GENETIC-COUNSELING - PREDICTING PATIENT OUTCOMES

With the rapid development of genetic testing, the demand for genetic counselling is increasing. Yet there is little known about what makes for effective or efficient genetic counselling. The aim of the current study is to determine the main factors influencing outcomes of geneti c consultations. One hundred and thirty one routine consultations cond ucted in a regional genetics centre were audiotaped, transcribed and c oded. The main predictors of outcome tested were pre-interview patient and counsellor expectations; pre-interview patient concerns; length o f consultations; counsellor directiveness; and the extent to which soc ial and emotional issues are addressed in the consultation. The main o utcomes were the patient's view of the extent to which their expectati ons were met, their satisfaction with information provided, and concer n about the problem they were referred with. Although there were six s ignificant correlations between the process of consultation and outcom e variables, multivariate analyses revealed no significant predictors of any of the outcomes. Using multiple regression analyses, small amou nts of variance in patient outcomes were predicted by patient and coun sellor variables assessed before the consultation, but none was predic ted by any of the process measures made of the consultation. Various e xplanations are considered to explain the lack of influence of process variables upon outcomes. One possible explanation for these findings is that the consultation has a minimal effect upon patient outcomes. A lternatively, the study, in design or analysis, was not sufficiently s ensitive to detect the influential aspects of the consultation.