Improving Nurse Confidence and Patient Counseling in Fertility Preservation Care

Training that increases self-confidence, reduces personal limitations, and decreases perceived barriers to fertility preservation (FP) care among oncology nurses  can improve their ability to counsel patients about fertility preservation (FP), according to a study published in Oncology Nursing Forum.

Fertility preservation in survivorship is an issue that may get overlooked for children and adolescents and young adults (AYAs) with cancer. Although oncology clinicians are more aware of the impacts of cancer treatment on fertility in younger cancer survivors, many AYAs lack understanding of the potential implications of gonadotoxic treatments on their future fertility.

Therefore, a team of researchers conducted a study to assess nurses’ views, experiences, and perceptions of the benefits and barriers to FP counseling for these patients.  

Data were collected from 236 nurses who provided care prior to gonadotrophic treatment to patients in 3 university hospitals in Istanbul, Turkey, between January and June 2018. The mean age of the nurses was 30.21 years, and 205 (87%) were women.

Eight-three participants reported working in the pediatric or pediatric oncology service, had practiced an average of 7.72 years, and provided care for patients with cancer for an average of 4.08 years. 

They provided care throughout the care continuum: 133 (56%) during diagnostic procedures, 146 (62%) at the treatment planning stage, 157 (67%) before chemotherapy, 150 (64%) after chemotherapy, 91 (39%) before radiation therapy, 85 (36%) after radiation therapy, 122 (52%) before surgery, and 129 (55%) after surgery.

A researcher-designed participant information form (PIF) was used to gather demographic information and ask about their views and experiences, including the availability of FP counseling at the clinic and patients’ questions about it. 

In addition, a 12-item Turkish version of the Oncology FP Survey (OFPS), a 5-point, 15-item Likert-type scale, was used to evaluate the nurses’ perceptions. The total score for this scale ranged from 12 to 60 points, with lower scores indicating a greater ability to discuss FP approaches with patients. 

Approximately 24% (56) of the nurses reported having provided FP counseling to their patients, and 5% (12) had received some sort of formal training, such as in-service training, vocational education, or conference attendance, on FP practices. 

Although information was provided to patients and families at 169 (72%) of the clinics, 122 (52%) of the nurses reported that physicians provided that information. 

The mean OFPS total score was 38.13, with total OFPS scores significantly higher (P =.047) for nurses who reported providing FP counseling in their practice than those who did not. 

“Counseling nurses may be aware of FP approaches and the importance of educating patients about FP, but the lack of time and resources allocated for counseling may create obstacles,” the researchers wrote. “Nurses who provide FP counseling may experience more difficulties and may be more aware of barriers around providing this counseling than nurses who do not.”

The participating nurses reported challenges to counseling on FP options were mostly related to self-confidence, personal limitations, and perceived barriers. “Nurses need to be aware of these potential barriers and should be supported in improving their knowledge and skills in this area,” the researchers noted in their report.