Translational Health Research Institute, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith South, 2751, Australia.
Reprod Health. 2018 Jan 5;15(1):2. doi: 10.1186/s12978-017-0441-z.
Individuals affected by cancer report a need for information about fertility from health care professionals (HCPs), in order to inform decision making and alleviate anxiety. However, there is evidence that many health professionals do not engage in such discussions.
A mixed method design was used to examine the construction and subjective experience of communication with health professionals about fertility in the context of cancer, from the perspective of patients. A survey was completed by 693 women and 185 men, across a range of cancer tumour types and age groups, and in-depth one-to-one interviews conducted with a purposively selected subsample of survey respondents, 61 women and 17 men. The chi square test for independence was used to test for group differences between women and men on closed survey items. Thematic analysis was used to examine the open ended survey responses and interviews.
Significantly more women (57%, n = 373) than men (46%, n = 80) (X = 6.54, p = .011) reported that they had discussed fertility with a HCP since diagnosis of cancer. Satisfaction with the discussion was reported by 65% (n = 242) of women and 69% (n = 54) (ns) of men. This discussion was reported to have been initiated by the patient or their partner in 44% (n = 165) of women and 47% (n = 37) (ns) of men. In the interviews and open ended surveys three themes were identified: Feeling heard and informed about fertility after cancer: Positive experiences of HCP communication; "I was never given full disclosure": HCP silence or reticence about discussing fertility after cancer, including the sub-theme "Their primary concern is getting me cancer free": Constructions of absence of fertility communication by HCPs; and Confusion and lack of compassion: Unsatisfactory information provision about fertility and cancer.
Discussion with a HCP about fertility concerns, and satisfaction with the discussion, was associated with reports of lower patient distress, greater knowledge and understanding of the consequences of cancer on fertility, involvement in the decision making process about fertility preservation, and satisfaction with health care.
患有癌症的个体报告称，他们需要从医疗保健专业人员（HCPs）那里获得有关生育能力的信息，以便做出决策并减轻焦虑。然而，有证据表明，许多卫生专业人员不进行此类讨论。
采用混合方法设计，从患者的角度考察了在癌症背景下与 HCP 就生育能力进行沟通的构建和主观体验。对 693 名女性和 185 名男性进行了一项调查，调查对象涵盖了多种癌症肿瘤类型和年龄组，并对调查受访者中的一个有目的的子样本进行了一对一的深入访谈，其中包括 61 名女性和 17 名男性。卡方检验用于检验女性和男性在封闭调查项目上的群体差异。使用主题分析方法来检查开放式调查回复和访谈。
报告称与 HCP 讨论过癌症诊断后生育能力的女性明显多于男性（57%，n=373 比 46%，n=80）（X=6.54，p=.011）。65%（n=242）的女性和 69%（n=54）（ns）的男性对讨论表示满意。报告称，讨论是由患者或其伴侣发起的，在 44%（n=165）的女性和 47%（n=37）（ns）的男性中。在访谈和开放式调查中，确定了三个主题：癌症后对生育能力的知情和知情：HCP 沟通的积极体验；“我从未被完全告知”：HCP 对癌症后讨论生育能力的沉默或回避，包括子主题“他们的首要关注点是让我无癌”：HCP 对生育能力沟通的缺失构建；以及困惑和缺乏同情心：关于生育能力和癌症的信息提供不令人满意。
与 HCP 讨论生育能力问题以及对讨论的满意度与报告的患者焦虑程度较低、对癌症对生育能力的后果的了解和理解程度更高、参与生育能力保留决策过程以及对医疗保健的满意度相关。
