title: Adolescents and Young Adults With Cancer: Oncology Nurses Report Attitudes and Barriers to Discussing Fertility Preservation.
abstract: BACKGROUND
  Fertility issues have been found to be an important topic for adolescents and young adults (AYAs) with cancer. Medical technology has made fertility preservation (FP) increasingly effective for postpubertal patients whose treatment course may inhibit their future ability to achieve biologic parenthood. Oncology providers' recommendations have been shown to vary, potentially affecting patients' decision-making processes regarding FP.
  
  
  OBJECTIVE
  This study was designed to assess oncology nurses' recommendations for patients to consider FP options and to explore what patient-related factors may influence discussion of FP with AYAs with cancer.
  
  
  METHODS
  116 oncology nurses participated in this study and were randomized to read one of four vignettes about a patient whose proposed treatment course could affect his or her fertility. Participants' recommendations to partake in FP were analyzed to test for differences by patient age and gender. Open-ended responses to questions about their experiences as oncology nurses were analyzed descriptively.
  
  
  RESULTS
  Nurses strongly recommended that all patients explore FP options before the start of treatment. Oncology nurses endorsed stronger opinions that young adult female patients should be given independent decision-making power to delay treatment for FP, compared to male and female adolescent patients and young adult male patients. Participants mentioned barriers to discussions that included concerns about exacerbating negative emotions and the decision-making capacity of young patients.
authors.affiliation: University of Rhode Island.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Nobel Murray
authors.affiliation: Connecticut College.
authors.forename: Joan C
authors.initials: JC
authors.lastname: Chrisler
authors.affiliation: University of Rhode Island.
authors.forename: Mark L
authors.initials: ML
authors.lastname: Robbins
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001291:Attitude of Health Personnel; D003142:Communication; D003657:Decision Making; D005260:Female; D059247:Fertility Preservation / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D009720:Nurse Clinicians / Q000523:psychology*; D009723:Nurse-Patient Relations; D009859:Oncology Nursing / Q000379:methods*; D010353:Patient Education as Topic; D012737:Sex Factors; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D055815:Young Adult
keywords: AYA oncology; fertility preservation; medical decision making; oncology nursing practice