Support and follow-up system for solving the sexual and reproductive health issues among young adults with cancer

Research Project

Project/Area Number	16K15932
Research Category	Grant-in-Aid for Challenging Exploratory Research
Allocation Type	Multi-year Fund
Research Field	Lifelong developmental nursing
Research Institution	University of Hyogo
Principal Investigator	KUDO Yoshiko 兵庫県立大学, 看護学部, 教授 (40234455)
Co-Investigator(Kenkyū-buntansha)	丸光恵甲南女子大学, 看護リハビリテーション学部, 教授 (50241980) 富岡晶子東京医療保健大学, 医療保健学部, 准教授 (90300045)
Project Period (FY)	2016-04-01 – 2019-03-31
Project Status	Completed (Fiscal Year 2018)
Budget Amount *help	¥3,380,000 (Direct Cost: ¥2,600,000、Indirect Cost: ¥780,000) Fiscal Year 2018: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000) Fiscal Year 2017: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000) Fiscal Year 2016: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Keywords	看護学 / 思春期 / 若年成人期 / がん患者 / セクシュアリティ / 思春期・成人期 / 思春期・若年成人期
Outline of Final Research Achievements	This study aims to explore nurses' perceptions of the sexual and reproductive health issues among young adults with cancer via group interviews. Although they did not encounter questions or consultations regarding sexual function raised by patients, patients might wonder how to ask about such issues. The nurses felt that they needed to improve their skills to open the discussion and to provide effective consultations. Two themes emerged from interviews about their cases. One was the nurses' dilemma about the patients who wished to have fertility preservation, but it was contraindicated due to his/her poor prognosis. The other one was the dilemma about the patients who desired to suspend or alter cancer treatment for continuing pregnancy. Thus, a multidisciplinary team including midwives will need to support the decision making process by weighing patients' desires and wishes against their medical conditions
Academic Significance and Societal Importance of the Research Achievements	若年成人期のがん患者の性・生殖機能に関する問題解決支援・フォローアップ体制構築の為には、特に①妊孕性に問題を生じる場合の意思決定時、②診断早期や、③初期治療後に性生活・性行動に関する身体・精神面への影響を自覚する時期に着目する事の重要性が本研究により示された。また、精神・心理面も含めたトータルケアを提供するフォローアップ体制が必要である。さらに、がんと生殖に関する知識を強化するだけでなく、倫理的葛藤の解決も含めた包括的な教育プログラムと、困難な意思決定支援を提供する専門職自身へのフォローアップ体制も重要である。