Kelly Kimberly M, Ellington Lee, Schoenberg Nancy, Agarwal Parul, Jackson Thomas, Dickinson Stephanie, Abraham Jame, Paskett Electra D, Leventhal Howard, Andrykowski Michael
School of Pharmacy, West Virginia University, Morgantown, WV, USA,
J Genet Couns. 2014 Oct;23(5):838-48. doi: 10.1007/s10897-014-9705-8. Epub 2014 Mar 28.
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.
很少有研究将实际的遗传咨询内容与短期结果联系起来。运用自我调节模型，对有家族性乳腺癌-卵巢癌高风险的个体，研究了遗传咨询中认知和情感内容对短期结果的影响。调查评估了因变量：痛苦程度、感知风险，以及在咨询前后测量的6项知识指标（阳性检测结果的意义；阴性检测结果的意义；个人行为；从业者知识；癌症遗传机制；遗传性癌症的发生率）。咨询过程中参与者认知和情感以及咨询师认知和情感内容的比例（使用LIWC软件）在回归分析中作为预测因素。5项指标的知识有所增加，而个人行为、痛苦程度和感知风险的知识有所减少。在控制年龄和教育程度后，三项指标的结果具有显著/边缘显著性。咨询师的内容越多，个人行为知识的减少就越明显。参与者情感内容越多而咨询师情感内容越少，与从业者知识的增加相关。咨询师认知内容越多，以及咨询师认知和情感内容的相互作用，与更高的感知风险相关。遗传咨询师主导着咨询过程的内容。因此，他们的内容比参与者的内容与短期结果的联系更为紧密。咨询过程中缺乏患者沟通可能会给理解复杂概念带来问题。
