scholarly journals Oncofertility Decision Support Resources for Women of Reproductive Age: Systematic Review

JMIR Cancer ◽  
10.2196/12593 ◽  
2019 ◽  
Vol 5 (1) ◽  
pp. e12593 ◽  
Author(s):  
Brittany Speller ◽  
Selena Micic ◽  
Corinne Daly ◽  
Lebei Pi ◽  
Tari Little ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Health Care Providers ◽  
Decision Aids ◽  
The United States ◽  
Reading Level ◽  
Reproductive Age ◽  
Care Providers ◽  
Women Of Reproductive Age ◽  
Specific Patient ◽  
Patient Information Needs

Background Cancer treatments have the potential to cause infertility among women of reproductive age. Many cancer patients do not receive sufficient oncofertility information or referrals to reproductive specialists prior to starting cancer treatment. While health care providers cite lack of awareness on the available oncofertility resources, the majority of cancer patients use the internet as a resource to find additional information to supplement discussions with their providers. Objective Our aim was to identify and characterize Web-based oncofertility decision aids and health education materials accessible for women of reproductive age with a diagnosis of any cancer. Methods We searched five databases and the gray literature for the years 1994-2018. The developer and content information for identified resources was extracted. Each resource underwent a quality assessment. Results We identified 31 open access resources including 4 decision aids and 27 health educational materials. The most common fertility preservation options listed in the resources included embryo (31/31, 100%), egg (31, 100%), and ovarian tissue freezing (30, 97%). Notably, approximately one-third (11, 35%) contained references and 5 (16%) had a reading level of grade 8 or below. Resources were of varying quality; two decision aids from Australia and the Netherlands, two booklets from Australia and the United Kingdom, and three websites from Canada and the United States rated as the highest quality. Conclusions This comprehensive review characterizes numerous resources available to support patients and providers with oncofertility information, counseling, and decision making. More focus is required to improve the awareness and the access of existing resources among patients and providers. Providers can address patient information needs by leveraging or adapting existing resources to support clinical discussions and their specific patient population.

scholarly journals Oncofertility decision support resources for women of reproductive age: a systematic review (Preprint)

2018 ◽  
Author(s):  
Brittany Speller ◽  
Selena Micic ◽  
Corinne Daly ◽  
Lebei Pi ◽  
Tari Little ◽  
...  
Keyword(s):  
Decision Support ◽  
Cancer Patients ◽  
Decision Aids ◽  
The United States ◽  
Reproductive Age ◽  
Care Providers ◽  
Women Of Reproductive Age ◽  
Specific Patient ◽  
Patient Information Needs ◽  
Support Resources

BACKGROUND Cancer treatments have the potential to cause infertility among women of reproductive age. Many cancer patients do not receive sufficient oncofertility information or referrals to reproductive specialists prior to beginning cancer treatment. While health care providers cite lack of awareness on the available oncofertility resources, the majority of cancer patients utilize the Internet as a resource to find additional information to supplement discussions with their providers. OBJECTIVE To identify and characterize existing oncofertility decision support resources for women of reproductive age with a diagnosis of any cancer. METHODS Five databases and the grey literature were searched from 1994 to 2018. The developer and content information for identified resources was extracted. Each resource underwent a quality assessment. RESULTS Thirty-one open access resources including four decision aids and 27 health educational materials were identified. The most common fertility preservation options listed in the resources included embryo (100%), egg (100%), and ovarian tissue (97%) freezing. Notably, approximately one-third (35%) contained references and five (16%) had a reading level of grade 8 or below. Resources were of varying quality; two decision aids from Australia and the Netherlands, two booklets from Australia and the United Kingdom, and three websites from Canada and the United States rated as the highest quality. CONCLUSIONS This comprehensive review characterizes numerous resources available to support patients and providers with oncofertility information, counseling, and decision-making. More focus is required to improve the awareness and the access of existing resources among patients and providers. Providers can address patient information needs by leveraging or adapting existing resources to support clinical discussions and their specific patient population. CLINICALTRIAL NA

scholarly journals Determinants of rural-urban differences in health care provider visits among women of reproductive age in the United States

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0240700
Author(s):  
Hyunjung Lee ◽  
Ashley H. Hirai ◽  
Ching-Ching Claire Lin ◽  
John E. Snyder
Keyword(s):  
Health Care ◽  
Women’S Health ◽  
Women's Health ◽  
Health Care Providers ◽  
Rural Women ◽  
Reproductive Age ◽  
County Level ◽  
Care Providers ◽  
Provider Type ◽  
Women Of Reproductive Age

Background Rural health disparities and access gaps may contribute to higher maternal and infant morbidity and mortality. Understanding and addressing access barriers for specialty women’s health services is important in mitigating risks for adverse childbirth events. The objective of this study was to investigate rural-urban differences in health care access for women of reproductive age by examining differences in past-year provider visit rates by provider type, and quantifying the contributing factors to these findings. Methods and findings Using a nationally-representative sample of reproductive age women (n = 37,026) from the Medical Expenditure Panel Survey (2010–2015) linked to the Area Health Resource File, rural-urban differences in past-year office visit rates with health care providers were examined. Blinder-Oaxaca decomposition analysis quantified the portion of disparities explained by individual- and county-level sociodemographic and provider supply characteristics. Overall, there were no rural-urban differences in past-year visits with women’s health providers collectively (65.0% vs 62.4%), however differences were observed by provider type. Rural women had lower past-year obstetrician-gynecologist (OB-GYN) visit rates than urban women (23.3% vs. 26.6%), and higher visit rates with family medicine physicians (24.3% vs. 20.9%) and nurse practitioners/physician assistants (NPs/PAs) (24.6% vs. 16.1%). Lower OB-GYN availability in rural versus urban counties (6.1 vs. 13.7 providers/100,000 population) explained most of the rural disadvantage in OB-GYN visit rates (83.8%), and much of the higher family physician (80.9%) and NP/PA (50.1%) visit rates. Other individual- and county-level characteristics had smaller effects on rural-urban differences. Conclusion Although there were no overall rural-urban differences in past-year visit rates, the lower OB-GYN availability in rural areas appears to affect the types of health care providers seen by women. Whether rural women are receiving adequate specialized women’s health care services, while seeing a different cadre of providers, warrants further investigation and has particular relevance for women experiencing high-risk pregnancies and deliveries.

scholarly journals Prevalence of alcohol use among women of reproductive age in Canada

2021 ◽  
Vol 41 (9) ◽  
pp. 267-271
Author(s):  
Mélanie Varin ◽  
Elia Palladino ◽  
Kate Hill MacaEachern ◽  
Lisa Belzak ◽  
Melissa M. Baker
Keyword(s):  
Alcohol Consumption ◽  
Alcohol Use ◽  
Health Care Providers ◽  
Alcohol Exposure ◽  
Reproductive Age ◽  
Sociodemographic Characteristics ◽  
Care Providers ◽  
Women Of Reproductive Age ◽  
Heavy Alcohol ◽  
Heavy Alcohol Consumption

Introduction Reporting on alcohol use among women of reproductive age in Canada addresses a major gap in evidence. Methods We assessed the prevalence of weekly and heavy alcohol consumption among women aged 15 to 54 years by sociodemographic characteristics, province of residence and concurrent use of other substance(s) using data from the 2019 Canadian Community Health Survey. Results Of the target population, 30.5% reported weekly and 18.3% reported heavy alcohol consumption in the past year. Prevalence varied by sociodemographic characteristics, province and substance use. The most notable and significant differences were to do with cannabis use and smoking. Conclusion This information can guide health care providers in assessing alcohol consumption and in promoting low-risk alcohol drinking to prevent alcohol exposure during pregnancy.

scholarly journals Do Sleeping Disorders Impair Sexual Function in Married Iranian Women of Reproductive Age? Results from a Cross-Sectional Study

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Poorandokht Afsahri ◽  
Zahra Salehnejad ◽  
Khadijeh Hekmat ◽  
Parvin Abedi ◽  
Ahmad Fakhri ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Sexual Function ◽  
Health Care Providers ◽  
Married Women ◽  
Reproductive Age ◽  
Poor Sleep ◽  
Care Providers ◽  
Iranian Women ◽  
Poor Sleep Quality ◽  
Women Of Reproductive Age

Purpose. This study aimed to evaluate the relationship between sleep quality and sexual function among Iranian women. Methods. This study was conducted on 277 married women of reproductive age. The inclusion criteria were as follows: married women aged 18–45 years, with at least basic literacy, and women married monogamously for at least one year. The following tools were used for gathering data: a demographic questionnaire; Pittsburgh Sleep Quality Index (PSQI); Insomnia Severity Index (ISI); Epworth Sleepiness Scale (ESS); and Female Sexual Function Index (FSFI). Pearson correlation coefficients, independent t-tests, chi-square tests, and linear regression analyses were used to analyze the data. Results. There was a significant inverse relation between poor sleep quality (r=-0.13, P=0.02), daytime sleepiness (r=-0.39, P<0.001), insomnia (r=-0.35, P<0.001), and sexual function. Sexual desire was significantly related to sleep quality and insomnia (P<0.001). Sexual arousal (r=-0.18, r=-0.29, P<0.001), lubrication (r=-0.21, r=-0.3, −0.12, P<0.001), orgasms (r=0.17, r=-0.15, P<0.001), and sexual satisfaction (r=-0.02, -r=0.3, r=-0.15, P<0.001) were significantly related to all types of sleep disorders (poor sleep quality, insomnia, and sleepiness). Pain during intercourse was significantly associated with poor sleep quality and insomnia. With each unit decrease in sleep quality, sexual function decreased by 0.49 (P<0.001), and with each unit increase in the delay of sleep onset, sexual function decreased by 1.58 (P=0.04). Conclusion. Results of this study showed that there was a significant relationship between sleep quality and sexual function in Iranian women of reproductive age. The quality of sleep among reproductive-aged women merits the attention of health care providers and policy makers.

Practice gaps and challenges integrating new immuno-oncology agents in the treatment of cancer patients in the United States: A mixed-method study.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 11028-11028
Author(s):  
Neal E. Ready ◽  
Aparna Raj Parikh ◽  
Patrice Lazure ◽  
Morgan Peniuta ◽  
Marianne Davies ◽  
...  
Keyword(s):  
United States ◽  
Health Care ◽  
Cancer Patients ◽  
Health Care Providers ◽  
Nurse Practitioners ◽  
Care Delivery ◽  
Predictive Biomarkers ◽  
The United States ◽  
Care Providers ◽  
Immune Biomarkers

11028 Background: Previous research has indicated challenges integrating new immuno-oncology agents (IOAs) and predictive immune biomarkers into practice. Barriers, clinical gaps and underlying causalities explaining these challenges, however, are poorly understood. Methods: A mixed-methods educational needs assessment was conducted with physicians from 6 specialties (oncology, interventional radiology, pathology, pulmonology, emergency medicine and rheumatology), clinical pharmacists, physician assistants and advanced nurse practitioners involved in the care of cancer patients in the United States. Semi-structured interviews and discussion groups were thematically analyzed to identify challenges, barriers and underlying causalities. Qualitative findings subsequently informed the development of online surveys, which served to quantify findings. The following findings pertain to oncologists. Results: A total of 660 health care providers participated in the study, in which 17 interviews and 88 surveys were completed with oncologists. Seventy-two percent reported sub-optimal knowledge of the interactions between IOAs and the tumor’s micro-environment, while 62% reported sub-optimal skills determining which IOA to select based on this information. Oncologists reported sub-optimal knowledge of best practices for using IOAs to treat cancer in presence of an autoimmune disease (74%-80% depending on condition), and sub-optimal skills weighing the risks and benefits of prescribing IOAs for these profiles (66%-77%). In addition, 50% of oncologists reported feeling overwhelmed by the volume of new IOAs being made available. Many oncologists expressed doubts regarding the clinical benefit (59%) and innovative nature (43%) of emerging IOAs. Finally, 46% reported limited skills identifying viable treatment options based on pharmacodiagnostic test reports. Barriers to having predictive biomarkers inform treatment decisions included sub-optimal communication between specialists regarding specimen requirements and desired biomarker information. Conclusions: This study demonstrates the need to further support healthcare professionals as they face challenges integrating new IOAs and predictive immune biomarkers into practice. Given the wide array of IOAs becoming available each year, addressing the knowledge, skills, confidence and attitude gaps identified in this study could help improve health care delivery and potentially optimize outcomes for cancer patients.

scholarly journals Best Practices in Counseling Young Female Cancer Survivors on Reproductive Health

2017 ◽  
Vol 35 (04) ◽  
pp. 378-389 ◽  
Author(s):  
Ksenya Shliakhtsitsava ◽  
Deepika Suresh ◽  
Tracy Hadnott ◽  
H. Su
Keyword(s):  
Reproductive Health ◽  
Cancer Survivors ◽  
Health Care Providers ◽  
Chromosomal Abnormalities ◽  
The United States ◽  
Reproductive Age ◽  
Care Providers ◽  
History Of ◽  
Adverse Pregnancy ◽  
History Of Cancer

AbstractIn the United States, there are more than 400,000 girls and young women of reproductive-age with a history of cancer. Cancer treatments including surgery, chemotherapy, targeted therapy, and radiation can adversely impact their reproductive health. This review discusses infertility, contraception, and adverse pregnancy and child health outcomes in reproductive-aged cancer survivors, to increase awareness of these health risks for survivors and their health care providers. Infertility rates are modestly higher, while rates of using contraception and using highly effective contraceptive methods are lower in cancer survivors than in women without a history of cancer. During pregnancy, preterm births are also more common in survivors, resulting in more low-birth-weight offspring. Children of cancer survivors do not have more childhood cancers, birth defects, or chromosomal abnormalities than the general population, with the exception of families with hereditary cancer. Reproductive risks in survivors depend on cancer treatment exposures. For example, women with prior abdominal or pelvic radiation have additional risks of spontaneous abortions, small-for-gestational-age offspring and stillbirths, while those with prior chest radiation or anthracycline exposures have higher risks of cardiomyopathy. To help survivors achieve their reproductive goals safely, family planning and preconception counseling are central to survivorship care.

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