TY - JOUR
T1 - Online decision support for persons having a genetic predisposition to cancer and their partners during reproductive decision-making
AU - Reumkens, Kelly
AU - Tummers, Marly H. E.
AU - Gietel-Habets, Joyce J. G.
AU - van Kuijk, Sander M. J.
AU - Aalfs, Cora M.
AU - van Asperen, Christi J.
AU - Ausems, Margreet G. E. M.
AU - Collee, Margriet
AU - Dommering, Charlotte J.
AU - Kets, C. Marleen
AU - van der Kolk, Lizet E.
AU - Oosterwijk, Jan C.
AU - Tjan-Heijnen, Vivianne C. G.
AU - van der Weijden, Trudy
AU - de Die-Smulders, Christine E. M.
AU - van Osch, Liesbeth A. D. M.
PY - 2019/6
Y1 - 2019/6
N2 - A nationwide pretest-posttest study was conducted in all clinical genetic centres in the Netherlands, to evaluate the effects of an online decision aid to support persons who have a genetic predisposition to cancer and their partners in making an informed decision regarding reproductive options. Main outcomes (decisional conflict, knowledge, realistic expectations, level of deliberation, and decision self-efficacy) were measured before use (T0), immediately after use (T1), and at 2 weeks (T2) after use of the decision aid. Paired sample t tests were used to compute differences between the first and subsequent measurements. T0-T1 and T0-T2 comparisons indicate a significant reduction in mean decisional conflict scores with stronger effects for participants with high baseline decisional conflict. Furthermore, use of the decision aid resulted in increased knowledge levels and improved realistic expectations. Level of deliberation only increased for participants with lower baseline levels of deliberation. Decision self-efficacy increased for those with low baseline scores, whereas those with high baseline scores showed a reduction at T2. It can be concluded that use of the decision aid resulted in several positive outcomes indicative of informed decision-making. The decision aid is an appropriate and highly appreciated tool to be used in addition to reproductive counseling.
AB - A nationwide pretest-posttest study was conducted in all clinical genetic centres in the Netherlands, to evaluate the effects of an online decision aid to support persons who have a genetic predisposition to cancer and their partners in making an informed decision regarding reproductive options. Main outcomes (decisional conflict, knowledge, realistic expectations, level of deliberation, and decision self-efficacy) were measured before use (T0), immediately after use (T1), and at 2 weeks (T2) after use of the decision aid. Paired sample t tests were used to compute differences between the first and subsequent measurements. T0-T1 and T0-T2 comparisons indicate a significant reduction in mean decisional conflict scores with stronger effects for participants with high baseline decisional conflict. Furthermore, use of the decision aid resulted in increased knowledge levels and improved realistic expectations. Level of deliberation only increased for participants with lower baseline levels of deliberation. Decision self-efficacy increased for those with low baseline scores, whereas those with high baseline scores showed a reduction at T2. It can be concluded that use of the decision aid resulted in several positive outcomes indicative of informed decision-making. The decision aid is an appropriate and highly appreciated tool to be used in addition to reproductive counseling.
KW - counseling
KW - decision aid
KW - genetics
KW - hereditary cancer
KW - informed decision-making
KW - oncology
KW - patient participation
KW - reproductive decision-making
KW - BREAST
KW - RISK
KW - COUPLES
KW - WOMEN
KW - INFORMATION
KW - DIAGNOSIS
KW - FAMILIES
KW - CARRIERS
KW - OPTIONS
KW - BRCA1
U2 - 10.1002/jgc4.1056
DO - 10.1002/jgc4.1056
M3 - Article
C2 - 30629779
VL - 28
SP - 533
EP - 542
JO - Journal of Genetic Counseling
JF - Journal of Genetic Counseling
SN - 1059-7700
IS - 3
ER -