Faculty of Medicine, University of Basel, Basel, Switzerland.
Department of Gynecology and Obstetrics, University Hospital Basel, Basel, Switzerland.
BMJ Sex Reprod Health. 2018 Jul;44(3):175-180. doi: 10.1136/bmjsrh-2017-101820. Epub 2017 Nov 17.
Health professionals are challenged by a growing number of young long-term cancer survivors with their specific needs with regard to family planning. This study aimed at assessing decisional conflict (DC) in young female cancer patients regarding fertility preservation, identifying demographic, fertility and fertility preservation related factors, which may affect DC, and assessing the helpfulness of various decision-supports.
A retrospective, cross-sectional, web-based survey via an online questionnaire available in three languages with specific items concerning cancer, fertility, fertility preservation and the validated Decisional Conflict Scale targeted at current or former female cancer patients aged 18-45 years, with cancer types or treatment potentially affecting reproductive function.
The 155 participating women showed considerable DC, especially with regard to missing information and support. DC was significantly lower in patients when the risk of infertility was discussed with a health professional, when they had undergone any procedure to preserve fertility, and when they had a university education. A longer time interval since cancer diagnosis was associated with higher DC. The most helpful decision-support tools were specialised websites and leaflets.
Young female cancer patients' DC with regard to fertility preservation is very high. Information and support seem to be deficient. More information through standardised information tools might be an effective strategy to lower their DC at the time when treatment decisions need to be taken, and to improve their reproductive health after they have overcome cancer in the future.
越来越多的年轻长期癌症幸存者有特定的生育计划需求，这给健康专业人员带来了挑战。本研究旨在评估年轻女性癌症患者在生育力保存方面的决策冲突（DC），确定可能影响 DC 的人口统计学、生育力和生育力保存相关因素，并评估各种决策支持的有效性。
采用回顾性、横断面、基于网络的问卷调查，通过三种语言的在线问卷，针对当前或曾经的 18-45 岁患有可能影响生殖功能的癌症类型或治疗的女性癌症患者，设计了专门针对癌症、生育力、生育力保存和经过验证的决策冲突量表的特定项目。
155 名参与的女性表现出相当大的决策冲突，尤其是在信息缺失和支持方面。当与健康专业人员讨论不孕风险、进行任何生育力保存程序以及接受过大学教育时，患者的 DC 显著降低。癌症诊断后时间间隔较长与较高的 DC 相关。最有用的决策支持工具是专门的网站和宣传册。
年轻女性癌症患者在生育力保存方面的决策冲突非常高。信息和支持似乎不足。通过标准化信息工具提供更多信息可能是一种有效的策略，可以在需要做出治疗决策时降低他们的 DC，并在他们未来战胜癌症后改善他们的生殖健康。
