title: Anxiety and depression symptoms among women attending group-based patient education courses for hereditary breast and ovarian cancer.
abstract: BACKGROUND
  Women carryingBRCA-mutations are facing significant challenges, including decision making regarding surveillance and risk-reducing surgery. They often report that they are left alone with these important decisions. In order to enhance the genetic counselling session we organized a group-based patient education (GPE) course for women withBRCA-mutations. The study aims were to characterize women attending a group-based patient education (GPE) course for hereditary breast and ovarian cancer, consider the usefulness of the course, evaluate symptoms of anxiety and depression among the participants, and finally investigate whether their levels of anxiety and depression changed from before to after the course session.
  
  
  METHODS
  A prospective study was conducted. Two weeks before (T1) and 2 weeks after (T2) attending the GPE-course the participants received questionnaires by mail. We collected information on demographic- and medical variables, anxiety and depression using Hospital Anxiety and Depression Scale (HADS), self-efficacy using The Bergen Genetic Counseling Self-Efficacy scale (BGCSES) and coping style using the Threatening Medical Situations Inventory (TMSI). A total ofN= 100 (77% response rate) women participated at baseline and 75 (58% response rate) also completed post-course assessment.
  
  
  RESULTS
  The mean level of anxiety symptoms was elevated among participants but decreased significantly during follow-up. Lower anxiety symptom levels were associated with "longer time since disclosure of gene test result", "higher levels of self-efficacy" and having experienced "loss of a close relative due to breast or ovarian cancer". Lower depression symptom levels were associated with "higher levels of education" and "loss of a close relative due to breast or ovarian cancer".
  
  
  CONCLUSIONS
  The women in this study seemed to benefit from the GPE course. Women newly diagnosed with aBRCAmutation who reported lower levels of self-efficacy and lower levels of education were more vulnerable. These women need special attention.
authors.affiliation: Western Norway Familial Cancer Center, Haukeland University Hospital, Bergen, Norway ; Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen, Norway.
authors.forename: Wenche
authors.identifier: 0000-0002-2001-0850
authors.initials: W
authors.lastname: Listøl
authors.affiliation: Western Norway Familial Cancer Center, Haukeland University Hospital, Bergen, Norway ; Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen, Norway.
authors.forename: Hildegunn
authors.initials: H
authors.lastname: Høberg-Vetti
authors.affiliation: Centre of Clinical Research, Haukeland University Hospital, Bergen, Norway ; Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
authors.forename: Geir Egil
authors.initials: GE
authors.lastname: Eide
authors.affiliation: Western Norway Familial Cancer Center, Haukeland University Hospital, Bergen, Norway ; Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen, Norway ; Learning and Mastery Center in Bergen, Bergen, Norway ; Department of Clinical Science, University of Bergen, Bergen, Norway.
authors.forename: Cathrine
authors.initials: C
authors.lastname: Bjorvatn
keywords: Anxiety symptoms; Depression symptoms; Genetic counseling; Group-based patient education course; Hereditary cancer