Patient Satisfaction with two different models of cancer genetic services in south-east Scotland

Holloway, S, Porteous, Mary E, Cetnarskyj, Roseanne, Anderson, E, Rush, Robert, Fry, A, Gorman, D, Steel, M and Campbell, Harry (2004) Patient Satisfaction with two different models of cancer genetic services in south-east Scotland. British Journal of Cancer, 90 (3). pp. 582-589. ISSN 0007-0920

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There is a need to integrate primary- and secondary-care cancer genetic services, but the most appropriate model of service delivery remains unclear. This study reports patients' expectations of breast cancer genetic services and a comparison of their satisfaction with two service models. In the first model, risk assessment was carried out using mailed family history data. Women estimated as being at high/moderate risk were offered an appointment at the familial breast cancer clinic, and those at low risk were sent a letter of reassurance. In the second model, all women were seen by a genetic nurse specialist, who assessed risk, referred high/moderate-risk women to the above clinic and discharged those at low risk. Over 60% of all women in the study regarded access to breast screening by mammogram and regular check-ups as very important. This underlines the demand for a multidisciplinary service providing both clinical genetic and surgical services. Satisfaction was high with both models of service, although significantly lower among women not at increased cancer risk and thus not offered a clinical check-up and mammography. Increased cancer worry was associated with a greater expressed need for information and for reassurance through follow-up clinical checks and mammography. Better targeting of counselling to the expressed concerns and needs of these women is required to improve the service offered. GPs and patients expressed no clear preference for any specific service location or staffing configuration. The novel community service was less expensive in terms of both staff and patient costs. The potential to decrease health staff/patient contact time and to employ nurse practitioners with both clinical genetic and oncology training should be explored further. The rapidly rising demand for these services suggests that the evaluation of further new models needs to continue to be given priority to guide the development of cancer genetic services.

Item Type: Article
Print ISSN: 0007-0920
Electronic ISSN: 1532-1827
Uncontrolled Keywords: Breast cancer; Cancer genetic services; Patient expectations; Genetic counselling; Patient satisfaction
University Divisions/Research Centres: Faculty of Health, Life & Social Sciences > School of Nursing, Midwifery and Social Care
Dewey Decimal Subjects: 600 Technology > 610 Medicine & health > 610 Medicine & health
600 Technology > 610 Medicine & health > 614 Incidence & prevention of disease
Library of Congress Subjects: R Medicine > R Medicine (General)
R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
Item ID: 1582
Depositing User: RAE Import
Date Deposited: 04 Mar 2008 17:14
Last Modified: 13 Mar 2014 11:08

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