Abstract
Spinocerebellar ataxias and Huntington disease are heritable, adult onset, neurodegenerative disorders of movement. Both are autosomal dominant and caused by expansions in trinucleotide sequences in several genes. Because these expansions are associated with an almost complete penetrance, genetic tests are available at the diagnostic and predictive level. In this study, we describe the expectations and issues raised during pre-test interviews for genetic counselling for these diseases. Data from pre-test interviews with 97 patients and at-risk relatives for spinocerebellar ataxia (SCA) or Huntington disease was comprised of close-ended questions (demographics, personal and current disease history) and open-ended questions, where individuals were asked to describe their hopes and expectations on the genetic counselling evaluation and also their degree of knowledge about genetics and medical genetics. Amongst the main expectations identified in patients and at-risk relatives, issues related to the aetiological diagnosis and/or disclosure of the at-risk status were those most frequently mentioned (57 %). Improvement in quality of life was another identified issue (17 %). Interestingly, the issue of inheritance/transmission was identified as the main expectation by a minority of individuals (3 %). Pre-test interviews are valuable tools to identify issues raised by consultands and promote a better communication between the patient, family and the genetic counselling team.
Similar content being viewed by others
References
Bardin L (1979) Análise de conteúdo. Edições 70, Lisboa
Beck AT, Emery G, Greenberg RL (1985) Anxiety disorders and phobias: a cognitive perspective. Basic Books, New York
Becker HS (1999) Métodos de pesquisas em ciências sociais. Hucitec, São Paulo
Bernhardt BA, Biesecker BB, Mastromarino CL (2000) Goals, benefits, and outcomes of genetic counseling: client and genetic counselor assessment. Am J Med Genet 94:189–197
Biesecker BB, Peters KF (2000) Process studies in genetic counseling: peering into the black box. Am J Med Genet 106:191–198
Bombard Y, Palin J, Friedman JM, Veenstra G, Creighton S, Bottorff JL et al (2011) Beyond the patient: the broader impact of genetic discrimination among individuals at risk of Huntington disease. Am J Med Genet B 159B:217–226
Boutté M (1990) Waiting for the family legacy: the experience of being at risk for Machado-Joseph disease. Soc Sci Med 30:839–847
Brasil. Presidência da República (1991) Lei n°8213 de 24 de julho de 1991. Available at: www.planalto.gov.br/ccivil_03/leis/l8213cons.htm; accessed 15 Oct 2014
de Wit ACD, Tibben A, Duivenvoorden HJ, Niermeijer MF, Passchier J, Trijsburg RW, Rotterdam/Leiden Genetics Workgroup (1998) Distress in individuals facing predictive DNA testing for autosomal dominant late-onset disorders: comparing questionnaire results with in-depth interviews. Am J Med Genet 75:62–74
Evers-Kiebooms G, Welkenhuysen M, Claes E, Decruyenaere M, Denayer L (2000) The psychological complexity of predictive testing for late onset neurogenetic diseases and hereditary cancers: implications for multidisciplinary counselling and for genetic education. Soc Sci Med 51:831–841
Forrest LE, Delatycki MB, Skene L, Aitken MA (2007) Communicating genetic information in families—a review of guidelines and position papers. Eur J Hum Genet 15:612–618
Guimarães L, Sequeiros J, Skirton H, Paneque M (2013) What counts as effective genetic counselling for presymptomatic testing in late-onset disorders? A study of the consultand’s perspective. J Genet Counsel 22:437–447
Harper PS (2008) A short history of medical genetics. Oxford University Press, Cambridge
Kessler S (1979) Genetic counseling: psychological dimensions. Academic Press, INC, London
Kessler S (1994) Predictive testing for Huntington disease: a psychologist’s view. Am J Med Genet 54:161–166
Klitzman R (2010) Misunderstandings concerning genetics among patients confronting genetic disease. J Genet Counsel 19:430–446
Licklederer C, Gerhard W, Jürgen B (2008) Mental health and quality of life after genetic testing for Huntington disease: a long-term effect study in Germany. Am J Med Genet 146A:2078–2085
Lippman A, Frazer FC (1979) Genetic counseling: parents’ responses to uncertainty. Birth Defects Orig Artic Ser 5:325–339
MacLeod R, Tibben A, Frontali M, Evers-Kiebooms G, Jones A, Martinez-Descales A, Roos RA, Editorial Committee and Working Group ‘Genetic Testing Counselling’ of the European Huntington Disease Network (2013) Recommendations for the predictive genetic test in Huntington’s disease. Clin Genet 83:221–231
Penchaszadeh VB (2004) Problemas éticos do determinismo genético. Rev Bioética 12:61–68
Peters KF, Petrill SA (2011) Development of a scale to assess the background, needs, and expectations of genetic counseling clients. Am J Med Genet A 155:673–683
Zimmern RL (2014) Issues concerning the evaluation and regulation of predictive genetic testing. J Community Genet 5:49–57
Acknowledgments
FRV is a recipient of the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) grant 486599/2012–4 and Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ) grant E26/110.535/2012.
Ethical statement
The present study was approved by the local Institutional Review Board. Subjects were included in the study after information, discussion and signature of an informed consent form. The authors declare they have no conflicts of interest.
Author information
Authors and Affiliations
Corresponding author
Additional information
This article is part of the special issue on “Genetics and Ethics in Latin America”.
Rights and permissions
About this article
Cite this article
do Nascimento Marinho, A.S., de Faria Domingues de Lima, M.A. & Vargas, F.R. Analysis of pre-test interviews in a cohort of Brazilian patients with movement disorders. J Community Genet 6, 259–264 (2015). https://doi.org/10.1007/s12687-015-0235-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12687-015-0235-3