Roher S I G, Gibson J, Gibson B E, Gupta A A
Joint Centre for Bioethics, University of Toronto, and Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto.
Department of Physical Therapy, University of Toronto, and Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital; and.
Curr Oncol. 2017 Feb;24(1):10-15. doi: 10.3747/co.24.3419. Epub 2017 Feb 27.
Despite clinical practice guideline recommendations mandating that fertility preservation be discussed with young cancer patients, many providers fail to initiate such discussions with adolescents. Researchers and clinicians often focus on system-level changes to improve access to fertility preservation for adolescents and young adults in Canada. However, little of the available information considers the in which health care providers approach those discussions. Research has shown that, even when fertility preservation options are broached with adolescents, survivors often report dissatisfaction with those conversations, thus raising additional concerns about their content and quality. Here, we consider how a narrative approach-and the Frank narrative typology in particular-could improve the quality of such conversations by helping providers to more accurately and thoughtfully respond to the needs of adolescent patients when discussing the possibility of fertility preservation. Based on findings from a qualitative research project, we provide concrete suggestions for how to more sensitively approach fertility preservation conversations with male adolescent cancer patients and survivors.
尽管临床实践指南建议必须与年轻癌症患者讨论生育力保存问题，但许多医疗服务提供者并未与青少年患者展开此类讨论。加拿大的研究人员和临床医生常常专注于系统层面的变革，以改善青少年和年轻成年人获取生育力保存服务的机会。然而，现有的信息很少考虑医疗服务提供者进行这些讨论的方式。研究表明，即使与青少年提及了生育力保存选项，幸存者们往往对这些谈话表示不满，从而引发了对谈话内容和质量的更多担忧。在此，我们探讨一种叙事方法——尤其是弗兰克叙事类型学——如何通过帮助医疗服务提供者在讨论生育力保存可能性时更准确、周到地回应青少年患者的需求，来提高此类谈话的质量。基于一个定性研究项目的结果，我们针对如何更敏感地与男性青少年癌症患者及幸存者进行生育力保存谈话提供了具体建议。
