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癌症青年女性在癌症治疗期间如何体验生育力保存咨询?丹麦一家三级医院的定性单中心研究。

How Do Young Women with Cancer Experience Oncofertility Counselling during Cancer Treatment? A Qualitative, Single Centre Study at a Danish Tertiary Hospital.

作者信息

Bentsen Line, Pappot Helle, Hjerming Maiken, Colmorn Lotte B, Macklon Kirsten T, Hanghøj Signe

机构信息

Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark.

Department of Hematology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark.

出版信息

Cancers (Basel). 2021 Mar 17;13(6):1355. doi: 10.3390/cancers13061355.

Abstract

BACKGROUND

Adolescents and young adults (AYAs) with cancer are at risk of therapy-induced infertility. The importance of initial and specialized fertility counselling to this patient group is undisputed. Despite international guidelines, oncofertility counselling is still inadequate. The purpose of this study was to examine how female AYA cancer patients and survivors experienced initial and specialized oncofertility counselling, and to present their specific suggestions on how to improve the oncofertility counselling.

METHODS

Twelve individual semi-structured interviews were performed with AYAs aged 20-35 with cancer or who were survivors. Participants were recruited via a youth support centre and social organization for AYAs with cancer. Data was analysed using thematic analysis.

RESULTS

Three main themes were found: Support is needed for navigating the fertility information jungle; The doctor's approach determines the content of the patient consultation; Inadequate and worrying information causes mistrust and frustration.

CONCLUSION

Results indicate a continuing problem regarding insufficient oncofertility counselling to AYAs with cancer. To ensure adequate and uniform information, especially in the initial oncofertility counselling, national guidelines for oncology specialists are suggested including multidisciplinary effort and collaboration between oncology and fertility specialists in mind. In addition, participants suggest focus on communication skills.

摘要

背景

罹患癌症的青少年及青年(AYA)面临治疗导致不孕的风险。对该患者群体进行初始及专业的生育咨询的重要性是无可争议的。尽管有国际指南,但肿瘤生育咨询仍然不足。本研究的目的是调查女性AYA癌症患者及幸存者对初始及专业肿瘤生育咨询的体验,并就如何改善肿瘤生育咨询提出她们的具体建议。

方法

对年龄在20 - 35岁的患癌或已康复的AYA进行了12次个人半结构化访谈。参与者通过一个青年支持中心和一个针对患癌AYA的社会组织招募。使用主题分析法对数据进行分析。

结果

发现了三个主要主题:在生育信息丛林中导航需要支持;医生的方法决定患者咨询的内容;信息不足且令人担忧会导致不信任和沮丧。

结论

结果表明,为患癌AYA提供的肿瘤生育咨询不足这一问题仍然存在。为确保提供充分且统一的信息,尤其是在初始肿瘤生育咨询中,建议为肿瘤专科医生制定国家指南,其中要考虑到多学科的努力以及肿瘤专科医生与生育专科医生之间的协作。此外,参与者建议关注沟通技巧。

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