TY - JOUR
T1 - Exploring the short-term impact of DNA-testing in breast cancer patients: The counselees' perception matters, but the actual BRCA1/2 result does not
AU - Vos, Joel
AU - Oosterwijk, Jan C.
AU - Gomez-Garcia, Encarna
AU - Menko, Fred H.
AU - Collee, Margriet J.
AU - van Asperen, Christi J.
AU - Jansen, Anna M.
AU - Stiggelbout, Anne M.
AU - Tibben, Aad
PY - 2012/2
Y1 - 2012/2
N2 - Objective: Previous studies suggest that learning a DNA-test-result has no direct impact on the medical-decisions and psychological well-being of counselees. Their perception, especially their recollections and interpretations of their cancer-risks and heredity, predict and/or mediate this impact. These studies were criticized for their small range of predictors, mediators, outcomes and contextual factors. We studied the short-term impact of DNA-testing with an extended model. Methods: Three months after disclosure of BRCA1/2-test-results, we sent counselees a questionnaire about their perception, medical and psychological outcomes, and medical, familial and psychological contexts. 248 affected women participated: 30 had received pathogenic-mutations, 16 unclassified-variants and 202 uninformative-results. Results: The actually communicated genetic-information and the contextual variables predicted the counselees' perception, but did not directly predict any outcomes. The counselees' perception predicted and/or completely mediated the counselees' medical intentions and behavior, physical and psychological life-changes, stigma, mastery, negativity and cancer-worries. Short-term distress was related to the perception not only of their own risks, but also of their relatives' risks and heredity-likelihood. Effect sizes were medium to large. Conclusions and implications: The outcomes of DNA-testing were better predicted by the counselees' perception than by the actually given genetic-information. We recommend genetic-counselors to have tailored, interactive dialogues about the counselees' perception.
AB - Objective: Previous studies suggest that learning a DNA-test-result has no direct impact on the medical-decisions and psychological well-being of counselees. Their perception, especially their recollections and interpretations of their cancer-risks and heredity, predict and/or mediate this impact. These studies were criticized for their small range of predictors, mediators, outcomes and contextual factors. We studied the short-term impact of DNA-testing with an extended model. Methods: Three months after disclosure of BRCA1/2-test-results, we sent counselees a questionnaire about their perception, medical and psychological outcomes, and medical, familial and psychological contexts. 248 affected women participated: 30 had received pathogenic-mutations, 16 unclassified-variants and 202 uninformative-results. Results: The actually communicated genetic-information and the contextual variables predicted the counselees' perception, but did not directly predict any outcomes. The counselees' perception predicted and/or completely mediated the counselees' medical intentions and behavior, physical and psychological life-changes, stigma, mastery, negativity and cancer-worries. Short-term distress was related to the perception not only of their own risks, but also of their relatives' risks and heredity-likelihood. Effect sizes were medium to large. Conclusions and implications: The outcomes of DNA-testing were better predicted by the counselees' perception than by the actually given genetic-information. We recommend genetic-counselors to have tailored, interactive dialogues about the counselees' perception.
KW - BRCA1/2
KW - Risk perception
KW - Breast cancer
KW - Ovarian cancer
KW - Oncology
KW - Psychology
KW - Genetic-counseling
U2 - 10.1016/j.pec.2011.04.017
DO - 10.1016/j.pec.2011.04.017
M3 - Article
C2 - 21684708
SN - 0738-3991
VL - 86
SP - 239
EP - 251
JO - Patient Education and Counseling
JF - Patient Education and Counseling
IS - 2
ER -