Pre-counseling Education for Low Literacy Women at Risk of Hereditary Breast and Ovarian Cancer (HBOC): Patient Experiences Using the Cancer Risk Education Intervention Tool (CREdIT)
Pre-counseling Education for Low Literacy Women at Risk of Hereditary Breast and Ovarian Cancer (HBOC): Patient Experiences Using the Cancer Risk Education Intervention Tool (CREdIT)
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DOI：
10.1007/s10897-010-9303-3
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发表时间：
2010-10-01
影响因子：
1.9
通讯作者：
Luce, Judith
中科院分区：
文献类型：
--
作者：
Joseph, Galen;Beattie, Mary S.;Luce, Judith
癌症风险教育干预工具是一种基于计算机的(非交互式)幻灯片演示，旨在教育有遗传性乳腺癌和卵巢癌(HBOC)风险的低识字率、种族和种族多元化的公立医院患者有关遗传学的知识。为了定性地评估参与者对作为遗传咨询辅助的遗传教育项目的体验和看法，我们对干预进行了直接观察，对11名查看信用的女性进行了半结构化面谈，并与两名参与咨询的遗传咨询师进行了咨询后问卷调查。对访谈的分析得出了五个主题：(1)乳腺癌/卵巢癌的遗传咨询和检测是一个新概念；(2)信贷的故事形式特别吸引人；(3)参与者对乳腺癌风险感知的变化各不相同；(4)信贷和咨询之后，对个人风险和遗传的一些误解仍然存在；(5)信贷的观看背景决定了对演讲的反应。观察展示了使信贷和遗传咨询师提供的信息更加一致的方法。在会后咨询师问卷中，咨询师对患者在会前的准备情况的评分明显高于其他患者。这一新的教育工具通过为识字率较低和不同族裔/种族背景的妇女量身定做信息，填补了HBOC教育的一个空白。该工具受到了面试参与者和咨询师的好评。需要进一步的研究来检验信贷对风险认知的不同影响。此外，在不同的临床环境中实施信贷，以及针对特定人群调整信贷的文化，反映了今后工作的重要领域。
The Cancer Risk Education Intervention Tool (CREdIT) is a computer-based (non-interactive) slide presentation designed to educate low-literacy, and ethnically and racially diverse public hospital patients at risk of Hereditary Breast and Ovarian Cancer (HBOC) about genetics. To qualitatively evaluate participants' experience with and perceptions of a genetic education program as an adjunct to genetic counseling, we conducted direct observations of the intervention, semi-structured in person interviews with 11 women who viewed CREdIT, and post-counseling questionnaires with the two participating genetic counselors. Five themes emerged from the analysis of interviews: (1) genetic counseling and testing for breast/ovarian cancer was a new concept; (2) CREdIT's story format was particularly appealing; (3) changes in participants' perceived risk for breast cancer varied; (4) some misunderstandings about individual risk and heredity persisted after CREdIT and counseling; (5) the context for viewing CREdIT shaped responses to the presentation. Observations demonstrated ways to make the information provided in CREdIT and by genetic counselors more consistent. In a post-session counselor questionnaire, counselors' rating of the patient's preparedness before the session was significantly higher for patients who viewed CREdIT prior to their appointments than for other patients. This novel educational tool fills a gap in HBOC education by tailoring information to women of lower literacy and diverse ethnic/racial backgrounds. The tool was well received by interview participants and counselors alike. Further study is needed to examine the varied effects of CREdIT on risk perception. In addition, the implementation of CREdIT in diverse clinical settings and the cultural adaptation of CREdIT to specific populations reflect important areas for future work.