Female survivors of childhood cancer who received gonadotoxic cancer treatment are at risk for treatment- related infertility. Potential infertility is a top concern among young cancer survivors, yet many survivors are unsure of their fertility status and this uncertainty contributes to fertility-related distress. Little is known about the perceived reproductive health needs and factors associated with receipt of a fertility status assessment (FSA) among female cancer survivors, a gap that will be addressed in the proposed study. Emerging adulthood (period of transition from adolescence to adulthood) is a developmental period ripe for family planning and prioritizing reproductive health needs. There is a lack of developmentally appropriate reproductive health and fertility-related psychoeducational and decisional support interventions available for emerging adult cancer survivors. The purpose of this study is to explore the perceived reproductive health needs of emerging adult female cancer survivors and to identify decisional and contextual factors that influence pursuit of FSA using a sequential explanatory mixed method design. This study will enroll 325 female survivors (currently aged 18 to 29 years and >1-year post treatment; diagnosed with cancer < age 21 years) from four cancer centers in the United States to complete a quantitative survey; a subset of participants will take part in qualitative interview. The specific aims of this study are to (1) establish a knowledge base of the perceived reproductive health needs among young adult cancer survivors and identify relevant factors related to FSA, (2) elucidate patient experiences with FSA and preferences for a decisional support intervention, and (3) explore decisional satisfaction as an outcome for a future intervention. The long-term objective of this patient-oriented research is to inform the testing of a decisional support intervention for survivors interested in an FSA. The focus of this research aligns with the National Institute of Nursing Research research priority of “improving quality of life among individuals with chronic disease” by supporting female cancer survivors who are at risk for treatment-related infertility and fertility-related distress. The candidate’s long-term career goal is to become an independent investigator with a program of research focused on improving reproductive health outcomes among cancer survivors. Under the mentorship of international leaders in cancer survivorship at Emory University and Children’s Healthcare of Atlanta, the candidate will achieve her short-term goals to expand expertise in reproductive health among cancer survivors, obtain training in mixed methods research, and gain experience with team science. The proposed training aims include a combination of focused interdisciplinary mentorship, didactic courses, and structured learning activities that will enrich candidate’s research knowledge and skills, providing her with a solid foundation for a career as an independent investigator.