Evaluating Effects of Cancer Genetic Counseling on Several Brief Patient Impact Measures

Many outcomes for assessing cancer genetic counseling (GC) utility have been proposed, with few studies evaluating multiple, theory-based, brief patient-reported experience and outcome measures simultaneously as part of a single study. We conducted a pilot study in which patients seen for pre-test cancer GC took a survey before and after their GC session to evaluate the session’s impact on multiple patient impact measures and assess the relationship between these measures. Measures based on the self-determination theory (SDT) assessed three basic needs including: 1) perceived autonomy support, 2) relatedness to the provider, and 3) competence to make a decision. SDT posits that when these three basic needs are met, patient-reported outcomes should improve. Thus, we also assessed the following patient-reported outcomes: 1) knowledge specific to informed consent for panel testing, 2) decisional empowerment/decisional conflict (using the SURE checklist) and 3) general ‘empowerment’ (using the Genomic Outcomes Scale). Following GC, significant improvements were found in patient competence, knowledge, and both measures of empowerment. Post session competence and perceived autonomy support were significantly correlated to decisional empowerment, while relatedness to the provider was not. The two empowerment measures were not significantly correlated with one another. These findings confirm previous findings of pre-test GC service utility and provide evidence that a patient experience measure (autonomy support from the GC) is positively related to patient-reported outcomes. Findings also confirm that general empowerment and empowerment to make a decision are different and unique constructs