title: "I wouldn't classify myself as a patient": the importance of a "well-being" environment for individuals receiving counseling about familial cancer risk.
abstract: Many individuals receiving genetic counseling are healthy with no need for clinical cancer services. We have recently relocated our cancer genetic clinic to a small house on the outskirts of a hospital site which incorporates many elements proven to be important in creating a "well-being" environment. This study explored participants' perceptions of such an environment. Eleven semi-structured telephone interviews were conducted with women who had attended the new cancer genetic clinic. All were at high risk of familial cancer, five were gene carriers and three had a personal diagnosis of cancer. The new clinic was perceived to be less medical and more relaxing than other clinics, encouraged other family members to attend in support of the attendee and did not appear to impede information comprehension. The importance of not being made to feel like an ill patient was apparent. A desire for a quiet area allowing time for reflection whilst waiting for, and following, counseling was identified. A poorly designed counseling area could reduce the quality of the interaction between patient and counselor. Consideration of specific environmental design features may promote individuals' well-being and make those attending genetic counseling feel less like "patients." Larger studies should seek to explore further the potential associations between factors such as environmental design, psychological well-being and comprehension of risk information.
authors.affiliation: Institute of Medical Genetics, School of Medicine, Cardiff University, SAC Building, Cardiff, Wales CF14 4XN, UK. phelpsc@cardiff.ac.uk
authors.forename: Ceri
authors.initials: C
authors.lastname: Phelps
authors.forename: Debra
authors.initials: D
authors.lastname: Horrigan
authors.forename: Liwsi Kim
authors.initials: LK
authors.lastname: Protheroe
authors.forename: Janina
authors.initials: J
authors.lastname: Hopkin
authors.forename: Wendy
authors.initials: W
authors.lastname: Jones
authors.forename: Alexandra
authors.initials: A
authors.lastname: Murray
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005817:Genetic Counseling; D020022:Genetic Predisposition to Disease; D006801:Humans; D008875:Middle Aged; D010361:Patients / Q000523:psychology*; D010865:Pilot Projects; D018907:Privacy; D012307:Risk Factors; D014852:Wales