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Assessment of psychosocial difficulties by genetic clinicians and distress in women at high risk of breast cancer: a prospective study

Abstract : We examined how often genetic clinicians correctly identify psychosocial difficulties in women at high breast cancer risk and explored effects of this assessment and the genetic test result on counselees’ distress. A prospective observational study of counselee–clinician dyads was performed in three French, German and Spanish genetic clinics, involving 709 counselees (participation rate, 83.4%) and 31 clinicians (participation rate, 100%). Counselee–clinician agreement in perceived psychosocial difficulties was measured after the pre-test genetic consultation. Multivariate mixed linear models accounting for clinicians were tested. Predicted distress levels were assessed after the pre- (T1) and post-test result disclosure consultations (T2). Depending on the difficulty domain, clinicians adequately assessed the presence or absence of difficulties in 51% (“familial issues”) to 59% (“emotions”) of counselees. When counselees’ and clinicians’ perceptions disagreed, difficulties were generally underestimated by clinicians. Counselees’ distress levels remained stable from T1 to T2, irrespective of clinicians’ appraisal adequacy, and the genetic test result disclosure. Psychological referral need were found in 20–42% of counselees, more frequently observed for difficulties in the “emotions” domain. Our findings suggest that the genetic test result is a suboptimal indicator for psychological referral. Instead, clinicians should focus on emotions expressed by counselees to appraise their needs for psychological support.
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https://hal.univ-lorraine.fr/hal-03636613
Contributor : Jean-Luc Kop Connect in order to contact the contributor
Submitted on : Monday, April 11, 2022 - 9:14:45 AM
Last modification on : Friday, April 15, 2022 - 3:10:56 AM

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Anne Brédart, Jean-Luc Kop, Anja Tüchler, Antoine de Pauw, Alejandra Cano, et al.. Assessment of psychosocial difficulties by genetic clinicians and distress in women at high risk of breast cancer: a prospective study. European Journal of Human Genetics, Nature Publishing Group, 2022, ⟨10.1038/s41431-022-01096-9⟩. ⟨hal-03636613⟩

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