解决癌症患者生育力保存的障碍：生育力保护患者导航的作用。
Addressing Barriers to Fertility Preservation for Cancer Patients: The Role of Oncofertility Patient Navigation.
作者信息
Dorfman Caroline S, Stalls Juliann M, Mills Coleman, Voelkel Shannon, Thompson Mallori, Acharya Kelly S, Baker Karen C, Wagner Lars M, Miller Nolan, Boswell Amy, Corbett Cheyenne
机构信息
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC.
Duke Supportive Care and Survivorship Center, Duke Cancer Institute, Duke University Medical Center, Durham, NC.
出版信息
J Oncol Navig Surviv. 2021 Oct;12(10):332-348.
BACKGROUND
Infertility is a common late effect for cancer survivors. Whereas assisted reproductive technology has made it possible for survivors to take steps to preserve fertility before starting treatment, only a minority of patients proceed with preservation. Patient-, provider-, health system-, and societal-level barriers to fertility preservation (FP) exist. Oncofertility patient navigation is a valuable resource for addressing FP barriers.
OBJECTIVES
To highlight the critical role of oncofertility patient navigation in addressing barriers to FP within an academic oncofertility program.
METHODS
The role of the oncofertility patient navigator in reducing FP barriers, promoting informed decision-making, and ensuring program sustainability is described. Program metrics illustrating the impact of oncofertility patient navigation on referrals for FP counseling and access to FP in the last year also are provided.
DISCUSSION
The oncofertility program at our academic adult and pediatric medical centers aims to facilitate rapid referral to fertility counseling and preservation services for postpubertal cancer patients. The patient navigator is integral to the success of the program. The navigator ensures that patients are: (1) well-informed about the potential impact of cancer on fertility and FP options, (2) aware of available resources (eg, financial) for pursuing FP, (3) able to access FP services if desired, and (4) well supported in making an informed FP decision. The inclusion of the patient navigator has led to an almost 2-fold increase in referrals for FP counseling in the past year over the historic annual average.
CONCLUSIONS
Our institution's oncofertility program, with patient navigation at the core, provides a potential model for increasing patient access to oncofertility care and promoting program sustainability. Oncofertility patient navigation is a valuable resource for providing patients and families with education and support regarding FP decision-making, as well as addressing the multilevel barriers to FP.
背景
不孕是癌症幸存者常见的晚期影响。虽然辅助生殖技术使幸存者在开始治疗前能够采取措施保存生育能力，但只有少数患者进行保存。在患者、提供者、卫生系统和社会层面存在生育力保存（FP）的障碍。肿瘤生育患者导航是解决FP障碍的宝贵资源。
目的
强调肿瘤生育患者导航在学术肿瘤生育项目中解决FP障碍的关键作用。
方法
描述了肿瘤生育患者导航员在减少FP障碍、促进知情决策和确保项目可持续性方面的作用。还提供了项目指标，说明了去年肿瘤生育患者导航对FP咨询转诊和FP可及性的影响。
讨论
我们学术性成人及儿科医疗中心的肿瘤生育项目旨在促进青春期后癌症患者快速转诊至生育咨询和保存服务。患者导航员是该项目成功的关键。导航员确保患者：（1）充分了解癌症对生育能力的潜在影响以及FP选项；（2）知晓用于进行FP的可用资源（如资金）；（3）如有需要能够获得FP服务；（4）在做出明智的FP决策时得到充分支持。在过去一年中，纳入患者导航员后，FP咨询转诊量比历史年度平均水平增加了近两倍。
结论
我们机构以患者导航为核心的肿瘤生育项目为增加患者获得肿瘤生育护理的机会和促进项目可持续性提供了一个潜在模式。肿瘤生育患者导航是为患者及其家庭提供有关FP决策的教育和支持以及解决FP多层次障碍的宝贵资源。
Zotero 插件