The impact of genetic counselling about breast cancer risk on women's risk perceptions and levels of distress.
The impact of genetic counselling about breast cancer risk on women's risk perceptions and levels of distress.
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DOI：
10.1038/sj.bjc.6690078
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发表时间：
1999-02
影响因子：
8.8
通讯作者：
Steel, M
中科院分区：
文献类型：
--
作者：
Cull, A;Anderson, EDC;Campbell, S;MacKay, J;Smyth, E;Steel, M
妇女转介到一个家族性乳腺癌诊所完成问卷咨询前后，并在每年的后续行动，以评估其风险估计和心理特征。目的是确定那些参加诊所的人是否高估了他们的风险或高度焦虑，以及咨询是否影响风险估计和痛苦程度。该诊所的女性（n = 450）更有可能低估（39%）而不是高估（14%）他们的风险。平均特质焦虑得分高于一般人群数据（t = 4.9，n = 1059，P < 0.001），但与其他筛选样本的已发表数据无显著差异。高估者（z = 5.69，P < 0.0001）和低估者（z =-8.01，P < 0.0001）在咨询后报告了显著不同的风险估计（即准确性增加），但显著的不准确性仍然存在。过度估计者（n = 12）和低估者（n = 60）在咨询后的风险估计仍然不准确，误差系数为2。30%的样本在心理困扰筛查措施-一般健康问卷-上的得分高于病例识别的截止值（5/6）。咨询后GHQ评分显著降低（t = 3.6，d. f. = 384，P = 0.0004），没有证据表明风险估计增加会导致痛苦增加。年轻女性和那些在第一次就诊时更痛苦的人在咨询后痛苦的风险更大。所提供的咨询有效地提高了风险认知的准确性，而不会给那些最初低估其风险的人带来痛苦。令人担忧的是，不准确的情况一直存在，特别是因为对服务的需求减少了该诊所提供的咨询时间。需要进一步开展工作，利用更先进的评估风险认识的方法，评估提供服务的替代模式。© 1999癌症研究运动
Women referred to a familial breast cancer clinic completed questionnaires before and after counselling and at annual follow-up to assess their risk estimate and psychological characteristics. The aims were to determine whether those who attended the clinic overestimated their risk or were highly anxious and whether counselling influenced risk estimates and levels of distress. Women (n = 450) at this clinic were more likely to underestimate (39%) than overestimate (14%) their risk. Mean trait anxiety scores were higher than general population data (t = 4.9, n = 1059, P < 0.001) but not significantly different from published data from other screening samples. Overestimators (z = 5.69, P < 0.0001) and underestimators (z = –8.01, P < 0.0001) reported significantly different risk estimates (i.e. increased accuracy) after counselling, but significant inaccuracies persisted. Over- (n = 12) and underestimators (n = 60) were still inaccurate in their risk estimates by a factor of 2 after counselling. Thirty per cent of the sample scored above the cut-off (5/6) for case identification on a screening measure for psychological distress, the General Health Questionnaire (GHQ). GHQ scores were significantly lower after counselling (t = 3.6, d.f. = 384, P = 0.0004) with no evidence of increasing risk estimate causing increased distress. The risk of distress after counselling was greater for younger women and those who were more distressed at first presentation. The counselling offered was effective in increasing the accuracy of risk perceptions without causing distress to those who initially underestimated their risk. It is worrying that inaccuracies persisted, particularly as the demand for service has since reduced the consultation time offered in this clinic. Further work is needed to evaluate alternative models of service delivery using more sophisticated methods of assessing understanding of risk. © 1999 Cancer Research Campaign
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影响因子：
7.6
作者：
MILLER, SM
通讯作者：
MILLER, SM
影响因子：
8.8
作者：
EVANS, DGR;BURNELL, LD;HOWELL, A
通讯作者：
HOWELL, A
DOI：
10.1093/jnci/84.1.24
发表时间：
1992-01-01
期刊：
JOURNAL OF THE NATIONAL CANCER INSTITUTE
影响因子：
--
作者：
KASH, KM;HOLLAND, JC;MILLER, DG
通讯作者：
MILLER, DG
DOI：
10.1093/jnci/85.13.1074
发表时间：
1993-07-07
期刊：
JOURNAL OF THE NATIONAL CANCER INSTITUTE
影响因子：
--
作者：
LERMAN, C;DALY, M;ENGSTROM, P
通讯作者：
ENGSTROM, P
影响因子：
8.8
作者：
Thirlaway, K;Fallowfield, L;Powles, T
通讯作者：
Powles, T