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支持性肿瘤生育护理、心理健康和生殖关注:一项定性研究。

Supportive oncofertility care, psychological health and reproductive concerns: a qualitative study.

机构信息

School of Women and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, Australia.

Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia.

出版信息

Support Care Cancer. 2020 Feb;28(2):809-817. doi: 10.1007/s00520-019-04883-1. Epub 2019 Jun 1.

Abstract

PURPOSE

Impaired fertility in cancer patients and survivors of reproductive age (15-45 years) may lead to psychological distress and poor mental health outcomes, and may negatively impact quality of life. Limited research has focused on the fertility experiences of those who have had access to supportive oncofertility care. This study aims to explore the fertility-care experiences and reproductive concerns of reproductive age cancer patients at the time of their cancer diagnosis who have had access to oncofertility care.

METHODS

The qualitative data from a larger mixed method study is presented, comprising 30 semi-structured telephone interviews with newly diagnosed cancer patients across Australia and New Zealand, undertaken between April 2016 and April 2018.

RESULTS

Interviews were undertaken with 9 male patients and 21 female patients aged between 15 and 44 years. All patients recalled a discussion about fertility and majority underwent some form of fertility preservation. Thematic analysis identified five main themes: (i) satisfaction with oncofertility care, (ii) a need for individualised treatment and support, (iii) desire for parenthood, (iv) fertility treatment can be challenging, and (v) fertility preservation provides a safety net for the future.

CONCLUSIONS

Participants who access supportive oncofertility care report low emotional impact of threatened future infertility at the time of cancer diagnosis. These results suggest that such services may assist in lowering the emotional burden of potential infertility in survivors. Long-term research is needed to assess the longitudinal benefits for different models of care.

摘要

目的

处于生育年龄(15-45 岁)的癌症患者和幸存者生育能力受损可能导致心理困扰和心理健康不良后果,并可能对生活质量产生负面影响。有限的研究集中在那些获得支持性肿瘤生育护理的人的生育经历上。本研究旨在探讨在癌症诊断时已获得肿瘤生育护理的生育年龄癌症患者的生育护理体验和生殖关注。

方法

本研究报告了一项更大的混合方法研究的定性数据,该研究包括 2016 年 4 月至 2018 年 4 月期间在澳大利亚和新西兰进行的 30 次与新诊断癌症患者的半结构式电话访谈。

结果

共访谈了 9 名年龄在 15 至 44 岁之间的男性患者和 21 名女性患者。所有患者都回忆起了关于生育能力的讨论,大多数患者都进行了某种形式的生育力保存。主题分析确定了五个主要主题:(i)对肿瘤生育护理的满意度,(ii)需要个体化的治疗和支持,(iii)对父母身份的渴望,(iv)生育治疗具有挑战性,以及(v)生育力保存为未来提供了安全网。

结论

接受支持性肿瘤生育护理的参与者在癌症诊断时报告对未来生育能力受到威胁的情绪影响较低。这些结果表明,此类服务可能有助于降低幸存者潜在不孕的情绪负担。需要进行长期研究来评估不同护理模式的长期效益。

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