Psychological impact of comprehensive tumor genomic profiling results for advanced cancer patients

被引：6

作者：

Butow, Phyllis N. ^{[1
,9
]}

Davies, Grace ^{[1
]}

Schlub, Timothy ^{[2
]}

Napier, Christine E. ^{[3
]}

Bartley, Nicci ^{[1
]}

Ballinger, Mandy L. ^{[3
,4
]}

Juraskova, Ilona ^{[5
]}

Meiser, Bettina ^{[6
]}

Goldstein, David ^{[7
]}

Biesecker, Barbara ^{[8
]}

Thomas, David M. ^{[3
,4
]}

机构：

[1] Univ Sydney, Sch Psychol, Psychooncol Cooperat Res Grp PoCoG, Level 6 North Lifehouse C36Z, Sydney 2006, Australia

[2] Univ Sydney, Sch Publ Hlth, Sydney 2006, Australia

[3] Garvan Inst Med Res, Canc Theme, 384 Victoria St, Darlinghurst, NSW 2010, Australia

[4] Univ NSW, St Vincents Clin Sch, Sydney, Australia

[5] Univ Sydney, Sch Psychol, Sydney 2006, Australia

[6] Univ NSW, Prince Wales Clin Sch, Psychosocial Res Grp, Sydney, NSW 2052, Australia

[7] Prince Wales Hosp, Dept Med Oncol, 320-346 Barker St, Randwick, NSW 2031, Australia

[8] RTI Int, Newborn Screening Ethics & Disabil Studies, Washington, DC USA

[9] Univ Sydney, Level North, Lifehouse C39Z, Sydney, NSW 2006, Australia

来源：

PATIENT EDUCATION AND COUNSELING | 2022年 / 105卷 / 07期

基金：

澳大利亚国家健康与医学研究理事会; 英国医学研究理事会;

关键词：

Psychological outcomes; Genomics; Comprehensive tumor genomic profiling; HEALTH-CARE; UNCERTAINTY; SATISFACTION; DISTRESS;

D O I：

10.1016/j.pec.2022.01.011

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

Objective: Comprehensive tumor genomic profiling (CTGP) is increasingly used to personalize treatments, providing hope, but potentially disappointment, for patients. We explored psychological outcomes in patients with advanced, incurable cancer, after receiving CTGP results.Methods: Participants with advanced, incurable cancer (n = 560, mean age 56, 43% university educated) in this longitudinal substudy of the Molecular Screening and Therapeutics Program (MoST), completed questionnaires before and after receiving CGP results. MoST participants, recruited from Australian oncology clinics, undergo CTGP, and if there are actionable findings, are offered treatment in a related therapeutic trial if available.Results: Patients who received actionable results, (n = 356, 64%) had lower gene-related distress (MICRA) (p < 0.001) and Impact of Events scores (p = 0.039) than patients with non-actionable results. Those with actionable results offered ensured access to tailored treatment (n = 151) reported lower anxiety (p = 0.002) and depressive symptoms (p = 0.01) and greater hope (p = 0.002) than those not offered. Positive attitudes towards uncertainty and higher self-efficacy for coping with results were associated with lower psychological distress and uncertainty, and higher hope and satisfaction with the decision to have CTGP (ps=0.001-0.047). Those with higher knowledge reported greater anxiety (p = 0.034). Conclusion: Receiving a non-actionable CTGP result, or an actionable result without ensured access to treatment, may cause increased distress in advanced cancer patients. Coping style was also associated with distress. Practice implications: Pre-testing assessment and counseling addressing attitudes toward uncertainty and selfefficacy, and post-CTGP result support for patients receiving a non-actionable result or who receive an actionable results without ensured access to treatment, may benefit patients.

引用

页码：2206 / 2216

页数：11

共 32 条

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