Albada Akke, Werrett Julie, Van Dulmen Sandra, Bensing Jozien M, Chapman Cyril, Ausems Margreet G E M, Metcalfe Alison
NIVEL (Netherlands Institute for Health Services Research), P.O. Box 1568, 3500 BN, Utrecht, the Netherlands,
J Community Genet. 2011 Dec;2(4):233-47. doi: 10.1007/s12687-011-0061-1. Epub 2011 Aug 18.
Counselees from different countries may differ in demographic and medical characteristics and this could affect their pre-counselling cognitions and psychosocial variables. Research outcomes may therefore not be easily transferable between countries. To examine this, a cross-national comparison of UK (West Midlands: WM) and Dutch (Middle Netherlands: MN) counselees in breast cancer genetic counselling was conducted. Two hundred thirty-eight WM and 156 MN proband counselees were compared on demographics, breast cancer history and referral pathways. Multivariate logistic regression analyses were performed to check whether national differences in knowledge of breast cancer and heredity, risk perception, worry and information needs persisted when corrected for the background characteristics. About half of the Dutch compared to 8% of UK counselees were affected by breast cancer. More UK than Dutch counselees were at high risk from hereditary breast cancer. UK counselees had higher risk perceptions and more knowledge about breast cancer prevalence, but these differences lost significance when corrected for counselees' risk levels and other background characteristics. Counselees from the UK might report higher levels of worry than Dutch counselees and this could not be explained by their background characteristics. Comparisons of findings between the UK and the Netherlands show that the UK seems to have a higher percentage of high-risk referrals and these counselees seem to have higher risk perceptions. Irrespective of their actual risk level, UK counselees might be more worried. Comparing findings between the different countries raises questions about how transferable research findings are from one culture to another.
来自不同国家的咨询对象在人口统计学和医学特征方面可能存在差异，这可能会影响他们咨询前的认知和心理社会变量。因此，研究结果可能不易在不同国家之间进行转换。为了对此进行研究，我们对英国（西米德兰兹郡：WM）和荷兰（荷兰中部：MN）的乳腺癌遗传咨询对象进行了跨国比较。比较了238名WM和156名MN先证者咨询对象的人口统计学、乳腺癌病史和转诊途径。进行多变量逻辑回归分析，以检查在对背景特征进行校正后，乳腺癌和遗传知识、风险认知、担忧及信息需求方面的国家差异是否仍然存在。与8%的英国咨询对象相比，约一半的荷兰咨询对象受到乳腺癌影响。英国患遗传性乳腺癌高风险的咨询对象比荷兰更多。英国咨询对象有更高的风险认知，对乳腺癌患病率的了解也更多，但在对咨询对象的风险水平和其他背景特征进行校正后，这些差异不再显著。英国咨询对象报告的担忧程度可能高于荷兰咨询对象，而这无法用他们的背景特征来解释。英国和荷兰之间的研究结果比较表明，英国似乎有更高比例的高风险转诊对象，而且这些咨询对象似乎有更高的风险认知。无论实际风险水平如何，英国咨询对象可能更担心。比较不同国家之间的研究结果引发了关于研究结果从一种文化向另一种文化转换程度的问题。
