Addressing the support needs of women at high risk for breast cancer: evidence-based care by advanced practice nurses.
OBJECTIVE
To identify support needs of women at high risk for breast cancer and enhance an evidence-based service.


METHODS
Descriptive study.


METHODS
A comprehensive, breast-health service for high-risk women.


METHODS
97 high-risk women with a 1.66% or greater five-year risk of breast cancer, atypical hyperplasia, lobular carcinoma in situ, or positive genetic screen.


METHODS
A self-assessment questionnaire completed previsit and a satisfaction survey completed postvisit.


METHODS
Women's perceived informational, emotional, and decisional support needs, current self-care practices, and satisfaction with the service provided.


RESULTS
Women under age 50 (n = 54) wanted information on breast cancer screening, risk of breast cancer, lifestyle options to lower risk, and hormone replacement therapy; older women (n = 43) wanted information on risk of breast cancer, lifestyle options, breast cancer screening, and chemoprevention. More than 75% of all women wanted information to help them make decisions on breast cancer prevention options, benefits, and risks. The satisfaction survey (N = 61) revealed that most women's needs were met.


CONCLUSIONS
Support needs were consistent with the literature that focused primarily on younger women seeking genetic counseling. Proactive planning assisted with addressing the needs of these women.


CONCLUSIONS
A previsit questionnaire facilitates individualized proactive planning before the visit. However, further assessment of self-care practices and emotional needs is required. Interventions should evaluate outcomes, such as accurate risk perception, lifestyle changes, screening follow-through, and decision quality. Advanced practice nurses require specialized skills, including evidence-based risk communication, behavior modification, and decision support.
Stacey
Dawn
D
Ottawa Health Research Institute, University of Ottawa, Ontario, Canada. dstacey@ohri.ca
DeGrasse
Cathy
C
Johnston
Lisa
L
D000328:Adult; D000367:Age Factors; D000368:Aged; D001943:Breast Neoplasms / Q000235:genetics / Q000451:nursing / Q000517:prevention & control / Q000523:psychology; D003657:Decision Making; D019317:Evidence-Based Medicine; D005260:Female; D005817:Genetic Counseling; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D020380:Needs Assessment; D009722:Nurse Practitioners; D024802:Nurse's Role; D011322:Primary Prevention / Q000379:methods; D012306:Risk; D012648:Self Care; D012944:Social Support; D011795:Surveys and Questionnaires; D016387:Women's Health