Micaux Obol C, Armuand G M, Rodriguez-Wallberg K A, Ahlgren J, Ljungman P, Wettergren L, Lampic C
a Department of Neurobiology, Care Sciences and Society, Division of Nursing , Karolinska Institutet , Huddinge , Sweden.
b Department of Oncology-Pathology , Karolinska Institutet, Karolinska University Hospital , Stockholm , Sweden.
Acta Oncol. 2017 Aug;56(8):1103-1110. doi: 10.1080/0284186X.2017.1310394. Epub 2017 Apr 5.
Despite the negative impacts of several cancer treatments on fertility, many patients do not recall having fertility-related discussions with their physicians. This study was conducted to identify those factors related to physicians' discussing the treatment impacts on fertility with cancer patients of reproductive age.
In this nationwide survey of cancer care physicians (n = 329, response rate 55%), oncologists and hematologists (mainly) completed a questionnaire on practice behavior, barriers, attitudes and confidence in knowledge regarding treatment-related fertility risks. Logistic regression analyses were conducted to identify factors associated with not routinely discussing fertility issues with patients.
Most of the physicians agreed that they were responsible for discussing fertility issues with patients of reproductive age (91%), but approximately 30% did not do so regularly. Those factors decreasing the likelihood of discussion were: patient already had children (female/male OR 3.0/6.9), high workload (OR 3.3/4.8), seeing <5 female/male patients of reproductive age weekly (OR 3.2/3.4) and access to a reproduction clinic (OR 5.2/4.2).
Most Swedish oncologists and hematologists regularly discuss impact of treatment on fertility with their patients. Those factors having a negative impact on fertility discussions may guide targeted organizational and educational efforts to further improve fertility-related communication in cancer care.
尽管几种癌症治疗方法会对生育能力产生负面影响，但许多患者并未回忆起与医生进行过与生育相关的讨论。本研究旨在确定与医生和育龄期癌症患者讨论治疗对生育能力影响相关的因素。
在这项针对癌症护理医生的全国性调查中（n = 329，回复率55%），肿瘤学家和血液学家（主要是）完成了一份关于实践行为、障碍、态度以及对治疗相关生育风险知识的信心的问卷。进行逻辑回归分析以确定与未定期与患者讨论生育问题相关的因素。
大多数医生同意他们有责任与育龄期患者讨论生育问题（91%），但约30%的医生并非定期这样做。那些降低讨论可能性的因素包括：患者已有子女（女性/男性的比值比分别为3.0/6.9）、工作量大（比值比分别为3.3/4.8）、每周诊治的育龄期女性/男性患者少于5名（比值比分别为3.2/3.4）以及是否能获得生殖诊所的服务（比值比分别为5.2/4.2）。
大多数瑞典肿瘤学家和血液学家会定期与患者讨论治疗对生育能力的影响。那些对生育问题讨论产生负面影响的因素可能会指导有针对性的组织和教育工作，以进一步改善癌症护理中与生育相关的沟通。
