Krouwel E M, Nicolai M P J, van Steijn-van Tol A Q M J, Putter H, Osanto S, Pelger R C M, Elzevier H W
Department of Urology, Leiden University Medical Centre, Leiden, The Netherlands.
Department of Oncology, Leiden University Medical Centre, Leiden, The Netherlands.
Eur J Cancer Care (Engl). 2017 Nov;26(6). doi: 10.1111/ecc.12614. Epub 2016 Dec 27.
Cancer and its treatments may result in impaired fertility, which could cause long-term distress to cancer survivors. For eligible patients, fertility preservation (FP) is available to secure future reproductive potential. Many physicians, however, feel inhibited about discussing FP. Oncology nurses may serve as an initiator for discussing the subject and provide additional support. Our aim was to investigate their knowledge about FP, the way they apply this, and possible barriers to discussing FP with patients of reproductive age. A questionnaire was administered via mail, Internet and the Dutch Oncology Nursing Congress. Four hundred and twenty-one oncology nurses participated, a third of whom (31.1%) had "sufficient" knowledge of FP. Twenty-eight per cent of participants reported that they "never/hardly ever" discussed FP; 32.2% "almost always/always." FP discussions were more frequently performed by graduate nurses, academic nurses, experienced nurses and nurses with sufficient knowledge. Reasons for not discussing FP were a "lack of knowledge" (25.2%), "poor prognosis" (16.4%) and "lack of time" (10.5%). In conclusion, several obstacles may result in FP not being routinely discussed, specifically a lack of knowledge. Yet nurses feel responsible for addressing the issue, indicating that assistance with FP discussions should be encouraged. Educational training about FP is recommended.
癌症及其治疗可能导致生育能力受损，这可能给癌症幸存者带来长期困扰。对于符合条件的患者，可以进行生育力保存（FP）以确保未来的生殖潜力。然而，许多医生对于讨论生育力保存感到有所顾虑。肿瘤学护士可以作为讨论该主题的发起者，并提供额外的支持。我们的目的是调查她们关于生育力保存的知识、她们应用这些知识的方式以及与育龄患者讨论生育力保存时可能存在的障碍。通过邮件、互联网和荷兰肿瘤学护理大会发放了一份调查问卷。421名肿瘤学护士参与了调查，其中三分之一（31.1%）对生育力保存有“足够的”了解。28%的参与者表示她们“从不/几乎从不”讨论生育力保存；32.2%“几乎总是/总是”讨论。研究生护士、学术型护士、经验丰富的护士以及有足够知识的护士更频繁地进行生育力保存的讨论。不讨论生育力保存的原因包括“知识不足”（25.2%）、“预后不良”（16.4%）和“时间不足”（10.5%）。总之，一些障碍可能导致生育力保存无法得到常规讨论，特别是知识的缺乏。然而，护士们觉得自己有责任解决这个问题，这表明应该鼓励在生育力保存讨论方面提供协助。建议开展关于生育力保存的教育培训。
