Karen E Dyer1,2, Gwendolyn P Quinn3,4. 1. Department of Anthropology, University of South Florida, Tampa, FL, USA. karen.dyer@vcuhealth.org. 2. Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, P.O. Box 980149, Richmond, VA, 23298, USA. karen.dyer@vcuhealth.org. 3. Health Outcomes and Behavior Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA. 4. Morsani College of Medicine, University of South Florida, Tampa, FL, USA.
Abstract
PURPOSE: This study aims to examine healthcare provider perceptions of cancer-related infertility and fertility preservation (FP) in an underserved population and to highlight cognitive and structural barriers to use. METHODS: In-depth, semi-structured interviews were conducted with a sample of 16 healthcare providers participating in a larger ethnographic study on cancer survivorship and cancer-related infertility in Puerto Rico, an unincorporated US territory. Interviews were conducted in-person, audio-recorded, transcribed verbatim, and coded using the constant comparative method. RESULTS: Providers identified several barriers to FP in Puerto Rico: high cost in relation to income levels, lack of insurance coverage, gaps in provider knowledge of fertility clinics and financial assistance, lower prioritization of quality-of-life needs leading to inconsistent physician disclosure of fertility risks, geographical location of fertility clinics, and logistical challenges to maintaining FP offerings. Two factors act as facilitators: a high value placed on patient-provider communication and relationships and the formation of local alliances between the oncology and reproductive medicine fields, potentially leading to increased cross-specialty communication and referral. CONCLUSIONS: Infertility is a continuing source of distress for cancer patients and survivors, and barriers to FP vary cross-culturally. In Puerto Rico, context-specific factors indicate potential areas of intervention. Greater awareness of fertility risks and options can be fostered through physician training in conjunction with organizational measures targeting cost barriers.
PURPOSE: This study aims to examine healthcare provider perceptions of cancer-related infertility and fertility preservation (FP) in an underserved population and to highlight cognitive and structural barriers to use. METHODS: In-depth, semi-structured interviews were conducted with a sample of 16 healthcare providers participating in a larger ethnographic study on cancer survivorship and cancer-related infertility in Puerto Rico, an unincorporated US territory. Interviews were conducted in-person, audio-recorded, transcribed verbatim, and coded using the constant comparative method. RESULTS: Providers identified several barriers to FP in Puerto Rico: high cost in relation to income levels, lack of insurance coverage, gaps in provider knowledge of fertility clinics and financial assistance, lower prioritization of quality-of-life needs leading to inconsistent physician disclosure of fertility risks, geographical location of fertility clinics, and logistical challenges to maintaining FP offerings. Two factors act as facilitators: a high value placed on patient-provider communication and relationships and the formation of local alliances between the oncology and reproductive medicine fields, potentially leading to increased cross-specialty communication and referral. CONCLUSIONS:Infertility is a continuing source of distress for cancerpatients and survivors, and barriers to FP vary cross-culturally. In Puerto Rico, context-specific factors indicate potential areas of intervention. Greater awareness of fertility risks and options can be fostered through physician training in conjunction with organizational measures targeting cost barriers.
Entities:
Keywords:
Cancer; Fertility preservation; Healthcare providers; Infertility; Puerto Rico
Authors: Lindsey King; Gwendolyn P Quinn; Susan T Vadaparampil; Cheryl A Miree; Crystal Wilson; Heather Clayton; Brad Zebrack Journal: Soc Work Health Care Date: 2008
Authors: Gwendolyn P Quinn; Susan T Vadaparampil; Clement K Gwede; Cheryl Miree; Lindsey M King; Heather B Clayton; Crystal Wilson; Pamela Munster Journal: J Cancer Surviv Date: 2007-06 Impact factor: 4.062