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癌症患者在确定性和不确定性情况下的生育决策制定

Fertility decision-making under certainty and uncertainty in cancer patients.

作者信息

Komatsu Hiroko, Yagasaki Kaori, Yamauchi Hideko

机构信息

Faculty of Nursing and Medical Care, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.

Department of Breast Surgery, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo 104-8560, Japan.

出版信息

Sex Reprod Healthc. 2018 Mar;15:40-45. doi: 10.1016/j.srhc.2017.12.002. Epub 2017 Dec 7.

Abstract

OBJECTIVE

The objective of this study was to understand how reproductive-age women with breast cancer make fertility-related decisions.

METHODS

Using grounded theory methodology, we collected data from 11 reproductive-age women with breast cancer between March and August 2016. Verbatim transcriptions were analyzed using constant comparative analysis and open, axial, and selective coding.

RESULTS

"Fertility Decision-Making under Certainty and Uncertainty" emerged as a core category. Fertility decision-making started with the participants' "values and preferences" about having a child. In making a decision, there were certainty ("Information" and "Emotional support") and uncertainty ("Time constraints," "Recurrent risk," "Labeling," and "Unmet needs") factors. Participants had more uncertainty factors than certainty factors, and healthcare professionals' services accounted for one of the uncertainty factors.

CONCLUSIONS

After fertility preservation counseling, women with cancer made difficult decisions in stressful situations without sufficient healthcare information and support. Tailored information should be provided to individual women in collaboration between oncology and reproductive health professionals.

摘要

目的

本研究的目的是了解患有乳腺癌的育龄妇女如何做出与生育相关的决定。

方法

采用扎根理论方法,我们于2016年3月至8月间收集了11名患有乳腺癌的育龄妇女的数据。使用持续比较分析以及开放编码、轴心编码和选择编码对逐字记录进行分析。

结果

“确定性和不确定性下的生育决策”成为一个核心类别。生育决策始于参与者对生育孩子的“价值观和偏好”。在做决定时,存在确定性因素(“信息”和“情感支持”)和不确定性因素(“时间限制”、“复发风险”、“标签”和“未满足的需求”)。参与者面临的不确定性因素多于确定性因素,医疗保健专业人员的服务是不确定性因素之一。

结论

在接受生育力保存咨询后,患有癌症的女性在压力情境下,在没有足够医疗信息和支持的情况下做出了艰难的决定。肿瘤学和生殖健康专业人员应合作,为个体女性提供量身定制的信息。

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