| Exploring the short-term impact of DNA-testing in breast cancer patients: The counselees' perception matters, but the actual BRCA1/2 result does not. | |
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MedLine Citation:
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PMID: 21684708 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVE: Previous studies suggest that learning a DNA-test-result has no direct impact on the medical-decisions and psychological well-being of counselees. Their perception, especially their recollections and interpretations of their cancer-risks and heredity, predict and/or mediate this impact. These studies were criticized for their small range of predictors, mediators, outcomes and contextual factors. We studied the short-term impact of DNA-testing with an extended model. METHODS: Three months after disclosure of BRCA1/2-test-results, we sent counselees a questionnaire about their perception, medical and psychological outcomes, and medical, familial and psychological contexts. 248 affected women participated; 30 had received pathogenic-mutations, 16 unclassified-variants and 202 uninformative-results. RESULTS: The actually communicated genetic-information and the contextual variables predicted the counselees' perception, but did not directly predict any outcomes. The counselees' perception predicted and/or completely mediated the counselees' medical intentions and behavior, physical and psychological life-changes, stigma, mastery, negativity and cancer-worries. Short-term distress was related to the perception not only of their own risks, but also of their relatives' risks and heredity-likelihood. Effect sizes were medium to large. CONCLUSIONS AND IMPLICATIONS: The outcomes of DNA-testing were better predicted by the counselees' perception than by the actually given genetic-information. We recommend genetic-counselors to have tailored, interactive dialogues about the counselees' perception. |
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Authors:
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Joël Vos; Jan C Oosterwijk; Encarna Gomez-Garcia; Fred H Menko; Margriet J Collee; Christi J van Asperen; Anna M Jansen; Anne M Stiggelbout; Aad Tibben |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-6-17 |
Journal Detail:
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Title: Patient education and counseling Volume: - ISSN: 1873-5134 ISO Abbreviation: - Publication Date: 2011 Jun |
Date Detail:
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Created Date: 2011-6-20 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8406280 Medline TA: Patient Educ Couns Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 Elsevier Ireland Ltd. All rights reserved. |
Affiliation:
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Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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