Development of materials to promote explanation of effects of cancer treatment on reproductive function and fertility preservation

• Project/Area Number: 20K23245
• Research Category: Grant-in-Aid for Research Activity Start-up
• Allocation Type: Multi-year Fund
• Review Section: 0908:Society medicine, nursing, and related fields
• Research Institution: National Cancer Center Japan
• Principal Investigator: Okamura Masako 国立研究開発法人国立がん研究センター, がん対策研究所, 研究員 (90872804)
• Project Period (FY): 2020-09-11 – 2023-03-31
• Project Status: Completed (Fiscal Year 2022)
• Budget Amount: ¥2,860,000 (Direct Cost: ¥2,200,000、Indirect Cost: ¥660,000); Fiscal Year 2021: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000); Fiscal Year 2020: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
• Keywords: 思春期若年成人世代がん患者 / 生殖機能 / 妊孕性温存 / がん治療 / 説明促進資材

Outline of Research at the Start

思春期・若年成人世代がん患者の生殖機能・妊孕性に関する情報ニーズは高い一方で、がん治療前に実際説明を受けた患者の割合は低い。
本研究では、治療開始前に医師が患者に対し「治療による生殖機能への影響と妊孕性温存」に関する説明を行う際の阻害要因と促進要因を明らかにし、各要因を踏まえ医師による患者への説明を多職種で実施促進する資材を開発することを目的とする。
本研究により、医師と多職種チームが使用可能な共通の「治療による生殖機能への影響と妊孕性温存」に関する説明促進資材が開発されることにより、患者が治療前に十分納得される説明を受け意思決定が促進され、患者のQOLの向上、医師の負担軽減が期待される。

Outline of Final Research Achievements

In 2020 and 2021, an interview survey was conducted with 16 doctors and 4 nurses who were involed in the treatment of adolescent and young adults (AYAs) with cancer. We also interviewed 10 AYAs with cancer. From 2021 to 2022, 30 interviewees' verbatim transcripts were analyzed by four analysts based on the Consolidated Framework for Implementation Research (CFIR), which is an integrated framework for implementation research.
As a result of analysis of the interview data with healthcare providers, barriers and facilitators of explanations about the effect of treatment on reproductive function and fertility preservation were clarified. In addition, the analysis of patient interview data revealed the patients' preferences regarding fertility care.

Academic Significance and Societal Importance of the Research Achievements

先行研究でAYA世代がん患者のニーズや実態調査が行われているが、話し合いを促進するための解決策は世界的にも提案されていない。本研究は患者に対する説明の際の阻害促進要因に着目し、医療者と患者を対象とした調査により要因を踏まえた説明促進資材を開発する点で学術的意義が高いと言える。
本研究の成果により妊孕性ケアの阻害促進要因と患者の意向が明らかとなり、説明とケアを促進する患者側と医療者側への介入開発に繋がっている。第４期がん対策推進基本計画のがん医療分野の目標の一つである妊孕性温存療法に関する提供体制の充実に向け、患者の意向に沿った妊孕性ケアを届けるための取り組みに貢献する。

Research Products

• [Journal Article] Development of an Online Communication Skills Training Program for Oncologists Working with Adolescents and Young Adults (2023)
  • Author(s): Masako Okamura, Maiko Fujimori, Eiichi Saito, Yuko Osugi, Nobuya Akizuki, Yosuke Uchitomi
  • Journal Title: JOURNAL OF ADOLESCENT AND YOUNG ADULT ONCOLOGY Volume: - Pages: 1-7
  • DOI: 10.1089/jayao.2022.0102
  • Peer Reviewed / Open Access
• [Journal Article] Prevalence and associated factors of psychological distress among young adult cancer patients in Japan (2022)
  • Author(s): Okamura Masako、Fujimori Maiko、Goto Shinichi、Obama Kyoko、Kadowaki Midori、Sato Ayako、Hirayama Takatoshi、Uchitomi Yosuke
  • Journal Title: Palliative and Supportive Care Volume: - Issue: 1 Pages: 1-7
  • DOI: 10.1017/s1478951521002054
  • Peer Reviewed / Open Access
• [Journal Article] Assessing the need for a question prompt list that encourages end-of-life discussions between patients with advanced cancer and their physicians: A focus group interview study ? ERRATUM (2022)
  • Author(s): Sato Ayako、Fujimori Maiko、Shirai Yuki、Umezawa Shino、Mori Masanori、Jinno Sayaka、Umehashi Mihoto、Okamura Masako、Okusaka Takuji、Majima Yoshiyuki、Miyake Satoshi、Uchitomi Yosuke
  • Journal Title: Palliative and Supportive Care Volume: online ahead Issue: 4 Pages: 1-3
  • DOI: 10.1017/s1478951522000153
  • Peer Reviewed / Open Access
• [Journal Article] Clinical practice guidelines for the care of psychologically distressed bereaved families who have lost members to physical illness including cancer (2022)
  • Author(s): Akechi T, Kubota Y, Ohtake Y, Setou N, Fujimori M, Takeuchi E, Kurata A, Okamura M, Hasuo H, Sakamoto R, Miyamoto S, Asai M, Shinozaki K, Onishi H, Shinomiya T, Okuyama T, Sakaguchi Y, Matsuoka H.
  • Journal Title: Japanese Journal of Clinical Oncology Volume: - Issue: 6 Pages: 1-5
  • DOI: 10.1093/jjco/hyac025
  • Peer Reviewed
• [Journal Article] Validity and reliability of the Japanese version of the Peace, Equanimity, and Acceptance in the Cancer Experience (PEACE) questionnaire (2021)
  • Author(s): Okamura Masako、Fujimori Maiko、Hata Kotone、Mori Masanori、Mack Jennifer W.、Prigerson Holly G.、Uchitomi Yosuke
  • Journal Title: Palliative and Supportive Care Volume: online ahead Issue: 4 Pages: 1-7
  • DOI: 10.1017/s1478951521000924
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] 高確率で起きる「Bad News」を伝える-① 抗がん薬による副作用への対策・対応 (2021)
  • Author(s): 岡村優子, 藤森麻衣子, 内富庸介
  • Journal Title: 薬局 Volume: Vol. 72, No. 12 Pages: 3341-3346
• [Journal Article] Unmet supportive care needs and associated factors among young adult cancer patients in Japan (2021)
  • Author(s): Okamura Masako、Fujimori Maiko、Sato Ayako、Uchitomi Yosuke
  • Journal Title: BMC Cancer Volume: 21 Issue: 1 Pages: 17-17
  • DOI: 10.1186/s12885-020-07721-4
  • Peer Reviewed / Open Access
• [Journal Article] 病名告知 難治がんの時代における変遷 (2020)
  • Author(s): 岡村優子、藤森麻衣子、森雅紀、内富庸介
  • Journal Title: 精神医学 Volume: 62 Pages: 1123-1130
• [Journal Article] 皮膚科専門医に役立つサイコオンコロジー (2020)
  • Author(s): 岡村優子、内富庸介
  • Journal Title: MB Derma Volume: 301 Pages: 1-8
• [Presentation] 医師を対象とした思春期・若年成人世代がん患者とのコミュニケーション技術研修会開発 (2022)
  • Author(s): 岡村優子
  • Organizer: 第35回日本サイコオンコロジー学会総会
• [Presentation] 医師を対するコミュニケーション技術研修－精神科医の役割と新しい取り組み－ (2022)
  • Author(s): 岡村優子
  • Organizer: 第35回日本総合病院精神医学学会総会
• [Presentation] Prevalence and associated factors of psychological distress among survivors of adolescent and young adult cancer in Japan (2021)
  • Author(s): Okamura M, Fujimori M, Goto S, Obama K, Kadowaki M, Sato A, Hirayama T, Uchitomi Y
  • Organizer: THe 22nd World Congress of Psyho-Oncology & Psychosocial Academy
  • Int'l Joint Research