Research

Patricia Hershberger, PhD, APRN Funded Projects

Building Interdisciplinary Research Careers in Women's Health (BIRCWH)

Funding Source: National Institute of Child Health and Human Development

Dates: 1/2009-1/2011

Abstract: The purpose of the BIRCWH scholar program is to optimize the success of junior faculty in developing a substantive and sustained research program in women's health science through interdisciplinary training, mentorship, and career development. The particular focus of Dr. Hershberger's research program centers on helping women manage their reproductive decision making in the context of emerging assisted reproductive technology and advanced genetics. Her long-term research program will ultimately address the development and testing of targeted and tailored decisional support interventions that are based on a comprehensive understanding of women's decision making regarding medical options for fertility management, most particularly when emerging technologies are involved, and the ‘quality of life' effects of those decisions. Further, she plans to work towards mitigating health disparities in the use of medical options for fertility management that involve assisted reproductive technologies.

Fertility Preservation Decisions Among Young Women Diagnosed with a Life Threatening Illness

Funding Source: University of Michigan

Dates: 08/2006 - 7/2011

Abstract: Advances in cancer therapy and reproductive technology have culminated in innovative fertility preservation options (i.e., egg, embryo and ovarian cryopreservation) for young women who are diagnosed with a life threatening illness such as cancer. Despite the overwhelming and far reaching significance of the woman's decision of whether or not to undergo fertility preservation treatment, research examining the decision processes among women is virtually nonexistent. The purpose of this research is to learn more about young women's decision making processes when they are newly diagnosed or recently re-diagnosed with a life threatening illness and are confronted with the choice of undergoing or not undergoing fertility preservation. This study involves interviewing a total of 25 to 30 women between the ages of 18 to 42 years old who are considering egg, embryo, or ovarian cryopreservation prior to or concurrently with treatment for their life threatening illness. Recruitment strategies will proceed through infertility clinics and via the internet. Each participant will complete one detailed face-to-face, telephone, or electronic interview and answer two short questionnaires. During the interview, the women will be asked to think out loud about their choice to undergo or not undergo fertility preservation treatment. In addition, they will be asked to talk about their decision making related to how nurses, physicians, and other healthcare professionals can provide decision support to them when they are making the choice to undergo or not undergo egg, embryo, or ovarian cryopreservation. Three specific aims have been developed for the study. They are to: 1.) explicate how women describe their decision to undergo or not undergo fertility preservation prior to or concurrently with their medical or surgical treatment, 2.) examine women's perception of decisional support from nurses, physicians, and other healthcare providers surrounding their decision to undergo or not undergo fertility preservation, and 3.) provide a conceptual model for understanding women's decision making processes and decision support regarding fertility preservation in cancer care. Participation in this research will contribute to the very limited knowledge about young women's decision making regarding fertility preservation when they are newly diagnosed or recently re-diagnosed with cancer. The information obtained from the study will help healthcare professionals understand the decision making experiences of young women who are diagnosed with a life threatening illness and ultimately improve decision support and decision outcomes.

PGD: Couples' Decision Making at the Genetic and Reproductive Interface

Funding Source: National Institute of Nursing Research

Dates: 9/2008 – 8/2010

Co-Investigators: Karen Kavanaugh, Rebekah Hamilton

Abstract: Advances in human genetics and assisted reproduction have expanded dramatically and most recently includes the innovative option of Preimplantation Genetic Diagnosis (PGD). This relatively new form of genetic screening circumvents conventional forms of prenatal diagnosis by identifying genetic disorders or chromosomal rearrangements prior to establishing uterine implantation and establishment of pregnancy. Couples where one or both partners are carriers of genetic disorders may benefit from using PGD because they avoid the difficult decision of whether or not to terminate a pregnancy after receiving an unfavorable prenatal diagnosis. Despite this benefit, there are multiple disadvantages of using PGD including the need for in vitro fertilization, potential misdiagnosis, financial expense, potential for supernumerary embryos and confronting fundamental values of disability prevention. Despite these far reaching considerations, little is known about the decision making processes of couples surrounding PGD use. The purpose of this study is to develop an initial theoretical understanding of the decision making process of couples who have recently accepted or declined the use of PGD for childhood genetic disorders and to evaluate and refine recruitment and methodological procedures to prepare for a larger study. Grounded theory design will guide this exploratory study. Recruitment of 20 couples will proceed through three approaches: a large urban infertility center, Internet web sites, and regional newsletters distributed by a nationally recognized support group. Couples, consisting of a male and female dyad, will be interviewed independently from their partner. In-depth, open-ended interviews will be completed with each participant via telephone or e-mail within three months from the time of physician consultation about PGD. Concepts derived from the interviews will be grouped into categories that reflect the meaning in the data that will eventually be integrated to develop the initial theoretical description of this dynamic decision process surrounding PGD use. The findings will also serve to guide the development of a planned larger study that will examine the decision making processes of couples surrounding PGD in more depth and will assist with the formulation of professional guidelines, inform public health policies, and promote understanding in other emerging areas of genetic testing and treatment.

Web Site: PGD: Couple's Decision Making at the Genetic and Reproductive Interface

Preimplantation Genetic Diagnosis: Couples’ Decision Making at the Genetic and Reproductive Interface: A Pilot Study

Funding Source: Internal Research Support Program

Dates: 06/01/08– 05/31/09

Co-Investigators: Karen Kavanaugh

Abstract: The purpose of this pilot study is to refine recruitment and data collection measures in preparation for a larger R03 study. For this pilot study, recruitment of six couples will proceed through three approaches: an infertility center, a national newsletter and Internet web sites. Couples, consisting of a male and female dyad, will be interviewed independently from their partner. In-depth, open-ended interviews will be completed via telephone. The PI will record multiple recruitment data points into a detailed Reflexive Journal. Descriptive statistics and content analysis will guide the analysis. The findings will serve to refine both recruitment approaches and the interview guide and will strengthen the resubmission of an NIH proposal, if needed, or facilitate the implementation and completion of the study if an NIH award is received.