ENRICH: A promising oncology nurse training program to implement ASCO clinical practice guidelines on fertility for AYA cancer patients

Abstract

Objective We describe the impact of ENRICH (Educating Nurses about Reproductive Issues in Cancer Healthcare), a web-based communication-skill-building curriculum for oncology nurses regarding AYA fertility and other reproductive health issues. Methods Participants completed an 8-week course that incorporated didactic content, case studies, and interactive learning. Each learner completed a pre- and post-test assessing knowledge and a 6-month follow-up survey assessing learner behaviors and institutional changes. Results Out of 77 participants, the majority (72%) scored higher on the post-test. Fifty-four participants completed the follow-up survey: 41% reviewed current institutional practices, 20% formed a committee, and 37% gathered patient materials or financial resources (22%). Participants also reported new policies (30%), in-service education (37%), new patient education materials (26%), a patient navigator role (28%), and workplace collaborations with reproductive specialists (46%). Conclusion ENRICH improved nurses’ knowledge and involvement in activities addressing fertility needs of oncology patients. Our study provides a readily accessible model to prepare oncology nurses to integrate American Society of Clinical Oncology guidelines and improve Quality Oncology Practice Initiative measures related to fertility. Practice Implications Nurses will be better prepared to discuss important survivorship issues related to fertility and reproductive health, leading to improved quality of life outcomes for AYAs.

Effective patient-provider communication about sexual concerns in breast cancer: a qualitative study

“…By offering education and training in key communication skills (e.g., asking questions, normalizing patients’ concerns), a provider-focused intervention could foster the development of positive provider beliefs (i.e., that sexual concerns are important to discuss clinically, that discussions of sexual concerns need not take long clinically), and decrease providers’ emotional discomfort in having discussions about sexual concerns. Although few prior studies have evaluated patient-provider communication interventions about cancer-related sexual concerns [41, 42], findings from this study suggest that activating patients (i.e., increasing awareness, self-advocacy, and communication skills) to discuss sexual concerns may ultimately be one of the most critical strategies for driving increased provider communication . Interestingly, some women in this study reported feeling cast aside when given referrals that did not meet their needs.…”

Patient-provider communication about sexual concerns in cancer: a systematic review

“…These findings suggest that focusing on the modifiable outcome of training could offer an encouraging direction for intervention, particularly for medical students and trainees, who lack clinical experience from which to draw. In fact, findings from several intervention studies testing either the provision of clinical symptom summaries to providers [73] or communication skills training interventions [74, 75] suggest that such approaches may offer promise in improving communication about sexual and/or fertility-related concerns.…”

Oncologists' and pediatric oncologists' perspectives and challenges for fertility preservation

“…This kind of communication training can also be helpful in increasing clinicians' understanding of patient perspectives and priorities. There appears to be a shortage of reports on educational interventions to increase health‐care providers' knowledge about FP, but promising results have been reported for an online training program found to improve knowledge about fertility risks and FP options among oncology nurses . In addition, different types of educational resources for patients have been suggested to improve patient‐provider communication about FP .…”