Exploring the short-term impact of DNA-testing in breast cancer patients: The counselees' perception matters, but the actual BRCA1/2 result does not
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.
|Keywords||BRCA1/2, Breast cancer, Genetic-counseling, Oncology, Ovarian cancer, Psychology, Risk perception|
|Persistent URL||dx.doi.org/10.1016/j.pec.2011.04.017, hdl.handle.net/1765/31445|
|Journal||Patient Education and Counseling|
Vos, J, Oosterwijk, J.C, Gómez García, E.B, Menko, F, Collee, J.M, van Asperen, C.J, … Tibben, A. (2012). Exploring the short-term impact of DNA-testing in breast cancer patients: The counselees' perception matters, but the actual BRCA1/2 result does not. Patient Education and Counseling, 86(2), 239–251. doi:10.1016/j.pec.2011.04.017