The Development of an International Oncofertility Competency Framework: A Model to Increase Oncofertility Implementation

The oncologist

article

Antoinette Anazodo¹  Ronald Barr⁴  Nao Suzuki⁵  Seido Takae⁵  Ricardo Marinho⁶  Shuo Xiao⁷  Qiong-Hua Chen⁸  Nalini Mahajan⁹  Madhuri Patil^1,10  Devika Gunasheela^1,11  Kristen Smith^1,12  Paula Laws¹  Leonard Sender^1,13  Cláudia Melo^1,14  Teresa Almeida-Santos^1,14  Mahmoud Salama^1,15  Leslie Appiah^1,16  Irene Su^1,19  Sheila Lane^2,20  Teresa K. Woodruff^1,12  Allan Pacey^2,22  Richard A. Anderson^2,23  Shanna Logan³  Francoise Shenfield^2,24  Elizabeth Sullivan^2,25  William Ledger³  Carla Saunders^2,27  Jo Travaglia^2,27  Brigitte Gerstl¹  Natalie Bradford^2,28  Richard Cohn¹  Mary Birdsall^2,29 

[1] Kids Cancer Centre, Sydney Children's Hospital;Nelune Cancer Centre, Prince of Wales Hospital;School of Women's and Children's Health, University of New South Wales;Department of Pediatrics, McMaster University;St. Marianna University School of Medicine;Pro Criar Medicina Reprodutiva;Reproductive Health and Toxicology Lab, Department of Environmental Health Sciences Arnold School of Public Health, University of South Carolina;Department of Obstetrics and Gynecology, First Affiliated Hospital of Xiamen University;Mother and Child Hospital;Dr. Patil's Fertility and Endoscopy Clinic, Center for Assisted Reproductive Technology;Gunasheela Surgical and Maternity Hospital;Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University;Children's Hospital Orange County;Centro Hospitalar e Universitário de Coimbra;Reproductive Medicine Department, National Research Center;The Ohio State University College of Medicine, Department of Obstetrics and Gynecology;The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute;Nationwide Children's Hospital, Department of Paediatric Surgery;University of California San Diego;Children's Hospital Oxford Headley Way, United Kingdom;University of Oxford, United Kingdom;Academic Unit of Reproductive and Developmental Medicine, Department of Oncology and Metabolism, University of Sheffield, United Kingdom;MRC Centre for Reproductive Health, The Queen's Medical Research Institute, Edinburgh University, United Kingdom;Reproductive Medicine Unit, University College London Hospital, United Kingdom;Faculty of Health, University of Technology Sydney;Fertility and Research Centre, Royal Hospital for Women;Australian Centre for Public and Population Health Research, University of Technology Sydney;Institute of Health and Biomedical Innovation, Queensland University of Technology;Fertility Associates

关键词: Fertility preservation;    Oncofertility;    Models of care;    Competency;    Training;    Cancer;   

DOI  :  10.1634/theoncologist.2019-0043

学科分类：地质学

来源: AlphaMed Press Incorporated

【 摘 要 】

Background Despite international evidence about fertility preservation (FP), several barriers still prevent the implementation of equitable FP practice. Currently, oncofertility competencies do not exist. The aim of this study was to develop an oncofertility competency framework that defines the key components of oncofertility care, develops a model for prioritizing service development, and defines the roles that health care professionals (HCPs) play. Materials and Method A quantitative modified Delphi methodology was used to conduct two rounds of an electronic survey, querying and synthesizing opinions about statements regarding oncofertility care with HCPs and patient and family advocacy groups (PFAs) from 16 countries (12 high and 4 middle income). Statements included the roles of HCPs and priorities for service development care across ten domains (communication, oncofertility decision aids, age-appropriate care, referral pathways, documentation, oncofertility training, reproductive survivorship care and fertility-related psychosocial support, supportive care, and ethical frameworks) that represent 33 different elements of care. Results The first questionnaire was completed by 457 participants (332 HCPs and 125 PFAs). One hundred and thirty-eight participants completed the second questionnaire (122 HCPs and 16 PFAs). Consensus was agreed on 108 oncofertility competencies and the roles HCPs should play in oncofertility care. A three-tier service development model is proposed, with gradual implementation of different components of care. A total of 92.8% of the 108 agreed competencies also had agreement between high and middle income participants. Conclusion FP guidelines establish best practice but do not consider the skills and requirements to implement these guidelines. The competency framework gives HCPs and services a structure for the training of HCPs and implementation of care, as well as defining a model for prioritizing oncofertility service development. Implications for Practice Despite international evidence about fertility preservation (FP), several barriers still prevent the implementation of equitable FP practice. The competency framework gives 108 competencies that will allow health care professionals (HCPs) and services a structure for the development of oncofertility care, as well as define the role HCPs play to provide care and support. The framework also proposes a three-tier oncofertility service development model which prioritizes the development of components of oncofertility care into essential, enhanced, and expert services, giving clear recommendations for service development. The competency framework will enhance the implementation of FP guidelines, improving the equitable access to medical and psychological oncofertility care.

【 授权许可】

CC BY|CC BY-NC