中国育龄期女性乳腺癌患者生育忧虑现状及影响因素的系统评价

A systematic evaluation of fertility anxiety and influencing factors in Chinese women of childbearing age with breast cancer

目的 系统评价中国育龄期女性乳腺癌患者生育忧虑现状及影响因素,为构建生育忧虑预测模型提供依据。方法 计算机检索The Cochrane Library、PubMed、Embase、Web of Science、Sinomed、中国知网、万方和维普数据库中有关中国育龄期女性乳腺癌患者生育忧虑的横断面研究。检索时限为建库至2023年7月10日。对符合标准的文献采用Meta分析方法进行分析。结果 最终纳入15篇文献,均为中等质量。Meta分析结果显示,中国育龄期女性乳腺癌患者的生育忧虑总分为56.27(95%CI:54.21~58.33)分。生育忧虑各维度得分分别为怀孕能力13.05(95%CI:9.69~16.41)分、自身健康17.04(95%CI:11.54~22.54)分、子女健康15.63(95%CI:12.06~19.21)分、配偶知情10.61(95%CI:8.44~12.78)分、不孕接受度11.88(95%CI:9.75~14.00)分、备孕13.56(95%CI:9.33~17.79)分。Meta分析结果显示,年龄、居住地、婚姻状况、文化程度、月收入、子女性别、子女数量、实施生育保护、生育意愿、治疗方式、临床分期和手术方式是乳腺癌患者发生生育忧虑的影响因素(P<0.05)。结论 中国育龄期女性乳腺癌患者生育忧虑水平较高,年龄、居住地、婚姻状况、生育意愿等是乳腺癌患者发生生育忧虑的影响因素。

Objective To systematically evaluate the status and influencing factors of fertility anxiety in Chinese women of childbearing age with breast cancer, so as to provide a basis for constructing a predictive model of fertility anxiety. Methods The Cochrane Library, PubMed, EMbase, Web of Science, Sinomed, CNKI,Wanfang and VIP databases were computerized searched for cross-sectional studies on fertility concerns.The search period was from database construction to July 10,2023.Stata 16.0 software was used for statistical analysis of the literatures meeting the criteria. Results A total of 15 studies were included, and the results of meta-analysis showed that the total score of fertility anxiety was 56.27(95%CI:54.21-58.33).The scores of each dimension of fertility worry were 13.05(95%CI:9.69-16.41) for pregnancy ability, 17.04(95%CI:11.54-22.54) for own health, 15.63(95%CI:12.06-19.21) for children's health, 10.61(95%CI:8.44-12.78) for spouse's knowledge, 11.88(95%CI:9.75-14.00) for infertility acceptance, and 13.56(95%CI:9.33-17.79) for pregnancy preparation.The results of meta-analysis showed that age, place of residence, marital status, education level, monthly income, gender of children, number of children, implementation of fertility protection, fertility intention, treatment mode, clinical stage and operation mode were the influencing factors of fertility anxiety in breast cancer patients(P<0.05).There was no statistical significance for fertility anxiety in breast cancer patients in terms of duration of disease and coping style. Conclusion The existing evidence shows that age, place of residence, marital status and fertility intention are the influencing factors of fertility anxiety in breast cancer patients, which is of great significance for the construction of fertility anxiety prediction model and the selection of effective predictors.