1929 KNOWLEDGE, ATTITUDES AND PRACTICES AMONG GENITOURINARY ONCOLOGY CLINICIANS REGARDING FERTILITY PRESERVATION

Abstract

You have accessJournal of UrologyInfertility: Therapy/Evaluation1 Apr 20101929 KNOWLEDGE, ATTITUDES AND PRACTICES AMONG GENITOURINARY ONCOLOGY CLINICIANS REGARDING FERTILITY PRESERVATION Joanne Frankel Kelvin, Brigitte Thom, Mary McCabe, and John Mulhall Joanne Frankel KelvinJoanne Frankel Kelvin More articles by this author , Brigitte ThomBrigitte Thom More articles by this author , Mary McCabeMary McCabe More articles by this author , and John MulhallJohn Mulhall More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1897AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Approximately 126,000 patients between ages 20-44 years are diagnosed with cancer in the US each year. Many have not yet started or completed their families. Despite the advances in and the availability of reproductive technologies, clinicians do not routinely discuss fertility preservation prior to cancer therapy. As a prelude to launching a fertility preservation (FP) program we undertook a survey of oncology clinicians regarding FP in their patients. METHODS Physicians (medical and surgical) and nurses involved in the management of genitourinary malignancies were asked to complete a web-based questionnaire developed by the investigators based on available literature. The questionnaire assessed knowledge base, attitudes and practices pertaining to FP. For knowledge and attitude assessment, the instrument was structured using a 5-point Likert scale, ranging from strongly disagree to strongly agree. For assessment of barriers to FP, we used percentage selecting at least one of 6 options. For practice assessment, we looked at proportion discussing various factors with >75% of patients. RESULTS From a total pool of 89 clinicians (MD 30, RN 59), 58% responded (MD 43%, RN 66%). The percentage of respondents who agreed/strongly agreed with received adequate training on: effect of cancer therapy 50%, FP options 31%; Have resources to educate patients on: effects of treatment 52%, FP options 48%; All patients should be informed 96%; Prefer to have others discuss FP 46%. With regard to perceived barriers, % reporting: not adequate training 56%, not enough time in clinic 31%, unaware of referral clinicians 28%, uncomfortable with topic 8%, high cost of FP 6%. Significant differences in practice behaviors were seen among clinicians when asked regarding male vs female FP, with more respondents discussing the role of FP in males compared to females. Significant differences were seen between MD and RN respondents in: perceived degree of training in effects of cancer therapy (MD better), preference for other clinicians to discuss FP (MD better), discomfort in discussing FP (RN better). CONCLUSIONS Despite a wide appreciation of the effects of cancer therapies on future fertility, clinicians feel inadequately trained, feel short of resources, are generally uncomfortable discussing this topic with patients and cite time pressures in clinic as a significant barrier. These factors lead to a minority of clinicians discussing FP with their male or female cancer patients. New York, NY© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e749-e750 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Joanne Frankel Kelvin More articles by this author Brigitte Thom More articles by this author Mary McCabe More articles by this author John Mulhall More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...