基于前景理论的青年乳腺癌女性生育力保存决策支持系统的构建与实证研究

抗肿瘤治疗的远期性腺毒性作用，使青年乳腺癌女性在治疗后面临生育挑战。癌症女性生育力保存是近年全球性热点议题。我们前期研究发现，生育忧虑正成为该群体生存期一项特殊困扰，且与生存质量密切相关。生育力保存技术，可帮助患者实现未来生育可能，但往往被患者忽视。患者确诊后在紧迫的时间压力下，面对生育力保存决策往往不知所措，事后决策后悔，影响远期生存状态。为此，本研究聚焦确诊期青年乳腺癌女性生育力保存决策过程，引入行为经济学前景理论，从有限理性视角，通过结构方程模型建立患者生育力保存决策机制模型，探明其复杂决策背后的判断逻辑和影响决策的敏感要素；基于此，开展利益相关共同体焦点访谈，识别患者决策时的潜在需求，依据IPADS标准，综合循证证据、专家工作组法与Delphi专家咨询法，构建基于前景理论的患者生育力保存决策支持系统；设计随机对照实验，验证干预有效性，为未来拓展其他癌症人群应用积累经验。

The long-term adenotoxicity of antitumor therapy poses a fertility challenge to young women with breast cancer after treatment. Fertility preservation of women with breast cancer is a criitical topic recently. Our previous study found that fertility anxiety is becoming a special distress in the long-term survival of this population, and is closely related to the quality of life.Fertility preservation techniques, which can help patients achieve future fertility possibilities, are often neglected by patients.Patients at the stage of diagnosis are often at a loss when facing fertility preservation decisions under urgent time pressure, leading to regret in future decisions and affecting long-term survival status.Therefore, this research has focused on phase of the youth breast cancer diagnosis female fertility preservation decision process, the introduction of the prospect theory of behavioral economics, from the perspective of bounded rationality, through a structural equation model is established in young female fertility preservation decision process model, breast cancer patients with proven complex decision-making logic and the influence on the judgment of the behind the sensitive elements;Based on this, the focus interview of stakeholder community was carried out to identify the potential needs of patients in the decision-making process. Based on evidence-based evidence, with the help of expert working group method and Delphi expert consultation method, the decision support system for fertility preservation of young women with breast cancer based on the prospect theory was constructed.Randomized controlled trials were designed to verify the effectiveness of the intervention and accumulate experience for future application in other cancer populations.