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Barriers and facilitators to sexual and reproductive health communication between pediatric oncology clinicians and adolescent and young adult patients: The clinician perspective
Author(s) -
Frederick Natasha N.,
Campbell Kevin,
Kenney Lisa B.,
Moss Kerry,
Speckhart Ashley,
Bober Sharon L.
Publication year - 2018
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.27087
Subject(s) - medicine , fertility preservation , thematic analysis , focus group , family medicine , reproductive health , qualitative research , nursing , medline , health care , population , fertility , social science , environmental health , marketing , sociology , political science , law , business , economics , economic growth
Background Sexual and reproductive health (SRH) is identified by adolescent and young adult (AYA) patients with cancer as an important but often neglected aspect of their comprehensive cancer care. The purpose of this study was to investigate the attitudes and perceptions of pediatric oncology clinicians towards discussing SRH with AYAs, and to understand perceived barriers to effective communication in current practice. Procedure Pediatric oncology clinicians (physicians, certified nurse practitioners, and physician assistants) participated in semi‐structured qualitative interviews investigating attitudes about SRH communication with AYAs and barriers to such conversations. Twenty‐two clinicians participated from seven institutions in the Northeastern United States. Interviews were audio‐recorded, transcribed, and coded using a thematic analysis approach. Results Interviews with pediatric oncology clinicians revealed the following five primary themes: the role for pediatric oncology clinicians to discuss SRH, the focus of current SRH conversations on fertility, the meaning of “sexual health” as safe sex and contraception only, clinician‐reported barriers to SRH conversations, and the need for education and support. Communication barriers included lack of knowledge/experience, lack of resources/referrals, low priority, parents/family, patient discomfort, clinician discomfort, time, and lack of rapport. Clinicians identified resource and support needs, including formal education and SRH education materials for patients and families. Conclusions Although the study participants identified a role for pediatric oncology clinicians in SRH care for AYA patients with cancer, multiple barriers interfere with such discussions taking place on a regular basis. Future efforts must focus on resource development and provider education and training in SRH to optimize the care provided to this unique patient population.