Geue Kristina, Richter Diana, Schmidt Ricarda, Sender Annekathrin, Siedentopf Friederike, Brähler Elmar, Stöbel-Richter Yve
Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany.
Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany.
J Adolesc Health. 2014 May;54(5):527-35. doi: 10.1016/j.jadohealth.2013.10.005. Epub 2013 Dec 4.
For young cancer patients, family planning is not always completed at the time of cancer diagnosis. This study investigated young cancer patients' desire to have children, its intensity, and their discussion with oncologists and fertility specialists about fertility. Furthermore, gender differences, differences between childless patients and patients with children, and correlations with psychological distress were analyzed.
A total of 149 cancer patients (range, 18-45 years of age) answered a self-developed questionnaire. Psychological distress was measured with the Patient Health Questionnaire.
Seventy-four percent of patients had a desire to have children at the time of diagnosis. Whereas the intensity of the desire for children increased pre- to post-treatment in childless patients, it decreased in patients who already had children. A total of 55 patients who wanted a child (50%) needed supportive care concerning this issue; 60% of the total sample had discussed fertility aspects with their oncologists and 20% with fertility specialists. Patients reported higher levels of satisfaction with their discussions with fertility specialists than with their discussions with oncologists. Men (56%) underwent fertility preservation more often than did women (31%). Female sex was the only variable predicting psychological distress, whereas parenthood, fertility preservation, and desire for children had no significant impact.
The desire to have children and the fertility issues involved are important for young cancer patients. Reasons for not discussing fertility aspects with oncologists and the cause of low referral rates to fertility specialists should be explored in future studies. The implementation of structured psychosocial supportive care might address the needs of highly fertility-distressed patients.
对于年轻癌症患者而言，计划生育在癌症确诊时往往未能完成。本研究调查了年轻癌症患者生育子女的愿望、其强烈程度，以及他们与肿瘤学家和生殖专家就生育问题的讨论情况。此外，还分析了性别差异、无子女患者与有子女患者之间的差异，以及与心理困扰的相关性。
共有149名癌症患者（年龄范围18 - 45岁）回答了一份自行编制的问卷。采用患者健康问卷测量心理困扰程度。
74%的患者在确诊时有生育愿望。无子女患者对生育的愿望强度在治疗前至治疗后有所增加，而已有子女的患者则有所下降。共有55名想要孩子的患者（占50%）在这个问题上需要支持性护理；60%的总样本与肿瘤学家讨论过生育方面的问题，20%与生殖专家讨论过。患者对与生殖专家讨论的满意度高于与肿瘤学家的讨论。男性（56%）比女性（31%）更常进行生育力保存。女性性别是预测心理困扰的唯一变量，而父母身份、生育力保存和生育愿望没有显著影响。
生育愿望及相关生育问题对年轻癌症患者很重要。未来研究应探讨不与肿瘤学家讨论生育问题的原因以及转诊至生殖专家的低比例原因。实施结构化的社会心理支持性护理可能满足生育困扰严重患者的需求。
