三级甲等医院肿瘤相关科室医师对于患者生育力保存认知度的调查  

Survey on physicians who engage in cancer diagnosis and treatment from third-grade class A hospitals regarding the perceptions of cancer patients' fertility preservation

作　　者：张凤春[1,2] 马越[3] 林玉梅[4] 刘照南 闫宁宁[1,2] 徐海燕[1] 徐迎春[3] 王理伟[3] ZHANG Feng-chun1, 2, MA Yue3, LIN Yu-mei4＊, LIU Zhao-nan3, YAN Ning-ning1, 2, XU Hai-yan1, XU Ying-chun3, WANG Li-wei3(1. Department of Oncology, Suzhou Kowloon Hospital, Shanghai Jiao Tong University School of Medicine, Suzhou 215021, China; 2. Department of Oncology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; 3. Department of Oncology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; 4. Department of Hematology and Oncology, China-Japan Union Hospital, Jilin University, Changchun 130021, Chin)

机构地区：[1]上海交通大学医学院附属苏州九龙医院肿瘤科,苏州215021 [2]上海交通大学医学院附属瑞金医院肿瘤科,上海200025 [3]上海交通大学医学院附属仁济医院肿瘤科,上海200127 [4]吉林大学中日联谊医院血液肿瘤科,长春130021

出　　处：《上海交通大学学报（医学版）》2018年第5期514-519,共6页Journal of Shanghai Jiao tong University:Medical Science

基　　金：国家自然科学基金(81301858);苏州市科技计划项目(SYS201404)~~

摘　　要：目的·了解三级甲等医院从事肿瘤诊疗相关工作的医师对于肿瘤患者生育力保存(fertility preservation,FP)的认知情况和存在的主要问题。方法·采用问卷调查的方法,于2017年1月1日—12月31日,对4家三级甲等医院从事肿瘤诊疗相关工作的各级医师进行问卷调查,共计179名肿瘤内科医师、77名放疗科医师及79名肿瘤外科医师参与调查。采集性别、年龄、职称、教育背景和FP认知等相关资料,采用Logistic回归分析影响医师对患者进行FP推荐的因素。结果·本次实际调查医师335名,包括88名男医师和247名女医师,平均年龄(35.94±6.27)岁(23~59岁)。96.4%的医师明确知道放射治疗和化学治疗会造成患者生育力的损伤,并且85.1%的医师认为应该向患者及家属介绍FP的措施,但实际工作中只有28.1%的医师进行了相关FP推荐。其中肿瘤内、外科医师,女医师,职称相对较高及具有更高教育背景的医师更倾向选择FP推荐。有63.3%的医师提出知道男性FP,但只有37.9%和21.2%的医师知道确切的保存方法和地点;对于65.1%的自称了解女性FP的医师中,有49.9%和24.5%的医师明确知道确切的保存方法和地点。对于进行相关推荐的最大顾虑是医师认为肿瘤患者已不适合孕育后代(占32.8%),其次是医师本人缺乏FP的知识和担心FP措施会延误患者抗肿瘤治疗时机。结论·肿瘤诊治医师目前缺乏对于肿瘤患者进行FP推荐的意识和知识背景,需要规范培训,提高其认识水平。Objective To explore the perceptions and current practice barriers of Chinese physicians who engage in cancer diagnosis and treatment from third-grade Class A hospitals regarding cancer patients＇ perceptions of fertility preservation（FP）. Methods A study was conducted in physicians from 4 third-grade Class A hospitals with different clinical specialties assisting cancer patients through a structured self-report questionnaire between January 2017 and December 2017. A total of 179 medical oncologists, 77 radiation oncologists and 79 surgeons were included. Their information on gender, age, title, education background and perceptions of FP was obtained. Logistic regression analysis was used to examine the correlation between the recommendation of FP and risk factors. Results There were 335 physicians, including 88 male physicians and 247 female physicians, with an average age of（35.94±6.27） years（range from 23-59 years） in the current study. Although 96.4% of the physicians knew that chemotherapy and radiation had a profound effect on impairment of fertility and 85.1% of them thought it was necessary to recommend FP, only 28.1% of them gave FP-related recommendations to the cancer patients. The oncologists and surgeons, female physicians, and those with higher professional titles and education background were more likely to make the FP recommendation. Among 63.3% of the physicians knowing male FP, only 37.9% and 21.2% of them noted the exact methods and place for FP, respectively. Similarly, for the 65.1% of the physicians knowing female FP, the percentage was 49.9% and 24.5%, respectively. When it came to the barriers of FP decision-making, 32.8% of the oncologists reported their concerns on whether cancer patients were suitable to reproduce. Secondly, the physicians honestly admitted that they lacked expertise in FP and worried about that FP would delay cancer treatment. Conclusion Physicians who engage in cancer diagnosis and treatment lack the awareness and knowledge background of FP recommendatio

关 键 词：肿瘤 医师 生育力保存 认知度 问卷 

分 类 号：R730[医药卫生—肿瘤]