title: Repair of the threatened feminine identity: experience of women with cervical cancer undergoing fertility preservation surgery.
abstract: BACKGROUND
  Fertility preservation is important for women of reproductive age with cervical cancer. The underlying reasons behind suboptimal reproductive results after successful fertility-preserving surgery have not yet been fully revealed.
  
  
  OBJECTIVE
  The objective of this study was to explore the experience of fertility preservation with radical trachelectomy from the perspective of women with cervical cancer.
  
  
  METHODS
  We conducted interviews with women with cervical cancer who underwent radical trachelectomy using a Grounded Theory methodology with a theoretical framework of symbolic interactionism.
  
  
  RESULTS
  Our findings articulate a process in which feminine identity is first threatened by a diagnosis of cancer, then repaired by fertility preservation with radical trachelectomy, and finally reconstructed after the surgery, through interactions with self, others, and external events in women with cervical cancer. Feeling incomplete as a woman because of the loss of the uterus was a critical factor in the women's feeling that their feminine identity was threatened. Thus, fertility preservation was significant for these women. The meaning of fertility preservation varied among the women, and their life perspectives were therefore distinct after the surgery.
  
  
  CONCLUSIONS
  Women with cervical cancer who undergo radical trachelectomy experience an identity transformation process, and child bearing is not the only expected outcome of fertility preservation.
  
  
  CONCLUSIONS
  Nurses should coordinate care through the cancer trajectory. Understanding the identity transformation process helps nurses to assess patients' needs and provide appropriate individual care.
authors.affiliation: Author Affiliations: Faculty of Nursing and Medical Care (Dr Komatsu and Ms Yagasaki) and Department of Obstetrics and Gynecology, School of Medicine (Drs Iwata, Sugiyama, and Fujii), Keio University, and Keio University Hospital (Mss Shoda and Chung), Tokyo, Japan.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Komatsu
authors.forename: Kaori
authors.initials: K
authors.lastname: Yagasaki
authors.forename: Rie
authors.initials: R
authors.lastname: Shoda
authors.forename: Younghui
authors.initials: Y
authors.lastname: Chung
authors.forename: Takashi
authors.initials: T
authors.lastname: Iwata
authors.forename: Juri
authors.initials: J
authors.lastname: Sugiyama
authors.forename: Takuma
authors.initials: T
authors.lastname: Fujii
mesh_terms: D000328:Adult; D005260:Female; D005298:Fertility; D059247:Fertility Preservation / Q000451:nursing*; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D007044:Hysterectomy / Q000451:nursing*; D010045:Outpatients; D017060:Patient Satisfaction; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000451:nursing* / Q000601:surgery