Assessment of psychosocial difficulties by genetic clinicians and distress in women at high risk of breast cancer : a prospective study
Brédart, Anne (Paris University. Psychopathology and Health Process Laboratory)
Kop, Jean-Luc (Université de Lorraine, 2LPN)
Tüchler, Anja (Center for Hereditary Breast and Ovarian Cancer, Faculty of Medicine and University Hospital Cologne, University Hospital of Cologne, University of Cologne)
De Pauw, Antoine (INSERM U830, Paris University. Institut Curie, Department of Genetics)
Cano, Alejandra (Universitat Autònoma de Barcelona. Departament de Psicologia Clínica i de la Salut)
Dick, Julia (Cancer Center Cologne)
Rhiem, Kerstin (Center for Hereditary Breast and Ovarian Cancer, Faculty of Medicine and University Hospital Cologne, University Hospital of Cologne, University of Cologne)
Devilee, Peter (Leiden University Medical Centre, Department of Human Genetics, Department of Pathology, S4-P)
Schmutzler, Rita (Center for Hereditary Breast and Ovarian Cancer, Faculty of Medicine and University Hospital Cologne, University Hospital of Cologne, University of Cologne)
Stoppa-Lyonnet, Dominique (INSERM U830, Paris University. Institut Curie, Department of Genetics)
Dolbeault, Sylvie (CESP, University Paris-Sud, UVSQ, INSERM, University Paris-Saclay)

Date:	2022
Abstract:	We examined how often genetic clinicians correctly identify psychosocial difficulties in women at high breast cancer risk and explored effects of this assessment and the genetic test result on counselees' distress. A prospective observational study of counselee-clinician dyads was performed in three French, German and Spanish genetic clinics, involving 709 counselees (participation rate, 83. 4%) and 31 clinicians (participation rate, 100%). Counselee-clinician agreement in perceived psychosocial difficulties was measured after the pre-test genetic consultation. Multivariate mixed linear models accounting for clinicians were tested. Predicted distress levels were assessed after the pre- (T1) and post-test result disclosure consultations (T2). Depending on the difficulty domain, clinicians adequately assessed the presence or absence of difficulties in 51% ("familial issues") to 59% ("emotions") of counselees. When counselees' and clinicians' perceptions disagreed, difficulties were generally underestimated by clinicians. Counselees' distress levels remained stable from T1 to T2, irrespective of clinicians' appraisal adequacy, and the genetic test result disclosure. Psychological referral need were found in 20-42% of counselees, more frequently observed for difficulties in the "emotions" domain. Our findings suggest that the genetic test result is a suboptimal indicator for psychological referral. Instead, clinicians should focus on emotions expressed by counselees to appraise their needs for psychological support.
Grants:	European Commission. Horizon 2020 634935 (BRIDGES)
Note:	Altres ajuts: Institut Curie INCa-DGOS-Inserm_12554
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Quality of life ; Translational research ; Patient education
Published in:	European Journal of Human Genetics, Vol. 30 (april 2022) , p. 1067-1075, ISSN 1476-5438

DOI: 10.1038/s41431-022-01096-9
PMID: 35399119

9 p, 736.4 KB

The record appears in these collections:
Articles > Research articles
Articles > Published articles