Situation and Development of Genetic Counseling for Breast Cancer at Ubonratchathani Cancer Hospital
Keywords:
genetic counseling, breast cancer, hereditary cancer syndromesAbstract
This research and development aimed to describe the situation, develop and evaluate a cancer genetic counseling model at Ubonratchathani Cancer Hospital, Thailand. This study was conducted between February 2022 to December 2023. The research comprised two phases. Phase 1 studied the situation. The sample consisted of 2 physicians, 7 registered nurses, 2 medical technologists and 17 cancer patients by using questionnaires and semi-structured interviews. Phase 2 was developing a model, conducting an implementation and evaluating the cancer genetic counseling model. The sample consisted of 5 physicians and 31 registered nurses. In addition, 88 counseling service recipients selected by a simple random quota sampling method who met the inclusion criteria also evaluated the counseling model. Divided into an experimental group of 44 people who were at high risk for hereditary breast and ovarian cancer syndrome (HBOC) received an individual cancer genetic counseling program in Ubonratchathani Cancer Hospital. Comparison or control group was 44 people who received treatment as usual. Data were collected using knowledge, attitude, skills assessment form, satisfaction assessment form, Thai hospital anxiety and depression scale (Thai-HAD), and the cancer worry scale. The gathered data were analyzed using descriptive statistics, content analysis, thematic analysis, and t-test statistics.
The study revealed that existing cancer genetic counseling service was unclear. Medical personnel had insufficient knowledge and competence about the cancer genetic counseling. In terms of model development results, three main operational components were the structure, staff and system. The nurses’ knowledge, attitude, and skills after the training for setting up the counseling service increased significantly (p-value<.05). Satisfaction with the overall service was at the highest level. The knowledge and attitude of the service recipients after the consultation increased and were higher than the control group (p-value<.05). As for the Thai-HAD, the level of cancer worry of clients after the model set up was lower than before and was significantly lower than the control group (p-value<.05). Overall, the satisfaction of receiving the counseling service was at the highest level.
In conclusion, genetic counseling was a communication process that helped patients or families understand the disease, its causes, treatment, and prevention methods, as well as making the most possible and appropriate risk management options. It also helped the patients and family members to accommodate the disease. Therefore, this cancer genetic counseling model should be applied to be the standard of cancer genetic counseling service for the cancer health service unit.
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