Fertility Preservation Decision-Making Experience in Patients with Early-Stage Gynecologic Malignancies from the Perspective of Healthcare Professionals and Patients: A Qualitative Research Study

BACKGROUND: The treatment of gynecologic malignancies can cause direct damage to reproductive function. Fertility preservation decision-making is necessary and complex, which results in a heavy internal burden for patients with early-stage gynecologic malignancies. OBJECTIVE: To explore the real experiences of patients with early-stage gynecologic malignancies in fertility preservation decision-making. METHODS: A descriptive qualitative study was conducted. Semistructured interviews were performed with 12 patients with early-stage gynecologic malignancies and 12 healthcare professionals. Data were analyzed using NVivo 11 software. RESULTS: Three main themes were identified: decision-making dilemmas (anxiety, conflict, and avoidance), decision-making needs (the need for information support, emotional support, and decision support), and decision-making influencing factors (patients' cognitive levels, value preferences and family involvement, providers' professional competence and communication skills, and healthcare resource accessibility and policy support). CONCLUSION: Patients with early-stage gynecologic malignancies are prone to multiple dilemmas when faced with fertility preservation decisions, have multiple types of needs, and are affected by multiple factors that make decision-making difficult. These challenges can be addressed at multiple levels, including healthcare professionals, families, and society, to optimize the shared decision-making process between patients and healthcare professionals. IMPLICATIONS FOR PRACTICE: Healthcare professionals should understand the decision-making psychology and needs of patients with early-stage gynecologic malignancies facing fertility preservation decision-making and provide them with comprehensive, accurate decision support to help enhance patients' decision confidence and improve decision quality.