Abstract
Background. Advances in genetic science and biotechnology accumulated huge knowledge of genes and various genetic tests and diagnostic tools for healthcare providers including nurses. Genetic counseling became important to assist patients making decisions about obtaining genetic testing or preventive measures. Method. This review was conducted to describe the counseling topics, various interventions adopted in genetic counseling, and their effectiveness. Experimental studies (N=39) published between 1999 and 2012 were synthesized. Results. The most frequently covered topic was benefits and limitations of genetic testing on breast cancer ovarian and colorectal cancers. Most of researchers focused on evaluating cognitive aspect and psychological well-being. Conclusion. No single intervention was consistently reported to be effective. Decision aids enhanced with information technologies have potential to improve the outcomes of genetic counseling by providing tailored information and facilitating active engagement of patients in information uptake. Clinical Implication. When nurses are familiar with topics and interventions of genetic counseling, they are well positioned to provide genetic/genomic information to the patient and families.
Highlights
As advances in genetic science and biotechnology have led to discovery of the genes that increase the risk for certain common diseases, various genetic tests and other diagnostic tools have become available to healthcare providers including nurses
Majority of the studies (35 of 39) described the interventions related to genetic counseling on breast, ovarian, or colorectal cancers [19,20,21,22,23,24,25, 27,28,29,30,31,32,33,34,35,36,37,38, 40, 41, 43,44,45,46,47,48,49,50,51,52,53,54,55,56]
Findings (i) Phone GC improved knowledge about inherited breast and ovarian ca. in African Americana at high risk for (i) before counseling inherited breast ca., questionnaires, (ii) participants with greater education (ii) after counseling showed significantly greater gain in questionnaires knowledge, (iii) women who had prior genetic counseling outside of this study showed significantly higher knowledge (i) No differences in changes in risk (i) Baseline interview perception in women both in culturally tailored genetic counseling (CTGC) and before counseling
Summary
As advances in genetic science and biotechnology have led to discovery of the genes that increase the risk for certain common diseases, various genetic tests and other diagnostic tools have become available to healthcare providers including nurses. A primary focus of genetic counseling in the 1960s and 70s was to assist patients with reproductive decision makings by educating them about etiology and recurrence risks of certain congenital conditions [14]. Studies conducted in this period focused mostly on finding ways to increase a patients’ knowledge. Since the 1990s, with the advances in genetic/genomic science the goals of genetic counseling are more focused to promoting necessary changes in health behavior, adoption of timely screening for a hereditary disease, psychosocial adjustment to the stress caused by the increased risk of developing a hereditary disease, and promotion of informed decision making [15]. Effective delivery of the information on the genetic risk and the various risk mitigation options to the patients is the goal of genetic counseling
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