Discuss about the Quality Research Methodology In Health.
Fertility preservation is the process that is required to cure the patients those who face the issues regarding fertility. The articles below have discussed about various factors and the aspects that affect the fertility of the patients who suffers from cancer or those who are transgender. The discussion provides various types of knowledge regarding the topic nada los about the experiences of different types of people regarding the fertility preservation counselling and treatment.
This study includes a counselling session for the women patients regarding the Fertility Preservation techniques that can be availed by them. There were 129 women who were counselled for the techniques and after that the questionnaire has been given to them to research about their decision. The questionnaire has been sent to 108 of the women and out of that 64 have responded. Bastings, et al. (2014) aims at identifying about the experience of the women after getting the counselling over Fertility Preservation.
This is the qualitative research in which the patient’s characteristics, decision conflicts and the decision regret has been examined. It has been analysed from the research that most of the women have positive experience after having the counselling while other who have some negative views were because of the decision conflicts and decision regrets. The sample that has been taken in the study was equal to and above the age of 16. This has been done so that the women who are mature enough can only take participation in the research. It is also relayed with the ethical concern that giving such knowledge requires the patients to be equal to 16 years of age. In order to develop the questionnaire Bastings, et al. (2014) argues that they have interviewed five women to understand all the related aspects so that the questionnaire can be made effective enough for the patients to answer. The questionnaire has been developed in two parts, one section was related to the scaling and other section was related to questions. The scales were used to identify the FP decision making and also FP decision regrets by the patients. Decision conflicts were observed to be generated when the person was uninformed. It has been analysed that short period of time in the relationship and their young age is one of the reasons. As far as the limitations of the study are concerned, it has been analysed that the research has not considered the casualty of the associations (Lee, et al. 2006). It has been analysed that keeping the sample as 16 years of age may limit the study. This is because it restricts the generalization of the population and the results may vary because of that. Even after having such limitations, the research is quite good because it has used mixed methods to conduct the research.
It is the research regarding the experience of the transgender after having the fertility treatment by the technique of cryopreservation of the oocytes. It has been analysed from the research that the impact of the prior techniques that were practiced before oocyte cryopreservation was found to be very negative on the gender dysphoria. This is because the treatments were aligned to the female sex that has been assigned to men at the time of birth and it is not at all linked with the current status of gender of the men. The technique that has been used to conduct the research was interviews. Armuand, et al. (2017) interviewed 15 patients out of whom 12 were from the metropolitan city, 2 were from the rural area and 1 was from the urban area. 8 of the patients were partnered but not have given birth and 7 of them were single yet.
The interviews have been conducted with 15 men and thematic content analysis was used to determine the results and analyse the data. The results of the study were divided into three sections that include their journeys to FP, the reaction to FP and strategies for coping. It has been analysed that the homogenous group of patient who are undergoing FP have been selected to be interviewed and this act as the strength of the study because the results can be implemented or assumed for the other trans genders in future who are taking FP by cryopreservation of oocytes. As analysed that different participants have different ages, relationship status and background thus they provide mixed results and provide variability in the experiences. The major limitation that has been found in the research is that most of the participants were from urban area or metro cities while the participants from rural area were 1 in number. This may be possible that people from rural areas have different experiences because of their thinking process and the societal pressure. Thus the results may vary in that case (De Roo, et al. 2016).
It is the study that focuses on identifying the experience of the breast cancer patients regarding fertility preservation. These were the patients who were referred for FP by the practitioners. These types of aspects have been considered in the study. The experience of the patients regarding the referral, consultation and their decision making for FP has been analysed in this research.
It is the qualitative study in which the questionnaire has been mailed to 53 participants who aware suffering from breast cancer and were referred, consulted or make their decision regarding FP between the year of 2005 to 2010. Different types of topics have been included in the questionnaire regarding the stage of the cancer, demography and age of the patient, their decisions regarding FP, their knowledge regarding the topic etc. the questionnaire has been sent to 53 women out of which only 51% if the women have participated in the questionnaire research. As far as the age of the participants is considered, the range is 24 to 31. The major strength of the research in that the participants who were participated in the research were of different age group, different religion, have different language, different relationship status and different income. This heterogeneity in the sample allowed the researcher to study the experiences of every kind of people and also helps in understanding the factors that may affect the experience of different people. The common result has been found after conducting the research. It has been analysed that most of the women find difficulty in making decisions because of inadequate timings. They commented that they require more written information regarding the fertility preservation method and the options available to them should be told at the initial stage. They want to meet the counsellor who can resolve their queries (Wallace, Blough & Kondapalli, 2014). The major limitation that has been found in the study is its sample size. Firstly the sample size is too small and secondly it is taking from the single institution. Another drawback of the study is that many of the women have not participated in the survey and reason of non-participation has not been found. It may be possible that the respondent of the survey were only the women who are educated enough and thus the results for satisfaction from consultation of FP may be overestimated as all the women who have participated were from high society and educated. It is difficult to find out the exact result with such biasness as the women who were facing the issues but are not educated enough may have different experiences which needs to be considered.
The aim of this study was to identify and analyse the experiences of the young women who have been diagnosed with cancel recently regarding the counselling of fertility preservation. These women were those who have received the counselling of FP in few days after they have been diagnosed with cancer and begin their therapy. It is the qualitative study that has been conducted as small level.
As far as the participants that were involved in the study are concerned, it has been analysed that they were between the ranges of 18 to39 years of age. The number of women that were participated in the study was 5. Thus the study is conducted at very small scale. Hoeg, Schmidt & Macklon, (2016) tries to include the participants with heterogeneity in terms of marital status, motherhood, choice of fertility treatments etc. before interviewing those women, they were counselled by the practitioners of the heath care centre regarding the fertility preservation procedures and techniques so that full information can be given to them. Provision of counselling helps in getting better results as if the women have no idea about FP then there is no sense asking about their experiences. Half knowledge may not result in actual outcomes (Johnson & Finlayson, 2016). It is considered as the strength of the study that every participant has the full knowledge about fertility preservation as they have attended the counselling session. Difference in their characteristics such as marital status and other factors results in providing multivariable results that are more appropriate. This has also provided the impact of difference factors on the decision and experience of the women having cancer. As the method used for the study is interviews thus it allows the women to speak up their heart and what they actually feel in their own words (Oktay, et al. 2003). This provides better outcomes then the use of questionnaires. The limitation of the study is very obvious that the sample size is too low. Only 5 of the women were interviewed in the study which restricts the study to very limited conditions (Oktay, et al. 2005). Even when the interviews lasted for 45 to 90 minutes but the results cannot be so satisfied and can be implemented to the whole population as only 5 women cannot represent all the women experiences. It was required by the researcher to take more number of sample or large sample size so that the outcomes that have been identified could have been reliable. Using such a small sample size restricts the results of the research to a small segment only.
Conclusion:
As far as the article of Bastings, L., Baysal, Ö., Beerendonk, C. C. M., IntHout, J., Traas, M. A. F., Verhaak, C. M., … & Nelen, W. L. D. M. (2014) is considered, it found that the most of the patients who have undergone the Fertility preservation counselling have positive impact of the same. The patients who have given negative views suggest that the negativity is because of the decision conflicts and the decision regret. There were various reasons for decision conflicts nada one of the reasons that has been identified is uninformed or half knowledge regarding the topic. The study of Armuand, et al. (2017) concludes that there are three basis for the results or the outcomes of the study. The first one is the referral to FP which concludes that it is lined up with doubts; the second one was reaction for FP. This concludes that the treatments results in hormonal changes among the patients and thus becomes the reason for dysphoria. The final result was regarding the coping strategy such as support of friends and family. It has been analysed from the Hill, et al. (2012) article that the cancer patients should be given the referral of FP at the initial stages of their diagnosis and these women needs proper written material regarding the FP practices and consultation. Counsellor can help those women in making the decision. It has been concluded from the study of Hoeg, et al. (2016) that women needs counselling so that they can make decide over their future fertility.
References:
Armuand, G., Dhejne, C., Olofsson, J. I., & Rodriguez-Wallberg, K. A. (2017). Transgender men’s experiences of fertility preservation: a qualitative study. Human Reproduction, 32(2), 383-390.
Bastings, L., Baysal, Ö., Beerendonk, C. C. M., IntHout, J., Traas, M. A. F., Verhaak, C. M., … & Nelen, W. L. D. M. (2014). Deciding about fertility preservation after specialist counselling. Human reproduction, 29(8), 1721-1729.
De Roo, C., Tilleman, K., T’Sjoen, G., & De Sutter, P. (2016). Fertility options in transgender people. International Review of Psychiatry, 28(1), 112-119.
Hill, K. A., Nadler, T., Mandel, R., Burlein-Hall, S., Librach, C., Glass, K., & Warner, E. (2012). Experience of young women diagnosed with breast cancer who undergo fertility preservation consultation. Clinical breast cancer, 12(2), 127-132.
Hoeg, D., Schmidt, L., & Macklon, K. T. (2016). Young female cancer patients’ experiences with fertility counselling and fertility preservation—a qualitative small-scale study within the Danish health care setting. Upsala journal of medical sciences, 121(4), 283-288.
Johnson, E. K., & Finlayson, C. (2016). Preservation of fertility potential for gender and sex diverse individuals. Transgender Health, 1(1), 41-44.
Lee, S. J., Schover, L. R., Partridge, A. H., Patrizio, P., Wallace, W. H., Hagerty, K., … & Oktay, K. (2006). American Society of Clinical Oncology recommendations on fertility preservation in cancer patients. Journal of clinical oncology, 24(18), 2917-2931.
Oktay, K., Buyuk, E., Davis, O., Yermakova, I., Veeck, L., & Rosenwaks, Z. (2003). Fertility preservation in breast cancer patients: IVF and embryo cryopreservation after ovarian stimulation with tamoxifen. Human Reproduction, 18(1), 90-95.
Oktay, K., Buyuk, E., Libertella, N., Akar, M., & Rosenwaks, Z. (2005). Fertility preservation in breast cancer patients: a prospective controlled comparison of ovarian stimulation with tamoxifen and letrozole for embryo cryopreservation. Journal of Clinical Oncology, 23(19), 4347-4353.
Wallace, S. A., Blough, K. L., & Kondapalli, L. A. (2014). Fertility preservation in the transgender patient: expanding oncofertility care beyond cancer. Gyne
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