Melo Cláudia, Fonseca Ana, Silva Cristina, Almeida-Santos Teresa, Canavarro Maria Cristina
Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal.
Unit of Psychological Intervention, Maternity Daniel de Matos, Coimbra Hospital and University Centre, Coimbra, Portugal.
Eur J Cancer Care (Engl). 2018 Mar;27(2):e12812. doi: 10.1111/ecc.12812. Epub 2018 Jan 4.
This study aims to investigate the current practice patterns of Portuguese oncologists with different clinical specialties regarding female fertility preservation (FP) and to determine the relative endorsement of different barriers to these practices. A total of 111 doctors with different clinical specialties assisting female cancer patients of childbearing age at Portuguese clinical institutions completed a self-report questionnaire to assess their current practice patterns regarding female FP and their perceptions of the barriers to these practices. Although the majority of the oncologists reported discussing the reproductive future with their patients, 2.8% and 7.2% of these clinicians reported never informing about the risk of infertility and about FP, respectively, and 75.8% of the participants have referred fewer than ten patients to a reproductive medicine doctor. Time with patients was the strongest endorsed barrier to these practices. A stronger endorsement of the barriers "oncologists' communication skills" and "patient-related factors" was related to a lower frequency of informing about both the risk of cancer-related infertility and about FP. It is important to overcome the intrinsic barriers that emerged as being the most relevant to oncologists' FP practices and that can be modified, namely the lack of communication skills and the oncologists' perceptions of their patients' characteristics.
本研究旨在调查葡萄牙不同临床专业的肿瘤学家在女性生育力保存（FP）方面的当前实践模式，并确定这些实践中不同障碍的相对认可度。共有111名在葡萄牙临床机构为育龄期女性癌症患者提供治疗的不同临床专业的医生完成了一份自我报告问卷，以评估他们在女性生育力保存方面的当前实践模式以及对这些实践障碍的看法。尽管大多数肿瘤学家报告称会与患者讨论生殖未来，但分别有2.8%和7.2%的临床医生报告从未告知患者不孕风险和生育力保存相关信息，并且75.8%的参与者转诊给生殖医学医生的患者少于10名。与患者相处的时间是这些实践中认可度最高的障碍。对“肿瘤学家的沟通技巧”和“患者相关因素”障碍的更高认可度与告知癌症相关不孕风险和生育力保存相关信息的频率较低有关。克服那些已显现出与肿瘤学家的生育力保存实践最相关且可改变的内在障碍很重要，即沟通技巧的缺乏以及肿瘤学家对患者特征的看法。
