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Liu X, Wang Q, Sheng H, Liang X, Wang Z, Meng T, Li Y, Dong H, Zhu W, Yang J, Zhang Z, Jiang X, Zhang A, Liang Z, He X, Song C, Li F, Zhang X. Fertility preservation in males with cancer of trends, region development, and efficacy in mainland China from 16 regions Chinese sperm banks. J Assist Reprod Genet 2024; 41:1893-1906. [PMID: 38676843 PMCID: PMC11263528 DOI: 10.1007/s10815-024-03121-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 04/09/2024] [Indexed: 04/29/2024] Open
Abstract
PURPOSE Male cancer survivors experience confusion about fertility following cancer treatment. The aims of this study were to evaluate survivors' semen quality in different tumor type groups in China and to analyze the current situation and challenges of male cancer patients with sperm cryopreservation. METHODS This was a multicenter retrospective study of male patients with cancer who underwent sperm cryopreservation in 16 regions of the national sperm banks over an 11-year period from 2010 to 2020. RESULTS The number of male cancer patients with sperm cryopreservation showed an overall upward trend. The development of male cancer fertility preservation (FP) in the eastern, central, and western regions of Chinese displayed imbalance. There are seven tumor types for sperm preservation in the top incidence ten tumor types, including lymphoma, leukemia, nasopharyngeal carcinoma, sarcoma, thyroid cancer, and brain tumor. Moreover, nasopharyngeal carcinoma is a high incidence rate in China, which is related to high sperm preservation rate, different from other countries. The most percentage of males receiving sperm cryopreservation in the testicular cancers (15-39 years old) of China in 2020 was 5.55%, 1.29% in the lymphoma, and 0.39% in the leukemia. According to the type of cancer, a statistically significant lower pre-sperm density, total sperm output, and post-sperm density was observed in testicular cancers. It is worth noting that the prevalence of azoospermia 22.2% in leukemia patients attribute to urgent treatment before sperm cryopreservation. Disposition of cryopreserved sperm categories included continued storage (47.2%), discarded (9%), death (0.9%), and use (3.7%). CONCLUSION This study provides the first comprehensive national statistical census and review of fertility preservation in male cancer patients with respect to trends, prevalence, and cancer types. The development of male cancer fertility preservation in China is imbalanced and percentage of males receiving sperm cryopreservation in the adolescent and young adult cancers was low. Sixteen human sperm banks from China analyze current problems and challenges, and then prioritize steps toward the achievement of the FP strategy framework for Healthy China 2030.
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Affiliation(s)
- Xiao Liu
- Department of Andrology/Sichuan Human Sperm Bank, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Qiling Wang
- NHC Key Laboratory of Male Reproduction and Genetics Guangdong Provincial Reproductive, Science Institute (Guangdong Provincial Fertility Hospital), Guangzhou, 510062, Guangdong, China
| | - Huiqiang Sheng
- Zhejiang Mater Child and Reproductive Health Center, Hangzhou, 310000, Zhejiang, China
| | - Xiaowei Liang
- Human Sperm Bank of National Research Institute for Family Planning, Beijing, 100098, China
| | - Zhiqiang Wang
- The First Affiliated Hospital of Guangxi Medical University, Guilin, 530021, Guangxi, China
| | - Tianqing Meng
- Hubei Province Human Sperm Bank, Center for Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430010, Hubei, China
| | - Yushan Li
- Henan Human Sperm Bank, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450014, Henan, China
| | - Hao Dong
- Department of Urological Surgery, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan, China
| | - Wenbing Zhu
- Reproductive & Genetic Hospital of CITIC-Xiangya, Changsha, 410008, Hunan, China
| | - Jigao Yang
- Chongqing Research Institute for Population and Family Planning Science and Technology, Human Sperm Bank, Chongqing, 401121, China
| | - Zhou Zhang
- Northwest Women's and Children's Hospital, Xian, 610045, Shaanxi, China
| | - Xianglong Jiang
- Nanchang Reproductive Hospital, Nanchang, 330001, Jiangxi, China
| | - Aiping Zhang
- Human Sperm Bank of The First Hospital of Lanzhou University, Lanzhou, 730099, Gansu, China
| | - Zuowen Liang
- The First Hospital of Jilin University, Changchun, 130021, Jilin, China
| | - Xiaojin He
- Anhui Provincial Human Sperm Bank, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
| | - Chunying Song
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Sperm Bank, Taiyuan, 030001, Shanxi, China
| | - Fuping Li
- Department of Andrology/Sichuan Human Sperm Bank, West China Second University Hospital, Sichuan University, Chengdu, China.
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China.
| | - Xinzong Zhang
- NHC Key Laboratory of Male Reproduction and Genetics Guangdong Provincial Reproductive, Science Institute (Guangdong Provincial Fertility Hospital), Guangzhou, 510062, Guangdong, China.
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2
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Kiss N, Jongebloed H, Baguley B, Marshall S, White VM, Livingston PM, Bell K, Young L, Sabesan S, Swiatek D, Boltong A, Britto JM, Ugalde A. Meaningful consumer involvement in cancer care: a systematic review on co-design methods and processes. JNCI Cancer Spectr 2024; 8:pkae048. [PMID: 38897655 PMCID: PMC11240760 DOI: 10.1093/jncics/pkae048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 05/30/2024] [Accepted: 06/13/2024] [Indexed: 06/21/2024] Open
Abstract
OBJECTIVE Although the benefits of consumer involvement in research and health care initiatives are known, there is a need to optimize this for all people with cancer. This systematic review aimed to synthesize and evaluate the application of co-design in the oncology literature and develop recommendations to guide the application of optimal co-design processes and reporting in oncology research, practice, and policy. METHODS A systematic review of co-design studies in adults with cancer was conducted, searching MEDLINE, CINAHL, Embase, and PsycINFO databases and included studies focused on 2 concepts, co-design and oncology. RESULTS A total of 5652 titles and abstracts were screened, resulting in 66 eligible publications reporting on 51 unique studies. Four frameworks were applied to describe the co-design initiatives. Most co-design initiatives were designed for use in an outpatient setting (n = 38; 74%) and were predominantly digital resources (n = 14; 27%) or apps (n = 12; 23%). Most studies (n = 25; 49%) used a co-production approach to consumer engagement. Although some studies presented strong co-design methodology, most (n = 36; 70%) did not report the co-design approach, and 14% used no framework. Reporting was poor for the participant level of involvement, the frequency, and time commitment of co-design sessions. Consumer participation level was predominantly collaborate (n = 25; 49%). CONCLUSIONS There are opportunities to improve the application of co-design in oncology research. This review has generated recommendations to guide 1) methodology and frameworks, 2) recruitment and engagement of co-design participants, and 3) evaluation of the co-design process. These recommendations can help drive appropriate, meaningful, and equitable co-design, leading to better cancer research and care.
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Affiliation(s)
- Nicole Kiss
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Hannah Jongebloed
- Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
| | - Brenton Baguley
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Skye Marshall
- Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
- Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, Brisbane, QLD, Australia
- Bond University Nutrition & Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
| | - Victoria M White
- School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Patricia M Livingston
- Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
- Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Kathy Bell
- Clinical Oncology Society of Australia, Sydney, NSW, Australia
| | - Leonie Young
- Clinical Oncology Society of Australia, Sydney, NSW, Australia
| | - Sabe Sabesan
- Clinical Oncology Society of Australia, Sydney, NSW, Australia
- Department of Medical Oncology, Townsville Cancer Centre, Townsville, QLD, Australia
| | - Dayna Swiatek
- Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Anna Boltong
- Kirby Institute, University of New South Wales, NSW 2052, Australia
- Department of Nutrition, Dietetics and Food, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton 3800, Victoria, Australia
| | - Joanne M Britto
- Victorian Comprehensive Cancer Centre Alliance, Parkville, VIC, Australia
| | - Anna Ugalde
- Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
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Baek SY, Kim HK, Park S, Yu JH, Lee MH, Youn HJ, Kim HA, Han JH, Choi JE, Lee JR, Lee KH, Chung S, Chae HD, Kim S, Yoo S, Hahm SK, Kim HJ. Multidisciplinary Shared Decision Making for Fertility Preservation in Young Women With Breast Cancer. J Breast Cancer 2023; 26:582-592. [PMID: 37985382 PMCID: PMC10761754 DOI: 10.4048/jbc.2023.26.e44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 08/14/2023] [Accepted: 09/25/2023] [Indexed: 11/22/2023] Open
Abstract
PURPOSE Fertility preservation (FP) is an important issue for young survivors of breast cancer. Although international guidelines recommend pre-treatment fertility counseling for women with breast cancer, there is no standardized protocol or referral system for FP in South Korea. There are also barriers to discussing FP that make patient-centered decision making difficult. This study aimed to develop a shared decision making program for FP and compare the rates of FP procedures between the usual care and shared decision making groups. We hypothesized that multidisciplinary shared decision making for FP would increase the rate of FP procedures and patient satisfaction. METHODS The multidisciplinary shared decision making for FP in young women with breast cancer (MYBC) is a multicenter, clustered, stepped-wedge, randomized trial. A total of 1100 patients with breast cancer, aged 19-40 years, from nine hospitals in South Korea, will be enrolled. They will be randomized at the institutional level and assigned to usual care and shared decision making groups. Four institutions, each of which can recruit more than 200 patients, will each become a cluster, whereas five institutions, each of which can recruit more than 50 patients, will become one cluster, for a total of five clusters. The shared decision making groups will receive multidisciplinary programs for FP developed by the investigator. The primary outcome is the rate of FP procedures; secondary outcomes include fertility results, satisfaction, and quality of life. Outcomes will be measured at enrollment, treatment initiation, and the 1-, 3-, and 5-year follow-ups after starting breast cancer treatment. DISCUSSION A multidisciplinary shared decision making program for FP is expected to increase fertility rates and satisfaction among young patients with breast cancer. This study will provide the evidence to implement a multidisciplinary system for patients with breast cancer. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05139641. Registered on December 1, 2021.
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Affiliation(s)
- Soo Yeon Baek
- Department of Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Hong-Kyu Kim
- Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Seho Park
- Division of Breast Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Jong Han Yu
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Min Hyuk Lee
- Department of Surgery, Soonchunhyang University Hospital, Seoul, Korea
| | - Hyun Jo Youn
- Department of Surgery, Jeonbuk National University Medical School, Jeonju, Korea
| | - Hyun-Ah Kim
- Department of Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
| | - Jai Hong Han
- Department of Surgery, Center of Breast Cancer, National Cancer Center, Goyang, Korea
| | - Jung Eun Choi
- Division of Breast Surgical Oncology, Department of Surgery, Yeungnam University College of Medicine, Daegu, Korea
| | - Jung Ryeol Lee
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Kyung-Hun Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
| | - Seockhoon Chung
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hee Dong Chae
- Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seonok Kim
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, Seoul, Korea
| | - Soyoung Yoo
- Human Research Protection Center, Asan Medical Center, Seoul, Korea
| | - Sang Keun Hahm
- Department of Family Medicine, Hanil General Hospital, Seoul, Korea
| | - Hee Jeong Kim
- Division of Breast Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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Qiu J, Tang L, Li P, Liu G, Rong X. Psychological and reproductive decision-making experiences of young women after breast cancer diagnosis: a qualitative study. Support Care Cancer 2023; 31:423. [PMID: 37358675 DOI: 10.1007/s00520-023-07880-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 06/10/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUND Breast cancer has the highest incidence rate among malignant tumors in China, with a trend of affecting younger women. The treatment has short- and long-term adverse effects such as damage to the ovaries, which may result in infertility. Such consequences then increase patients' concerns over future reproduction. At present, nor do medical staffs continuously assess their overall well-being, or ensure that they have the knowledge necessary to manage their reproductive concerns. This qualitative study aimed to explore psychological and reproductive decision-making experiences of young women who had experienced childbirth after their diagnosis. METHODS The phenomenological research, as a kind of qualitative study, was conducted on 12 young women who experienced childbirth after breast cancer diagnosis. Data collection was from September 2021 to January 2022 and content analysis method was used to analyze the data. RESULTS Five main themes were identified: (1) desire for childbearing from individual, familial, and social aspects after the diagnosis of breast cancer; (2) emotional experiences through pregnancy till raising children; (3) support needs from professionals, family, and peer; (4) self and doctors' influencing factors on reproductive decision-making; and (5) satisfaction with the outcome of reproductive decision-making. CONCLUSIONS The desire for childbearing of young women should be considered during the reproductive decision-making process. A multidisciplinary team is suggested to be set up to provide professional support. During the reproductive process, professional and peer support should be strengthened to improve decision-making abilities, alleviate negative emotional experience, and smoothen the process of reproductive experience for young patients.
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Affiliation(s)
- Jiajia Qiu
- Department of Nursing Administration, Shanghai Cancer Center, Fudan University, Shanghai, China.
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
| | - Lichen Tang
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Department of Breast Surgery, Shanghai Cancer Center, Fudan University, Shanghai, China
| | - Ping Li
- Department of Nursing Administration, Shanghai Cancer Center, Fudan University, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Guangyu Liu
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Department of Breast Surgery, Shanghai Cancer Center, Fudan University, Shanghai, China
| | - Xinyi Rong
- School of Nursing, Fudan University, Shanghai, China
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Lewinsohn R, Zheng Y, Rosenberg SM, Ruddy KJ, Tamimi RM, Schapira L, Peppercorn J, Borges VF, Come S, Snow C, Ginsburg ES, Partridge AH. Fertility Preferences and Practices Among Young Women With Breast Cancer: Germline Genetic Carriers Versus Noncarriers. Clin Breast Cancer 2023; 23:317-323. [PMID: 36628811 DOI: 10.1016/j.clbc.2022.12.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 12/15/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Young women with breast cancer who carry germline genetic pathogenic variants may face distinct fertility concerns, yet limited data exist comparing fertility preferences and practices between carriers and noncarriers. PATIENTS AND METHODS Participants in the Young Women's Breast Cancer Study (NCT01468246), a prospective cohort of women diagnosed with breast cancer at ≤40 years, who completed a modified Fertility Issues Survey were included in this analysis. RESULTS Of 1052 eligible participants, 118 (11%) tested positive for a pathogenic variant. Similar proportions (P = .23) of carriers (46%, [54/118]) and noncarriers (37%, [346/934]) desired more biologic children prediagnosis, and desire decreased similarly postdiagnosis (carriers, 30% [35/118] vs. noncarriers, 26% [244/934], P = .35). Among those desiring children postdiagnosis (n = 279), concern about cancer risk heritability was more common among carriers (74% [26/35] vs. noncarriers, 36% [88/244], P < .01). Carriers were more likely to report that concern about cancer risk heritability contributed to a lack of certainty or interest in future pregnancies (20% [16/81] vs. noncarriers, 7% [49/674], P = .001). Similar proportions (P = .65) of carriers (36% [43/118]) and noncarriers (38% [351/934]) were somewhat or very concerned about infertility post-treatment; utilization of fertility preservation strategies was also similar (carriers, 14% [17/118] vs. noncarriers, 12% [113/934], P = .78). CONCLUSION Carriers were similarly concerned about future fertility and as likely to pursue fertility preservation as noncarriers. Concern about cancer risk heritability was more frequent among carriers and impacted decisions not to pursue future pregnancies for some, underscoring the importance of counseling regarding strategies to prevent transmission to offspring, including preimplantation genetic testing.
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Affiliation(s)
- Rebecca Lewinsohn
- Harvard Medical School, Boston, MA; Medical Oncology, Dana-Farber Cancer Institute, Boston, MA; Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA
| | - Yue Zheng
- Data Sciences, Dana-Farber Cancer Institute, Boston, MA
| | | | | | | | | | - Jeffrey Peppercorn
- Harvard Medical School, Boston, MA; Massachusetts General Hospital, Boston, MA
| | | | - Steven Come
- Harvard Medical School, Boston, MA; Beth Israel Deaconess Medical Center, Boston, MA
| | - Craig Snow
- Medical Oncology, Dana-Farber Cancer Institute, Boston, MA; Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA
| | | | - Ann H Partridge
- Harvard Medical School, Boston, MA; Medical Oncology, Dana-Farber Cancer Institute, Boston, MA; Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA.
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Yu T, Jin C, Wu X, Yue D. Implementation of Shared Decision-Making Within Internet Hospitals in China Based on Patients' Needs: Feasibility Study and Content Analysis. JMIR Form Res 2023; 7:e39965. [PMID: 36607710 PMCID: PMC9862330 DOI: 10.2196/39965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 09/19/2022] [Accepted: 11/28/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Internet hospitals are developing rapidly in China, and their convenient and efficient medical services are being increasingly recognized by patients. Many hospitals have set up their own internet hospitals to provide web-based medical services. Tianjin Medical University General Hospital has established a multidisciplinary and comprehensive internet hospital to provide diversified medical services according to the needs of patients. A way to further improve web-based medical services is by examining how shared decision-making (SDM) can be carried out in internet hospital diagnosis and treatment services, thereby improving patients' medical experience. OBJECTIVE The aim of this study was to analyze the feasibility of implementing doctor-patient SDM in internet hospital diagnosis and treatment services based on patients' needs in China. METHODS In this study, the medical data of 10 representative departments in the internet hospital of Tianjin Medical University General Hospital from January 1 to January 31, 2022, were extracted as a whole; 25,266 cases were selected. After excluding 2056 cases with incomplete information, 23,210 cases were finally included in this study. A chi-square test was performed to analyze the characteristics and medical service needs of internet hospital patients in order to identify the strengths of SDM in internet hospitals. RESULTS The internet hospital patients from 10 clinical departments were significantly different in terms of gender (χ29=3425.6; P<.001), age (χ236=27,375.8; P<.001), mode of payment (χ29=3501.1; P<.001), geographic distribution (χ29=347.2; P<.001), and duration of illness (χ236=2863.3; P<.001). Patient medical needs included drug prescriptions, examination prescriptions, medical record explanations, drug use instructions, prehospitalization preparations, further consultations with doctors (unspecified purpose), treatment plan consultations, initial diagnoses based on symptoms, and follow-up consultations after discharge. The medical needs of the patients in different clinical departments were significantly different (χ272=8465.5; P<.001). CONCLUSIONS Our study provides a practical and theoretical basis for the feasibility of doctor-patient SDM in internet hospitals and offers some implementation strategies. We focus on the application of SDM in web-based diagnosis and treatment in internet hospitals rather than on a disease or a disease management software. The medical service needs of different patient groups can be effectively obtained from an internet hospital, which provides the practical conditions for the promotion of doctor-patient SDM. Our findings show that the internet hospital platform expands the scope of SDM and is a new way for the large-scale application of doctor-patient SDM.
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Affiliation(s)
- Tianzhi Yu
- Internet Hospital, Tianjin Medical University General Hospital, Tianjin, China
| | - Chunjie Jin
- Internet Hospital, Tianjin Medical University General Hospital, Tianjin, China
| | - Xiaodan Wu
- School of Economics and Management, Hebei University of Technology, Tianjin, China
| | - Dianmin Yue
- School of Economics and Management, Hebei University of Technology, Tianjin, China
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Chen H, Xiong Y, Zhang Z, Zhou Q, Wang D, Wang X, Zhang X. Theoretical model and measurement of shared decision making in web-based pharmaceutical care consultation. Digit Health 2022; 8:20552076221089794. [PMID: 35402000 PMCID: PMC8984866 DOI: 10.1177/20552076221089794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objectives We aimed to construct a theoretical model and an observer-based measurement
of shared decision making (SDM) in web-based pharmaceutical care
consultation. Methods We first constructed a theoretical model through analysis of SDM models and
interviews with 24 key informants. Then, the initial measurement was
formulated, and the content was evaluated by 16 key informants alone. A
cross-sectional study was executed, where 300 provider-patient encounters
were collected at the online platform ‘Good Doctor Website’, for reliability
and validity assessment. Content validity was evaluated by appropriateness
score, that is the median of 7–9 and without disagreement. Interrater
reliability was evaluated by Spearman correlation coefficient using 30 out
of 300 samples. Single indicator validity was tested by Pearson correlation
analysis, and convergent validity was evaluated by the Multiple Indicators
Multiple Causes (MIMIC) model using 300 samples. Results Theoretical model constructed included four elements: ‘comprehensive
understanding of the patient's condition’, ‘exchanging ideas on medication
options’, ‘achieving a medication plan’, and ‘providing decision support’.
Measurement constructed included four dimensions and 19 items, and four
dimensions were in accordance with four elements of the theoretical model.
We found median scores of these dimensions and items were 7–9 and without
disagreement, indicating good content validity. Spearman correlation
coefficients of 19 items were greater than 0.750, suggesting good interrater
reliability. Pearson coefficients between 19 items and their external
variables were significant (p < 0.001), and MIMIC model
results showed that the R2 values of dimensions
1–4 were over 0.5, indicating good single indicator validity and convergent
validity. Conclusions Characteristics of web-based pharmaceutical care consultation, highlighting
the importance of medication history, medication regimen, and detailed
medication plan, were observed in the theoretical model. Measurement
constructed had good reliability and validity and may be used by health
policymakers to improve the quality of pharmaceutical care consultation
online.
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Affiliation(s)
- Haihong Chen
- School of Health Policy & Management, Nanjing Medical University, Nanjing, China
| | - Yuqi Xiong
- Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Zinan Zhang
- School of Health Policy & Management, Nanjing Medical University, Nanjing, China
| | - Qian Zhou
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Dan Wang
- School of Management, Hubei University of Chinese Medicine, Wuhan, China
| | - Xuemei Wang
- Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Xinping Zhang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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8
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Cheng HY, Chau HC, Cheung CKC, Yang LS, Lee SLK, Leung AWK, Li CK, Lam TTN, Yeung NCY, Cheung YT. Perceptions of Infertility Risk Among Chinese Parents of Children with Cancer: A Qualitative Study. J Adolesc Young Adult Oncol 2021; 11:394-401. [PMID: 34613849 DOI: 10.1089/jayao.2021.0106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective: Anticancer treatment may be associated with damage to the reproductive organs and risk of infertility in children with cancer. The collectivist cultural norms of Asian societies may lead Chinese parents to have unique concerns regarding infertility. This qualitative study explored the perceptions of infertility risk and parenthood among parents of childhood cancer survivors in Hong Kong. Methods: Thirteen parents were recruited via a snowball sampling approach from a nongovernmental organization in Hong Kong, representing nine survivors of childhood cancer (leukemia n = 5, solid tumors n = 4). The in-depth semistructured interviews were audiotaped and transcribed verbatim. A thematic analysis was performed using ATLAS.ti 8. Results: Parents mostly perceived their children's fertility status as a distant concern (n = 11, 85%) but emphasized the need for timely information from clinicians when their children reach young adulthood (n = 8, 62%). They reported receiving inconsistent fertility information from different oncology practitioners (n = 9, 69%). A few parents acknowledged that under the influence of the Chinese culture, their children, especially sons, have an important duty to continue the family lineage. However, even if the cancer treatment were associated with infertility risk, almost all parents (n = 12, 92%) stated that it would still not affect their willingness to let their child undergo treatment because survival and cure were still their highest priority. Conclusion: Our findings suggest the need to proactively provide fertility information to parents both during active treatment and when survivors reach reproductive age. Future studies should evaluate the benefits of developing culturally relevant decision-making aids to address parents' informational needs regarding fertility issues.
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Affiliation(s)
- Ho Yu Cheng
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
| | - Ho Cheung Chau
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
| | - Cedric Ka Chun Cheung
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
| | - Lok Sum Yang
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
| | - Samantha Lai-Ka Lee
- Department of Paediatrics & Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong, Hong Kong SAR, China
| | - Alex Wing Kwan Leung
- Department of Paediatrics & Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong, Hong Kong SAR, China.,Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China.,Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
| | - Chi Kong Li
- Department of Paediatrics & Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong, Hong Kong SAR, China.,Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China.,Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
| | - Teddy Tai Ning Lam
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China.,Little Life Warriors Society Hong Kong, Kowloon, Hong Kong SAR, China
| | - Nelson Chun Yiu Yeung
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
| | - Yin Ting Cheung
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
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