Quinn Gwendolyn P, Vadaparampil Susan T, Gwede Clement K, Miree Cheryl, King Lindsey M, Clayton Heather B, Wilson Crystal, Munster Pamela
Department of Interdisciplinary Oncology, College of Medicine, University of South Florida, Tampa, FL, USA.
J Cancer Surviv. 2007 Jun;1(2):146-55. doi: 10.1007/s11764-007-0019-9.
Although physician discussion with patients regarding fertility preservation (FP) options prior to cancer treatment can provide important information for survivors concerning their future fertility, little is known about the extent to which physicians discuss FP with patients. This qualitative study sought to identify current physician FP communication practices and determine factors that may impact communication efforts regarding FP.
Qualitative data were collected using semi structured interviews with 16 physicians practicing at a major cancer center in the South.
All providers were board certified in medical oncology, radiation oncology or surgical oncology. The main factors that emerged from qualitative analysis included distinct variations in quality of discussion about FP, knowledge of FP resources, attitudes, practice behaviors and perceptions of patient characteristics.
While most physicians discussed potential fertility loss as a side effect of cancer treatment, few provided information to patients about preserving fertility. Patient characteristics such as gender and cancer site may impact the discussion, as well as system factors such as costs of procedures and access to FP resources. Education and training for physicians about FP options for cancer patients, particularly females, may promote discussion of FP. In addition, system barriers related to availability and affordability of FP resources must also be addressed.
Physicians should consider providing patients with timely, understandable information related to their FP options, prior to the administration of treatment. Such discussions may lead to improved quality of life for individuals as they transition from patients to survivors.
尽管医生在癌症治疗前与患者讨论生育力保存（FP）选项可为幸存者提供有关其未来生育能力的重要信息，但对于医生与患者讨论FP的程度知之甚少。这项定性研究旨在确定当前医生关于FP的沟通实践，并确定可能影响FP沟通工作的因素。
通过对在南方一家大型癌症中心执业的16名医生进行半结构化访谈收集定性数据。
所有提供者均获得医学肿瘤学、放射肿瘤学或外科肿瘤学委员会认证。定性分析中出现的主要因素包括关于FP讨论质量的明显差异、对FP资源的了解、态度、实践行为以及对患者特征的看法。
虽然大多数医生将潜在的生育力丧失作为癌症治疗的副作用进行了讨论，但很少向患者提供关于保存生育力的信息。患者特征（如性别和癌症部位）以及系统因素（如手术费用和获得FP资源的机会）可能会影响讨论。对医生进行关于癌症患者（尤其是女性）FP选项的教育和培训，可能会促进对FP的讨论。此外，还必须解决与FP资源的可用性和可承受性相关的系统障碍。
医生应考虑在治疗前向患者提供与他们的FP选项相关的及时、易懂的信息。此类讨论可能会改善个人从患者过渡到幸存者期间的生活质量。
