Concordance between genetic counselees’ and clinicians’ perceptions of distress and psychosocial needs in women undergoing breast cancer risk assessment in French and German genetic clinics: a multilevel analysis
Abstract
Objectives/purpose: Breast cancer risk assessment can now incorporate a vast array of breast cancer genetic (e.g., moderate genetic risk, personal genetic profile) and non-genetic risk factors (e.g., breast density on mammogram, hormonal or lifestyle elements). This increases the complexity of counselling, requiring particular attention to counselees' psychosocial needs. We assess the concordance, and related factors, between genetic counselees’ and clinicians’ perceptions of distress and psychosocial needs in women from high-risk families undergoing breast/ovarian cancer risk assessment in French and German genetic clinics.
Methods: Counselees, consecutively accrued, were cross-sectionally assessed after the initial genetic consultation, using the counselee and clinician versions of the “Distress Thermometer (DT)” and the "Psychosocial Aspects in Hereditary Cancer (PAHC)" questionnaires addressing their distress and psychosocial needs, respectively. Additionally, counselees completed the “Hospital Anxiety and Depression Scale (HADS)”, and clinicians their self-efficacy in assessing counselees’ needs and wish for their referral for psychological care. Socio-demographic, family history data, and uptake of psychological help were also collected. Multilevel analyses were carried out accounting for the clinic and clinician who met the counselee during the consultation.
Results: On the 1st of December 2020, 400 counselees were included. Data analyses are in progress.
Conclusions and clinical implications: Little is known about the adequacy of genetics clinicians’ assessment of counselees’ distress and psychosocial needs. This study will inform on the need to implement psychosocial screening tools in cancer genetic clinics.