dc.contributor.author | Bradford, Natalie K | |
dc.contributor.author | Walker, Roderick | |
dc.contributor.author | Henney, Roslyn | |
dc.contributor.author | Inglis, Po | |
dc.contributor.author | Chan, Raymond J | |
dc.date.accessioned | 2020-08-11T03:14:28Z | |
dc.date.available | 2020-08-11T03:14:28Z | |
dc.date.issued | 2018 | |
dc.identifier.issn | 2156-5333 | |
dc.identifier.doi | 10.1089/jayao.2017.0042 | |
dc.identifier.uri | http://hdl.handle.net/10072/390534 | |
dc.description.abstract | Aims: The consequences of cancer and treatment on fertility can be a continuing source of distress for adolescents and young adults. The study aims were to assess the effects of bundled interventions on clinical practice concerning fertility in young people aged 14-25 years with cancer. Methods: Bundled interventions, including development of quality indicators, resources, and targeted education, were introduced during 2015 across five cancer centers. Data before interventions (2012-2014) were compared with data prospectively collected during 2015-2016. Relative risks (RR) with 95% confidence intervals (CI) were calculated to assess effects of interventions. Results: Compared with the pre-intervention cohort (n = 260), the post-intervention cohort (n = 216) was 1.47 times more likely to have documented discussion of risk of infertility (95% CI 1.12-1.63, p = <0.001). Similarly, documented referral to fertility specialists was more likely in the post-intervention cohort (RR 1.53, 95% CI 1.26-1.87, p = <0.001) as was documented fertility preservation outcomes (RR 2.56, 95% CI 1.91-3.44, p = <0.001). These differences were significant across age, gender, and diseases. Females had greater improvement in documented risk of infertility discussion between cohorts (RR 1.70, 95% CI 1.19-2.08, p = <0.001). Among diseases, the greatest improvements were seen in those with brain cancers (RR 2.15, 95% CI 1.28-3.62, p = 0.004) and soft tissue sarcoma (RR 2.60, 95% CI 1.17-5.78, p = 0.02). Conclusions: We have demonstrated the effects of bundled interventions to improve clinical practice associated with fertility preservation in young people with cancer. Interventions were successful for reducing disparities identified in the pre-intervention cohort associated with gender and certain diseases. Assessment of the quality of patient care is not possible without accurate, consistent documentation. | |
dc.description.peerreviewed | Yes | |
dc.language | English | |
dc.language.iso | eng | |
dc.publisher | Mary Ann Liebert, Inc | |
dc.relation.ispartofpagefrom | 37 | |
dc.relation.ispartofpageto | 45 | |
dc.relation.ispartofissue | 1 | |
dc.relation.ispartofjournal | Journal of Adolescent and Young Adult Oncology | |
dc.relation.ispartofvolume | 7 | |
dc.subject.fieldofresearch | Nursing | |
dc.subject.fieldofresearch | Oncology and carcinogenesis | |
dc.subject.fieldofresearch | Health services and systems | |
dc.subject.fieldofresearch | Public health | |
dc.subject.fieldofresearchcode | 4205 | |
dc.subject.fieldofresearchcode | 3211 | |
dc.subject.fieldofresearchcode | 4203 | |
dc.subject.fieldofresearchcode | 4206 | |
dc.subject.keywords | Science & Technology | |
dc.subject.keywords | Life Sciences & Biomedicine | |
dc.subject.keywords | Oncology | |
dc.subject.keywords | fertility preservation | |
dc.subject.keywords | oncofertility | |
dc.title | Improvements in Clinical Practice for Fertility Preservation Among Young Cancer Patients: Results from Bundled Interventions | |
dc.type | Journal article | |
dc.type.description | C1 - Articles | |
dcterms.bibliographicCitation | Bradford, NK; Walker, R; Henney, R; Inglis, P; Chan, RJ, Improvements in Clinical Practice for Fertility Preservation Among Young Cancer Patients: Results from Bundled Interventions, Journal of Adolescent and Young Adult Oncology, 2018, 7 (1), pp. 37-45 | |
dc.date.updated | 2020-01-16T04:32:01Z | |
dc.description.version | Accepted Manuscript (AM) | |
gro.rights.copyright | This is a copy of an article published in Journal of Adolescent and Young Adult Oncology. Copyright 2018 Mary Ann Liebert, Inc. Final publication is available from Mary Ann Liebert, Inc., publishers https://doi.org/10.1089/jayao.2017.0042 | |
gro.hasfulltext | Full Text | |
gro.griffith.author | Chan, Ray | |