がんと診断された女性の妊孕性温存に関する意思決定葛藤の関連因子

Related Factors of Decisional Conflict Regarding Fertility Preservation in Women Diagnosed with Cancer

　がんと診断された女性は，がん治療前の限られた期間にがん治療と妊孕性温存の意思決定を求められる．本研究は，がんと診断された女性の妊孕性温存に関する意思決定において，意思決定葛藤の関連因子に着目して文献検討を行った．

　データベースEBSCOを用い，“cancer”，“female”，“fertility”，and “decision making”をキーワードとして検索し，英語論文21件を対象とした．

　結果として，【時間的制約】，【経済的負担感】，【ソーシャルサポート不足】，【パートナーとの不安定な関係】，【情報不足】，【情報過多】，【矛盾する情報源】，【曖昧な個人的価値観】，【医療資源不足】，【医療者とのコミュニケーション不足】の10の関連因子が抽出された．

　がんと診断された女性の妊孕性温存に関する意思決定葛藤に対して，卵巣毒性のある治療開始の限られた時間に，女性のみならず，パートナーや家族への情報提供や意思決定支援の重要性が再確認された．腫瘍医，生殖医の連携システム不足など医療資源の未充足も課題である．

　Women diagnosed with cancer are often required to make decisions about cancer treatment and fertility preservation in a limited period before commencing cancer treatment. This study conducted a literature review focusing on factors of decisional conflict in fertility preservation decision-making among women diagnosed with cancer. We searched EBSCO using the keywords “cancer”, “female”, “fertility”, and “decision making” and identified 21 articles in English. As a result, ten factors were extracted: “time constraints”, “financial burden”, “lack of social support”, “unstable relationship with partner”, “lack of information”, “too much information”, “conflicting sources of information”, “ambiguous personal values”, “lack of medical resources”, and “poor communication with healthcare providers”. Enabling the alleviation of decisional conflict regarding fertility preservation in women diagnosed with cancer reaffirmed the importance of providing information and decision-making support to the women and their partners and family during the limited time before initiating ovarian-toxic treatments. The insufficiency of medical resources, such as the lack of a collaborative system of oncologists and reproductive physicians, is also an issue.