The desire for children among adult survivors of childhood cancer: Psychometric evaluation of a cancer‐specific questionnaire and relations with sociodemographic and psychological characteristics

Abstract

Objective Long‐term childhood cancer survivors (CCS) are less likely to become parents than their peers of the same age. Previous research has suggested that besides fertility, this outcome is shaped by psychosocial factors such as emotional motives toward having a child. Drawing from a sample of CCS with survival times >25 years, we present the validation of a questionnaire assessing cancer‐specific reproductive motives and concerns. Methods We evaluated the cancer‐specific version of the Leipzig Questionnaire of Motives to have a Child (LKM‐C) in a register‐based sample of adult CCS (N = 632, 31% had children, 44.5% women). We conducted a confirmatory factor analysis and tested associations with sociodemographic characteristics and psychological symptoms (PHQ‐9, GAD‐2). Results The questionnaire showed good item discrimination parameters and reliability (α = 0.86). The two‐factorial structure was confirmed with the independent scales “return to normalcy” and “illness‐related worries (child's/own health).” On average, CCS reported more motives in favor of a child than worries (P < .001; d = 1.12). Favorable attitudes were associated with the presence of a partnership and children, stronger current desire for a child, and fewer depressive symptoms. Worries were associated with an unfulfilled desire to have a child and elevated levels of depression and anxiety symptoms. Conclusions The LKM‐C offers a brief measure of parenthood motivations in long‐term CCS. Having a child signifies return to normalcy, health, fulfillment of life perspectives, and enrichment of the partnership. Less intense worries included illnesses of the child and concerns regarding one's own health. The questionnaire could inform follow‐up care, psychotherapy, and fertility treatments.

Ajuste y adaptación psicosocial de adultos jóvenes supervivientes de un cáncer en etapa pediátrica: Revisión sistemática

“…En segundo lugar, con respecto a los síntomas de ansiedad y/o depresión, varios estudios (15,19,23,24) con muestras superiores a 200 participantes, coinciden en señalar un mayor riesgo de presencia de esos síntomas específicos en la población de supervivientes en comparación con la población control. Algunas de las variables identificadas que se asocian con dicho riesgo son la IS (15) , el deseo de paternidad o maternidad (p.e., niveles más altos de ansiedad y depresión se relacionan con motivos en contra de tener un hijo) (25) y la intolerancia al ejercicio físico. Esto último, puede aparecer debido a secuelas de la enfermedad (p.e., complicaciones cardíacas, pulmonares, musculo-esqueléticas, etc.).…”

Reproductive concerns among adolescent and young adult cancer survivors: A scoping review of current research situations

“…Various measures were used to examine reproductive concerns, which were reported as a primary outcome in 40 articles (Supplement File). Measurements of reproductive concerns involved the Reproductive Concerns Scale (RCS), 21–23 the Reproductive Concerns After Cancer Scale (RCAC), 18,24–48 the Female Sexual Function Inventory (FSFI), 49 the Fertility Problem Inventory, 50 the Cancer‐specific version of the Leipzig Questionnaire of Motives to have a Child (LQM‐C), 51 the Fertility Issues Survey, 52–54 and the Fertility Issues and Outcomes Scale 55 . Hammond, Abrams, and Syrjala used a digital scoring method (scored from 0 = not at all to 10 = very much) to measure the level of concern about infertility 56 .…”

Fertility Preservation in Children and Adolescents during Oncological Treatment—A Review of Healthcare System Factors and Attitudes of Patients and Their Caregivers

“…Improving survival rates translates into an increase in the percentage of patients interested in having genetic offspring. Available research data show the following correlation: being diagnosed with cancer in childhood increases survivors' motivation to have offspring in the future [7][8][9][10]. However, the very same systemic treatment or radiation that saves lives has a negative impact on the patient's future fertility because of the gonadotoxic effects in males and the depletion of ovarian follicles, significantly affecting females.…”