遗传咨询是一件有压力的事情吗？
Is genetic counseling a stressful event?
机构信息
Department of Public Health and Caring Sciences, Uppsala University, Sweden.
出版信息
Acta Oncol. 2011 Oct;50(7):1089-97. doi: 10.3109/0284186X.2011.604343. Epub 2011 Aug 24.
PURPOSE
The aim of this paper was to investigate whether cancer genetic counseling could be considered as a stressful event and associated with more anxiety and/or depression compared to other cancer-related events for instance attending mammography screening or receiving a cancer diagnosis.
METHODS
A total of 4911 individuals from three Scandinavian countries were included in the study. Data was collected from individuals who had attended either cancer genetic counseling (self-referred and physician-referred) or routine mammography screening, were recalled for a second mammograpy due to a suspicious mammogram, had received a cancer diagnosis or had received medical follow-up after a breast cancer-surgery. Data from the genetic counseling group was also compared to normative data. Participants filled in the Hospital Anxiety and Depression Scale twice: prior to a potentially stressful event and 14 days after the event.
RESULTS
Pre-counseling cancer genetic counselees reported significant lower level of anxiety compared to the cancer-related group, but higher levels of anxiety compared to the general population. Furthermore, the level of depression observed within the genetic counseling group was lower compared to other participants. Post-event there was no significant difference in anxiety levels between the cancer genetic counselees and all other groups; however, the level of depression reported in the self-referred group was significantly lower than observed in all other groups. Notably, the level of anxiety and depression had decreased significantly from pre-to post-events within the genetic counseling group. In the cancer-related group only the level of anxiety had decreased significantly post-event.
CONCLUSION
Individuals who attend cancer genetic counseling do not suffer more anxiety or depression compared to all other cancer-related groups. However, some counselees might need additional sessions and extended support. Thus, identifying extremely worried individuals who need more support, and allocating further resources to their care, seems to be more sufficient.
目的
本文旨在研究癌症遗传咨询是否可以被视为一种压力事件，并与其他癌症相关事件（如参加乳房 X 光筛查或确诊癌症）相比，导致更多的焦虑和/或抑郁。
方法
本研究共纳入了来自三个斯堪的纳维亚国家的 4911 名个体。数据来自以下人群：参加过癌症遗传咨询（自我推荐和医生推荐）或常规乳房 X 光筛查的个体、因乳房 X 光片可疑而召回进行第二次乳房 X 光检查的个体、确诊癌症的个体、或在乳腺癌手术后接受医学随访的个体。遗传咨询组的数据还与常模数据进行了比较。参与者两次填写医院焦虑和抑郁量表（HADS）：一次是在潜在压力事件之前，一次是在事件发生后 14 天。
结果
在咨询前，癌症遗传咨询者报告的焦虑水平明显低于癌症相关组，但高于一般人群。此外，遗传咨询组观察到的抑郁水平低于其他参与者。事件发生后，癌症遗传咨询者与其他所有组之间的焦虑水平没有显著差异；然而，自我推荐组报告的抑郁水平明显低于其他所有组。值得注意的是，遗传咨询组的焦虑和抑郁水平在事件前后均显著下降。在癌症相关组中，只有焦虑水平在事件后显著下降。
结论
参加癌症遗传咨询的个体与其他所有癌症相关组相比，不会遭受更多的焦虑或抑郁。然而，一些咨询者可能需要额外的咨询和扩展的支持。因此，识别出需要更多支持的极度担忧的个体，并为他们提供更多的资源，似乎更为充分。
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