摘要
目的:总结育龄期乳腺癌病人生育力保护决策的相关证据,为开展对育龄期乳腺癌病人的相关生育力保护决策提供参考。方法:系统检索UpToDate、BMJ Best Practice、Cochrane Library、Joanna Briggs Institute(JBI)循证卫生保健中心数据库、英国国家卫生与临床优化研究所、PubMed、Web of Science、EMbase等网站或数据库中关于育龄期乳腺癌病人生育力保护的临床决策、指南、系统评价、证据总结和专家共识等证据,检索时限为建库至2025年2月18日,由2名具有循证护理研究背景的研究者独立完成文献的质量评价,并结合专业人士的意见对符合质量标准的文献进行证据提取及总结。结果:共纳入15篇文献,包括2篇临床决策、4篇指南、3篇专家共识、2篇证据总结和4篇系统评价;总结的最佳证据包括决策团队、决策前评估、决策方式和决策内容4个方面,共30条最佳证据。结论:总结的最佳证据可为临床医护人员开展育龄期乳腺癌病人生育力保护决策提供循证依据。在临床应用时,医护人员需要尊重病人生育意愿,不断推进生育力保护决策进程,尽可能保护乳腺癌病人的生育能力。
Objective:To summarize the best available evidence regarding fertility preservation decision⁃making for breast cancer patients of reproductive age,so as to provide a reference for supporting these patients making decisions.Methods:The databases and websites including UpToDate,BMJ Best Practice,Cochrane Library,JBI Evidence⁃Based Healthcare Center database,the UK National Institute for Health and Care Excellence(NICE),PubMed,Web of Science,and EMbase for evidence related to fertility preservation decision⁃making for breast cancer patients of reproductive age were systematically searched.The types of evidence sought included clinical decision support tools,guidelines,systematic reviews,evidence summaries,and expert consensus documents.The search period was from the inception of each database to Februry 18,2025.Two researchers with a background in evidence⁃based nursing independently conducted the literature quality assessment.Evidence meeting quality standards was then extracted and summarized,incorporating input from relevant professionals.Results:A total of 15 articles were included,comprising 2 clinical decision support documents,4 guidelines,3 expert consensuses,2 evidence summaries,and 4 systematic reviews.The summarized best evidence covers four key aspects:the fertility preservation decision⁃making team,pre⁃decision assessment,decision⁃making methods,and decision content,resulting in a total of 30 best evidence statements.Conclusions:The summarized best evidence provides an evidence⁃based foundation for clinical healthcare professionals to support fertility preservation decision⁃making in breast cancer patients of reproductive age.In clinical application,healthcare providers need to respect patients′reproductive intentions,continuously advance the decision⁃making process,and protect the fertility potential of breast cancer patients as much as possible.
作者
张思颖
钟敏慧
刘贤亮
阮良婧
段霞
ZHANG Siying;ZHONG Minhui;LIU Xianliang;RUAN Liangjing;DUAN Xia(School of Medicine,Tongji University,Shanghai 200092 China;Shanghai First Maternity and Infant Hospital,Tongji University;School of Nursing and Health Studies,Hong Kong Metropolitan University,China)
出处
《护理研究》
北大核心
2026年第5期787-796,共10页
Chinese Nursing Research
基金
上海市卫生健康委员会科研项目,编号:202340048。
关键词
乳腺癌
育龄期
生育力保护
共享决策
证据总结
循证护理
breast cancer
reproductive age
fertility preservation
shared decision⁃making
evidence summary
evidence⁃based nursing
