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针对携带BRCA基因突变者的教育支持小组满足了信息需求,但并未影响情绪困扰。

Educational-support groups for BRCA mutation carriers satisfy need for information but do not affect emotional distress.

作者信息

Landsbergen K M, Brunner H G, Manders P, Hoogerbrugge N, Prins J B

机构信息

Department of Human Genetics, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.

出版信息

Genet Couns. 2010;21(4):423-37.

Abstract

INTRODUCTION

Due to high cancer risks, women carrying a BRCA 1/2 mutation face a complex choice between breast and ovarian cancer surveillance and prophylactic surgery. The aim of this study is to evaluate educational-support groups, which are offered to facilitate mutual support between BRCA mutation carriers and to provide adequate information.

METHODS

Female BRCA mutation carriers were approached by a social worker after genetic test disclosure and offered participation in educational-support groups. Data regarding emotional well-being, breast cancer risk knowledge and perception, cancer risk management behaviour and family communication were collected both before (T1) and after group participation (T2).

RESULTS

Of the 34 participants, mean levels of negative mood states at T1 were significantly higher compared to those of a norm group (depression p < 0.001, anger p < 0.001, fatigue p = 0.04, tension p = 0.03) and remained high at T2. Self-perceived breast cancer risk and frequency of cancer thoughts were high both at T1 and T2. Breast cancer risk knowledge was accurate both at T1 and T2; women either followed current surveillance advices or obtained prophylactic surgery. Communication with the family of origin was significantly reduced at T2 compared to T1 (p = 0.02). At T2, all women indicated that group participation highly met their needs of BRCA-related information to support their decision-making processes regarding cancer surveillance or prophylactic surgery.

CONCLUSION

After following an educational support group female BRCA mutation carriers were able to make cancer risk management decisions but still reported high levels of emotional distress while family communication appeared diminished.

摘要

引言

由于患癌风险高,携带BRCA 1/2基因突变的女性在乳腺癌和卵巢癌监测以及预防性手术之间面临复杂的选择。本研究的目的是评估教育支持小组,该小组旨在促进BRCA基因突变携带者之间的相互支持并提供充分的信息。

方法

在基因检测结果披露后,一名社会工作者联系了携带BRCA基因突变的女性,并邀请她们参加教育支持小组。在小组参与前(T1)和参与后(T2)都收集了有关情绪健康、乳腺癌风险知识与认知、癌症风险管理行为以及家庭沟通的数据。

结果

在34名参与者中,T1时负面情绪状态的平均水平显著高于正常组(抑郁p < 0.001,愤怒p < 0.001,疲劳p = 0.04,紧张p = 0.03),且在T2时仍居高不下。T1和T2时自我感知的乳腺癌风险以及癌症相关想法的频率都很高。T1和T2时乳腺癌风险知识都是准确的;女性要么遵循当前的监测建议,要么接受预防性手术。与原生家庭的沟通在T2时相较于T1显著减少(p = 0.02)。在T2时,所有女性都表示小组参与极大地满足了她们对BRCA相关信息的需求,以支持她们在癌症监测或预防性手术方面的决策过程。

结论

参加教育支持小组后,携带BRCA基因突变的女性能够做出癌症风险管理决策,但仍报告情绪困扰程度较高,而家庭沟通似乎有所减少。

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