'It's like having 46 copies of the Joys of Cooking': Exploring communication during cancer genetic counseling and its impact on illness representations.

摘要

This study explored genetic counseling sessions using the Common Sense Model of Illness Representations (CSM) as a framework to analyze changes from pre-counseling to post-counseling. Additionally, the CSM was used in conjunction with patient-centered communication to explore communication during the genetic counseling session. Previous literature indicated that the genetic counseling session provides a unique opportunity to encourage preventive health behaviors. However, little research focused on theoretical investigations of communication of complex genetic information to counselees in a way that promotes understanding and motivates preventive health behaviors. This study explored the application of the CSM to the genetic counseling session to examine the communication during the session and to identify subsequent outcomes. Thirty-five women attending their first appointment with a cancer genetic counselor for a possible BRCA1/2 mutation or Lynch Syndrome agreed to participate in this study. Participants completed a pre-counseling survey, a post-counseling survey, and agreed to have their genetic counseling session audio-recorded. Survey data indicated counselees perceived they had a better understanding of their genetic risk for developing cancer after the genetic counseling session. Furthermore, correlations were found between chronic duration and serious consequences related to risk perception and worry. The audio recordings provided support for the use of the CSM in exploring the content of communication during the discussion of risk in the cancer genetic counseling session. Theoretical and practical implications of this study are discussed along with limitations of this project and suggestions for future research.