Reproductive concerns and fertility intentions in cancer survivors: A longitudinal study of decision-making conflict as mediator

IF 3.1 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Patient Education and Counseling Pub Date : 2025-09-08 DOI:10.1016/j.pec.2025.109344

Qingchun Geng , Mei Kong , Qingqing Diao , Yang Li , Lina Xiong , Hongwen Ma , Shuzhen Niu , Jiping Tan , Xiaoxiao Hu , Ruofen Yan , Yanfei Jin

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引用次数: 0

Abstract

Objective

To investigate the impact of reproductive concerns on fertility intentions among cancer survivors of childbearing age and evaluate the mediating role of decision-making conflicts in this relationship.

Methods

A prospective longitudinal survey was conducted with 223 cancer patients (aged 18–50) across three regions in China. Assessments using validated scales for fertility intentions, reproductive concerns, and decision-making conflicts were completed at three timepoints: 3, 6, and 9 months post-treatment. A longitudinal path model was constructed using cross-lagged analysis

Results

Decision-making conflict significantly mediated the relationship between reproductive concerns and fertility intentions (β = −0.031, 95 % CI = [-0.075, −0.006]). Reproductive concerns predicted increased decision-making conflict (β = 0.347, p < 0.001), which subsequently led to decreased fertility intentions (β = −0.167, p < 0.001). These relationships remained stable across measurement timepoints.

Conclusion

Decision-making conflict serves as a key mediator between reproductive concerns and fertility intentions among cancer survivors of childbearing age, suggesting a potential intervention target for enhancing fertility outcomes in this population.

Practice Implications

Healthcare providers should address decision-making conflict through structured counseling interventions, particularly in the context of precision medicine where fertility implications of novel therapies may be uncertain. Developing tailored decision support tools could help reduce decision-making conflict and potentially improve alignment between patients’ fertility values and intentions.

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癌症幸存者的生殖关注和生育意向：决策冲突作为中介的纵向研究

目的探讨生育顾虑对育龄癌症幸存者生育意愿的影响，并评价决策冲突在这一关系中的中介作用。方法对中国3个地区223例年龄在18-50岁的癌症患者进行前瞻性纵向调查。在治疗后3个月、6个月和9个月的三个时间点，使用有效的生育意图、生殖问题和决策冲突量表进行评估。结果决策冲突显著中介了生育关注与生育意愿之间的关系（β = - 0.031, 95 % CI =[-0.075, - 0.006]）。生育问题预测决策冲突增加（β = 0.347, p <； 0.001），随后导致生育意愿下降（β = - 0.167, p <； 0.001）。这些关系在测量时间点上保持稳定。结论决策冲突是育龄癌症幸存者生育意愿与生育意愿之间的重要中介因素，是提高该人群生育结局的潜在干预目标。实践意义卫生保健提供者应该通过结构化的咨询干预来解决决策冲突，特别是在精准医学的背景下，新疗法对生育的影响可能是不确定的。开发量身定制的决策支持工具可以帮助减少决策冲突，并可能改善患者生育价值观和意愿之间的一致性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Patient Education and Counseling 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.60

自引率

11.40%

发文量

384

审稿时长

46 days

期刊介绍： Patient Education and Counseling is an interdisciplinary, international journal for patient education and health promotion researchers, managers and clinicians. The journal seeks to explore and elucidate the educational, counseling and communication models in health care. Its aim is to provide a forum for fundamental as well as applied research, and to promote the study of organizational issues involved with the delivery of patient education, counseling, health promotion services and training models in improving communication between providers and patients.