Results from a Pilot Study Testing a Fertility Preservation Decision Aid for Women of Reproductive Age Diagnosed with Cancer
Creators: name: Nagle, Caroline
Publisher: name: The University of North Carolina at Chapel Hill University Libraries
Year: 2019

description: Background: Women in the US are increasingly delaying childbirth until later years. Due to this delay in age at first birth and increased risk of cancer with age, a woman may receive a cancer diagnosis before completing bearing children. Cancer treatments may have a detrimental effect on ovarian function, and future fertility after cancer is difficult to predict. Although the American Society of Clinical Oncology recommends that women be presented with Fertility Preservation (FP) options as soon as possible after diagnosis, patients may have limited knowledge and understanding of available FP options prior to attending a FP consultation. Further, due to the threat of future infertility and limited time constraints to make a decision, decisional conflict may affect women considering FP, even after a consultation. A web-based decision aid (DA) video explaining available fertility options was developed to assist women in making a choice regarding FP.Methods: Thirteen women ages 18-43 recently diagnosed with cancer were referred to UNC Fertility. Participants completed an initial survey to collect data on demographics and assess baseline FP knowledge and decisional conflict. After viewing a web-based FP video DA and completing a worksheet, participants attending a consultation with a FP specialist. Upon completion of viewing the DA video, completing a DA worksheet, and meeting with the FP specialist, a second survey was administered to collect information regarding FP knowledge and decisional conflict. Participants completed surveys again at 2 weeks and 6 months after viewing the DA to assess FP knowledge retention and decisional conflict.Results: Before viewing the DA and attending the FP consultation, mean Knowledge Score (KS) for participants was 29.5% (±21.7), indicating low knowledge regarding fertility preservation options, and mean Decisional Conflict Score (DCS) was high at 61.7% (±21.9), indicating a high level of decisional conflict experienced. Mean KS increased to 71.2% (±16.8) after viewing the DA and attending the FP consultation, and participants demonstrated a reduction in DCS with a mean of 35.3% (±11.4). KS was maintained at a similar level when participants were surveyed 6 months later, with a mean score of 64.1% (±12.6), demonstrating knowledge retention at prolonged follow-up, Reduction in DCS was similarly maintained 6 months later, with a mean DCS of 22.8% (±14.2).Conclusion: After viewing a web-based DA video, coupled with a traditional FP consultation, participants demonstrated increases in knowledge regarding FP and decreases in DCS. Additionally, participants demonstrated long-term knowledge retention and reduced DCS 6 months after viewing the DA. The DA video is an effective tool for increasing knowledge and decreasing decisional conflict among participants. This DA has the potential to be a useful resource for future women diagnosed with cancer considering FP.