title: A randomised controlled trial of breast cancer genetics services in South East Scotland: psychological impact.
abstract: This study compared the psychological impact of two models of breast cancer genetics services in South East Scotland. One hundred and seventy general practices were randomised to refer patients to the existing standard regional service or the novel community-based service. Participants completed postal questionnaires at baseline (n=373), 4 weeks (n=276) and 6 months (n=263) to assess perceived risk of breast cancer, subjective and objective understanding of genetics and screening issues, general psychological distress, cancer worry and health behaviours. For participants in both arms of the trial, there were improvements in subjective and objective understanding up to 4 weeks which were generally sustained up to 6 months. However, improvements in subjective understanding for the women at low risk of breast cancer (i.e. not at significantly increased risk) in the standard service arm did not reach statistical significance. Cancer worry was significantly reduced at 6 months for participants in both arms of the trial. The two models of cancer genetics services tested were generally comparable in terms of the participants' psychological outcomes. Therefore, decisions regarding the implementation of the novel community-based service should be based on the resources required and client satisfaction with the service.
authors.affiliation: Cancer Research UK, Edinburgh Oncology Unit, Western General Hospital, Crewe Road South, Edinburgh EH4 2XR, UK.
authors.forename: A
authors.initials: A
authors.lastname: Fry
authors.forename: A
authors.initials: A
authors.lastname: Cull
authors.forename: S
authors.initials: S
authors.lastname: Appleton
authors.forename: R
authors.initials: R
authors.lastname: Rush
authors.forename: S
authors.initials: S
authors.lastname: Holloway
authors.forename: D
authors.initials: D
authors.lastname: Gorman
authors.forename: R
authors.initials: R
authors.lastname: Cetnarskyj
authors.forename: R
authors.initials: R
authors.lastname: Thomas
authors.forename: J
authors.initials: J
authors.lastname: Campbell
authors.forename: E
authors.initials: E
authors.lastname: Anderson
authors.forename: M
authors.initials: M
authors.lastname: Steel
authors.forename: M
authors.initials: M
authors.lastname: Porteous
authors.forename: H
authors.initials: H
authors.lastname: Campbell
mesh_terms: D000293:Adolescent; D000328:Adult; D001943:Breast Neoplasms / Q000209:etiology / Q000235:genetics* / Q000523:psychology*; D003695:Delivery of Health Care; D005260:Female; D005817:Genetic Counseling / Q000523:psychology*; D005820:Genetic Testing / Q000523:psychology*; D006801:Humans; D008954:Models, Biological; D017060:Patient Satisfaction; D012307:Risk Factors; D012606:Scotland; D013315:Stress, Psychological; D011795:Surveys and Questionnaires