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Critoph DJ, Taylor RM, Spathis A, Duschinsky R, Hatcher H, Clyne E, Kuhn I, Smith LAM. Triadic communication with teenagers and young adults with cancer: a systematic literature review - 'make me feel like I'm not the third person'. BMJ Open 2024; 14:e080024. [PMID: 38367963 PMCID: PMC10875529 DOI: 10.1136/bmjopen-2023-080024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 02/02/2024] [Indexed: 02/19/2024] Open
Abstract
OBJECTIVES Clinical communication needs of teenagers and young adults with cancer (TYACs) are increasingly recognised to differ significantly from younger children and older adults. We sought to understand who is present with TYACs, TYACs' experiences of triadic communication and its impact. We generated three research questions to focus this review: (1) Who is present with TYACs in healthcare consultations/communication?, (2) What are TYACs' experiences of communication with the supporter present? and (3) What is the impact of a TYAC's supporter being present in the communication? DESIGN Systematic review with narrative synthesis. DATA SOURCES The search was conducted across six databases: Medline, CINAHL, Embase, PsycINFO, Web of Science and AMED for all publications up to December 2023. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Included papers were empirical research published after 2005; participants had malignant disease, diagnosed aged 13-24 years (for over 50% of participants); the research addressed any area of clinical communication. DATA EXTRACTION AND SYNTHESIS Three independent reviewers undertook full-text screening. A review-specific data extraction form was used to record participant characteristics and methods from each included paper and results relevant to the three review questions. RESULTS A total of 8480 studies were identified in the search, of which 36 fulfilled the inclusion criteria. We found that mothers were the most common supporter present in clinical communication encounters. TYACs' experiences of triadic communication are paradoxical in nature-the supporter can help or hinder the involvement of the young person in care-related communication. Overall, young people are not included in clinical communication and decisions at their preferred level. CONCLUSION Triadic communication in TYACs' care is common, complex and dynamic. Due to the degree of challenge and nuances raised, healthcare professionals need further training on effective triadic communication. PROSPERO REGISTRATION NUMBER CRD42022374528.
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Affiliation(s)
- Deborah J Critoph
- Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK
| | - Rachel M Taylor
- CNMAR, University College London Hospitals NHS Foundation Trust, London, UK
| | - Anna Spathis
- Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK
| | - Robbie Duschinsky
- Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK
| | - Helen Hatcher
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | - Isla Kuhn
- Medical Library, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Luke A M Smith
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
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2
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Maezawa T, Suzuki N, Takeuchi H, Nishioka M, Hidaka M, Manabe A, Koga Y, Kawaguchi H, Sasahara Y, Tachibana M, Iwamoto S, Horie A, Hiramatsu H, Kato M, Harada M, Yuza Y, Hirayama M, Takita J, Ikeda T, Matsumoto K. Challenges to Widespread Use of Fertility Preservation Facilities for Pediatric Cancer Patients in Japan. J Adolesc Young Adult Oncol 2024; 13:197-202. [PMID: 37535825 DOI: 10.1089/jayao.2023.0059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023] Open
Abstract
Purpose: Although fertility preservation for pediatric cancer patients is becoming more widespread in Japan, some facilities do not provide sufficient information regarding fertility. This study aimed to elucidate the problems pertaining to the lack of information about fertility among patients. Methods: Based on a 2020 survey, seminars addressing fertility preservation were held from the Designated Pediatric Cancer Care Hospitals in each of the seven blocks in Japan to their partner hospital (pediatric cancer hospitals). The seminar consisted of lectures and group discussions, and a questionnaire was also administered after each seminar. Results: In the group discussions, a lack of explanations to patients and explanatory materials for children were cited as issues by many facilities. The survey results revealed a lack of material explaining fertility preservation and a lack of knowledge among health care providers. There were also many requests to use the patient explanation videos presented at the seminar. Conclusion: The results indicate that further education for health care providers by seminar and other sources and enhancement of explanatory materials are important for fertility preservation in pediatric cancer hospitals in Japan.
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Affiliation(s)
- Tadashi Maezawa
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Mie University, Tsu, Japan
| | - Nao Suzuki
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Hiroki Takeuchi
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Mie University, Tsu, Japan
| | - Mikiko Nishioka
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Mie University, Tsu, Japan
| | - Moe Hidaka
- Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Japan
| | - Atsushi Manabe
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Yuhki Koga
- Department of Perinatal and Pediatric Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroshi Kawaguchi
- Department of Pediatrics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Yoji Sasahara
- Department of Pediatrics and Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Masahito Tachibana
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Shotaro Iwamoto
- Department of Pediatrics, Graduate School of Medicine, Mie University,Tsu, Japan
| | - Akihito Horie
- Department of Gynecology and Obstetrics and Graduate School of Medicine, Kyoto University, Kyoto city, Japan
| | - Hidefumi Hiramatsu
- Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto city, Japan
| | - Motohiro Kato
- Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Japan
| | - Miyuki Harada
- Department of Gynecology and Obstetrics, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Japan
| | - Yuki Yuza
- Division of Hematology/Oncology, Tokyo Metropolitan Children's Medical Center, Fuchu-shi, Japan
| | - Masahiro Hirayama
- Department of Pediatrics, Graduate School of Medicine, Mie University,Tsu, Japan
| | - Junko Takita
- Department of Gynecology and Obstetrics and Graduate School of Medicine, Kyoto University, Kyoto city, Japan
| | - Tomoaki Ikeda
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Mie University, Tsu, Japan
| | - Kimikazu Matsumoto
- Children's Cancer Center, National Center for Child Health and Development, Setagaya-ku, Japan
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Iwahata Y, Takae S, Iwahata H, Matsumoto K, Hirayama M, Takita J, Manabe A, Cho Y, Ikeda T, Maezawa T, Miyachi M, Keino D, Koizumi T, Mori T, Shimizu N, Woodruff TK, Suzuki N. Investigation of Fertility Preservation Education Videos for Pediatric Patients Based on International and Historical Survey. J Adolesc Young Adult Oncol 2023; 12:835-842. [PMID: 37155199 DOI: 10.1089/jayao.2022.0154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023] Open
Abstract
Purpose: Recently, direct communication with children about cancer seems to have shifted, but little is known about communication regarding discussions of future infertility risk due to cancer therapy. This study conducted cross-cultural comparisons between Japan and the United States to clarify communication patterns about cancer notification and develop appropriate information about fertility issues. Methods: An online survey was distributed to members of the Japanese Society of Pediatric Hematology/Oncology in July 2019 and the American Society of Pediatric Hematology/Oncology in July 2020. Based on the results from the survey, we developed three types of educational videos: a prepubertal version A, B, and a pubertal version. Next, we conducted a survey to assess whether these were appropriate for clinical practice. Results: We analyzed 325 physicians in Japan and 46 in the United States. In Japan, 80.5%, 91.7%, and 92.1% of the physicians notified patients aged 7-9, 10-14, and 15-17 years of their cancer diagnosis directly, respectively, compared within the United States, where the rate was 100%, regardless of age. Further, 9% and 45% of physicians in Japan and the United States, respectively, discuss fertility issues directly with patients aged 7-9 years. In the survey to assess the educational videos, 85% of the physicians preferred to use the educational videos in clinical practice. Conclusion: This is the first step in bringing concordance to communication patters for emerging cancer care around the globe and that this study and its intervention arm provide guidance in ways that ensure global equity in care.
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Affiliation(s)
- Yuriko Iwahata
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Seido Takae
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Hideyuki Iwahata
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Kimikazu Matsumoto
- National Center for Child Health and Development, Children's Cancer Center, Tokyo, Japan
| | - Masahiro Hirayama
- Department of Pediatrics, Mie University Graduate School of Medicine, Tsu, Japan
| | - Junko Takita
- Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Atsushi Manabe
- Department of Pediatrics, Hokkaido University, Sapporo, Japan
| | - Yuko Cho
- Department of Pediatrics, Hokkaido University, Sapporo, Japan
| | - Tomoaki Ikeda
- Department of Obstetrics and Gynecology, Mie University, Tsu, Japan
| | - Tadashi Maezawa
- Department of Obstetrics and Gynecology, Mie University, Tsu, Japan
| | - Mitsuru Miyachi
- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Dai Keino
- Division of Hematology/Oncology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Tomoe Koizumi
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kanagawa, Japan
- International Center for Reproductive Medicine, Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan
| | - Tetsuya Mori
- Department of Pediatrics, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Naoki Shimizu
- Department of Pediatrics, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Teresa K Woodruff
- Department of Obstetrics and Gynecology, Michigan State University, East Lansing, Michigan, USA
| | - Nao Suzuki
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kanagawa, Japan
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Clasen NHZ, van der Perk MEM, Neggers SJCMM, Bos AME, van den Heuvel-Eibrink MM. Experiences of Female Childhood Cancer Patients and Survivors Regarding Information and Counselling on Gonadotoxicity Risk and Fertility Preservation at Diagnosis: A Systematic Review. Cancers (Basel) 2023; 15:cancers15071946. [PMID: 37046607 PMCID: PMC10093478 DOI: 10.3390/cancers15071946] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/12/2023] [Accepted: 03/21/2023] [Indexed: 03/29/2023] Open
Abstract
Background: Childhood cancer patients and their families are increasingly offered oncofertility care including information regarding their risk of gonadal damage by paediatric oncologists, fertility counselling by fertility specialists and fertility preservation options. However, experiences regarding oncofertility care are underreported. We aimed to summarize the available evidence of experiences of female childhood cancer patients and survivors regarding oncofertility care. Methods: Manuscripts were systematically identified using the PubMed and Embase database. From, respectively, 1256 and 3857 manuscripts, 7 articles were included and assessed, including risk of bias assessment. Outcome measures included data describing experiences of female childhood cancer patients and survivors, regarding fertility information, counselling and/or preservation. Results: Female patients and survivors are variably satisfied with fertility information, report challenges in communication with healthcare professionals and prefer to receive general information at diagnosis and detailed fertility information later. Regrets after fertility counselling are underreported, but are associated with refusing fertility preservation. Lastly, regardless of counselling, female patients and survivors report fertility concerns about their future children’s health and effect on relationships. Conclusion: Currently, the satisfaction with oncofertility care varies and female patients or survivors report regrets and concerns regardless of receiving fertility information or counselling. These results may help to improve the content of fertility information, communication skills of healthcare professionals and timing of counselling.
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Affiliation(s)
- Nikita H Z Clasen
- Princess Máxima Center for Pediatric Oncology, 3584CS Utrecht, The Netherlands
- Faculty of Medicine, Vrije Universiteit Amsterdam, 1081CX Amsterdam, The Netherlands
| | | | - Sebastian J C M M Neggers
- Department of Internal Medicine, Section Endocrinology, Erasmus Medical Center, 3015GD Rotterdam, The Netherlands
| | - Annelies M E Bos
- Princess Máxima Center for Pediatric Oncology, 3584CS Utrecht, The Netherlands
| | - Marry M van den Heuvel-Eibrink
- Princess Máxima Center for Pediatric Oncology, 3584CS Utrecht, The Netherlands
- Division of Child Health, Wilhelmina Children's Hospital, University Medical Center Utrecht, 3584EA Utrecht, The Netherlands
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Ligon JA, Hayashi M, Ciampa D, Kramer C, Guastella A, Fuchs RJ, Herati AS, Christianson MS, Chen AR. A multidisciplinary pediatric oncofertility team improves fertility preservation and counseling across 7 years. Cancer Rep (Hoboken) 2023; 6:e1753. [PMID: 36346013 PMCID: PMC9939996 DOI: 10.1002/cnr2.1753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 09/20/2022] [Accepted: 10/13/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Oncofertility is a developing field of increasing importance, particularly in pediatric oncology, where most patients are likely to survive long-term and have not yet had the opportunity to have children. AIMS We performed a quality improvement initiative to increase our rates of fertility preservation counseling and referral through the implementation of a pediatric oncofertility team, and we report outcomes 7 years following implementation of our initiative. METHODS AND RESULTS We compare our baseline oncofertility survey to 44 post-intervention survey respondents and electronic medical record documentation for 149 patients treated in 2019. Ninety-five percent of post-intervention survey respondents recalled fertility counseling (baseline 70%, p = .004) and 89.3% were appropriately referred for fertility preservation (baseline 50%, p = .017). Counseling was documented in 60.4% of charts; 81% of patients analyzed by chart review were appropriately referred for fertility preservation. Fertility preservation outcomes differed by sex assigned at birth. CONCLUSION Creation of an oncofertility team produced improvements in fertility counseling and fertility preservation referral across an extended period of time.
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Affiliation(s)
- John A. Ligon
- Sidney Kimmel Comprehensive Cancer CenterJohns Hopkins University (JHU)BaltimoreMarylandUSA
- Department of Pediatrics, Division of Hematology/OncologyUniversity of FloridaGainesvilleFloridaUSA
| | - Masanori Hayashi
- Department of Pediatrics—Hematology/oncology and Bone Marrow TransplantationUniversity of ColoradoAuroraColoradoUSA
| | - Devon Ciampa
- Sidney Kimmel Comprehensive Cancer CenterJohns Hopkins University (JHU)BaltimoreMarylandUSA
| | - Cara Kramer
- Sidney Kimmel Comprehensive Cancer CenterJohns Hopkins University (JHU)BaltimoreMarylandUSA
| | - Alfredo Guastella
- Sidney Kimmel Comprehensive Cancer CenterJohns Hopkins University (JHU)BaltimoreMarylandUSA
| | - Robert J. Fuchs
- Sidney Kimmel Comprehensive Cancer CenterJohns Hopkins University (JHU)BaltimoreMarylandUSA
| | - Amin S. Herati
- James Buchanan Brady Urological Institute and Department of UrologyJHUBaltimoreMarylandUSA
| | | | - Allen R. Chen
- Sidney Kimmel Comprehensive Cancer CenterJohns Hopkins University (JHU)BaltimoreMarylandUSA
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6
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van den Berg M, Kaal SEJ, Schuurman TN, Braat DDM, Mandigers CMPW, Tol J, Tromp JM, van der Vorst MJDL, Beerendonk CCM, Hermens RPMG. Quality of integrated female oncofertility care is suboptimal: A patient-reported measurement. Cancer Med 2022; 12:2691-2701. [PMID: 36031940 PMCID: PMC9939180 DOI: 10.1002/cam4.5149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 07/28/2022] [Accepted: 08/08/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Clinical practice guidelines recommend to inform female cancer patients about their infertility risks due to cancer treatment. Unfortunately, it seems that guideline adherence is suboptimal. In order to improve quality of integrated female oncofertility care, a systematic assessment of current practice is necessary. METHODS A multicenter cross-sectional survey study in which a set of systematically developed quality indicators was processed, was conducted among female cancer patients (diagnosed in 2016/2017). These indicators represented all domains in oncofertility care; risk communication, referral, counseling, and decision-making. Indicator scores were calculated, and determinants were assessed by multilevel multivariate analyses. RESULTS One hundred twenty-one out of 344 female cancer patients participated. Eight out of 11 indicators scored below 90% adherence. Of all patients, 72.7% was informed about their infertility, 51.2% was offered a referral, with 18.8% all aspects were discussed in counseling, and 35.5% received written and/or digital information. Patient's age, strength of wish to conceive, time before cancer treatment, and type of healthcare provider significantly influenced the scores of three indicators. CONCLUSIONS Current quality of female oncofertility care is far from optimal. Therefore, improvement is needed. To achieve this, improvement strategies that are tailored to the identified determinants and to guideline-specific barriers should be developed.
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Affiliation(s)
- Michelle van den Berg
- Department of Obstetrics and GynecologyRadboud University Medical CenterNijmegenthe Netherlands
| | - Suzanne E. J. Kaal
- Department of Medical OncologyRadboud University Medical CenterNijmegenthe Netherlands,Dutch AYA ‘Young and Cancer’ Care NetworkIKNLUtrechtthe Netherlands
| | - Teska N. Schuurman
- Center for Gynecologic Oncology AmsterdamThe Netherlands Cancer Institute‐Antoni van Leeuwenhoek HospitalAmsterdamThe Netherlands
| | - Didi D. M. Braat
- Department of Obstetrics and GynecologyRadboud University Medical CenterNijmegenthe Netherlands
| | | | - Jolien Tol
- Department of Medical Oncology, Jeroen Bosch HospitalDen BoschThe Netherlands
| | - Jacqueline M. Tromp
- Dutch AYA ‘Young and Cancer’ Care NetworkIKNLUtrechtthe Netherlands,Department of Medical OncologyAmsterdam University Medical CenterAmsterdamThe Netherlands
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Patel V, Jones P, Judd A, Senko V, Altieri G, Pettee D. Recollection of Fertility Discussion in Adolescent and Young Adult Oncology Patients: A Single-Institution Study. J Adolesc Young Adult Oncol 2020; 9:72-77. [DOI: 10.1089/jayao.2019.0075] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- Vanisha Patel
- Division of Pediatric Hematology Oncology, Akron Children's Hospital, Akron, Ohio
| | - Pamela Jones
- Division of Pediatric Hematology Oncology, Akron Children's Hospital, Akron, Ohio
| | - Alexis Judd
- Division of Pediatric Hematology Oncology, Akron Children's Hospital, Akron, Ohio
| | - Valerie Senko
- Division of Pediatric Hematology Oncology, Akron Children's Hospital, Akron, Ohio
| | - Gina Altieri
- Division of Pediatric Hematology Oncology, Akron Children's Hospital, Akron, Ohio
| | - Daniel Pettee
- Division of Pediatric Hematology Oncology, Akron Children's Hospital, Akron, Ohio
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