Kim Minji, Ha Juyoung
College of Nursing, Pusan National University, Yangsan, Korea.
Department of Nursing, Pusan National University Hospital, Busan, Korea.
J Korean Acad Nurs. 2024 Aug;54(3):418-431. doi: 10.4040/jkan.23151.
This study aimed to identify factors influencing oncofertility and to explore the oncofertility experiences of patients with gynecological cancer using quantitative and qualitative methods, respectively.
An explanatory sequential mixed-methods study was conducted. The quantitative study involved 222 patients with gynecological cancer recruited from online cafes and hospitals. Data were analyzed using IBM SPSS Statistics 28. For qualitative research, eight patients with gynecological cancer were interviewed. Data were analyzed using theme analysis method.
Oncofertility performance was quantitatively assessed in 40 patients (18.0%). Factors that significantly affected oncofertility were fertility preservation awareness (odds ratio [OR] = 14.97, 95% confidence interval [CI]: 4.2253.08), number of children planned before cancer diagnosis (OR = 6.08, 95% CI: 1.8919.62; OR = 5.04, 95% CI: 1.5616.29), monthly income (OR= 3.29, 95% CI: 1.238.86), social support (OR = 1.08, 95% CI: 1.011.17), and anxiety (OR = 0.79, 95% CI: 0.660.95). Qualitative results showed three theme clusters and eight themes: (1) themes for determinant factors affecting oncofertility selection: 'desire to have children' and 'special meaning of the uterus and ovaries;' (2) themes for obstructive factors affecting oncofertility selection: 'fertility preservation fall behind priorities,' 'confusion caused by inaccurate information,' and 'my choice was not supported;' (3) themes for support factors affecting oncofertility selection: 'provide accurate and reasonable information about oncofertility,' 'addressing the healthcare gap,' and 'need financial support for oncofertility.'
Financial support, sufficient information, social support, and anxiety-relief interventions are required for oncofertility in patients with gynecological cancer.
本研究旨在分别运用定量和定性方法，确定影响肿瘤生育力的因素，并探索妇科癌症患者的肿瘤生育力经历。
开展了一项解释性序贯混合方法研究。定量研究纳入了从网吧和医院招募的222例妇科癌症患者。使用IBM SPSS Statistics 28对数据进行分析。定性研究方面，对8例妇科癌症患者进行了访谈。采用主题分析法对数据进行分析。
对40例患者（18.0%）进行了肿瘤生育力表现的定量评估。显著影响肿瘤生育力的因素有生育力保存意识（比值比[OR]=14.97，95%置信区间[CI]：4.2253.08）、癌症诊断前计划生育的子女数（OR=6.08，95% CI：1.8919.62；OR=5.04，95% CI：1.5616.29）、月收入（OR=3.29，95% CI：1.238.86）、社会支持（OR=1.08，95% CI：1.011.17）和焦虑（OR=0.79，95% CI：0.660.95）。定性结果显示了三个主题集群和八个主题：（1）影响肿瘤生育力选择的决定因素主题：“生育愿望”和“子宫与卵巢的特殊意义”；（2）影响肿瘤生育力选择的阻碍因素主题：“生育力保存落后于优先事项”、“不准确信息导致的困惑”和“我的选择未得到支持”；（3）影响肿瘤生育力选择的支持因素主题：“提供关于肿瘤生育力的准确合理信息”、“解决医疗差距”和“肿瘤生育力需要资金支持”。
妇科癌症患者的肿瘤生育力需要资金支持、充分的信息、社会支持和缓解焦虑的干预措施。
