Qualitative study of the fertility information support experiences of young breast cancer patients

Exploration of the Fertility Decision-Making Experiences of Women of Reproductive Age With Cancer: A Qualitative Systematic Review

Women of reproductive age with cancer face unique considerations in terms of fertility. The related decision-making process is complicated, and insufficient support can lead to decisional conflict. The aim of this qualitative systematic review was to identify and integrate qualitative evidence regarding the fertility decision-making process of women of reproductive age undergoing treatment for cancer. A qualitative systematic review was conducted following the Joanna Briggs Institute's methodology. Eight electronic databases were searched from inception to June 2023 for articles describing qualitative studies of the fertility decision-making process of women of reproductive age with cancer. Only original, full-text literature was examined, no limitation was placed on the publication language. Finally, 18 studies were included in a thematic analysis. We identified three analytical themes, namely "Perceived changes in fertility," "Influential participants in the decision-making process" and "Hard fertility decision-making processes of women," and nine descriptive themes that described the three analytical themes in detail. The results of qualitative synthesis emphasized that for women of reproductive age with cancer, fertility decision-making is a complex and dynamic process. These patients had experienced decisional conflict. Decision support from health care professionals was considered to be essential, and the use of patient decision aids in clinical settings was recommended. The synthesis results clarify women's fertility decision-making process, decision needs and the influencing factors, which offer evidence to guide the development of applicable patient decision aid tools to provide high-quality fertility services to women. TRIAL REGISTRATION: PROSPERO Registration Number: CRD42023434490.

Development and psychometric testing of the family caregiver self-efficacy scale for patients in the early post-coronary artery bypass grafting

BACKGROUND AND OBJECTIVES

Family caregiver self-efficacy plays an important role in improving the health and quality of life of patients in the early post-coronary artery bypass grafting (CABG). However, there is a lack of targeted self-efficacy assessment tool for caregivers of patients. Thus, the purpose of this study was to develop a Family Caregiver Self-Efficacy Scale for patients in the early post-CABG (FCSES-EPCABG) and to test its reliability and validity.

METHODS

Based on self-efficacy theory, the initial scale was formed by the literature review, semi-structured interviews, Delphi expert consultation, and pre-survey. Through the convenience sampling method, 133 caregivers who met the selection criteria were chosen for the questionnaire survey at Wuhan Asian Heart Hospital from January 2024 to May 2024. The aim was to test the reliability and validity of the scale.

RESULTS

The final scale contained five dimensions of wound care, medication management, cardiac rehabilitation management, social support, and self-care, with a total of 22 items. The item-level content validity index ranged from 0.889 to 1.000, the scale-level content validity index/average was 0.985, and the content validity ratio ranged from 0.778 to 1.000. The exploratory factor analysis showed that the cumulative variance contribution rate of the five dimensions was 69.433%. In the criterion-related validity analysis, the total score of the FCSES-EPCABG was positively correlated with the total score of the General Self-Efficacy Scale (r = 0.762, P<0.001). The Cronbach's alpha coefficient of the scale was 0.919, the half reliability was 0.779, and the test-retest reliability was 0.936.

CONCLUSION

The FCSES-EPCABG has satisfactory reliability and validity, which is suitable for evaluating the self-efficacy of family caregivers of patients in the early post-CABG.

Exploring Strategies to Alleviate Reproductive Concerns in Cancer Survivors: A Comprehensive Scoping Review of International Research

Objective: This review aims to summarize existing interventions from the international literature addressing fertility concerns in cancer patients, providing theoretical and practical guidance for future interventions. Methods: In September 2023, a systematic search covering 13 databases was conducted using the methodology outlined by the Joanne Briggs Institute for a comprehensive systematic review. This search identified published English and Chinese-language papers. Results: A total of 20 studies meeting inclusion criteria were included in this review. The studies predominantly originated in China and the United States. A comprehensive synthesis of interventions from the included literature across three dimensions and seven aspects was conducted. The interventions primarily focused on psychological interventions and web-based self-help tools for patients. The Reproductive Concerns After Cancer Scale (RCAC) was the primary assessment tool employed. Conclusion: Addressing fertility concerns in cancer patients is a complex issue involving various stakeholders and diverse intervention strategies. Lessons from international research can inform the development of context-specific interventions tailored to individual needs.

Post-Treatment Experiences of Reproductive Concerns Among Young Breast Cancer Survivors: A Descriptive Phenomenological Study

PURPOSE

The long-term fertility impact of cancer treatments is a significant concern for young breast cancer survivors. These reproductive concerns often become a persistent source of stress, negatively affecting their quality of life. This study aims to explore the reproductive concerns experienced by young breast cancer survivors post-treatment and the factors influencing their perceptions.

METHODS

This phenomenological study utilized semi-structured interviews to collect data. Eighteen participants were recruited from a tertiary hospital in Mainland China. The interviews were transcribed verbatim and analyzed using Colaizzi's method.

RESULTS

Data analysis revealed five themes and fourteen subthemes: (1) multiple emotional burdens interwoven with concerns about fertility; (2) concerns about risks associated with reproduction; (3) dilemma of childrearing; (4) the significance of reproduction; (5) support needs from family, peers, and professionals.

CONCLUSION

Young breast cancer survivors in China face significant challenges related to reproductive issues. Reproductive health is a crucial aspect of breast cancer survivorship care. Healthcare providers must be attentive to the reproductive concerns of survivors, recognize the importance of multidimensional support for positive adaptation, and offer tailored and ongoing interventions to manage reproductive health in young breast cancer survivors.

Breast cancer patients' perspectives and needs about wed-based surgical decision aid: A qualitative study

PURPOSE

Breast cancer diagnosis often presents patients with complex treatment decisions, particularly concerning surgical options. A patient decision aid can assist patients in making better decisions, and ultimately improving health outcomes positively. This study aims to explore the perceptions and needs of breast cancer patients regarding the utilization of wed-based surgical decision aids.

METHODS

A descriptive qualitative study was conducted using semi-structured interviews with purposive sampling that were audio recorded and transcribed verbatim. A thematic analysis was conducted using NVivo 12 software. Participants were recruited from a tertiary general hospital in Shanghai, China. Inclusion criteria were being diagnosed with breast cancer, age over 18 years old, considering breast cancer surgery as a treatment option and able/willing to give informed consent.

RESULTS

From March to May 2023, 16 patients consented to participate and completed the interviews. Three major themes were revealed, with corresponding sub-themes: (1) informative and useful content (need to know as much information as possible, easy to understand and presented in multiple ways and highly credible from reliable resource); (2) user-friendly on design (easy to operate, simple function and man-machine interaction); and (3) suggested timing of use.

CONCLUSIONS

Patients' perspectives and needs about wed-based surgical decision aids are numerous and diverse. In designing wed-based surgical decision aids for breast cancer patients, content, design and timing are all factors that need to be taken into consideration to encourage informed surgical decisions. Further work will focus on developing a feasible and acceptable web-based surgical patient decision aid (PtDA), and test its usability in a clinical setting to understand if the PtDA can meet the decisional needs of breast cancer patients, thus to improve quality of decision-making.

Experiences of doctors and nurses offering fertility guidance to young breast cancer patients: A qualitative study

PURPOSE

Existing qualitative studies on young breast cancer patients' fertility have explored patients' perspectives rather than those of doctors and nurses. With the goal of presenting a scientific basis for the design of high-quality fertility guidance programs, this study examines the advantages and disadvantages of providing fertility guidance, as well as the obstacles perceived by doctors and nurses.

METHODS

Purposive sampling was used to select 16 doctors and nurses from a Class III Grade A cancer hospital in Hunan Province, China, from March to May 2023. Face-to-face in-depth interviews were conducted. The interview data were analyzed and organized using Colaizzi's seven-step analysis method and NVivo software, respectively.

RESULTS

Three themes and nine sub-themes were extracted from the data: (1) Attitude: maintain patients' fertility hope, respect patients' fertility wishes; (2) Obstacles: patient factors, family factors, healthcare worker factors; (3) Suggestions: enhance the professional confidence of doctors and nurses, ensure two-way communication between doctors and patients, promote interdisciplinary knowledge sharing, and establish a whole-process fertility guidance model.

CONCLUSIONS

When carrying out fertility guidance for young breast cancer patients, doctors and nurses should fully respect and safeguard the patients' fertility wishes and hope, continuously strengthen their own knowledge reserve, promote interdisciplinary cooperation and improve their communication abilities, rationally analyze the hindrances, and provide continuous and personalized fertility guidance considering factors related to the patient and their family.

The experiences of reproductive concerns in cancer survivors: A systematic review and meta-synthesis of qualitative studies

AIM

The aim of this study was to synthesize qualitative research evidence on cancer survivors' experiences with reproductive concerns (RC).

METHODS

We conducted a systematic search of qualitative studies and utilized the meta-aggregation approach. The database searches were extended up to May 14, 2023, encompassing 12 databases, specifically MEDLINE, CINAHL, PubMed, EMBASE, Scopus, Web of Science (Core Collection), AMED, PsycINFO, The Cochrane Library, CNKI, Wan Fang Data, and VIP.

RESULTS

Three overarching themes were synthesized from the analysis of 21 studies that explored cancer patients' awareness of reproductive concerns, their perceptions, needs, and coping styles. These themes encapsulate the multifaceted aspects of cancer patients' reproductive concerns: "Gender differences in fertility concerns among cancer patients: Perspectives from men and women"; "The influence of age: Experiences with fertility issues among cancer patients at different life stages"; "The impact of treatment stages on fertility concerns: The evolution of perception and coping strategies in the course of cancer treatment".

CONCLUSION

Our study presents an in-depth exploration of the reproductive concerns experienced by cancer patients from various perspectives. We found that the internal experiences of reproductive concerns, their perceptions, needs, and coping mechanisms differ based on their roles. This comprehensive understanding of the complex emotions and needs of cancer patients when confronted with fertility issues can guide clinicians in providing more effective medical assistance, psychological counseling, and fertility-related information services.

Reproductive concerns among young adult women with breast cancer: a systematic review protocol

INTRODUCTION

Reproductive concerns refer to worries about impaired or lost reproductive ability due to disease or/and treatment. Many young female patients with breast cancer experience reproductive concerns because they still desire to have children at the time of diagnosis. Reproductive concerns can impact patients' treatment decision-making as well as their psychological health and quality of life. Understanding the situation, contributing factors and health-related consequences of reproductive concerns among patients with breast cancer is essential to minimise their impacts.

METHODS AND ANALYSIS

A systematic review will be conducted. We will search five English databases (PubMed, Embase, CINAHL, Web of Science and APA PsycInfo) and four Chinese databases (Wang Fang database, VIP, CBM and CNKI) for pertinent studies. Other relevant studies will be identified from the reference lists of included studies. Two reviewers will independently perform study selection, data extraction and quality appraisal. Any discrepancies between the two reviewers will be resolved through consultation and discussion with the senior reviewer. A formal narrative synthesis will be performed to summarise the findings of individual studies. This review aims to improve understanding of the level of reproductive concerns, factors associated with reproductive concerns and health-related consequences of reproductive concerns among patients with breast cancer. The findings can contribute to the development of tailored interventions to alleviate reproductive concerns of patients with breast cancer, enhancing their psychological health and quality of life.

ETHICS AND DISSEMINATION

Ethical approval is not required for this review, as it will be based on published studies. The findings will be disseminated by publishing in a journal.

PROSPERO REGISTRATION NUMBER

CRD42022375247.