Meisel Susanne F, Fraser Lindsay Sarah Macduff, Side Lucy, Gessler Sue, Hann Katie E J, Wardle Jane, Lanceley Anne
Dept of Psychology, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK.
Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK.
BMJ Open. 2017 Dec 22;7(12):e017675. doi: 10.1136/bmjopen-2017-017675.
BACKGROUND: Genetic risk assessment for breast cancer and ovarian cancer (BCOC) is expected to make major inroads into mainstream clinical practice. It is important to evaluate the potential impact on women ahead of its implementation in order to maximise health benefits, as predictive genetic testing without adequate support could lead to adverse psychological and behavioural responses to risk disclosure. OBJECTIVE: To examine anticipated health behaviour changes and perceived control to disclosure of genetic risk for BCOC and establish demographic and person-specific correlates of adverse anticipated responses in a population-based sample of women. DESIGN: Cross-sectional quantitative survey study carried out by the UK Office for National Statistics in January and March 2014. SETTING: Face-to-face computer-assisted interviews conducted by trained researchers in participants' homes. PARTICIPANTS: 837 women randomly chosen from households across the UK identified from the Royal Mail's Postcode Address File. OUTCOME MEASURES: Anticipated health behaviour change and perceived control to disclosure of BCOC risk. RESULTS: In response to a genetic test result, most women (72%) indicated 'I would try harder to have a healthy lifestyle', and over half (55%) felt 'it would give me more control over my life'. These associations were independent of demographic factors or perceived risk of BCOC in Bonferroni-corrected multivariate analyses. However, a minority of women (14%) felt 'it isn't worth making lifestyle changes' and that 'I would feel less free to make choices in my life' (16%) in response to BCOC risk disclosure. The former belief was more likely to be held by women who were educated below university degree level (P<0.001) after adjusting for other demographic and person-specific correlates. CONCLUSION: These findings indicate that women in the UK largely anticipate that they would engage in positive health behaviour changes in response to BCOC risk disclosure.
背景:乳腺癌和卵巢癌(BCOC)的基因风险评估有望在主流临床实践中取得重大进展。在实施之前评估其对女性的潜在影响非常重要,以便最大限度地提高健康效益,因为没有足够支持的预测性基因检测可能会导致对风险披露产生不良的心理和行为反应。 目的:在以人群为基础的女性样本中,研究BCOC基因风险披露后预期的健康行为变化和感知控制,并确定不良预期反应的人口统计学和个体相关因素。 设计:英国国家统计局于2014年1月和3月进行的横断面定量调查研究。 设置:由经过培训的研究人员在参与者家中进行面对面的计算机辅助访谈。 参与者:从皇家邮政邮政编码地址文件中识别出的英国各地家庭中随机抽取的837名女性。 结果指标:BCOC风险披露后的预期健康行为变化和感知控制。 结果:对于基因检测结果,大多数女性(72%)表示“我会更加努力保持健康的生活方式”,超过一半(55%)的人认为“这会让我对自己的生活有更多掌控”。在Bonferroni校正的多变量分析中,这些关联独立于人口统计学因素或BCOC的感知风险。然而,少数女性(14%)认为“改变生活方式不值得”,并且在BCOC风险披露后“我在生活中做选择时会感觉不那么自由”(16%)。在调整其他人口统计学和个体相关因素后,学历低于大学水平的女性更有可能持有前一种观点(P<0.001)。 结论:这些发现表明,英国女性在很大程度上预计,她们会因BCOC风险披露而积极改变健康行为。
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