育龄男性癌症患者生育力保护知识及需求调查
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摘要
目的了解育龄男性癌症患者对于生育力保护的知识水平及生育力保护需求现况。方法采用自制的育龄男性癌症患者生育力保护知识水平及需求调查问卷对332例育龄男性癌症患者进行横断面调查。结果男性癌症患者生育力保护知识得分(3. 5±0. 7)分。77. 71%患者意识到癌症治疗会损害生育能力,63. 86%和80. 72%患者不知晓生育力保护的常规方法及场所。仅10. 54%患者在肿瘤治疗前选择精子库进行生育力保存,有68. 67%患者在治疗过程中希望进行生育力保存。多因素Logistic回归分析结果显示,家庭月收入、年龄是患者生育力保护知识水平的影响因素(均P <0. 05);年龄、有无子女是患者生育力保护需求的影响因素(均P <0. 05)。结论育龄男性癌症患者对生育力保护的知识水平不高,多数患者在治疗前并未选择生育力保护措施,但是在治疗期间有生育力保护的需求。年轻及家庭月收入≥8 000元的患者具备更多生育力保护知识。年轻及无子女的患者在治疗过程中有生育力保存的需求。医务人员需要在患者进行治疗前充分告知生育力保护的相关信息,全面评估患者对信息的掌握程度,为患者提供切实可行的生育力保护措施和指导。
Objective To explore the knowledge and needs of fertility preservation in reproductive-aged male patients with cancer. Methods A cross-sectional survey was conducted in 322 reproductive aged male patients with cancer regarding their knowledge and needs of fertility preservation. Results The participants scored (3. 5 ± 0. 7) points in fertility preservation knowledge; 77. 71% rea-lized that cancer treatment could impair fertility,63. 86% didn't know how to,and 80. 72% didn't know where to,preserve fertility. Only 10. 54% had resorted to a sperm bank to preserve fertility before cancer treatment,and 68. 67% wanted to preserve fertility during cancer treatment. Multivariate logistic regression analysis showed that,family monthly income,and ages influenced the participants' knowledge of fertility preservation (P< 0. 05 for both); ages and having a child or not influenced the participants' ( P < 0. 05 for both). Conclusion Male cancer patients of reproductive age had limited knowledge of fertility preservation,and the majority didn't make fertility preservation arrangements before cancer treatment. However,a large proportion of them wished to preserve fertility during cancer treatment. Young patients and those who had family monthly income ≥8 000 Yuan tended to be more knowledgeable of fertility preservation; young and child-free patients had the needs of fertility preservation during cancer treatment. Medical staff should fully discuss with patients about fertility preservation issues,make a full assessment of patients' understanding of fertility preservation information,and arrange practical fertility preservation measures and guidance for them.
Objective To explore the knowledge and needs of fertility preservation in reproductive-aged male patients with cancer. Methods A cross-sectional survey was conducted in 322 reproductive aged male patients with cancer regarding their knowledge and needs of fertility preservation. Results The participants scored (3. 5 ± 0. 7) points in fertility preservation knowledge; 77. 71% rea-lized that cancer treatment could impair fertility,63. 86% didn't know how to,and 80. 72% didn't know where to,preserve fertility. Only 10. 54% had resorted to a sperm bank to preserve fertility before cancer treatment,and 68. 67% wanted to preserve fertility during cancer treatment. Multivariate logistic regression analysis showed that,family monthly income,and ages influenced the participants' knowledge of fertility preservation (P< 0. 05 for both); ages and having a child or not influenced the participants' ( P < 0. 05 for both). Conclusion Male cancer patients of reproductive age had limited knowledge of fertility preservation,and the majority didn't make fertility preservation arrangements before cancer treatment. However,a large proportion of them wished to preserve fertility during cancer treatment. Young patients and those who had family monthly income ≥8 000 Yuan tended to be more knowledgeable of fertility preservation; young and child-free patients had the needs of fertility preservation during cancer treatment. Medical staff should fully discuss with patients about fertility preservation issues,make a full assessment of patients' understanding of fertility preservation information,and arrange practical fertility preservation measures and guidance for them.
引文
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[19]Stein D M,Victorson D E,Choy J T,et al.Fertility preservation preferences and perspectives among adult male survivors of pediatric cancer and their parents[J].J Adolesc Young Adult Oncol.2014,3(2):75-82.
[20]刘秀儒,林霞.女性癌症患者生育忧虑研究进展[J].护理学杂志,2017,32(16):100-103.
[21]刘思邈,邓成艳.女性化疗患者的生育能力保护[J].生殖医学杂志,2013,22(3):205-209.
[22]Bahadur G.Fertility issues for cancer patients[J].Mol Cell Endocrinol,2000,169(1-2):117-122.
[2]Loren A W,Mangu P B,Beck L N,et al.Fertility preservation for patients with cancer:American Society of Clinical Oncology clinical practice guideline update[J].J Clin Oncol,2013,31(19):2500-2510.
[3]Saito K,Suzuki K,Iwasaki A,et al.Sperm cryopreservation before cancer chemotherapy helps in the emotio-nal battle against cancer[J].Cancer,2005,104(3):521-524.
[4]Griggs J J,Sorbero M E S,Mallinger J B,et al.Vitality,mental health,and satisfaction with information after breast cancer[J].Patient Educ Counsel,2007,66(1):58-66.
[5]Rosen A,Rodriguez-Wallberg K A,Rosenzweig L.Psychosocial distress in young cancer survivors[J].Semin Oncol Nurs,2009,25(4):268-277.
[6]Johnson J A,Tough S.Society of Obstetricians and Gynaecologists of Canada.Delayed child-bearing[J].J Obstet Gynaecol Can,2012,34(1):80-93.
[7]Canada A L,Schover L R.The psychosocial impact of interrupted childbearing in long-term female cancer su-rvivors[J].Psychooncology,2012,21(2):134-143.
[8]Gorman J R,Bailey S,Pierce J P,et al.How do you feel about fertility and parenthood?The voices of young female cancer survivors[J].J Cancer Surviv,2012,6(2):200-209.
[9]Peccatori F A,Azim Jr H A,Orecchia R,et al.Cancer,pregnancy and fertility:ESMO Clinical Practice Guidelines for diagnosis,treatment and follow-up[J].Ann Oncol,2013,24(Suppl 6):vi160-170.
[10]Tournaye H,Dohle G R,Barratt C L.Fertility preservation in men with cancer[J].Lancet,2014,384(9950):1295-1301.
[11]Lambertini M,Del Mastro L,Pescio M C,et al.Cancer and fertility preservation:international recommendations from an expert meeting[J].BMC Med,2016,14:1.
[12]Forman E J,Anders C K,Behera M A.A nationwide survey of oncologists regarding treatment-related infertility and fertility preservation in female cancer patients[J].Fertil Steril,2010,94(5):1652-1656.
[13]Adams E,Hill E,Watson E.Fertility preservation in cancer survivors:a national survey of oncologists'current knowledge,practice and attitudes[J].Br J Cancer,2013,108(8):1602-1615.
[14]中华人民共和国卫生部.人类精子库管理办法[S].2001-08-01.
[15]Balthazar U,Fritz M A,Mersereau J E.Fertility preservation:a pilot study to assess previsit patient know-ledge quantitatively[J].Fertil Steril,2011,95(6):1913-1916.
[16]Quinn G P,Vadaparampil S T,Bell-Ellison B A,et al.Patient-physician communication barriers regarding fertility preservation among newly diagnosed cancer patients[J].Soc Sci Med,2008,66(3):784-789.
[17]Quinn G P,Vadaparampil S T,Lee J H,et al.Physician referral for fertility preservation in oncology patients:a National Study of Practice Behaviors[J].J Clin Oncol,2009,27(35):5952-5957.
[18]Shnorhavorian M,Harlan L C,Smith A W,et al.Fertility preservation knowledge,counseling,and actions among adolescent and young adult patients with cancer:a populationbased study[J].Cancer,2015,121(19):3499-3506.
[19]Stein D M,Victorson D E,Choy J T,et al.Fertility preservation preferences and perspectives among adult male survivors of pediatric cancer and their parents[J].J Adolesc Young Adult Oncol.2014,3(2):75-82.
[20]刘秀儒,林霞.女性癌症患者生育忧虑研究进展[J].护理学杂志,2017,32(16):100-103.
[21]刘思邈,邓成艳.女性化疗患者的生育能力保护[J].生殖医学杂志,2013,22(3):205-209.
[22]Bahadur G.Fertility issues for cancer patients[J].Mol Cell Endocrinol,2000,169(1-2):117-122.