Barriers and facilitators of oncofertility discussions among healthcare providers and patients in Japanese oncology practice: A qualitative study.
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OBJECTIVES: This study aimed to 1) identify barriers and facilitators to oncofertility discussions in Japanese oncology practice from the providers' perspective, and 2) describe patient preferences regarding these discussions. METHODS: We conducted semi-structured interviews with 20 healthcare providers (HCPs: 16 physicians, 4 nurses) across 10 designated cancer treatment hospitals and 10 adolescents and young adults with cancer (5 male, 5 female). HCP data were analyzed thematically using the Consolidated Framework for Implementation Research (CFIR). Patient data were analyzed using qualitative content analysis, with preferences organized using the SHARE communication model. RESULTS: 1) Barriers and facilitators were found in the 18 CFIR constructs. While key barriers included lack of training (access to knowledge & information), lack of knowledge and difficulty in discussing sexuality (knowledge & beliefs), and beliefs that it is not a physician's role (knowledge & beliefs), facilitators included the presence of champions (champions), involvement of the director (leadership engagement), and patients' statements and questions (patient needs). 2) Patients preferred to discuss with knowledgeable, same-gender HCPs before treatment, and expressed a desire for careful explanations using documents and emotional support. CONCLUSION: This study underscores the need for multi-level, context-specific strategies to promote oncofertility discussions that align with both patient communication preferences and institutional settings. PRACTICE IMPLICATIONS: Supporting patient-centered communication and strengthening organizational infrastructure may help address the informational and emotional needs of adolescents and young adults with cancer and bridge the evidence-practice gap in oncofertility discussions.