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Trends in Clinical Practice and Nurses' Attitudes About Fertility Preservation for Pediatric Patients With Cancer

Heather Clayton
Gwendolyn P. Quinn
Ji-Hyun Lee
Lindsey M. King
Cheryl A. Miree
Michael Nieder
Susan T. Vadaparampil
ONF 2008, 35(2), 249-255 DOI: 10.1188/08.ONF.249-255

Purpose/Objectives: To examine trends in fertility preservation attitudes and behaviors of pediatric oncology nurses and evaluate their awareness of fertility preservation guidelines published in June 2006 by the American Society of Clinical Oncology (ASCO).

Design: Cross-sectional surveys conducted in 2005 and 2006.

Setting: Annual meetings of the Florida Association of Pediatric Tumor Programs.

Sample: 115 pediatric oncology nurses in 2005 and 95 nurses in 2006.

Methods: A 45-item survey was distributed to conference attendees.

Main Research Variables: Knowledge, current fertility preservation practices, and awareness of fertility preservation guidelines.

Findings: Nurses' attitudes about fertility preservation discussions with patients did not change during the survey period; however, the number of nurses believing that one of their duties was to discuss fertility preservation with patients decreased from 91% in 2005 to 81% in 2006. Nurses' likelihood to discuss fertility preservation with patients with specific characteristics significantly changed over time. Fertility preservation discussions were just as likely for single patients as they were for those married or recently engaged, although nurses were more likely to discuss fertility preservation with patients who had at least one child or who had a poor prognosis. Nurses' awareness of ASCO guidelines was less than 5%.

Conclusions: A majority of nurses perceive that fertility preservation options should be offered to patients. However, practice and patient family barriers exist that may impede discussion. Attitudes and behaviors will be monitored with the 2006 ASCO guidelines.

Implications for Nursing: Nurses play a key role in survivorship discussions for pediatric patients with cancer and their families. Increased knowledge of fertility preservation guidelines may help promote the fertility preservation concept and lead to improved dissemination and implementation of training programs that focus on current ASCO fertility preservation guidelines and address the psychosocial needs of children aged 12-16 years.

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