Greater fertility distress and avoidance relate to poorer decision making about family building after cancer among adolescent and young adult female survivors
Many adolescent and young adult female (AYA-F) cancer survivors face decisions about family building using reproductive medicine or adoption to achieve parenthood. This study evaluated associations among reproductive distress, avoidance, and family-building decision making and identified sociodemogr...
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| Veröffentlicht in: | Psycho-oncology (Chichester, England) England), 2023-10, Vol.32 (10), p.1606-1615 |
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| creator | Benedict, Catherine Stal, Julia Davis, Ali Zeidman, Anna Pons, Devon Schapira, Lidia Diefenbach, Michael Ford, Jennifer S |
| description | Many adolescent and young adult female (AYA-F) cancer survivors face decisions about family building using reproductive medicine or adoption to achieve parenthood. This study evaluated associations among reproductive distress, avoidance, and family-building decision making and identified sociodemographic and clinical characteristics related to high distress and avoidance.
A cross-sectional survey assessed AYA-F survivors' oncofertility experiences. Measures included an investigator-designed Unmet Information Needs scale, Reproductive Concerns After Cancer Scale, Impact of Events Scale-Avoidance subscale, Decision Self-Efficacy scale, and Decision Conflict Scale. Two linear regression models evaluated correlates of decision self-efficacy and decisional conflict about family building after cancer. Bivariate analyses evaluated correlates of avoidance using Pearson's correlation, t-test, and ANOVA.
AYA-Fs (N = 111) averaged 31-years-old (SD = 5.49) and 3 years post-treatment (range: 1-23 years); 90% were nulliparous. Most common diagnoses were leukemia (24%) and breast cancer (22%). Average decisional conflict was 52.12 (SD = 23.87, range: 0-100); 74% of the sample reported DCS scores within the clinically significant range. Higher levels of reproductive distress (B = -0.23, p = 0.04) and avoidance (B = -0.24, p = 0.02) related to lower decision self-efficacy. Younger age (B = -0.18, p = 0.03), greater unmet information needs (B = 0.33, p |
| doi_str_mv | 10.1002/pon.6212 |
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A cross-sectional survey assessed AYA-F survivors' oncofertility experiences. Measures included an investigator-designed Unmet Information Needs scale, Reproductive Concerns After Cancer Scale, Impact of Events Scale-Avoidance subscale, Decision Self-Efficacy scale, and Decision Conflict Scale. Two linear regression models evaluated correlates of decision self-efficacy and decisional conflict about family building after cancer. Bivariate analyses evaluated correlates of avoidance using Pearson's correlation, t-test, and ANOVA.
AYA-Fs (N = 111) averaged 31-years-old (SD = 5.49) and 3 years post-treatment (range: 1-23 years); 90% were nulliparous. Most common diagnoses were leukemia (24%) and breast cancer (22%). Average decisional conflict was 52.12 (SD = 23.87, range: 0-100); 74% of the sample reported DCS scores within the clinically significant range. Higher levels of reproductive distress (B = -0.23, p = 0.04) and avoidance (B = -0.24, p = 0.02) related to lower decision self-efficacy. Younger age (B = -0.18, p = 0.03), greater unmet information needs (B = 0.33, p < 0.001), and higher levels of reproductive distress (B = 0.34, p = 0.001) related to worse decisional conflict. Predictors of distress and avoidance were identified.
After cancer treatment, high fertility distress and avoidant coping were associated with poorer quality decision making about family building after cancer. Fertility counseling post-treatment should support self-efficacy and constructive coping skills to counteract high distress, maladaptive coping, and facilitate values-based decision making.</description><identifier>ISSN: 1057-9249</identifier><identifier>ISSN: 1099-1611</identifier><identifier>EISSN: 1099-1611</identifier><identifier>DOI: 10.1002/pon.6212</identifier><identifier>PMID: 37695291</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Adolescent ; Adolescent girls ; Adult ; Avoidance behavior ; Behavior problems ; Breast cancer ; Breast Neoplasms - complications ; Cancer ; Clinical significance ; Conflict ; Coping strategies ; Cross-Sectional Studies ; Decision Making ; Efficacy ; Female ; Fertility ; Fertility Preservation - psychology ; Humans ; Information needs ; Measures ; Neoplasms - psychology ; Parents & parenting ; Psychological distress ; Sociodemographics ; Survivor ; Survivors - psychology ; Teenagers ; Young Adult ; Young adults</subject><ispartof>Psycho-oncology (Chichester, England), 2023-10, Vol.32 (10), p.1606-1615</ispartof><rights>2023 John Wiley & Sons Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c401t-624eccfba4cb948a9351d7d3e92d6cd404078098740a5a65739101a327f3d3713</citedby><cites>FETCH-LOGICAL-c401t-624eccfba4cb948a9351d7d3e92d6cd404078098740a5a65739101a327f3d3713</cites><orcidid>0000-0001-9622-249X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902,30976</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37695291$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Benedict, Catherine</creatorcontrib><creatorcontrib>Stal, Julia</creatorcontrib><creatorcontrib>Davis, Ali</creatorcontrib><creatorcontrib>Zeidman, Anna</creatorcontrib><creatorcontrib>Pons, Devon</creatorcontrib><creatorcontrib>Schapira, Lidia</creatorcontrib><creatorcontrib>Diefenbach, Michael</creatorcontrib><creatorcontrib>Ford, Jennifer S</creatorcontrib><title>Greater fertility distress and avoidance relate to poorer decision making about family building after cancer among adolescent and young adult female survivors</title><title>Psycho-oncology (Chichester, England)</title><addtitle>Psychooncology</addtitle><description>Many adolescent and young adult female (AYA-F) cancer survivors face decisions about family building using reproductive medicine or adoption to achieve parenthood. This study evaluated associations among reproductive distress, avoidance, and family-building decision making and identified sociodemographic and clinical characteristics related to high distress and avoidance.
A cross-sectional survey assessed AYA-F survivors' oncofertility experiences. Measures included an investigator-designed Unmet Information Needs scale, Reproductive Concerns After Cancer Scale, Impact of Events Scale-Avoidance subscale, Decision Self-Efficacy scale, and Decision Conflict Scale. Two linear regression models evaluated correlates of decision self-efficacy and decisional conflict about family building after cancer. Bivariate analyses evaluated correlates of avoidance using Pearson's correlation, t-test, and ANOVA.
AYA-Fs (N = 111) averaged 31-years-old (SD = 5.49) and 3 years post-treatment (range: 1-23 years); 90% were nulliparous. Most common diagnoses were leukemia (24%) and breast cancer (22%). Average decisional conflict was 52.12 (SD = 23.87, range: 0-100); 74% of the sample reported DCS scores within the clinically significant range. Higher levels of reproductive distress (B = -0.23, p = 0.04) and avoidance (B = -0.24, p = 0.02) related to lower decision self-efficacy. Younger age (B = -0.18, p = 0.03), greater unmet information needs (B = 0.33, p < 0.001), and higher levels of reproductive distress (B = 0.34, p = 0.001) related to worse decisional conflict. Predictors of distress and avoidance were identified.
After cancer treatment, high fertility distress and avoidant coping were associated with poorer quality decision making about family building after cancer. Fertility counseling post-treatment should support self-efficacy and constructive coping skills to counteract high distress, maladaptive coping, and facilitate values-based decision making.</description><subject>Adolescent</subject><subject>Adolescent girls</subject><subject>Adult</subject><subject>Avoidance behavior</subject><subject>Behavior problems</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - complications</subject><subject>Cancer</subject><subject>Clinical significance</subject><subject>Conflict</subject><subject>Coping strategies</subject><subject>Cross-Sectional Studies</subject><subject>Decision Making</subject><subject>Efficacy</subject><subject>Female</subject><subject>Fertility</subject><subject>Fertility Preservation - psychology</subject><subject>Humans</subject><subject>Information needs</subject><subject>Measures</subject><subject>Neoplasms - psychology</subject><subject>Parents & parenting</subject><subject>Psychological distress</subject><subject>Sociodemographics</subject><subject>Survivor</subject><subject>Survivors - psychology</subject><subject>Teenagers</subject><subject>Young Adult</subject><subject>Young adults</subject><issn>1057-9249</issn><issn>1099-1611</issn><issn>1099-1611</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNpdkcuOFSEQhonROBdNfAJD4sZNj9y6aVbGTHTGZBI3uibVQI-MNByhOcl5GZ9V-jiOlxWk-Ornr_oRekHJBSWEvdmleDEwyh6hU0qU6uhA6ePt3stOMaFO0Fkpd4Q0WA1P0QmXg-qZoqfox1V2sLqMZ5dXH_x6wNaXNbtSMESLYZ-8hWgczi40EK8J71LKrcM644tPES_wzcdbDFOqK55h8eGAp-qDPVbnTd1sEhnDkraSTcEV4-J6_OKQ6rFYQ-t2CwSHS817v0-5PENPZgjFPb8_z9GXD-8_X153N5-uPl6-u-mMIHTtBiacMfMEwkxKjKB4T6203ClmB2MFEUSORI1SEOhh6CVXlFDgTM7cckn5OXr7S3dXp8XZzVuGoHfZL5APOoHX_75E_1Xfpr1uK1ZU0bEpvL5XyOl7dWXVi28zhgDRpVo0G4dt63IUDX31H3qXao5tvkZJRkdGBf8jaHIqJbv5wQ0lektdt9T1lnpDX_7t_gH8HTP_CYl4q8c</recordid><startdate>20231001</startdate><enddate>20231001</enddate><creator>Benedict, Catherine</creator><creator>Stal, Julia</creator><creator>Davis, Ali</creator><creator>Zeidman, Anna</creator><creator>Pons, Devon</creator><creator>Schapira, Lidia</creator><creator>Diefenbach, Michael</creator><creator>Ford, Jennifer S</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-9622-249X</orcidid></search><sort><creationdate>20231001</creationdate><title>Greater fertility distress and avoidance relate to poorer decision making about family building after cancer among adolescent and young adult female survivors</title><author>Benedict, Catherine ; Stal, Julia ; Davis, Ali ; Zeidman, Anna ; Pons, Devon ; Schapira, Lidia ; Diefenbach, Michael ; Ford, Jennifer S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c401t-624eccfba4cb948a9351d7d3e92d6cd404078098740a5a65739101a327f3d3713</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adolescent</topic><topic>Adolescent girls</topic><topic>Adult</topic><topic>Avoidance behavior</topic><topic>Behavior problems</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - complications</topic><topic>Cancer</topic><topic>Clinical significance</topic><topic>Conflict</topic><topic>Coping strategies</topic><topic>Cross-Sectional Studies</topic><topic>Decision Making</topic><topic>Efficacy</topic><topic>Female</topic><topic>Fertility</topic><topic>Fertility Preservation - psychology</topic><topic>Humans</topic><topic>Information needs</topic><topic>Measures</topic><topic>Neoplasms - psychology</topic><topic>Parents & parenting</topic><topic>Psychological distress</topic><topic>Sociodemographics</topic><topic>Survivor</topic><topic>Survivors - psychology</topic><topic>Teenagers</topic><topic>Young Adult</topic><topic>Young adults</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Benedict, Catherine</creatorcontrib><creatorcontrib>Stal, Julia</creatorcontrib><creatorcontrib>Davis, Ali</creatorcontrib><creatorcontrib>Zeidman, Anna</creatorcontrib><creatorcontrib>Pons, Devon</creatorcontrib><creatorcontrib>Schapira, Lidia</creatorcontrib><creatorcontrib>Diefenbach, Michael</creatorcontrib><creatorcontrib>Ford, Jennifer S</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Psycho-oncology (Chichester, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Benedict, Catherine</au><au>Stal, Julia</au><au>Davis, Ali</au><au>Zeidman, Anna</au><au>Pons, Devon</au><au>Schapira, Lidia</au><au>Diefenbach, Michael</au><au>Ford, Jennifer S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Greater fertility distress and avoidance relate to poorer decision making about family building after cancer among adolescent and young adult female survivors</atitle><jtitle>Psycho-oncology (Chichester, England)</jtitle><addtitle>Psychooncology</addtitle><date>2023-10-01</date><risdate>2023</risdate><volume>32</volume><issue>10</issue><spage>1606</spage><epage>1615</epage><pages>1606-1615</pages><issn>1057-9249</issn><issn>1099-1611</issn><eissn>1099-1611</eissn><abstract>Many adolescent and young adult female (AYA-F) cancer survivors face decisions about family building using reproductive medicine or adoption to achieve parenthood. This study evaluated associations among reproductive distress, avoidance, and family-building decision making and identified sociodemographic and clinical characteristics related to high distress and avoidance.
A cross-sectional survey assessed AYA-F survivors' oncofertility experiences. Measures included an investigator-designed Unmet Information Needs scale, Reproductive Concerns After Cancer Scale, Impact of Events Scale-Avoidance subscale, Decision Self-Efficacy scale, and Decision Conflict Scale. Two linear regression models evaluated correlates of decision self-efficacy and decisional conflict about family building after cancer. Bivariate analyses evaluated correlates of avoidance using Pearson's correlation, t-test, and ANOVA.
AYA-Fs (N = 111) averaged 31-years-old (SD = 5.49) and 3 years post-treatment (range: 1-23 years); 90% were nulliparous. Most common diagnoses were leukemia (24%) and breast cancer (22%). Average decisional conflict was 52.12 (SD = 23.87, range: 0-100); 74% of the sample reported DCS scores within the clinically significant range. Higher levels of reproductive distress (B = -0.23, p = 0.04) and avoidance (B = -0.24, p = 0.02) related to lower decision self-efficacy. Younger age (B = -0.18, p = 0.03), greater unmet information needs (B = 0.33, p < 0.001), and higher levels of reproductive distress (B = 0.34, p = 0.001) related to worse decisional conflict. Predictors of distress and avoidance were identified.
After cancer treatment, high fertility distress and avoidant coping were associated with poorer quality decision making about family building after cancer. Fertility counseling post-treatment should support self-efficacy and constructive coping skills to counteract high distress, maladaptive coping, and facilitate values-based decision making.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>37695291</pmid><doi>10.1002/pon.6212</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-9622-249X</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adolescent girls Adult Avoidance behavior Behavior problems Breast cancer Breast Neoplasms - complications Cancer Clinical significance Conflict Coping strategies Cross-Sectional Studies Decision Making Efficacy Female Fertility Fertility Preservation - psychology Humans Information needs Measures Neoplasms - psychology Parents & parenting Psychological distress Sociodemographics Survivor Survivors - psychology Teenagers Young Adult Young adults |
| title | Greater fertility distress and avoidance relate to poorer decision making about family building after cancer among adolescent and young adult female survivors |
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