Development and test of a question prompt list for fertility preservation in cervical cancer patients
LIN Meng
ZHAO Yi
BIAN Lingling
CHEN Xuan
WU Yanchun
TAN Yutian
YE Fanting
Abstract：Objective:To develop and evaluate a question prompt list(QPL)for fertility protection and preservation in cervical cancer patients,so as to provide a practical tool to facilitate patient engagement in medical decision-making.Methods:The preliminary QPL was developed through literature review and qualitative interviews,followed by two rounds of Delphi expert consultation and a pilot test to finalize the QPL.A total of 38 patients admitted between January and March 2024 were assigned to the control group,while 40 patients admitted between June and August 2024 were assigned to the intervention group.Assessments included the QPL feedback questionnaire,the Reproductive Concerns After Cancer Scale(RCAC),the Decisional Conflict Scale(DCS),and the Decision Regret Scale(DRS).Additionally,12 healthcare professionals evaluated the feasibility of the QPL.Results:In the two-round Delphi expert consultation,the authority coefficients were both 0.875.The second round showed variation coefficients ranging from 0.052 to 0.140,with a Kendall's W concordance coefficient of 0.401(P<0.001).The importance scores for secondary indicators in the second round ranged from 3.86 to 4.93.The final fertility protection and preservation QPL for cervical cancer patients was developed,comprising five dimensions:background knowledge,surgery and fertility protection,radiotherapy/chemotherapy and fertility,fertility preservation methods for cervical cancer and cost.Evaluation results demonstrated positive patient feedback on the QPL.All patients reported the QPL as helpful,with 80.00%(32/40)indicating it would be useful for future reference.Among the 12 participating healthcare providers,all affirmed the QPL's utility in facilitating patient questioning,and 91.67%(11/12)acknowledged its clinical value.At discharge,the control group exhibited significantly higher scores for decision conflict[31.25(29.69,32.81)],fertility-related distress(44.89±3.76),and decision regret[28.00(20.00,36.00)]compared to the intervention group,which scored[17.93(15.63,20.31)],(36.35±6.72),and[20.00(20.00,24.00)]respectively(all P<0.001).Conclusions:The QPL for fertility protection and preservation in cervical cancer patients is feasible.It can help patients pose concerns,reduce decisional conflict,reproductive concerns,and decision regret.
Keywords：cervical cancerfertility protectionfertility preservationquestion prompt listdecisional conflictreproductive concernsdecision regret
Publication Date：2025-09-10
Online Publishing Date：2025-09-12(First online date of this platform, not the publication date of the document)
Pages：9( 2859-2867 )