Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
Psychooncology. 2017 Oct;26(10):1684-1690. doi: 10.1002/pon.4507. Epub 2017 Aug 25.
The aim of this study was to investigate practice behaviours of Swedish physicians with regard to discussing the impact of cancer treatment on fertility with paediatric oncology patients and their parents, and to identify factors associated with such discussions.
A cross-sectional survey study was conducted targeting all physicians in Sweden working in paediatric oncology care settings. Participants responded to a questionnaire measuring practice behaviour, attitudes, barriers, and confidence in knowledge. Multivariable logistic regression was used to determine factors associated with seldom discussing fertility.
More than half of the physicians routinely talked with their patients/parents about the treatment's potential impact on fertility (male patients: 62%; female patients: 57%; P = 0.570). Factors associated with less frequently discussing fertility with patients/parents were working at a non-university hospital (male patients: OR 11.49, CI 1.98-66.67; female patients: OR 33.18, CI 4.06-271.07), concerns that the topic would cause worry (male patients: OR 8.23, CI 1.48-45.89; female patients: OR 12.38, CI 1.90-80.70), and perceiving the parents as anxious (male patients: OR 7.18, CI 1.20-42.85; female patients: OR 11.65, CI 1.32-103.17).
Based on our findings, we recommend structured training in how to communicate about fertility issues in stressful situations, which in turn might increase fertility-related discussions in paediatric oncology.
本研究旨在调查瑞典医生与儿科肿瘤患者及其家长讨论癌症治疗对生育能力影响的实践行为,并确定与这些讨论相关的因素。
本研究采用横断面调查,针对所有在瑞典从事儿科肿瘤护理工作的医生进行。参与者需回答一份问卷,内容涉及实践行为、态度、障碍和知识方面的信心。采用多变量逻辑回归来确定与较少讨论生育能力相关的因素。
超过一半的医生会定期与患者/家长讨论治疗对生育能力的潜在影响(男性患者:62%;女性患者:57%;P=0.570)。与较少与患者/家长讨论生育能力相关的因素包括在非大学医院工作(男性患者:OR 11.49,95%CI 1.98-66.67;女性患者:OR 33.18,95%CI 4.06-271.07)、担心该话题会引起担忧(男性患者:OR 8.23,95%CI 1.48-45.89;女性患者:OR 12.38,95%CI 1.90-80.70)以及认为家长焦虑(男性患者:OR 7.18,95%CI 1.20-42.85;女性患者:OR 11.65,95%CI 1.32-103.17)。
根据我们的发现,我们建议进行结构化培训,以掌握在紧张情况下如何沟通生育问题,这可能会增加儿科肿瘤学中的生育相关讨论。