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

Female Fertility Preservation / methods Humans Surveys and Questionnaires
Cancer Competency Fertility preservation Models of care Oncofertility Training

Journal

The oncologist
ISSN: 1549-490X
Titre abrégé: Oncologist
Pays: England
ID NLM: 9607837

Informations de publication

Date de publication:
12 2019
Historique:
received: 15 01 2019
accepted: 15 04 2019
pubmed: 31 5 2019
medline: 2 9 2020
entrez: 1 6 2019
Statut: ppublish

Résumé

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. 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. 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. 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. 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.

Sections du résumé

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.

Identifiants

DOI: 10.1634/theoncologist.2019-0043 PMID: 31147490 PMC: PMC6975957
pubmed: 31147490
pii: theoncologist.2019-0043
doi: 10.1634/theoncologist.2019-0043
pmc: PMC6975957
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e1450-e1459

Informations de copyright

© AlphaMed Press 2019.

Déclaration de conflit d'intérêts

Disclosures of potential conflicts of interest may be found at the end of this article.

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Auteurs

Antoinette Anazodo (A)

Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia antoinette.anazodo@health.nsw.gov.au.
Nelune Cancer Centre, Prince of Wales Hospital, Sydney, Australia.
School of Women's and Children's Health, University of New South Wales, Sydney, Australia.
ORCID: 0000-0002-5495-6062

Paula Laws (P)

Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia.

Shanna Logan (S)

School of Women's and Children's Health, University of New South Wales, Sydney, Australia.

Carla Saunders (C)

Australian Centre for Public and Population Health Research, University of Technology Sydney, Sydney, Australia.

Jo Travaglia (J)

Australian Centre for Public and Population Health Research, University of Technology Sydney, Sydney, Australia.

Brigitte Gerstl (B)

Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia.
School of Women's and Children's Health, University of New South Wales, Sydney, Australia.

Natalie Bradford (N)

Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia.

Richard Cohn (R)

Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia.
School of Women's and Children's Health, University of New South Wales, Sydney, Australia.

Mary Birdsall (M)

Fertility Associates, Auckland City, New Zealand.

Ronald Barr (R)

Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.

Nao Suzuki (N)

St. Marianna University School of Medicine, Kawasaki Kanagawa Prefecture, Japan.

Seido Takae (S)

St. Marianna University School of Medicine, Kawasaki Kanagawa Prefecture, Japan.

Ricardo Marinho (R)

Pro Criar Medicina Reprodutiva, Belo Horizonte, Brazil.

Shuo Xiao (S)

Reproductive Health and Toxicology Lab, Department of Environmental Health Sciences Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.

Qiong-Hua Chen (QH)

Department of Obstetrics and Gynecology, First Affiliated Hospital of Xiamen University, Siming Qu, Xiamen Shi, People's Republic of China.

Nalini Mahajan (N)

Mother and Child Hospital, New Delhi, India.

Madhuri Patil (M)

Dr. Patil's Fertility and Endoscopy Clinic, Center for Assisted Reproductive Technology, Endoscopic Surgery and Andrology, Bangalore, India.

Devika Gunasheela (D)

Gunasheela Surgical and Maternity Hospital, Basavanagudi, Bengaluru, Karnataka, India.

Kristen Smith (K)

Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Evanston, Illinois, USA.

Leonard Sender (L)

Children's Hospital Orange County, Orange, California, USA.

Cláudia Melo (C)

Centro de Preservação da Fertilidade, Serviço de Medicina da Reprodução, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.

Teresa Almeida-Santos (T)

Centro de Preservação da Fertilidade, Serviço de Medicina da Reprodução, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.

Mahmoud Salama (M)

Reproductive Medicine Department, National Research Center, Cairo, Egypt.
Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Evanston, Illinois, USA.

Leslie Appiah (L)

The Ohio State University College of Medicine, Department of Obstetrics and Gynecology, Columbus, Ohio, USA.
The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute, Columbus, Ohio, USA.
Nationwide Children's Hospital, Department of Paediatric Surgery, Columbus, Ohio, USA.

Irene Su (I)

University of California San Diego, San Diego, California, USA.

Sheila Lane (S)

Children's Hospital Oxford Headley Way, Oxford, United Kingdom.
University of Oxford, Oxford, United Kingdom.

Teresa K Woodruff (TK)

Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Evanston, Illinois, USA.

Allan Pacey (A)

Academic Unit of Reproductive and Developmental Medicine, Department of Oncology and Metabolism, University of Sheffield, Sheffield, South Yorkshire, United Kingdom.

Richard A Anderson (RA)

MRC Centre for Reproductive Health, The Queen's Medical Research Institute, Edinburgh University, Edinburgh, United Kingdom.

Francoise Shenfield (F)

Reproductive Medicine Unit, Elizabeth Garrett Anderson, University College London Hospital, London, United Kingdom.

Elizabeth Sullivan (E)

Faculty of Health, University of Technology Sydney, Sydney, Australia.

William Ledger (W)

School of Women's and Children's Health, University of New South Wales, Sydney, Australia.
Fertility and Research Centre, Royal Hospital for Women, Randwick, Sydney, Australia.

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Classifications MeSH

questionsmedicales.fr › Techniques d'investigation › Techniques de reproduction › Techniques de reproduction assistée › Préservation de la fertilité › The Development of an International...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › The Development of an International...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Collecte de données › Enquêtes et questionnaires › The Development of an International...