Matthew A Kemertzis1,2, Harene Ranjithakumaran2, Meredith Hand2, Michelle Peate2, Lynn Gillam3,4, Maria McCarthy5, Leanne Super6,7, Sarah McQuillan8, Sarah Drew2, Yasmin Jayasinghe1,2,9, Lisa Orme6. 1. Department of Gynaecology. 2. Department of Obstetrics & Gynaecology, Royal Women's Hospital. 3. Children's Bioethics Centre, Royal Children's Hospital. 4. School of Population and Global Health. 5. Murdoch Children's Research Institute, Melbourne. 6. Children's Cancer Centre, Royal Children's Hospital, Parkville. 7. Monash Children's Cancer Centre, Monash Medical Centre, Clayton, Victoria, Australia. 8. Obstetrics and Gynecology, Pediatric Gynecology, University of Calgary, The Alberta Children's Hospital, Calgary, AB, Canada. 9. Department of Pediatrics, University of Melbourne.
Abstract
PURPOSE: Fertility preservation (FP) discussions in children with cancer presents unique challenges due to ethical considerations, lack of models-of-care, and the triadic nature of discussions. This study evaluated a fertility toolkit for clinicians involved in FP discussions with pediatric, adolescent, and young adult patients and parents. MATERIALS AND METHODS: A survey-based, longitudinal study of clinicians at The Royal Children's Hospital Melbourne involved in FP discussions undertaken at 3 time-points: 2014, alongside an education session for baseline assessment of oncofertility practices (survey 1); after each toolkit use to evaluate case-specific implementation (survey 2); 2016, to evaluate impact on clinical practice (survey 3). RESULTS: Fifty-nine clinicians completed survey 1. Over 66% reported baseline dissatisfaction with the existing FP system; 56.7% were not confident in providing up-to-date information. Only 34.5% "often" or "always" provided verbal information; 14.0% "often" or "always" provided written information. Survey 2 was completed after 11 consultations. All clinicians were satisfied with the discussions and outcomes using the toolkit. Thirty-nine clinicians completed survey 3. Over 70% felt confident providing up-to-date FP knowledge, 67.7% "often" or "always" provided verbal information, and 35.4% "often" or "always" provided written information. CONCLUSIONS: Clinicians desire improvement in FP practice. The toolkit provided significant perceived and actual benefits.
PURPOSE: Fertility preservation (FP) discussions in children with cancer presents unique challenges due to ethical considerations, lack of models-of-care, and the triadic nature of discussions. This study evaluated a fertility toolkit for clinicians involved in FP discussions with pediatric, adolescent, and young adult patients and parents. MATERIALS AND METHODS: A survey-based, longitudinal study of clinicians at The Royal Children's Hospital Melbourne involved in FP discussions undertaken at 3 time-points: 2014, alongside an education session for baseline assessment of oncofertility practices (survey 1); after each toolkit use to evaluate case-specific implementation (survey 2); 2016, to evaluate impact on clinical practice (survey 3). RESULTS: Fifty-nine clinicians completed survey 1. Over 66% reported baseline dissatisfaction with the existing FP system; 56.7% were not confident in providing up-to-date information. Only 34.5% "often" or "always" provided verbal information; 14.0% "often" or "always" provided written information. Survey 2 was completed after 11 consultations. All clinicians were satisfied with the discussions and outcomes using the toolkit. Thirty-nine clinicians completed survey 3. Over 70% felt confident providing up-to-date FP knowledge, 67.7% "often" or "always" provided verbal information, and 35.4% "often" or "always" provided written information. CONCLUSIONS: Clinicians desire improvement in FP practice. The toolkit provided significant perceived and actual benefits.
Authors: Natasha N Frederick; Vicky Lehmann; Astrid Ahler; Kristen Carpenter; Brooke Cherven; James L Klosky; Leena Nahata; Gwendolyn P Quinn Journal: Pediatr Blood Cancer Date: 2021-12-06 Impact factor: 3.838