• This topic has 3 replies, 4 voices, and was last updated by Cissimol Joseph.
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    • #33117

      What strategies would you use to provide age and developmentally appropriate information about fertility preservation to parents of a pre-pubertal child?

      When providing age and developmentally appropriate information about fertility preservation to parents of a pre-pubertal child, I would first be sure to include setting clear goals/an outline for our conversation, followed by assessing the knowledge/understanding of the parents regarding their childs diagnosis and the topic of fertility preservation.  Further, I feel it would be important to assess where they are at mentally/emotionally with their childs diagnosis/situation to ensure they are in an appropriate state to have this discussion, receive more information and if it would be beneficial to have any other members of the interprofessional team (ex: psychology or social work) present for the discussion.

      After establishing clear goals, and a general assessment of the parents, I would present the facts related to their child`s diagnosis and expected course of treatment, in addition to pre-pubertal status in relation to fertility preservation.  I would be sure to provide frequent reminders to the family that there are no right or wrong choices, and that my goal is to equip them with the most knowledge I can so that they are able to make a decision for their child (and the future fertility of their child) that they will be at peace with.  Additionally, I would make an effort to encourage the family to ask questions and write down anything throughout our conversation that they may like more information on.

      Presenting information in a clear, concise format that includes both risks and benefits for both options (agreeing or declining) fertility preservation for their child is a top priority.  Allowing the parents to feel heard and leave the conversation confident that they have the tools they need to proceed with decision making.

    • #33124

      I agree with every point made in you discussion especially that it is essential to have a clear plan/goal when addressing this topic with the patient and family.  It would be essential to gain the parents perception and also do an independent assessment as the pre-pubertal patient may not share prior knowledge with the parent and allow the parent to think they are not ready mentally or emotionally.  I have personally found patients who pretend to not have prior knowledge or understanding when a parent is present but can educate me when alone and comfortable to share.

    • #33180

      Agree with the point above.

      I wanted to only add the importance of good documentation of these options and discussions with patients and families so that these can be referenced and expanded on by the whole care team.  In the tech world of health care, “copy/paste” can be all to common.  By having dates and the risks and options clearly defined specific to THAT patients individual diagnosis/age/sex organs etc… it reduces the likelihood of miscommunications.  Further, documenting the choice that was made/why/how helps for the whole care team know how to support this patient moving forward in next steps.  Also, having the documentation done well can serve as a prompt throughout the course of treatment and into survivorship to “check in” on how patients and families are coping with their decision and if further intervention or support is needed as decisions are often made urgently and feelings/thoughts/questions will undoubtedly evolve as they settle into their care plan.

       

      Thank you all for the discussion,

      Mikala B. LCSW

    • #33248

      Great discussion.

      I also allow if they want to record the conversation especially when we give tons of information at the time of the diagnosis, further treatment plan, schedule, side effects etc  – for them to hear later so that can review. I encourage them to contact us if they have further questions after the visit, which they reach out most of the time. Yes, it is overwhelming, and when primary team discuss  regarding fertility preservation,  high chances that patient and family might not give equal importance as with other discussion at that time.

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