Department of Psychiatry, University of British Columbia, Vancouver, Canada.
Department of Medical Genetics, University of British Columbia, Vancouver, Canada.
Clin Genet. 2018 Apr;93(4):830-836. doi: 10.1111/cge.13176. Epub 2018 Feb 20.
No studies have yet evaluated whether different modalities for the collection of family history data influence patient outcomes of genetic counseling. We retrospectively compared outcomes of genetic counseling between patients whose family history (Fhx) was collected (1) via telephone prior to their appointment (FhxPrior) or (2) during the appointment (FhxDuring). We used a psychiatric genetic counseling clinic database, where information about demographics and Fhx timing is recorded, and patients complete the Genetic Counseling Outcomes Scale (GCOS, measuring empowerment) and Illness Management Self-Efficacy Scale (IMSES) immediately prior to (T1) and 1 month after their appointment (T2). We used ANCOVA to evaluate the effect of the Fhx method on patient outcomes at T2. Complete data were available for 240 patients and were used for analysis (FhxPrior, n = 206; FhxDuring, n = 34). GCOS and IMSES scores increased from T1 to T2 (P < .0005 and P = .004, respectively). Although there was no difference between groups for GCOS (P = .412), T2 IMSES scores were significantly higher for FhxPrior than FhxDuring after controlling for T1 scores (P = .011). Our data suggest that obtaining Fhx via telephone prior to genetic counseling may lead to greater increases in patients' self-efficacy as compared to obtaining Fhx during the genetic counseling appointment.
目前尚无研究评估收集家族史数据的不同方式是否会影响遗传咨询患者的结局。我们回顾性比较了通过以下两种方式收集家族史(1)在预约前通过电话收集(FhxPrior),或(2)在预约时收集(FhxDuring)的遗传咨询患者的结局。我们使用了一个精神病学遗传咨询诊所数据库,该数据库记录了人口统计学和家族史收集时间的信息,患者在预约前(T1)和预约后 1 个月(T2)立即完成遗传咨询结局量表(GCOS,衡量赋权)和疾病管理自我效能感量表(IMSES)。我们使用协方差分析(ANCOVA)来评估家族史收集方法对 T2 时患者结局的影响。共有 240 名患者提供了完整的数据,并用于分析(FhxPrior,n=206;FhxDuring,n=34)。GCOS 和 IMSES 评分从 T1 到 T2 均升高(P<.0005 和 P=.004)。尽管 GCOS 组间无差异(P=.412),但在控制 T1 评分后,FhxPrior 的 T2 IMSES 评分明显高于 FhxDuring(P=.011)。我们的数据表明,与在遗传咨询预约期间收集家族史相比,在遗传咨询前通过电话收集家族史可能会导致患者自我效能感的显著提高。