Communication Analysis of BRCA1 Genetic Counseling

描述：(申请人摘要)：这一试点项目的主要目标是 探讨BRCA1遗传咨询沟通的关系 老年人癌症相关健康行为与心理社会适应的关系 种族和文化多样性的样本。该项目将提供第一个 BRCA1遗传咨询沟通过程详细考察 会话。该项目的数据来源于NCI资助的两项关于 BRCA1测试的心理社会和行为结果。录音带遗传 犹他州的一个高加索家庭(K2082)和一个大型 非裔美国人亲属(K2099)将使用一种广泛使用的 医患沟通分析系统，Roter互动分析 适用于本研究的系统(RIAS)。作为数据来源的两项研究 提供参与者前后的大量心理社会和行为数据 测试。这些数据使我们能够检查BRCA1基因与 咨询沟通模式和纵向结果。具体来说，我们 将检查有可能产生不良心理社会影响的个人 基因测试以及他们的交流过程是如何根据他们的 痛苦程度。这个项目是研究BRCA1的一个机会 两个不同文化和种族的家庭与 类似的癌症家族病史。 遗传咨询和患者沟通领域的专家将召开会议 实施并就适应现有的《区域投资协定》达成共识 遗传咨询课程。训练有素的程序员将分析180盘录音带(90盘 来自每个家族)的BRCA1预测试遗传咨询会话使用 RIAS的改编版本。这些通信变量将合并到 关于健康行为的基线和结果测量的更大数据集 (例如，癌症特有的痛苦)，测试后一周和四个月。 参与者适应的预测变量包括：社会人口学、 沟通因素(例如，医疗信息)、亲属、考试前的痛苦 级别和运营商状态。

DESCRIPTION: (Applicant's Abstract): The primary goal of this pilot project is to examine the relationship between BRCA1 genetic counseling communication patterns and cancer-related health behaviors and psychosocial adjustment of an ethnically and culturally diverse sample. This project will provide the first detailed examination of the communication process of BRCA1 genetic counseling sessions. Data for this project are derived from two NCI-funded studies on the psychosocial and behavioral outcomes of BRCA1 testing. Audio-taped genetic counseling sessions of a Utah-based Caucasian kindred (K2082) and a large African American kindred (K2099) will be analyzed using a widely used provider-patient communication analysis system, Roter Interaction Analysis System (RIAS) adapted for this study. The two studies used as data sources provide extensive psychosocial and behavioral data on participants pre and post testing. These data allow us to examine the relationship between BRCA1 genetic counseling communication patterns and longitudinal outcomes. Specifically, we will examine individuals who are at risk for adverse psychosocial effects of genetic testing and how their communication process varies according to their level of distress. This project is an opportunity to examine BRCA1 communication patterns of two culturally and ethnically diverse kindreds with similar family histories of cancer. Experts in the fields of genetic counseling and patient communication will meet to operationalize and achieve consensus on adaptations to the existing RIAS for genetic counseling sessions. Trained coders will analyze 180 audio tapes (90 from each kindred) of BRCA1 pre-test genetic counseling sessions using the adapted version of RIAS. These communication variables will be merged within the larger data sets of baseline and outcome measures on health behaviors (e.g., cancer-specific distress) for one week and four months post-testing. Predictor variables of participant adjustment include: sociodemographics, communication factors (e.g., medical information), kindred, pre-test distress levels, and carrier status.