Repair of the Threatened Feminine Identity

Abstract

Nurses should coordinate care through the cancer trajectory. Understanding the identity transformation process helps nurses to assess patients' needs and provide appropriate individual care.

A review of factors affecting patient fertility preservation discussions & decision-making from the perspectives of patients and providers

“…All included studies were published after 2007. Twenty-six studies used a qualitative design (Armuand, Wettergren, Rodriguez-Wallberg, & Lampic, 2015;Corney & Swinglehurst, 2014;Crawshaw, Glaser, Hale, & Sloper, 2009;Ehrbar et al, 2016;Garvelink et al, 2013;Hershberger, Finnegan, Altfeld, Lake, & Hirshfeld-Cytron, 2013;Hershberger, Sipsma, Finnegan, & Hirshfeld-Cytron, 2016;Keim-Malpass et al, 2013;King, Quinn, Vadaparampil, Gwede, et al, 2008a;King, Quinn, Vadaparampil, Miree, et al, 2008b;Kirkman et al, 2013Kirkman et al, , 2014Komatsu et al, 2014;Lee et al, 2011;Peddie et al, 2012;Penrose, Beatty, Mattiske, & Koczwara, 2012;Quinn et al, 2007;Quinn, Vadaparampil, King, et al, 2009;Russell, Galvin, Harper, & Clayman, 2016;Snyder & Tate, 2013;Snyder, Thazin, Pearse, & Moinuddin, 2010;Ussher, Cummings, Dryden, & Perz, 2016;Vadaparampil, Quinn, King, Wilson, & Nieder, 2008;Wilkes, Coulson, Crosland, Rubin, & Stewart, 2010) and three used a survey design with open-ended questions (Hill et al, 2012;King, Quinn, Vadaparampil, Gwede, et al, 2008a;Niemasik et al, 2012; Table 1). The included studies variously examined patients and providers' attitudes, experiences and perspectives, communication practices, fertility concerns, referrals, counselling/information provision, FP decision-making and barriers and facilitators.…”

“…The included studies variously examined patients and providers' attitudes, experiences and perspectives, communication practices, fertility concerns, referrals, counselling/information provision, FP decision-making and barriers and facilitators. Fourteen studies included participants with mixed types of cancers (Armuand et al, 2015;Crawshaw et al, 2009;Ehrbar et al, 2016;Garvelink et al, 2013;Gorman, Bailey, Pierce, & Su, 2012;Hershberger et al, 2013Hershberger et al, , 2016Keim-Malpass et al, 2013;Niemasik et al, 2012;Peddie et al, 2012;Penrose et al, 2012;Russell et al, 2016;Wilkes et al, 2010;Yee, Abrol, McDonald, Tonelli, & Liu, 2012), seven included breast cancer survivors (Corney & Swinglehurst, 2014;Hill et al, 2012;Kirkman et al, 2013Kirkman et al, , 2014Lee et al, 2011;Snyder & Tate, 2013;Snyder et al, 2010) and one included cervical cancer survivors (Komatsu et al, 2014). Studies examining providers included medical oncologists, hematologists, surgeons, obstetricians/gynaecologists and oncology nurses and social workers (King, Quinn, Vadaparampil, Gwede, et al, 2008a;King, Quinn, Vadaparampil, Miree, et al, 2008b;Peddie et al, 2012;Quinn et al, 2007;Quinn, Vadaparampil, King, et al, 2009;Ussher et al, 2016;Vadaparampil et al, 2008).…”

“…As rated against the CASP, more than half the qualitative studies did not provide clear justification for their choice of design (Corney & Swinglehurst, 2014;Crawshaw et al, 2009;Garvelink et al, 2013;Keim-Malpass et al, 2013;Kirkman et al, 2013Kirkman et al, , 2014Komatsu et al, 2014;Lee et al, 2011;Peddie et al, 2012), and the relationship between researcher and participants was adequately considered in only 10 studies (Armuand et al, 2015;Corney & Swinglehurst, 2014;Keim-Malpass et al, 2013;Kirkman et al, 2013;Komatsu et al, 2014;Peddie et al, 2012;Penrose et al, 2012;Quinn et al, 2007;Quinn, Vadaparampil, King, et al, 2009;Wilkes et al, 2010;Supporting Information Table S3). Despite these faults, all studies were of high or medium quality.…”

“…Studies reported that maximising survival (Armuand et al, 2015;Ehrbar et al, 2016;Hershberger et al, 2016;Peddie et al, 2012;Quinn et al, 2007), uncertain prognosis (King, Quinn, Vadaparampil, Gwede, et al, 2008a;Quinn, Vadaparampil, King, et al, 2009), concerns that treatment delays might negatively impact long-term survival (Lee et al, 2011;Penrose et al, 2012;Snyder & Tate, 2013;Wilkes et al, 2010) and iatrogenic effects of FP were primary considerations in women's decisions (Hershberger et al, 2016;Lee et al, 2011;Penrose et al, 2012;Snyder & Tate, 2013;Wilkes et al, 2010). Although survival was patients' primary priority (Crawshaw et al, 2009;Ehrbar et al, 2016;Gorman et al, 2012;Keim-Malpass et al, 2013;Komatsu et al, 2014;Lee et al, 2011;Peddie et al, 2012;Penrose et al, 2012;Snyder & Tate, 2013;Wilkes et al, 2010;Yee, Abrol, et al, 2012), fertility, and correspondingly, the desire and hope of being a parent after cancer were also important to women (Ehrbar et al, 2016;Hershberger et al, 2016;Niemasik et al, 2012;Penrose et al, 2012).…”

“…Fertility was perceived as a component of femininity and central to a women's identity (Ehrbar et al, 2016;Ussher et al, 2016). Women also expressed apprehension about success rates of FP, effects of FP technologies on the health of future children, vertical transmission of cancer genes and the potential for cancer recurrence (Ehrbar et al, 2016;Gorman et al, 2012;Hershberger et al, 2016;Komatsu et al, 2014;Niemasik et al, 2012;Wilkes et al, 2010). The latter was especially troubling for women with hormone receptive cancers considering FP options requiring ovarian stimulation (Corney & Swinglehurst, 2014).…”