FACILITATING WELL INFORMED DECISIONS FOR BRCA TESTING

描述(改编自《调查者摘要》)：基因检测 遗传性癌症易感性的研究，基于最近 已经确定的BRCA1和2基因，很快就会让许多健康的女性面临 选择接收有关乳腺癌和卵巢癌的反馈 前景看好。这些信息可能会产生深远的心理社会后果。 这最终会破坏调整和健康保护行为。一个 关于参与基因检测的真正知情的决定 因此，研究必须考虑到所有的后果 这对特定的个人来说是必要的。建议的女性研究(N=300) 乳腺癌和卵巢癌的高家族风险人群的目标是发展和 评估核心干预，基于最先进的理论和研究， 以促进BRCA1/2测试的明智决策。在这 程序，基因癌症测试候选人被帮助认知和 从情绪上预测可能会出现的各种情况 知情同意程序中概述的测试。其目标是使 生动地想象个人和社会对自己和 她的未来，在一个简短的，有组织的支持性咨询的背景下 会议。认知-情感准备(CAP)的效用 程序将在随机对照的情况下进行系统评估 试验，以一般健康信息(GHI)作为控制条件。 结果测量包括：深度、复杂性和准确性 信息处理、决策和评估， 参与基因测试；调整(即侵入性和回避性 思想、情感、生活质量)和坚持推荐的 防癌行为。此外，这项研究还探讨了 健康应对方式的个性差异 威胁，重点关注高度监控的影响(即，扫描 癌症相关线索)与低监控(例如，分心 癌症相关线索)关于信息处理、关于基因检测 决定和对后果的适应。评估将是 在基线、标准护理后、CAP或GHI之后、 预先披露和披露结果，以及1-2周和6个月 随访间隔时间。

DESCRIPTION (Adapted from the Investigator's Abstract): Genetic testing research for inherited cancer susceptibility, based on the recently identified BRCA1 and 2 genes, will soon confront many healthy women with the option of receiving feedback about their breast and ovarian cancer prospects. This information can have profound psychosocial consequences which ultimately undermine adjustment and health-protective behaviors. A truly informed decision with regard to participation in genetic testing research must therefore take into account the full range of consequences that it entails for a given individual. The proposed study (N=300) of women at high familial risk for breast and ovarian cancer aims to develop and assess a core intervention, based on state-of-the-art theory and research, to facilitate well-informed decisions for BRCA1/2 testing. In this procedure, the genetic cancer testing candidate is helped to cognitively and emotionally anticipate scenarios about alternative potential outcomes of testing outlined in the informed consent process. The goal is to enable the individual to vividly imagine the personal and social impact on herself and her future, in the context of a brief, structured supportive counseling session. The utility of this Cognitive-Affective Preparation (CAP) procedure will be evaluated systematically, in a randomized controlled trial, with General Health Information (GHI) serving as a control condition. Outcome measures include: the depth, complexity, and accuracy of information-processing, and decisions about, and evaluation of, participation in genetic testing; adjustment (i.e., intrusive and avoidant ideation, affect, quality of life) and adherence to recommended cancer-protective behaviors. In addition, the study explores the influence of characteristic individual differences in styles of coping with health threats, focusing on the impact of high monitoring (i.e., scanning for cancer-related cues) vs. low monitoring (i.e., distraction from cancer-related cues) on information processing, on the genetic testing decision and on adaptation to the consequences. Assessments will be obtained at baseline, after standard care, after CAP or GHI, after pre-disclosure and disclosure of results, and at 1-2 week and 6-month follow-up intervals.