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Health Psychol. 2009 Sep;28(5):569-578. doi: 10.1037/a0015205.

Cognitive and emotional factors predicting decisional conflict among high-risk breast cancer survivors who receive uninformative BRCA1/2 results.

Author information

1
Department of Oncological Sciences.
2
Lombardi Comprehensive Cancer Center.
3
Department of Genetics and Genomic Sciences.

Abstract

OBJECTIVE:

To investigate high-risk breast cancer survivors' risk reduction decision making and decisional conflict after an uninformative BRCA1/2 test.

DESIGN:

Prospective, longitudinal study of 182 probands undergoing BRCA1/2 testing, with assessments 1-, 6-, and 12-months postdisclosure.

MEASURES:

Primary predictors were health beliefs and emotional responses to testing assessed 1-month postdisclosure. Main outcomes included women's perception of whether they had made a final risk management decision (decision status) and decisional conflict related to this issue.

RESULTS:

There were four patterns of decision making, depending on how long it took women to make a final decision and the stability of their decision status across assessments. Late decision makers and nondecision makers reported the highest decisional conflict; however, substantial numbers of women--even early and intermediate decision makers--reported elevated decisional conflict. Analyses predicting decisional conflict 1- and 12-months postdisclosure found that, after accounting for control variables and decision status, health beliefs and emotional factors predicted decisional conflict at different timepoints, with health beliefs more important 1 month after test disclosure and emotional factors more important 1 year later.

CONCLUSION:

Many of these women may benefit from decision making assistance.

PMID:
19751083
PMCID:
PMC3510002
DOI:
10.1037/a0015205
[Indexed for MEDLINE]
Free PMC Article

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