title: Differences in individual approaches: communication in the familial breast cancer consultation and the effect on patient outcomes.
abstract: This multicenter study aimed to assess (i) whether individual clinical geneticists and genetic counselors vary in their communication skills and (ii) whether this variation in communication impacts on patient outcomes, such as anxiety, depression, genetics knowledge, and satisfaction. One hundred and fifty women from high-risk breast cancer families attending their first genetic counseling consultation completed pre and post-consultation self-report questionnaires. The consultations were audiotaped and transcribed verbatim. Univariate analyses showed highly significant differences between individual clinical geneticists and genetic counselors in: facilitating understanding (p < or = 0.001); facilitating active involvement (p < or = 0.001); facilitating partnership building (p = 0.003); addressing emotional concerns (p < or = 0.001); and discussing prophylactic mastectomy (p = 0.017). Multivariate linear regressions showed that this variation in communication resulted in a greater change in patient's depression 4 weeks after the counseling session (p = 0.017). These findings suggest clinical geneticists and genetic counselors have achieved some standardization in communicating information, but showed diversity in their facilitation skills. Communication skills may be a useful area to explore further in this field.
authors.affiliation: Medical Psychology Research Unit, Department of Psychology, The University of Sydney, Sydney, New South Wales, Australia. e.lobb@ecu.edu.au
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Lobb
authors.forename: Phyllis
authors.initials: P
authors.lastname: Butow
authors.forename: Alexandra
authors.initials: A
authors.lastname: Barratt
authors.forename: Bettina
authors.initials: B
authors.lastname: Meiser
authors.forename: Katherine
authors.initials: K
authors.lastname: Tucker
mesh_terms: D000223:Adaptation, Psychological; D001943:Breast Neoplasms / Q000235:genetics* / Q000523:psychology; D003142:Communication; D003657:Decision Making; D005260:Female; D005817:Genetic Counseling; D006801:Humans; D010817:Physician-Patient Relations; D012017:Referral and Consultation; D011795:Surveys and Questionnaires; D016896:Treatment Outcome