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    • #33114

      I would use active listening to assess their understanding of fertility presentation and ask open-ended questions. I would also inquire about what questions they have.

    • #33116

      I would also be sure have an understanding of where the child is and how much they understand. I would also  make sure they are included and feel included in all conversations and decisions. I have noticed sometimes the children get exlcuded even when the conversation directly involves them.

    • #33122

      I appreciate the strategies shared earlier; they are all great ideas.

      • In addition, I would recommend checking-in with the team (before meeting with family) to help assess health literacy of child and their family;  assess what info has already been shared and how family is coping.
      • Use the ask, talk, ask format with families. For example, ask them to share what they already know; provide education and ask how that could affect their child.
      • For single parents, invite them to bring a relative or friend for support.
      • It is important to share risks, complications, success and failure rates—but read the room to be sure it’s not too much info at one time.
    • #33228

      I always try and provide written material to the patient and family.  It has to be uncomfortable as a teen discussing this info and asking questions in front of parents.  I think it is important to talk with the AYA personally to see where they are emotionally, intellectually, etc.

    • #33231

      Ginny, some great ideas.  I think it’s important that you mentioned a single parent.  This can be a lot of information and hard to digest, so encouraging they bring a support person is so important.  This would also apply to any family with a limited support system.  Also, reading the room and knowing your audience is so important.  Being sure to check in with the primary team to see what discussion has already been had gives you a place to start your discussion.

    • #33274

      I think it is important to understand up front what the patient and the family know. I appreciated in the vidoe that he asked if they were familiar with fertility preservation. And once you know any past experience or understanding of it, you can adjust your conversation as needed. For example, if there are any negative experiences with infertility that have already occurred, it can help explain if patient’s parents are turned off or shut down.

      I also appreciated how he let them know that there is no right or wrong answer and that he is giving them information to make the best informed decision for themselves. I think it’s very important for the patient to not feel pressured when making this decision as they are already being faced with a variety of life changing choices. I think taking the pressure off up front opens the door for a better opportunity for the patient to take in the information and understand what their potential risks are with infertiltiy and knowing the fertility process. I feel that it helps establish a relationship with the patient and allows you to have these conversations with them at their level.

    • #33338

      I agree with what everyone already wrote. I also just think at a basic level that the idea of creating a forum for a specific discussion dedicated to fertility preservation elevates the importance of the conversation and provides a space for a family to really think about the risks to fertility and the available options. During the extremely stressful initial phase of new diagnosis and amount of information family’s are processing about the disease, treatments, procedures, impact on daily living, and the high level of emotion that comes with each of these factors (which can also impact information processing and decision making), unless there is a dedicated space for it, fertility preservation conversations can get lost or discounted. The idea of really creating a space for a conversation is so important to allows for a family to process the information, learn about options, and be comfortable with decisions made so that years later, they don’t regret not having had the time to really understand it.

    • #33350

      I think it is important to set a special time and place for this conversation to be held. Working in an outpatient setting, I believe that having this conversation on the same day as infusions or talking about a treatment plan may overwhelm the patient and family. Having a specific appointment set aside to hold a conversation about fertility is important. We do however, have to take inconsideration the constant hospital visits and the mental toll that takes on the family when having these conversation/appointments.

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