Zhong Lingzi, Rodriguez Yanete, Espinel Whitney, Ozanne Elissa M, Kaphingst Kimberly A
Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA.
Department of Communication, University of Utah, Salt Lake City, Utah, USA.
J Genet Couns. 2025 Apr;34(2):e1937. doi: 10.1002/jgc4.1937. Epub 2024 Jul 4.
Cascade testing is an imperative process to engage Lynch syndrome patients' at-risk relatives in early cancer risk reduction interventions. How genetic counselors communicate about cascade testing is crucial to patients' intentions of and actual involvement in family communication. Based on data from 20 interviews with genetic counselors, this qualitative study examined their perceptions of barriers and facilitators of offering cascade testing to at-risk relatives and the specific communication strategies they use to discuss cascade testing with patients. We identified patient-level, genetic counselor-level, and system-level barriers and facilitators of having discussions with Lynch syndrome patients about cascade testing. The qualitative data also revealed four prominent communication strategies that genetic counselors use for such discussions: build rapport, reframe the benefits of family communication, adapt communication, and provide various resources. These findings highlight genetic counselors' needs of practical and structural support to facilitate their communication about cascade testing, especially when patients are hesitant or lack resources or skills to notify at-risk relatives about cascade testing.
级联检测是让林奇综合征患者的高危亲属参与早期癌症风险降低干预措施的必要过程。基因咨询师如何就级联检测进行沟通对于患者进行家庭沟通的意愿和实际参与情况至关重要。基于对基因咨询师进行的20次访谈的数据，这项定性研究考察了他们对向高危亲属提供级联检测的障碍和促进因素的看法，以及他们与患者讨论级联检测时所使用的具体沟通策略。我们确定了在与林奇综合征患者讨论级联检测时患者层面、基因咨询师层面和系统层面的障碍和促进因素。定性数据还揭示了基因咨询师用于此类讨论的四种突出沟通策略：建立融洽关系、重新阐述家庭沟通的益处、调整沟通方式以及提供各种资源。这些发现凸显了基因咨询师在促进其关于级联检测的沟通方面对实际支持和结构性支持的需求，尤其是当患者犹豫不决或缺乏资源或技能来告知高危亲属有关级联检测时。
