调查疑似遗传性乳腺癌和卵巢癌综合征及林奇综合征女性中遗传咨询和种系突变检测的障碍。
Investigating barriers to genetic counseling and germline mutation testing in women with suspected hereditary breast and ovarian cancer syndrome and Lynch syndrome.
机构信息
St. John of God Subiaco Hospital, Subiaco, Western Australia, Australia.
Institute for Health Research, University of Notre Dame Australia, Fremantle, Western Australia, Australia.
出版信息
Patient Educ Couns. 2018 May;101(5):938-944. doi: 10.1016/j.pec.2017.12.011. Epub 2017 Dec 12.
OBJECTIVE
The aim of the current study was to explore barriers to genetic counseling and testing in women with gynecological cancers deemed at significant risk of carrying a germline mutation.
METHODS
A qualitative study using semi-structured interviews and inductively analysed thematically. Eight patients with ovarian or endometrial cancer participated in individual semi-structured telephone interviews that assessed motivation for genetic counseling and testing, perceived benefits and barriers, timing of the approach, perceptions of the referral process to genetic services and locus of control in relation to cancer and health.
RESULTS
Analysis of the interview transcripts revealed five themes relating to perceptions of genetic counseling and testing: Lack of importance; Level of information received; Timing of referral processes; Fear and anxiety; Resistance to and perceptions of counseling.
CONCLUSIONS
Participants had a limited understanding of hereditary cancer syndromes and did not appreciate the benefits of genetic testing. A consistent approach at the time of referral to genetic services is needed to ensure that the level and format of information is appropriate for patients.
PRACTICE IMPLICATIONS
The rationale for genetic testing needs to be better explained to patients and the timing of referral should be based both on treatment priorities and patient preferences.
目的
本研究旨在探讨妇科癌症患者中存在的遗传咨询和检测障碍,这些患者被认为有携带种系突变的高风险。
方法
采用半结构式访谈的定性研究,并进行了归纳主题分析。8 名患有卵巢癌或子宫内膜癌的患者参与了个体半结构式电话访谈,评估了遗传咨询和检测的动机、感知的益处和障碍、方法的时机、对遗传服务转诊过程的看法以及与癌症和健康相关的控制源。
结果
对访谈记录的分析揭示了与遗传咨询和检测的看法相关的五个主题:缺乏重要性;接受的信息量;转诊过程的时机;恐惧和焦虑;对咨询的抵触和看法。
结论
参与者对遗传性癌症综合征的理解有限,也不理解基因检测的益处。在向遗传服务机构转诊时,需要采用一致的方法,以确保信息的水平和格式适合患者。
实践意义
需要向患者更好地解释基因检测的理由,并且转诊的时机应基于治疗重点和患者的偏好。