Neuroscience & Public Policy Program, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA.
Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
J Genet Couns. 2022 Aug;31(4):989-997. doi: 10.1002/jgc4.1573. Epub 2022 Apr 23.
As more is understood about the hereditary nature of disease risk, the utility of genetic testing within cardiovascular medicine is increasingly being explored. Although testing may afford more personalized risk stratification, there is a paucity of information regarding patient knowledge, attitudes, and beliefs toward genetic testing among cardiology patients. Participants (n = 530) recruited primarily from a cardiology clinic filled out a 41-item written questionnaire assessing knowledge, beliefs, and attitudes toward genetic testing, motivators and detractors for considering genetic testing, and perceived likelihood for behavior change after hypothetical genetic testing risk stratification. Path analysis was used to test the hypothetical models predicting the likelihood of getting a genetic test and making behavior changes following genetic testing. The patient population was late-middle-aged (59.0 ± 14.5 years), majority women (61.5%), and about half reported having a bachelor's degree. 58.1% of participants self-identified as White, 25.7% as African American or Black, 6.8% as Spanish, Latino, or Hispanic, 3.0% as Asian or Pacific Islander, and 0.5% as Native American. Gender (being a woman) and more years of education were related to greater knowledge about genetic testing. Racial identity and years of education were related to beliefs about genetic testing. Beliefs, but not knowledge, were related to more positive attitudes and a higher likelihood of pursuing genetic testing. Positive attitudes were related to greater perceived personal control (PPC). Furthermore, attitudes and PPC were related to higher likelihood of lifestyle change after genetic testing. These results highlight the need to integrate the experiences of racialized communities into education/counseling efforts. Most educational counseling efforts lack a nuanced discussion of social determinants of health or beliefs. In addition to factual information, educational counseling must also address people's beliefs, concerns, and the intersecting experiences and identities, which shape patients' relationships with the evolving landscape of healthcare and personalized medicine.
随着人们对疾病风险遗传性质的了解越来越多,遗传检测在心血管医学中的应用也越来越受到关注。虽然检测可以提供更个性化的风险分层,但关于心脏病患者对遗传检测的知识、态度和信念,信息仍然匮乏。参与者(n=530)主要从心脏病诊所招募,填写了一份 41 项的书面问卷,评估他们对遗传检测的知识、信念和态度、考虑遗传检测的动机和阻碍因素,以及在假设的遗传检测风险分层后改变行为的可能性。路径分析用于测试预测进行遗传检测和进行遗传检测后改变行为的可能性的假设模型。患者人群为中老年(59.0±14.5 岁),大多数为女性(61.5%),约一半人拥有学士学位。58.1%的参与者自认为是白人,25.7%是非洲裔美国人或黑人,6.8%是西班牙裔、拉丁裔或西班牙裔,3.0%是亚裔或太平洋岛民,0.5%是美洲原住民。性别(女性)和受教育年限与遗传检测知识的增加有关。种族认同和受教育年限与对遗传检测的信念有关。信念而不是知识与更积极的态度和更高的遗传检测意愿有关。积极的态度与更大的个人控制感(PPC)有关。此外,态度和 PPC 与遗传检测后生活方式改变的可能性更高有关。这些结果强调需要将种族化社区的经验纳入教育/咨询工作中。大多数教育咨询工作缺乏对健康社会决定因素或信念的细致讨论。除了事实信息,教育咨询还必须解决人们的信仰、关注以及相互交织的经历和身份,这些因素塑造了患者与不断发展的医疗保健和个性化医疗的关系。