A pre-visit website with question prompt sheet for counselees facilitates communication in the first consultation for breast cancer genetic counseling: findings from a randomized controlled trial

被引:37
作者
Albada, Akke [1 ]
van Dulmen, Sandra [1 ]
Ausems, Margreet G. E. M. [2 ]
Bensing, Jozien M. [1 ,3 ]
机构
[1] Netherlands Inst Hlth Serv Res NIVEL, Utrecht, Netherlands
[2] Univ Med Ctr Utrecht, Dept Med Genet, Utrecht, Netherlands
[3] Univ Utrecht, Dept Hlth Psychol, Utrecht, Netherlands
关键词
BRCA1/2; communication; genetic counseling; Internet; patient information; TAILORING COMMUNICATION; INFORMATION NEEDS; KNOWLEDGE; RISK; DIALOGUE; LIST; RIAS;
D O I
10.1038/gim.2011.42
中图分类号
Q3 [遗传学];
学科分类号
071007 ; 090102 ;
摘要
Purpose: The initial breast cancer genetic counseling visit is mainly educational, with large amounts of relatively standard information and little counselee participation. Counselors might provide More counselee-specific information if counselees would participate more. A pre-visit website providing computer-tailored information and a question prompt sheet (QPS) might help counselees to pursue a more active role. Methods: Counselees were randomized to receive usual care (UC) or UC plus the pre-visit website. The QPS questions were sent to the counselor before the visit. All counselees completed a baseline questionnaire, and visits were videotaped. Results: Intervention-group counselees (n = 102) did not ask more questions than UC-group counselees (n = 90). However, counselees in the intervention group more often shared their agenda (B = 10.37; confidence interval (CI) 2.68-18.06; P = 0.01), directed the communication (B = 0.41; CI 0.28-0.53; P = 0.01), and paraphrased the counselors' words (B = 5.18; CI 0.43-9.92; P = 0.03). Counselors introduced and answered the QPS questions. As a result, they provided more information about the topics of these questions, and the information provided was more specific to whether there was an indication for DNA testing. Conclusion: A pre-visit website with QPS helped counselees to communicate more assertively. As a result, the information provided was more counselee specific, without affecting the visit duration.
引用
收藏
页码:535 / 542
页数:8
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