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Exploring the Psychosocial Experiences of Women Who Had Genetic Counseling via Telemedicine for Recently Diagnosed Breast Cancer

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Exploring the Psychosocial Experiences of Women Who Had Genetic Counseling via Telemedicine for Recently Diagnosed Breast Cancer

Jennifer Billiet 1 , Sara Shelley 1 , Katharine Bisordi 1 , Jessica Joines 2, Shannan Dixon1

1University of Maryland Baltimore, School of Medicine, Baltimore, Maryland 2Rutgers University, School of Arts and Sciences, Piscataway, NJ

Introduction:

Telemedicine (TM) is being used as an alternative model of genetic counseling (GC) service delivery in rural and underserved areas for a variety of medical subspecialties. Certain populations, such as women recently diagnosed with breast cancer, may have greater psychosocial needs than others.1,2 There is a lack of research regarding populations with greater psychosocial needs and their experiences with GC through TM. The goal of this study is to determine if GC through TM can fulfill the psychosocial needs of women recently diagnosed with breast cancer who have not fully completed treatment at the time of GC.

Methods:

Ten semi-structured interviews were conducted by phone. Eligible participants were identified through chart review.  Inclusion criteria were:

• Personal diagnosis of breast cancer,

• Completed GC via TM at Carroll Hospital Center from May 2014 to the present,

• Over the age of 18, and

• Undergoing treatment (surgery, chemotherapy, radiation) at the time of the GC appointment or have not yet begun treatment at the time of the GC appointment

Results: Participant demographics

Results: Interview Themes:

Feeling about the session immediately after

• 9/10 participants reported a neutral or positive reaction about the GC session immediately afterward

Perceptions of TM

• Half (n=5) had positive perceptions beforehand, noting: easier access to services, sooner appointments, overall convenience of TM.

• 2 participants had a negative perception (impersonal or strange) “I guess I thought it was a little strange, that we were having a teleconference about a medicalrelated issue, knowing that she was in the same state.”

• 2 participants were unaware of or felt confused by the interaction through TM.

• All post-appointment perceptions were either positive or unchanged.  “I felt like she was in the room with me so it really was not as distant as I had thought it would be.”

Psychosocial concerns

• All participants felt their concerns were understood through the TM interaction

• 9/10 also felt their concerns were addressed

A different perspective

• While 9/10 said they would they choose to schedule this appointment through TM again, one participant felt differently: “I think I would probably prefer in the future any medical things to be handled face to face….Just because it’s such an overwhelming experience to be in this.”

Conclusions:

Overall, most participants had a positive experience with TM

• Convenience was emphasized as a major advantage

• Participants felt their concerns were understood and addressed through the TM interaction

TM may not be suitable for everyone

• One participant in this study

• Further research is required to determine what may influence prior perceptions of TM and how they can be altered to maximize the patient experience with GC.

References:

1. Beatty, L., Oxlad, M., Koczwara, B., & Wade, T. (2008). The psychosocial concerns and needs of women recently diagnosed with breast cancer: a qualitative study of patient, nurse and volunteer perspectives. Health Expectations, 11(4), 331-342.

2. Wevers, M. R., Hahn, D. E. E., Verhoef, S., Bolhaar, M. D. K., Ausems, M. G. E. M., Aaronson, N. K., & Bleiker, E. M. A. (2012). Breast cancer genetic counseling after diagnosis but before treatment: A pilot study on treatment consequences and psychological impact. Patient Education and Counseling, 89(1), 89-95.

The authors have no conflicts of interest to declare.

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