1
|
Morrow A, Speechly C, Young AL, Tucker K, Harris R, Poplawski N, Andrews L, Nguyen Dumont T, Kirk J, Southey MC, Willis A. "Out of the blue": A qualitative study exploring the experiences of women and next of kin receiving unexpected results from BRA-STRAP research gene panel testing. J Genet Couns 2023. [PMID: 37864663 DOI: 10.1002/jgc4.1803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 10/23/2023]
Abstract
In the genomic era, the availability of gene panel and whole genome/exome sequencing is rapidly increasing. Opportunities for providing former patients with new genetic information are also increasing over time and recontacting former patients with new information is likely to become more common. Breast cancer Refined Analysis of Sequence Tests-Risk And Penetrance (BRA-STRAP) is an Australian study of individuals who had previously undertaken BRCA1 and BRCA2 genetic testing, with no pathogenic variants detected. Using a waiver of consent, stored DNA samples were retested using a breast/ovarian cancer gene panel and clinically significant results returned to the patient (or next of kin, if deceased). This qualitative study aimed to explore patient experiences, opinions, and expectations of recontacting in the Australian hereditary cancer setting. Participants were familial cancer clinic patients (or next of kin) who were notified of a new pathogenic variant identified via BRA-STRAP. In-depth, semi-structured interviews were conducted approximately 6 weeks post-result. Interviews were transcribed verbatim and analyzed using an inductive thematic approach. Thirty participants (all female; average age = 57; range 36-84) were interviewed. Twenty-five were probands, and five were next of kin. Most women reported initial shock upon being recontacted with unexpected news, after having obtained a sense of closure related to their initial genetic testing experiences and cancer diagnosis. For most, this initial distress was short-lived, followed by a process of readjustment, meaning-making and adaptation that was facilitated by perceived clinical and personal utility of the information. Women were overall satisfied with the waiver of consent approach and recontacting process. Results are in line with previous studies suggesting that patients have positive attitudes about recontacting. Women in this study valued new genetic information gained from retesting and were satisfied with the BRA-STRAP recontact model. Practice implications to facilitate readjustment and promote psychosocial adaptation were identified.
Collapse
Affiliation(s)
- April Morrow
- Implementation to Impact (i2i), School of Population Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
- Hereditary Cancer Centre, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Catherine Speechly
- Hereditary Cancer Centre, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Alison Luk Young
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
| | - Kathy Tucker
- Hereditary Cancer Centre, Prince of Wales Hospital, Randwick, New South Wales, Australia
- UNSW Prince of Wales Clinical School, Randwick, New South Wales, Australia
| | - Rebecca Harris
- Westmead Hospital Familial Cancer Service, Crown Princess Mary Cancer Centre, Westmead, New South Wales, Australia
| | - Nicola Poplawski
- Adult Genetics Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia
- Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | - Lesley Andrews
- Hereditary Cancer Centre, Prince of Wales Hospital, Randwick, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
| | - Tu Nguyen Dumont
- Department of Clinical Pathology, Melbourne Medical School, The University of Melbourne, Parkville, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Judy Kirk
- Westmead Hospital Familial Cancer Service, Crown Princess Mary Cancer Centre, Westmead, New South Wales, Australia
| | - Melissa C Southey
- Department of Clinical Pathology, Melbourne Medical School, The University of Melbourne, Parkville, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Amanda Willis
- Clinical Translation and Engagement Platform, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia
- School of Clinical Medicine, UNSW Medicine & Health, St Vincent's Healthcare Clinical Campus, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| |
Collapse
|
2
|
Madl JEM, Sturmbauer SC, Janka R, Bay S, Rohleder N. Preparing patients according to their individual coping style improves patient experience of magnetic resonance imaging. J Behav Med 2022; 45:841-854. [PMID: 36074316 PMCID: PMC9674768 DOI: 10.1007/s10865-022-00361-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 08/24/2022] [Indexed: 12/30/2022]
Abstract
MRI-related anxiety is present in 30% of patients and may evoke motion artifacts/failed scans, which impair clinical efficiency. It is unclear how patient anxiety can be countered most effectively. Habitual preferences for coping with stressful situations by focusing or distracting one’s attention thereof (coping style) may play a key role in this context. This study aimed to compare the effectiveness of two patient-preparation videos with informational vs. relaxational content and to determine whether the fit between content and coping style affects effectivity. The sample consisted of 142 patients (M = 48.31 ± 15.81 years). Key outcomes were anxiety, and cortisol as a physiological stress marker. When not considering coping style, neither intervention improved the patients’ reaction; only patient preparation that matched the patients’ coping style was associated with an earlier reduction of anxiety. This suggests that considering individual preferences for patient preparation may be more effective than a one-size-fits-all approach.
Collapse
Affiliation(s)
- Janika E M Madl
- Chair of Health Psychology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nägelsbachstr. 49a, 91052, Erlangen, Germany. .,Siemens Healthcare GmbH, Allee am Röthelheimpark 21, 91052, Erlangen, Germany.
| | - Sarah C Sturmbauer
- Chair of Health Psychology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nägelsbachstr. 49a, 91052, Erlangen, Germany
| | - Rolf Janka
- Department of Radiology, University Hospital Erlangen, Maximiliansplatz 1, 91054, Erlangen, Germany
| | - Susanne Bay
- Siemens Healthcare GmbH, Allee am Röthelheimpark 21, 91052, Erlangen, Germany
| | - Nicolas Rohleder
- Chair of Health Psychology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nägelsbachstr. 49a, 91052, Erlangen, Germany
| |
Collapse
|