nach oben

Erschienen in:

01.10.2014 | Original Research

Linking Genetic Counseling Content to Short-Term Outcomes in Individuals at Elevated Breast Cancer Risk

verfasst von: Kimberly M. Kelly, Lee Ellington, Nancy Schoenberg, Parul Agarwal, Thomas Jackson, Stephanie Dickinson, Jame Abraham, Electra D. Paskett, Howard Leventhal, Michael Andrykowski

Erschienen in: Journal of Genetic Counseling | Ausgabe 5/2014

Einloggen, um Zugang zu erhalten

Abstract

Few studies have linked actual genetic counseling content to short-term outcomes. Using the Self-regulation Model, the impact of cognitive and affective content in genetic counseling on short-term outcomes was studied in individuals at elevated risk of familial breast-ovarian cancer. Surveys assessed dependent variables: distress, perceived risk, and 6 knowledge measures (Meaning of Positive Test; Meaning of Negative Test; Personal Behavior; Practitioner Knowledge; Mechanisms of Cancer Inheritance; Frequency of Inherited Cancer) measured at pre- and post-counseling. Proportion of participant cognitive and affective and counselor cognitive and affective content during sessions (using LIWC software) were predictors in regressions. Knowledge increased for 5 measures and decreased for Personal Behavior, Distress and Perceived Risk. Controlling for age and education, results were significant/marginally significant for three measures. More counselor content was associated with decreases in knowledge of Personal Behavior. More participant and less counselor affective content was associated with gains in Practitioner Knowledge. More counselor cognitive, and interaction of counselor cognitive and affective content, were associated with higher perceived risk. Genetic counselors dominate the content of counseling sessions. Therefore, their content is tied more closely to short term outcomes than participant content. A lack of patient communication in sessions may pose problems for understanding of complex concepts.

Andrykowski, M. A., Lightner, R., Studts, J. L., & Munn, R. K. (1997). Hereditary cancer risk notification and testing: How interested is the general population? Journal of Clinical Oncology, 15(5), 2139–2148.PubMedCrossRef

Baty, B. J., Venne, V. L., McDonald, J., Croyle, R. T., Halls, C., Nash, J. E., et al. (1997). BRCA1 testing: genetic counseling protocol development and counseling issues. Journal of Genetic Counseling, 6(2), 223–244.PubMedCrossRef

Berliner, J. L., & Fay, A. M. (2007). Risk assessment and genetic counseling for hereditary breast and ovarian cancer: recommendations of the National Society of Genetic Counselors. Journal of Genetic Counseling, 16(3), 241–260.CrossRefPubMed

Berliner, J. L., Fay, A. M., Cummings, S. A., Burnett, B., & Tillmanns, T. (2013). NSGC practice guideline: risk assessment of genetic counseling for hereditary breast and ovarian cancer. Journal of Genetic Counseling, 22, 155–163.PubMedCrossRef

Biesecker, B. B., & Peters, K. F. (2001). Process studies in genetic counseling: peering into the black box. American Journal of Medical Genetics, 106(3), 191–198.CrossRefPubMed

Bish, A., Sutton, S., Jacobs, C., Levene, S., Ramirez, A., & Hodgson, S. (2002). Changes in psychological distress after cancer genetic counselling: a comparison of affected and unaffected women. British Journal of Cancer, 86(1), 43–50.PubMedPubMedCentralCrossRef

Bowen, D. J., Burke, W., McTiernan, A., Yasui, Y., & Andersen, M. R. (2004). Breast cancer risk counseling improves women’s functioning. Patient Education and Counseling, 53(1), 79–86.PubMedCrossRef

Brain, K., Norman, P., Gray, J., Rogers, C., Mansel, R., & Harper, P. (2002). A randomized trial of specialist genetic assessment: psychological impact on women at different levels of familial breast cancer risk. British Journal of Cancer, 86(2), 233–238.PubMedPubMedCentralCrossRef

Butow, P. N., & Lobb, E. A. (2004). Analyzing the process and content of genetic counseling in familial breast cancer consultations. Journal of Genetic Counseling, 13(5), 403–424.CrossRefPubMed

Butow, P. N., Lobb, E. A., Meiser, B., Barratt, A., & Tucker, K. M. (2003). Psychological outcomes and risk perception after genetic testing and counselling in breast cancer: a systematic review. The Medical Journal of Australia, 178(2), 77–81.PubMedCrossRef

Cameron, L., & Leventhal, H. (2003). Self-regulation, health, and illness: An overview. In H. L. Linda Cameron (Ed.), The self-regulations of health and illness behavior. New York: Routledge.

Cohen, S. (1988). Psychosocial models of the role of social support in the etiology of physical disease. Health Psychology, 7(3), 269–297.PubMedCrossRef

Collins, F. S., Green, E. D., Guttmacher, A. E., & Guyer, M. S. (2003). A vision for the future of genomics research. A blueprint for the genomic era. Nature, 422, 835–847.PubMedCrossRef

Cull, A., Anderson, E. D. C., Campbell, S., Mackay, J., Smyth, E., & Steel, M. (1999). The impact of genetic counselling about breast cancer risk on women’s risk perceptions and levels of distress. British Journal of Cancer, 79(3/4), 501–508.PubMedPubMedCentralCrossRef

Culver, J., Burke, W., Yasui, Y., Durfy, S., & Press, N. (2001). Participation in breast cancer genetic counseling: the influence of educational level, ethnic background, and risk perception. Journal of Genetic Counseling, 10(3), 215–231.CrossRef

DiGianni, L. M., Kim, H. T., Emmons, K., Gelman, R., Kalkbrenner, K. J., & Garber, J. E. (2003). Complementary medicine use among women enrolled in a genetic testing program. Cancer Epidemiology, Biomarkers & Prevention, 12(4), 321–326.

Dijkstra, H., Albada, A., Klöckner Cronauer, C., Ausems, M. G., & van Dulmen, S. (2013). Nonverbal communication and conversational contribution in breast cancer genetic counseling: Are counselors’ nonverbal communication and conversational contribution associated with counselees’ satisfaction, needs fulfillment and state anxiety in breast cancer genetic counseling? Patient Education and Counseling, 93, 216–223.PubMedCrossRef

Duric, V., Butow, P., Sharpe, L., Lobb, E., Meiser, B., Barratt, A., et al. (2003). Reducing psychological distress in a genetic counseling consultation for Breast Cancer. Journal of Genetic Counseling, 12(3), 243–264.PubMedCrossRef

Ellington, L., Roter, D., Dudley, W. N., Baty, B. J., Upchurch, R., Larson, S., et al. (2005). Communication analysis of BRCA1 genetic counseling. Journal of Genetic Counseling, 14(5), 377–386.CrossRefPubMed

Ellington, L., Baty, B. J., McDonald, J., Venne, V., Musters, A., Roter, D., et al. (2006). Exploring genetic counseling communication patterns: the role of teaching and counseling approaches. Journal of Genetic Counseling, 15(3), 179–189.PubMedCrossRef

Ellington, L., Kelly, K. M., Reblin, M., Latimer, S., & Roter, D. (2011). Communication in genetic counseling: cognitive and emotional processing. Health Communication, 26(7), 667–675.PubMedCrossRef

Graves, K. D., Schmidt, J., Bollmer, J., Fejfar, M., Langer, S., Blonder, L. X., et al. (2005a). Emotional expression and emotional recognition in breast cancer survivors: a controlled comparison. Psychology & Health, 20(5), 579–595.CrossRef

Graves, K. D., Schmidt, J. E., & Andrykowski, M. A. (2005b). Writing about September 11, 2001: the role of emotional intelligence and the social environment. Journal of Language and Social Psychology, 24(3), 285–299.CrossRef

Green, M. J., Peterson, S. K., Baker, M. W., Harper, G. R., Friedman, L. C., Rubinstein, W. S., et al. (2004). Effect of a computer-based decision aid on knowledge, perceptions, and intentions about genetic testing for breast cancer susceptibility: a randomized controlled trial. The Journal of the American Medical Association, 292(4), 442–452.PubMedCrossRef

Gwyn, K., Vernon, S. W., & Conoley, P. M. (2003). Intention to pursue genetic testing for breast cancer among women due for screening mammography. Cancer Epidemiology, Biomarkers and Prevention, 12, 96–102.PubMed

Helmes, A. W., Culver, J. O., & Bowen, D. J. (2006). Results of a randomized study of telephone versus in-person breast cancer risk counseling. Patient Education and Counseling, 64(1–3), 96–103.PubMedCrossRef

Hopwood, P. (2005). Psychosocial aspects of risk communication and mutation testing in familial breast-ovarian cancer. Current Opinion in Oncology, 17(4), 340–344.PubMedCrossRef

Kahn, J. H., Tobin, R. M., Massey, A. E., & Anderson, J. A. (2007). Measuring emotional expression with the Linguistic Inquiry and Word Count (LIWC). American Journal of Psychology, 120, 263–286.PubMed

Kelly, K., Leventhal, H., Toppmeyer, D., Much, J., Dermody, J., Marvin, M., et al. (2003). Subjective and objective risk of carrying a BRCA1/2 mutation in individuals of Ashkenazi Jewish descent. Journal of Genetic Counseling, 12(4), 351–371.PubMedCrossRef

Kelly, K., Leventhal, H., Marvin, M., Toppmeyer, D., Much, J., Dermody, J., et al. (2004a). Subjective and objective risk of breast cancer in Ashkenazi Jewish individuals at risk for BRCA1/2 mutations. Genetic Testing, 8(2), 139–147.PubMedCrossRef

Kelly, K., Leventhal, H., Andrykowski, M., Toppmeyer, D., Much, J., Dermody, J., et al. (2004b). The decision to test in women receiving genetic counseling for BRCA1 and BRCA2 mutations. Journal of Genetic Counseling, 13(3), 237–257.PubMedCrossRef

Kelly, K., Leventhal, H., Marvin, M., Toppmeyer, D., Baran, J., & Schwalb, M. (2004c). Cancer genetics knowledge and beliefs and receipt of results in Ashkenazi Jewish individuals receiving counseling for BRCA1/2 mutations. Cancer Control, 11(4), 236–244.PubMedCrossRef

Kelly, K., Leventhal, H., Andrykowski, M., Toppmeyer, D., Much, J., Dermody, J., et al. (2005). Using the common sense model to understand perceived cancer risk in individuals testing for BRCA1/2 mutations. Psycho-Oncology, 14(1), 34–48.PubMedCrossRef

Kelly, K., Andrews, J. E., Case, D. O., Allard, S. L., & Johnson, J. D. (2007). Information seeking and intentions to have genetic testing for hereditary cancers in rural and Appalachian Kentuckians. The Journal of Rural Health, 23(2), 166–172.PubMedCrossRef

Kinney, A. Y., Croyle, R. T., Dudley, W. N., Bailey, C. A., Pelias, M. K., & Neuhausen, S. L. (2001). Knowledge, attitudes, and interest in breast-ovarian cancer gene testing: a survey of a large African-American kindred with a BRCA1 mutation. Preventive Medicine, 33(6), 543–551.PubMedCrossRef

Lebo, M., & Nesselroade, J. (1978). Intraindividual differences dimensions of mood change during pregnancy identified in five P-technique factor analyses. Journal of Research in Personality, 12, 205–224.CrossRef

Lee, S. C., Bernhardt, B. A., & Helzlsouer, K. J. (2002). Utilization of BRCA1/2 genetic testing in the clinical setting: report from a single institution. Cancer, 94(6), 1876–1885.CrossRefPubMed

Lerman, C., Daly, M., Masny, A., & Balshem, A. (1994). Attitudes about genetic testing for breast-ovarian cancer susceptibility attitudes about genetic testing for breast-ovarian cancer susceptibility. Journal of Clinical Oncology, 12(4), 843–850.PubMedCrossRef

Lerman, C., Schwartz, M., Miller, S., Daly, M., Sands, C., & Rimer, B. (1996). A randomized trial of breast cancer risk counseling: Interacting effects of counseling, education level, and coping style. Health Psychology, 15(2), 75–83.PubMedCrossRef

Lerman, C., Biesecker, B., Benkendorf, J. L., Kerner, J., Gomez-Caminero, A., Hughes, C., et al. (1997a). Controlled trial of pretest education approaches to enhance informed decision-making for BRCA1 gene testing. Journal of the National Cancer Institute, 89(2), 148–157.PubMedCrossRef

Lerman, C., Schwartz, M. D., Lin, T. H., Hughes, C., Narod, S., & Lynch, H. T. (1997b). The influence of psychological distress on use of genetic testing for cancer risk. Journal of Consulting and Clinical Psychology, 65(3), 414–420.PubMedCrossRef

Leventhal, H. (1970). Findings and theory in the study of fear communications. Advances in Experimental Social Psychology, 5, 119–186.

Leventhal, H., Singer, R., & Jones, S. (1965). Effects of fear and specificity of recommendations upon attitudes and behavior. Journal of Personality and Social Psychology, 2, 20–29.PubMedCrossRef

Leventhal, H., Brisette, I., & Leventhal, E. (2003). The common-sense model of self-regulation of health and illness. In L. D. Cameron & H. Leventhal (Eds.), The self-regulation of health and illness behaviour (pp. 42–65). London: Routledge.

Lobb, E. A., Butow, P., Meiser, B., Barratt, A., Kirk, J., Gattas, M., et al. (2002a). The use of audiotapes in consultations with women from high risk breast cancer families: a randomised trial. Journal of Medical Genetics, 39(9), 697–703.PubMedPubMedCentralCrossRef

Lobb, E. A., Butow, P. N., Meiser, B., Barratt, A., Gaff, C., Young, M. A., et al. (2002b). Tailoring communication in consultations with women from high risk breast cancer families. British Journal of Cancer, 87(5), 502–508.PubMedPubMedCentralCrossRef

Lobb, E. A., Butow, P. N., Meiser, B., Barratt, A., Gaff, C., Young, M. A., et al. (2003). Women’s preferences and consultants’ communication of risk in consultations about familial breast cancer: impact on patient outcomes. Journal of Medical Genetics, 40(5), e56.PubMedPubMedCentralCrossRef

Lobb, E. A., Butow, P. N., Barratt, A., Meiser, B., Gaff, C., Young, M. A., et al. (2004). Communication and information-giving in high-risk breast cancer consultations: influence on patient outcomes. British Journal of Cancer, 90(2), 321–327.PubMedPubMedCentralCrossRef

Matloff, E. T., Moyer, A., Shannon, K. M., Niendorf, K. B., & Col, N. F. (2006). Healthy women with a family history of breast cancer: impact of a tailored genetic counseling intervention on risk perception, knowledge, and menopausal therapy decision making. Journal of Women’s Health, 15(7), 843–856.PubMedCrossRef

McNair, D., Lorr, M., & Droppleman, L. (1971). Profile of mood states. San Diego, CA: Educational and Industrial Testing Service.

Mehl, M. R., & Pennebaker, J. W. (2003). The sounds of social life: a psychometric analysis of students’ daily social environments and natural conversations. Journal of Personality and Social Psychology, 84(4), 857–870.PubMedCrossRef

Meiser, B., & Halliday, J. L. (2002). What is the impact of genetic counselling in women at increased risk of developing hereditary breast cancer? A meta-analytic review. Social Science & Medicine, 54, 1463–1470.CrossRef

Morse, J. M. (1991). Approaches to qualitative-quantitative methodological triangulation. Nursing Research, 40(2), 120–123.PubMedCrossRef

Moslehi, R., Chu, W., Karlan, B., Fishman, D., Risch, H., Fields, A., et al. (2000). BRCA1 and BRCA2 mutation analysis of 208 Ashkenazi Jewish women with ovarian cancer. American Journal of Human Genetics, 66(4), 1259–1272.PubMedPubMedCentralCrossRef

Neuhausen, S., Gilewski, T., Norton, L., Tran, T., McGuire, P., Swensen, J., et al. (1996). Recurrent BRCA2 6174delT mutations in Ashkenazi Jewish women affected by breast cancer. Nature Genetics, 13(1), 126–128.PubMedCrossRef

Niederhoffer, K. G., & Pennebaker, J. W. (2002). Linguistic style matching in social interaction. Journal of Language and Social Psychology, 21(4), 337–360.CrossRef

NSGC. (2004). Familial cancer risk counseling association: standard protocol. Retrieved 12/5/2008, from https://doi.org/www.nsgc.org

Pekrun, R. (1992). The impact of emotions on learning and achievement: towards a theory of cognitive/motivational mediators. Applied Psychology, 41(4), 359–376.CrossRef

Pennebaker, J., & Francis, M. E. (1996). Cognitive, emotional, and language processes in disclosure. Cognitive & Emotion, 10(6), 601–626.CrossRef

Pennebaker, J., & Francis, M. E. (2001). Linguistic inquiry and word count, the second version: SLIWC. Austin: University of Texas.

Pennebaker, J. W., Chung, C. K., Ireland, M., Gonzales, A., & Booth, R. J. (2007). The development and psychometric properties of LIWC2007. LIWC2007 Manual.

Pieterse, A. H., van Dulmen, A. M., Ausems, M. G., Beemer, F. A., & Bensing, J. M. (2005). Communication in cancer genetic counselling: does it reflect counselees’ previsit needs and preferences? British Journal of Cancer, 92(9), 1671–1678.PubMedPubMedCentralCrossRef

Pieterse, A. H., van Dulmen, A. M., Beemer, F. A., Bensing, J. M., & Ausems, M. G. (2007). Cancer genetic counseling: communication and counselees’ post-visit satisfaction, cognitions, anxiety, and needs fulfillment. Journal of Genetic Counseling, 16(1), 85–96.PubMedPubMedCentralCrossRef

Randall, J., Butow, P., Kirk, J., & Tucker, K. (2001). Psychological impact of genetic counselling and testing in women previously diagnosed with breast cancer. Internal Medicine Journal, 31(7), 397–405.PubMedCrossRef

Rees, G., Young, M. A., Gaff, C., & Martin, P. R. (2006). A qualitative study of health professionals’ views regarding provision of information about health-protective behaviors during genetic consultation for breast cancer. Journal of Genetic Counseling, 15(2), 95–104.PubMedCrossRef

Resta, R., Biesecker, B. B., Bennett, R. L., Blum, S., Hahn, S. E., Strecker, M. N., et al. (2006). A new definition of genetic counseling: National Society of Genetic Counselors’ task force report. Journal of Genetic Counseling, 15(2), 77–83.CrossRefPubMed

Rimes, K. A., Salkovskis, P. M., Jones, L., & Lucassen, A. M. (2006). Applying a cognitive behavioral model of health anxiety in a cancer genetics service. Health Psychology, 25(2), 171–180.PubMedCrossRef

Shiloh, S. (2006). Illness representations, self-regulation, and genetic counseling: a theoretical review. Journal of Genetic Counseling, 15(5), 325–337.PubMedCrossRef

Struewing, J. P., Hartge, P., Wacholder, S., Baker, S. M., Berlin, M., McAdams, M., et al. (1997). The risk of cancer associated with specific mutations of BRCA1 and BRCA2 among Ashkenazi Jews. The New England Journal of Medicine, 336(20), 1401–1408.PubMedCrossRef

Tonin, P., Weber, B., Offit, K., Couch, F., Rebbeck, T. R., Neuhausen, S., et al. (1996). Frequency of recurrent BRCA1 and BRCA2 mutations in Ashkenazi Jewish breast cancer families. Nature Medicine, 2(11), 1179–1183.PubMedCrossRef

van Dijk, S., Otten, W., Zoeteweij, M. W., Timmermans, D. R., van Asperen, C. J., Breuning, M. H., et al. (2003). Genetic counselling and the intention to undergo prophylactic mastectomy: effects of a breast cancer risk assessment. British Journal of Cancer, 88(11), 1675–1681.PubMedPubMedCentralCrossRef

Wang, C., Gonzalez, R., Milliron, K. J., Strecher, V. J., & Merajver, S. D. (2005). Genetic counseling for BRCA1/2: a randomized controlled trial of two strategies to facilitate the education and counseling process. American Journal of Medical Genetics. Part A, 134(1), 66–73.CrossRef

Watson, E. K., Shickle, D., Qureshi, N., Emery, J., & Austoker, J. (1999). The ‘new genetics’ and primary care: GPs’ views on their role and their educational needs. Family Practice, 16(4), 420–425.CrossRefPubMed

Wiebe, D. J., & Korbel, C. (2003). Defensive denial, affect, and the self-regulation of health threats. In L. D. Cameron & H. Leventhal (Eds.), The self-regulation of health and illness behaviour (pp. 184–203). London: Routledge.

Titel: Linking Genetic Counseling Content to Short-Term Outcomes in Individuals at Elevated Breast Cancer Risk
verfasst von: Kimberly M. Kelly
Lee Ellington
Nancy Schoenberg
Parul Agarwal
Thomas Jackson
Stephanie Dickinson
Jame Abraham
Electra D. Paskett
Howard Leventhal
Michael Andrykowski
Publikationsdatum: 01.10.2014
Verlag: Springer US
Erschienen in: Journal of Genetic Counseling / Ausgabe 5/2014
Print ISSN: 1059-7700
Elektronische ISSN: 1573-3599
DOI: https://doi.org/10.1007/s10897-014-9705-8

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.

Newsletter bestellen

Springer Medizin

Linking Genetic Counseling Content to Short-Term Outcomes in Individuals at Elevated Breast Cancer Risk

Abstract

Neu im Fachgebiet Gynäkologie und Geburtshilfe

Hirsutismus bei PCOS: Laser- und Lichttherapien helfen

ICI-Therapie in der Schwangerschaft wird gut toleriert

Weniger postpartale Depressionen nach Esketamin-Einmalgabe

Bei RSV-Impfung vor 60. Lebensjahr über Off-Label-Gebrauch aufklären!

Update Gynäkologie

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 5/2014

The Effect of Genetic Counseling for Adult Offspring of Patients with Type 2 Diabetes on Attitudes Toward Diabetes and its Heredity: A Randomized Controlled Trial

Maternal Uniparental Isodisomy Causing Autosomal Recessive GM1 Gangliosidosis: A Clinical Report

A Genetic Counseling Intervention to Facilitate Family Communication About Inherited Conditions

Balancing Life with an Increased Risk of Cancer: Lived Experiences in Healthy Individuals with Lynch Syndrome

Attitudes About Internet Support Groups Among Adolescents and Young Adults with Neurofibromatosis Type 1 and their Parents

Genetic Counseling in Direct-to-Consumer Exome Sequencing: A Case Report

Neu im Fachgebiet Gynäkologie und Geburtshilfe

Hirsutismus bei PCOS: Laser- und Lichttherapien helfen

ICI-Therapie in der Schwangerschaft wird gut toleriert

Weniger postpartale Depressionen nach Esketamin-Einmalgabe

Bei RSV-Impfung vor 60. Lebensjahr über Off-Label-Gebrauch aufklären!

Update Gynäkologie