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Bowen DJ, Robbins R, Bush N, Meischke H, Ludwig A, Wooldridge J. Effects of a web-based intervention on women's breast health behaviors. Transl Behav Med 2017; 7:309-319. [PMID: 28097625 PMCID: PMC5526799 DOI: 10.1007/s13142-016-0439-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Helping women make choices to reduce cancer risk and to improve breast health behaviors is important, but the best ways to reach more people with intervention assistance is not known. To test the efficacy of a web-based intervention designed to help women make better breast health choices, we adapted our previously tested, successful breast health intervention package to be delivered on the Internet, and then we tested it in a randomized trial. We recruited women from the general public to be randomized to either an active intervention group or a delayed intervention control group. The intervention consisted of a specialized website providing tailored and personalized risk information to all participants, followed by offers of additional support if needed. Follow-up at one-year post randomization revealed significant improvements in mammography screening in intervention women compared with control women (improvement of 13 percentage points). The intervention effects were more powerful in women who increased breast health knowledge and decreased cancer worry during intervention. These data indicate that increases in mammography can be accomplished in population-based mostly insured samples by implementing this simple, low resource intensive intervention.
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Affiliation(s)
- Deborah J Bowen
- Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., MP-900, Seattle, WA, 98109-1024, USA.
| | - Robert Robbins
- Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., MP-900, Seattle, WA, 98109-1024, USA
| | - Nigel Bush
- Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., MP-900, Seattle, WA, 98109-1024, USA
| | - Hendrika Meischke
- Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., MP-900, Seattle, WA, 98109-1024, USA
| | - Abi Ludwig
- Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., MP-900, Seattle, WA, 98109-1024, USA
| | - Jean Wooldridge
- Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., MP-900, Seattle, WA, 98109-1024, USA
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2
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Lichtenthal WG, Cruess DG, Schuchter LM, Ming ME. Psychosocial Factors Related to the Correspondence of Recipient and Provider Perceptions of Social Support among Patients Diagnosed with or at Risk for Malignant Melanoma. J Health Psychol 2016; 8:705-19. [PMID: 14670205 DOI: 10.1177/13591053030086005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study examined considered perceptions of social support and factors contributing to increased support among 18 patients diagnosed with or at risk for malignant melanoma and their partners. Partner support, perceived stress, emotional approach coping and partner empathy were evaluated. Results showed lack of correspondence between patient and partner reports of support. Greater correspondence between reports was associated with increased patient emotional approach coping. Partners reported increased empathy following the patients’ diagnoses and more perceived stress than patients. Patients indicated greater use of emotional approach coping than their partners. Male partners reported engaging in less emotional expression than female partners. Interventions might incorporate partner participation to resolve misperceptions of support and to foster factors that promote increased support.
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Affiliation(s)
- Wendy G Lichtenthal
- Department of Psychology, University of Pennsylvania, Philadelphia, PA 19104, USA
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3
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Phelps C, Bennett P, Hood K, Brain K, Murray A. A self-help coping intervention can reduce anxiety and avoidant health behaviours whilst waiting for cancer genetic risk information: results of a phase III randomised trial. Psychooncology 2012; 22:837-44. [PMID: 22473731 DOI: 10.1002/pon.3072] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2011] [Revised: 02/15/2012] [Accepted: 02/24/2012] [Indexed: 11/11/2022]
Affiliation(s)
- Ceri Phelps
- School of Psychology and Counselling; Swansea Metropolitan University; Wales UK
| | - Paul Bennett
- Psychology Department; Swansea University; Wales UK
| | - Kerenza Hood
- South East Wales Trials Unit, School of Medicine; Cardiff University; Wales UK
| | - Kate Brain
- Institute of Medical Genetics, School of Medicine; Cardiff University; Wales UK
| | - Alexandra Murray
- Institute of Medical Genetics; Cardiff and Vale University Health Board; UK
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4
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Bowen DJ, Robbins R, Bush N, Meischke H, Ludwig A, Wooldridge J. Effects of a Web-based intervention on women's breast health behaviors. Transl Behav Med 2011; 1:155-164. [PMID: 21643515 PMCID: PMC3104848 DOI: 10.1007/s13142-011-0028-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Helping women make choices to reduce cancer risk and to improve breast health behaviors is important, but the best ways to reach more people with intervention assistance is not known. To test the efficacy of a Web-based intervention designed to help women make better breast health choices, we adapted our previously tested, successful breast health intervention package to be delivered on the Internet, and then we tested it in a randomized trial. We recruited women from the general public to be randomized to either an active intervention group or a delayed intervention control group. The intervention consisted of a specialized Web site providing tailored and personalized risk information to all participants, followed by offers of additional support if needed. Follow-up at 1-year post-randomization revealed significant improvements in mammography screening in intervention women compared with control women (improvement of 13 percentage points). The intervention effects were more powerful in women who increased breast health knowledge and decreased cancer worry during intervention. These data indicate that increases in mammography can be accomplished in population-based mostly insured samples by implementing this simple, low resource intensive intervention.
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Affiliation(s)
- Deborah J Bowen
- />Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., MP-900, Seattle, WA 98109-1024 USA
- />Department of Community Sciences, Boston University School of Public Health, 801 Massachusetts Avenue, Boston, MA 02118 USA
| | - Robert Robbins
- />Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., MP-900, Seattle, WA 98109-1024 USA
| | - Nigel Bush
- />Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., MP-900, Seattle, WA 98109-1024 USA
| | - Hendrika Meischke
- />Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., MP-900, Seattle, WA 98109-1024 USA
| | - Abi Ludwig
- />Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., MP-900, Seattle, WA 98109-1024 USA
| | - Jean Wooldridge
- />Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., MP-900, Seattle, WA 98109-1024 USA
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Bowen DJ, Powers D. Effects of a Mail and Telephone Intervention on Breast Health Behaviors. HEALTH EDUCATION & BEHAVIOR 2010; 37:479-89. [DOI: 10.1177/1090198109348463] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This study evaluated a mail and telephone intervention to improve breast health behaviors while maintaining quality of life. Women recruited from the general public were randomized to a stepped-intensity intervention consisting of mailings, telephone calls, and counseling (if requested or appropriate given a woman’s genetic risk for breast cancer) or to a delayed treatment control group. Outcomes (mammography screening and quality of life) were measured at baseline in a telephone survey and again at a 12-month follow-up period. Women in the intervention group significantly increased screening mammography uptake by 12% and quality of life by 5.3 scale points compared to control participants. Changes in knowledge of breast cancer, genetic testing, and cancer worry all significantly predicted intervention changes. This successful intervention can help women make better breast health choices without causing increased worry.
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Affiliation(s)
| | - Diane Powers
- Fred Hutchinson Cancer Research Center, Seattle, Washington
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6
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Clarke S, Butler K, Esplen MJ. The phases of disclosing BRCA1/2 genetic information to offspring. Psychooncology 2009; 17:797-803. [PMID: 18646247 DOI: 10.1002/pon.1344] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Women who carry a genetic mutation for hereditary breast/ovarian cancer (BRCA1 or BRCA2) are at high risk to develop cancer. A positive genetic test result also has implications for a BRCA1/2 carrier's offspring who each have a 50% chance of inheriting the mutation. The dissemination of BRCA1/2-related information by carriers to offspring is not well understood. Our study examines the experiences of BRCA1/2 carriers in communicating genetic information to their offspring using a grounded theory approach. METHODS Qualitative data were obtained from a multi-site group therapy trial for BRCA1/2 carriers with primary themes identified and coded using the constant comparison technique and verified by team members. RESULTS Female participants had a mean age of 45.4 years, 83% were married, 71% had children (ranging from ages 2 to 30 years) and 45.9% had a prior diagnosis of cancer. Dissemination of genetic information by BRCA1/2 carriers to their offspring was described as a process involving several distinct phases with specific challenges within each phase. Several themes were identified including dilemmas on 'if' and 'when' to disclose to offspring, concerns should offspring receive a positive test result for BRCA1/2, dilemmas around feeling a need to protect versus the need to inform, and women as being the primary communicators. CONCLUSION These findings have implications for genetic counselling as well as follow-up.
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Affiliation(s)
- Susan Clarke
- Lawrence Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
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7
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Brain K, Henderson BJ, Tyndel S, Bankhead C, Watson E, Clements A, Austoker J. Predictors of breast cancer-related distress following mammography screening in younger women on a family history breast screening programme. Psychooncology 2008; 17:1180-8. [DOI: 10.1002/pon.1355] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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8
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Anderson FJ, Winkler AE. An integrated model of group psychotherapy for patients with fibromyalgia. Int J Group Psychother 2007; 57:451-74. [PMID: 17937508 DOI: 10.1521/ijgp.2007.57.4.451] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This study examined the effectiveness of an integrated model of brief group psychotherapy for treatment of fibromyalgia syndrome, using cognitive behavioral and supportive expressive techniques. In the context of an outpatient, multidisciplinary fibromyalgia treatment program, group psychotherapy was provided to 35 patients with 21 control patients. Pre-post treatment measures of depression, anxiety, fibromyalgia impact, pain, fatigue, and morning tiredness were obtained. Using a quasi-experimental design with validated psychometric instruments, the results showed a significant decrease in pre-versus post treatment measures of depression, fibromyalgia impact, fatigue, and pain for the treatment patients, suggesting that an integrated model of group psychotherapy may have beneficial psychological and functional effects for some patients with fibromyalgia.
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Affiliation(s)
- Frances J Anderson
- Department of Corporate Health and Wellness, St John's Regional Health Center, Springfield, MO 65804-2263, USA.
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9
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Braithwaite D, Emery J, Walter F, Prevost AT, Sutton S. Psychological impact of genetic counseling for familial cancer: a systematic review and meta-analysis. Fam Cancer 2006; 5:61-75. [PMID: 16528610 DOI: 10.1007/s10689-005-2577-1] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Identification of a genetic basis underlying certain types of cancer has led to an increase in demand for genetic counseling about individual risks of the disease. We conducted a systematic review of the literature to determine the quality and strength of evidence relating to psychological outcomes of genetic counseling for familial cancer. METHODS Six electronic databases were searched to identify controlled trials and prospective studies that examined the effect of genetic counseling on risk perception, knowledge, anxiety, cancer-specific worry, depression, and cancer surveillance. Twenty-one studies from 25 papers met inclusion criteria, including five controlled trials and 16 prospective studies. Analysis of each outcome was stratified by short-term (</=1 month) and long-term (>/=3 months) follow-up. Trial evidence was assessed with standardized differences of the means at follow-up between intervention and comparison groups, and these data were pooled by use of random-effects meta-analysis. RESULTS Meta-analysis of controlled trials showed that genetic counseling improved knowledge of cancer genetics (pooled short-term difference=0.70 U, 95% confidence interval (CI)=0.15 to 1.26 U) but did not alter the level of perceived risk (pooled short-term difference=-0.10 U, 95% CI=-0.23-0.04 U). Prospective studies reported improvements in the accuracy of perceived risk. No effect was observed in controlled trials on general anxiety (pooled long-term effect=0.05 U, 95% CI=-0.21-0.31 U) or cancer-specific worry (pooled long-term difference=-0.14 U, 95% CI=-0.35-0.06 U), although several prospective studies demonstrated short-term reductions in these outcomes. Few studies examined cancer surveillance behaviors, and no studies attempted to measure informed choice. CONCLUSIONS Genetic counseling for familial cancer is associated with improvement in knowledge but does not have an adverse effect on affective outcomes. We urge further investigation of these findings through well-designed, well-reported, randomized controlled trials with suitable comparison groups and additional outcome measures [J Natl Cancer Inst 2004; 96:122-33].
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Affiliation(s)
- Dejana Braithwaite
- Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, UK.
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10
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Wang C, Gonzalez R, Milliron KJ, Strecher VJ, Merajver SD. Genetic counseling forBRCA1/2: A randomized controlled trial of two strategies to facilitate the education and counseling process. Am J Med Genet A 2005; 134A:66-73. [PMID: 15690408 DOI: 10.1002/ajmg.a.30577] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Due to the complexity of information surrounding BRCA1/2 counseling and testing and its time consuming nature, efforts to facilitate the genetic counseling and education process are needed. Using a 2 x 2 factorial design, two strategies were examined: a CD-ROM program for patients and a feedback checklist to the genetic counselor on patients' prior misconceptions. A total of 197 women attending a breast and ovarian cancer risk evaluation clinic for BRCA1/2 counseling were randomized into one of four conditions: standard care, CD-ROM only, feedback to counselor only, and both CD-ROM and feedback. Counseling outcomes included face-to-face time with the genetics team, knowledge acquisition, changes in worry about having a gene mutation, and genetic testing decisions. Overall, women who viewed the CD-ROM spent less time with the genetic counselor and were less likely to undergo genetic testing compared to women who did not view the CD-ROM. Feedback to the genetic counselor resulted in greater gains in knowledge of genetics and breast cancer. Among women less worried at baseline, those who viewed the CD-ROM showed no changes in worry following genetic counseling, in contrast to those who did not view the CD-ROM who increased in worry over time. This latter finding raises concerns about the impact of the increased worry on genetic testing decisions. No interaction effects of the two intervention arms were found. The study results support the importance of both strategies as valuable supplements to clinical BRCA1/2 counseling.
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Affiliation(s)
- Catharine Wang
- Department of Health Behavior and Health Education, University of Michigan, School of Public Health, Ann Arbor, MI 48104, USA.
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11
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Hunter AGW, Cappelli M, Humphreys L, Allanson JE, Chiu TT, Peeters C, Moher D, Zimak A. A randomized trial comparing alternative approaches to prenatal diagnosis counseling in advanced maternal age patients. Clin Genet 2005; 67:303-13. [PMID: 15733266 DOI: 10.1111/j.1399-0004.2004.00405.x] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Prenatal diagnosis (PND) is offered routinely as part of pregnancy care to a large number of women at increased risk of fetal anomalies. Despite an extraordinary growth in the use of PND and significant resource allocation, few studies have examined outcomes of PND counseling, and virtually no research has evaluated the relative efficacy of various approaches to genetic counseling. This study was a randomized trial that compared which counseling methods - individual, group, and use of a decision aid - are effective in PND counseling for women of advanced maternal age (>/=35 years) and their partners. Three hundred and fifty-two women and 225 partners completed pre- and post-intervention questionnaires assessing changes in knowledge, decisional conflict, state anxiety, satisfaction, use of PND, and pregnancy outcomes. All participants showed a significant increase in knowledge and a decrease in decisional conflict post intervention. Those in the group intervention showed a significantly greater increase in knowledge than those in the individual counseling intervention. While high levels of satisfaction were reported by all, those in individual counseling were significantly more satisfied than those receiving group counseling or the decision aid. This study has shown unique benefits with each type of intervention such that women and their partners preferred individual genetic counseling, while they learned best in group-counseling sessions, and experienced the least decisional conflict regarding genetic testing with a decision aid.
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Affiliation(s)
- A G W Hunter
- Department of Genetics, Children's Hospital of Eastern Ontario (CHEO), Ottawa, Ontario, Canada.
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12
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Esplen MJ, Hunter J, Leszcz M, Warner E, Narod S, Metcalfe K, Glendon G, Butler K, Liede A, Young MA, Kieffer S, DiProspero L, Irwin E, Wong J. A multicenter study of supportive-expressive group therapy for women with BRCA1/BRCA2 mutations. Cancer 2004; 101:2327-40. [PMID: 15478194 DOI: 10.1002/cncr.20661] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Women with a BRCA1/BRCA2 mutation experience significant challenges. These include decision-making regarding surgical options and notification to offspring and family, along with a sense of isolation, which may lead to psychological and emotional distress. The current study developed, standardized, and conducted preliminary testing of a supportive-expressive group therapy intervention designed to address these challenges. METHODS Seventy women with a BRCA1/BRCA2 mutation recruited from familial cancer risk clinics participated in 12 sessions of supportive-expressive group therapy that lasted 6 months. Before and after measures of psychosocial functioning, knowledge, and surveillance/surgery activities were completed. RESULTS Sixty-seven women completed the intervention. Significant improvements were observed in psychosocial functioning: cancer worries (P = 0.005), anxiety (P = 0.033), and depression (P = 0.015). Knowledge level and surveillance levels were high at baseline and there were no significant changes postintervention. A significant number of women made decisions concerning prophylactic surgery (oophorectomy/mastectomy) during and after the intervention. CONCLUSIONS The feasibility of a supportive-expressive group for BRCA1/BRCA2 mutation carriers was demonstrated. Findings from the study are consistent with an effective intervention. However, further research is required using a randomized controlled study design.
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Affiliation(s)
- Mary Jane Esplen
- Behavioral Sciences and Health Research Division, University Health Network, University of Toronto, Toronto, Ontario, Canada.
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Bowen DJ, Burke W, McTiernan A, Yasui Y, Andersen MR. Breast cancer risk counseling improves women's functioning. PATIENT EDUCATION AND COUNSELING 2004; 53:79-86. [PMID: 15062908 DOI: 10.1016/s0738-3991(03)00122-8] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2002] [Revised: 02/19/2003] [Accepted: 03/05/2003] [Indexed: 05/24/2023]
Abstract
Helping people cope with health risks is an important area for research and practice. Counseling offers people the opportunity to relieve their distress and improve the ways in which they manage their health issues. This study was a randomized test of two different counseling methods, genetic and psychosocial counseling, compared to a control group. Eligibility requirements included being between 18 and 74 years old, having at least one relative with breast cancer, not having a family history consistent with carrying a BRCA1/2 mutation for breast cancer risk, having no personal history of breast or ovarian cancer, living within 60 miles of the research institute, and willingness to complete the research requirements of the project. Perceived risk decreased by 50% for participants in the two counseling groups relative to comparison participants. Cancer worry decreased in both counseling groups by one scale point (P < 0.05). These results indicate that counseling can relieve women's negative reactions to breast cancer risk.
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Affiliation(s)
- Deborah J Bowen
- Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, MP-900, Seattle, WA 98109, USA.
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Braithwaite D, Emery J, Walter F, Prevost AT, Sutton S. Psychological impact of genetic counseling for familial cancer: a systematic review and meta-analysis. J Natl Cancer Inst 2004; 96:122-33. [PMID: 14734702 DOI: 10.1093/jnci/djh017] [Citation(s) in RCA: 145] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Identification of a genetic basis underlying certain types of cancer has led to an increase in demand for genetic counseling about individual risks of the disease. We conducted a systematic review of the literature to determine the quality and strength of evidence relating to psychological outcomes of genetic counseling for familial cancer. METHODS Six electronic databases were searched to identify controlled trials and prospective studies that examined the effect of genetic counseling on risk perception, knowledge, anxiety, cancer-specific worry, depression, and cancer surveillance. Twenty-one studies from 25 papers met inclusion criteria, including five controlled trials and 16 prospective studies. Analysis of each outcome was stratified by short-term (< or =1 month) and long-term (> or = 3 months) follow-up. Trial evidence was assessed with standardized differences of the means at follow-up between intervention and comparison groups, and these data were pooled by use of random-effects meta-analysis. RESULTS Meta-analysis of controlled trials showed that genetic counseling improved knowledge of cancer genetics (pooled short-term difference = 0.70 U, 95% confidence interval [CI] = 0.15 to 1.26 U) but did not alter the level of perceived risk (pooled short-term difference = -0.10 U, 95% CI = -0.23 to 0.04 U). Prospective studies reported improvements in the accuracy of perceived risk. No effect was observed in controlled trials on general anxiety (pooled long-term effect = 0.05 U, 95% CI = -0.21 to 0.31 U) or cancer-specific worry (pooled long-term difference = -0.14 U, 95% CI = -0.35 to 0.06 U), although several prospective studies demonstrated short-term reductions in these outcomes. Few studies examined cancer surveillance behaviors, and no studies attempted to measure informed choice. CONCLUSIONS Genetic counseling for familial cancer is associated with improvement in knowledge but does not have an adverse effect on affective outcomes. We urge further investigation of these findings through well-designed, well-reported, randomized controlled trials with suitable comparison groups and additional outcome measures.
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Affiliation(s)
- Dejana Braithwaite
- Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, UK.
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15
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Elit L, Esplen MJ, Butler K, Narod S. Quality of life and psychosexual adjustment after prophylactic oophorectomy for a family history of ovarian cancer. Fam Cancer 2004; 1:149-56. [PMID: 14574171 DOI: 10.1023/a:1021119405814] [Citation(s) in RCA: 97] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES 1) To evaluate a woman's satisfaction with the decision to have a prophylactic oophorectomy for family history of ovarian cancer. 2) To explore the potential costs related to surgery such a menopausal symptoms and satisfaction with sexual functioning. METHODS Women who had undergone a prophylactic oophorectomy for a family history of ovarian cancer in Ontario were invited to participate. Forty women returned a package of questionnaires addressing demographic information, family history, decisional conflict, risk comprehension, menopause-specific quality of life, satisfaction with sexual function, and other psychosocial questionnaires. RESULTS The mean age of respondents was 54.8 years. Perceived risk for developing ovarian cancer decreased significantly after surgery (p = 0.0001). Overall quality of life on the SF-36 Health Survey demonstrated a level consistent with emotional and physical wellbeing in the general population. The Menopause-Specific Quality of Life scores were reduced compared to women of similar age on all parameters: vasomotor symptoms, psychosocial support, physical status and sexual quality of life. Satisfaction with sexual functioning was moderately to extremely compromised in 42.1%-53.7% of women. CONCLUSION While this study shows that women who choose to have prophylactic oophorectomy for a family history of ovarian cancer have a good overall quality of life and significant decrease in risk perception as a result of surgery, they experience menopausal symptoms and compromised sexual functioning.
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Affiliation(s)
- L Elit
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, Canada.
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16
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Esplen MJ, Toner B, Hunter J, Glendon G, Liede A, Narod S, Stuckless N, Butler K, Field B. A supportive-expressive group intervention for women with a family history of breast cancer: results of a phase II study. Psychooncology 2000; 9:243-52. [PMID: 10871720 DOI: 10.1002/1099-1611(200005/06)9:3<243::aid-pon457>3.0.co;2-i] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Evidence suggests that there are significant psychological and behavioural sequelae associated with having a family history of breast cancer (BC) which can interfere with comprehension of risk estimates. PURPOSE The purpose of this study was to develop, standardize and do preliminary testing of a group intervention designed to address the emotional impact of having a family history of BC. METHODS This study is a single-arm pilot design with pre- and post-measures of perceived risk, psychosocial distress, knowledge and screening practices. RESULTS The primary study outcome measure of risk comprehension was significantly improved by 70%, according to our predetermined criteria for success. In addition, the most important secondary measures of psychosocial functioning, such as cancer-related distress (p=0.025), depression (p=0.05), anxiety (p=0.005) and unresolved grief (p=0.034) were significantly improved. CONCLUSION The results of this initial pilot study are encouraging; however, further research is required, using a randomized controlled study design to evaluate the relative contribution of this intervention to the successful modification of risk comprehension, enhanced psychological functioning, and to promote optimal screening adherence.
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Affiliation(s)
- M J Esplen
- Department of Psychiatry, Mount Sinai Hospital, Toronto, Ontario, Canada.
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