摘要/Abstract

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。
关键词: 肿瘤, 医师, 生育力保存, 认知度, 问卷
Abstract:
Objective · To explore the perceptions and current practice barriers of Chinese physicians who engage in cancer diagnosis and treatment third-grade Class A hospitals regarding cancer patients perceptions of fertility preservation (FP). Methods · A study was conducted in physicians 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 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 suito 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 recommendation for cancer patients. It is important to improve the perceptions of cancer patients’ FP through standardize training.
Key words: cancer, physician, fertility preservation, perception, questionnaire


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