title: The use of telephone in genetic counseling versus in-person counseling: a randomized study on counselees' outcome.
abstract: Increased demand for genetic counseling services necessitates exploring alternatives to in-person counseling. Telephone counseling is a less time-consuming and more cost-effective alternative. So far there is insufficient evidence to support a pre-counseling telephone model. This randomized questionnaire study aims to evaluate the oncogenetic counseling process and to compare the impact of the initial part of the oncogenetic counseling, when conducted via telephone versus in-person. The aspects of evaluations were: patients' expectations, satisfaction and experiences of genetic counseling, worry for developing hereditary cancer and health related quality of life. A total of 215 participants representing several cancer syndromes were randomized to counseling via telephone or in-person. The questionnaires were completed before and after oncogenetic nurse counseling, and 1 year after the entire counseling process. Overall, a high satisfaction rate with the oncogenetic counseling process was found among the participants regardless of whether the oncogenetic nurse counseling was conducted by telephone or in-person. The results show that a considerable number of participants experienced difficulties with the process of creating a pedigree and dissatisfaction with information on surveillance and prevention. Affected participants reported lower levels in most SF-36 domains compared to non-affected and both groups reported lower levels as compared to a Swedish reference group. The results indicate that telephone pre-counseling works as well as in-person counseling. Emotional support during genetic counseling and information on recommended cancer prevention and surveillance should be improved.
authors.affiliation: Department of Oncology and Pathology, Karolinska University Hospital, 17176, Stockholm, Sweden. ulla.platten@karolinska.se
authors.forename: Ulla
authors.initials: U
authors.lastname: Platten
authors.forename: Johanna
authors.initials: J
authors.lastname: Rantala
authors.forename: Annika
authors.initials: A
authors.lastname: Lindblom
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Brandberg
authors.forename: Gunilla
authors.initials: G
authors.lastname: Lindgren
authors.forename: Brita
authors.initials: B
authors.lastname: Arver
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005817:Genetic Counseling / Q000379:methods* / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis / Q000235:genetics* / Q000523:psychology; D017060:Patient Satisfaction; D010375:Pedigree; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013548:Sweden; D013689:Telephone; D055815:Young Adult