Motivating cascade testing for familial hypercholesterolemia: applying the extended parallel process model for clinician communication.
Motivating cascade testing for familial hypercholesterolemia: applying the extended parallel process model for clinician communication.
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DOI：
10.1093/tbm/ibac018
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发表时间：
2022-07-18
影响因子：
3.6
通讯作者：
Sturm AC
中科院分区：
文献类型：
--
作者：
Campbell-Salome G;Walters NL;Ladd IG;Sheldon A;Ahmed CD;Brangan A;McMinn MN;Rahm AK;Schwartz MLB;Tricou E;Fisher CL;Sturm AC
激励高危亲属接受家族性高胆固醇血症（FH）的级联检测对于诊断和挽救生命的治疗至关重要。作为可靠的信息来源，临床医生可以帮助家庭沟通FH和激励级联测试的吸收。然而，没有关于临床医生如何与先证者（家庭中第一个被诊断的人）和高危亲属进行有效沟通的指导方针。患有FH的个人和家庭可以告知我们最有效的沟通，以促进级联测试的理解。在扩展并行过程模型（EPPM）的指导下，我们分析了FH患者个人和家庭的观点，以获得临床医生可用于促进级联检测的有效信息。我们分析了作为一个更大的混合方法研究的一部分收集的访谈和调查的叙事数据。EPPM用于识别FH个人和家族推荐的信息特征，重点关注四个关键结构（严重程度、易感性、反应疗效、自我疗效），以促进级联试验。参与者包括来自11个二元访谈和98个调查受访者的22个人。参与者描述了优先处理每个EPPM结构的多个消息，以提醒亲属他们的风险。他们说明了临床医生可以在每个EPPM结构中使用的策略，以与有风险的亲属沟通通过级联测试进行诊断的重要性，并随后治疗FH引起的高胆固醇。研究结果提供了指导有效的信息，以激励级联测试FH的吸收，并演示了如何EPPM可以引导与有风险的亲属有关遗传风险的沟通，并广泛地激励级联测试。患有家族性高胆固醇血症（FH）的个人和家庭建议临床医生结合使用恐惧和功效信息来激励高危亲属进行级联检测。
Motivating at-risk relatives to undergo cascade testing for familial hypercholesterolemia (FH) is critical for diagnosis and lifesaving treatment. As credible sources of information, clinicians can assist in family communication about FH and motivate cascade testing uptake. However, there are no guidelines regarding how clinicians should effectively communicate with probands (the first person diagnosed in the family) and at-risk relatives. Individuals and families with FH can inform our understanding of the most effective communications to promote cascade testing. Guided by the extended parallel process model (EPPM), we analyzed the perspectives of individuals and families with FH for effective messaging clinicians can use to promote cascade testing uptake. We analyzed narrative data from interviews and surveys collected as part of a larger mixed-methods study. The EPPM was used to identify message features recommended by individuals and families with FH that focus on four key constructs (severity, susceptibility, response efficacy, self-efficacy) to promote cascade testing. Participants included 22 individuals from 11 dyadic interviews and 98 survey respondents. Participants described prioritizing multiple messages that address each EPPM construct to alert relatives about their risk. They illustrated strategies clinicians could use within each EPPM construct to communicate to at-risk relatives about the importance of pursuing diagnosis via cascade testing and subsequent treatment for high cholesterol due to FH. Findings provide guidance on effective messaging to motivate cascade testing uptake for FH and demonstrates how the EPPM may guide communication with at-risk relatives about genetic risk and motivate cascade testing broadly. Individuals and families with familial hypercholesterolemia (FH) suggested clinicians use a combination of fear and efficacy messages to motivate at-risk relatives to pursue cascade testing.
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