Randomized Controlled Trial of a Psychosocial Telephone Counseling Intervention in BRCA1 and BRCA2 Mutation Carriers
Randomized Controlled Trial of a Psychosocial Telephone Counseling Intervention in BRCA1 and BRCA2 Mutation Carriers
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DOI：
10.1158/1055-9965.epi-09-0548
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发表时间：
2010-03-01
影响因子：
3.8
通讯作者：
Halbert, Chanita Hughes
中科院分区：
文献类型：
--
作者：
Graves, Kristi D.;Wenzel, Lari;Halbert, Chanita Hughes
背景：BRCA1/2基因检测后的反应与风险状态的理解相关，并可能在风险管理决策中发挥作用。这项研究的目的是评估在标准遗传咨询(SGC)之后对BRCA1/2突变携带者进行的心理社会电话咨询(PTC)干预。我们考察了干预对痛苦的影响和与基因测试相关的担忧。方法：这项前瞻性随机临床试验包括90名BRCA1/2突变携带者。我们在干预基线和披露后6个月和12个月测量焦虑、抑郁和基因测试痛苦的结果。结果：6个月时，PTC组较SGC组抑郁症状减轻(Z=-2.25，P=0.02)，基因测试困难减轻(Z=2.18，P=0.02)。此外，干预条件下的女性在6个月时报告的临床显著焦虑程度低于接受SGC治疗的女性(chi(2)(1)=4.11，P=0.04)。在12个月的随访中，我们发现干预组之间的结果没有差异。结论：作为SGC的补充，PTC在BRCA1/2测试阳性结果公布后交付，似乎对痛苦和焦虑提供了适度的短期好处。这些结果建立在越来越多的BRCA1/2携带者心理社会干预文献的基础上，考虑到影响对风险管理决策的潜在影响，这些结果表明，一些携带者可能从传统遗传咨询的辅助工具中受益。癌症流行病学生物标记物；19(3)；648-54。(C)2010年AACR。
Background: Responses following BRCA1/2 genetic testing are relevant for the comprehension of risk status and may play a role in risk management decision making. The objective of this study was to evaluate a psychosocial telephone counseling (PTC) intervention delivered to BRCA1/2 mutation carriers following standard genetic counseling (SGC). We examined the effect of the intervention on distress and the concerns related to genetic testing.Methods: This prospective randomized clinical trial included 90 BRCA1/2 mutation carriers. We measured anxiety, depression, and genetic testing distress outcomes at intervention baseline and 6 and 12 months following disclosure. We evaluated the effects of SGC versus SGC plus PTC on psychological outcomes using intention-to-treat analyses through generalized estimating equations.Results: At 6 months, PTC reduced depressive symptoms (Z = -2.25, P = 0.02) and genetic testing distress (Z = 2.18, P = 0.02) compared with SGC. Furthermore, women in the intervention condition reported less clinically significant anxiety at 6 months (chi(2)(1) = 4.11, P = 0.04) than women who received SGC. We found no differences in outcomes between the intervention groups at the 12-month follow-up.Conclusions: As an adjunct to SGC, PTC delivered following disclosure of positive BRCA1/2 test results seems to offer modest short-term benefits for distress and anxiety. These results build upon a growing literature of psychosocial interventions for BRCA1/2 carriers and, given the potential impact of affect on risk management decision making, suggest that some carriers may derive benefits from adjuncts to traditional genetic counseling. Cancer Epidemiol Biomarkers Prev; 19(3); 648-54. (C) 2010 AACR.