Prenatal Genetics Clinic, Regional Genetics Program, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.
Newborn Screening Ontario, Ottawa, ON, Canada.
Prenat Diagn. 2017 Nov;37(11):1112-1119. doi: 10.1002/pd.5149. Epub 2017 Oct 17.
To address the growing demand for prenatal genetic services, group genetic counseling was explored as an alternative service delivery model for women with a positive prenatal screening result.
Women were recruited from a prenatal genetic service and systematically allocated to a traditional individual appointment with a genetic counselor or a group genetic counseling session. Questionnaires were administered to assess patient psychological outcomes, knowledge, and satisfaction following individual and group genetic counseling for a positive prenatal screen. Genetic counselor time per type of patient was measured.
Of 172 participants, 107 (62.2%) received group genetic counseling and 65 (37.8%) received individual genetic counseling. Both group and individual genetic counseling encounters significantly decreased patient anxiety, increased perceived personal control, decreased decisional conflict, and increased knowledge. Satisfaction was high following both methods. Anxiety was significantly decreased in women who received individual genetic counseling compared with group sessions (P < .001). Genetic counselors spent less time per group patient seen compared with individual patients.
Group genetic counseling followed by the option of brief individual genetic counseling appears acceptable to women in a high-risk prenatal screening population. The findings support an alternative service delivery model for prenatal genetic services that could optimize the utilization of genetic counseling resources.
为满足日益增长的产前遗传服务需求，探索小组遗传咨询作为一种替代服务模式，为产前筛查阳性的女性提供服务。
从产前遗传服务中招募女性，并系统地分配给遗传咨询师进行传统的个体预约或小组遗传咨询会议。在接受阳性产前筛查的个体和小组遗传咨询后，通过问卷调查评估患者的心理结果、知识和满意度。测量每位患者的遗传咨询师时间。
在 172 名参与者中，107 名（62.2%）接受了小组遗传咨询，65 名（37.8%）接受了个体遗传咨询。小组和个体遗传咨询均显著降低了患者的焦虑，增加了个人控制感，降低了决策冲突，增加了知识。两种方法的满意度都很高。与小组咨询相比，接受个体遗传咨询的女性焦虑明显降低（P<.001）。与个体患者相比，遗传咨询师为每一位小组患者提供的咨询时间更少。
对于高危产前筛查人群，小组遗传咨询后提供简短的个体遗传咨询选择似乎是可以接受的。研究结果支持一种替代的产前遗传服务提供模式，可以优化遗传咨询资源的利用。
