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针对年轻成年女性癌症幸存者的癌症后生育决策辅助与规划工具的感知影响。

Perceived impact of a decision-aid and planning tool for family building after cancer for young adult female cancer survivors.

作者信息

Jagielo Annemarie D, Shanley Jacqueline, Diefenbach Michael A, Ford Jennifer S, Schapira Lidia, Benedict Catherine

机构信息

PGSP-Stanford Psy.D. Consortium, Palo Alto University, Palo Alto, CA, USA.

Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA, USA.

出版信息

Support Care Cancer. 2025 May 3;33(5):444. doi: 10.1007/s00520-025-09478-7.

Abstract

PURPOSE

Young adult female (YA-F) cancer survivors report fertility-related uncertainty and distress. Roadmap to Parenthood ("Roadmap") is a web-based decision aid and planning tool for family building after cancer. This study examined the perceived impact of Roadmap, encompassing aspects of website utility and its effects on confidence and motivation, identified factors related to the perceived impact of Roadmap, and evaluated whether the perceived impact related to changes in psychosocial outcomes.

METHODS

Secondary analyses of a single-arm pilot study were conducted. Participants completed a baseline survey (T1), accessed Roadmap, and completed a survey 1 month post-baseline (T2). The eHealth Impact Questionnaire (eHIQ) measured the perceived impact of Roadmap. A linear regression model evaluated associations between baseline factors and the eHIQ. Linear regression models evaluated relationships between the eHIQ and decisional conflict, unmet information needs, fertility self-efficacy, and self-efficacy for managing fertility-related negative emotions at T2, controlling for baseline (T1) levels of each outcome.

RESULTS

Among participants (N = 98), 93% reported accessing Roadmap. A more positive perceived impact of Roadmap was related to younger age (β =  - .348 p = .002), lower household income (β =  - .321. p = .021), greater health literacy (β = .326 p = .004), and dissatisfaction with post-treatment fertility discussions (β =  - .279 p = .029). Those who reported a more positive perceived impact of Roadmap reported lower decisional conflict (β =  - .368, p < .001) and unmet information needs (β =  - .515, p < .001); self-efficacy outcomes were not related.

CONCLUSION

A web-based decision aid for family building after cancer effectively supports important survivor subgroups. Future directions include assessing the needs of those with low health literacy and improving patient-provider communication.

摘要

目的

年轻成年女性(YA - F)癌症幸存者报告了与生育相关的不确定性和困扰。“为人父母路线图”(“路线图”)是一种基于网络的决策辅助工具和癌症后家庭生育规划工具。本研究考察了路线图的感知影响,包括网站效用的各个方面及其对信心和动机的影响,确定了与路线图感知影响相关的因素,并评估了感知影响是否与心理社会结果的变化有关。

方法

对一项单臂试点研究进行二次分析。参与者完成基线调查(T1),访问路线图,并在基线后1个月完成调查(T2)。电子健康影响问卷(eHIQ)测量路线图的感知影响。线性回归模型评估基线因素与eHIQ之间的关联。线性回归模型评估T2时eHIQ与决策冲突、未满足的信息需求、生育自我效能以及管理与生育相关负面情绪的自我效能之间的关系,并控制每个结果的基线(T1)水平。

结果

在参与者(N = 98)中,93%报告访问了路线图。路线图更积极的感知影响与年龄较小(β = -0.348,p = 0.002)、家庭收入较低(β = -0.321,p = 0.021)、健康素养较高(β = 0.326,p = 0.004)以及对治疗后生育讨论不满意(β = -0.279,p = 0.029)有关。那些报告路线图有更积极感知影响的人报告的决策冲突较低(β = -0.368,p < 0.001)和未满足的信息需求较低(β = -0.515,p < 0.001);自我效能结果无关。

结论

一种基于网络的癌症后家庭生育决策辅助工具有效地支持了重要的幸存者亚组。未来的方向包括评估健康素养低的人群的需求以及改善医患沟通。

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