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A review of factors affecting patient fertility preservation discussions & decision‐making from the perspectives of patients and providers
Author(s) -
Daly Corinne,
Micic Selena,
Facey Marcia,
Speller Brittany,
Yee Samantha,
Kennedy Erin D.,
Corter Arden L.,
Baxter Nancy N.
Publication year - 2019
Publication title -
european journal of cancer care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.849
H-Index - 67
eISSN - 1365-2354
pISSN - 0961-5423
DOI - 10.1111/ecc.12945
Subject(s) - thematic analysis , medicine , psychosocial , qualitative research , grey literature , inclusion (mineral) , fertility preservation , clinical decision making , medical education , medline , nursing , family medicine , fertility , psychology , population , social psychology , social science , psychiatry , environmental health , sociology , political science , law
Women undergoing cancer treatments and their healthcare providers encounter challenges in fertility preservation (FP) discussions and decision‐making. A systematic review of qualitative research was conducted to gain in‐depth understanding of factors influencing FP discussions and decision‐making. Major bibliographic databases and grey literature in English from 1994 to 2016 were searched for qualitative research exploring patient/provider perspectives on barriers and facilitators to FP decision‐making. Two researchers screened article titles, abstracts and full‐texts. Verbatim data on research questions, study methodology, participants, findings and discussions of findings were extracted. Quality assessment and thematic analysis were conducted. The search yielded 74 studies dating from 2007 onwards; 29 met the inclusion criteria. Analysis revealed three types of barriers: (a) FP knowledge, skills and information deficits contributed to discomfort for providers and discontent for patients; (b) psychosocial factors and clinical issues influenced providers’ practices around FP discussions and patients’ decision‐making; and (c) material, social and structural factors (e.g., lack of resources and accessibility) posed challenges to FP discussions. Potential facilitators to FP discussions and decision‐making were also identified. A discussion of ways to improve physician's knowledge and facilitate women's decision‐making and access to FP is presented, along with areas for policy development and further research.