Skip to main content
NCBI home page
Journal of Medical Genetics logoLink to Journal of Medical Genetics
. 1997 Mar;34(3):237–241. doi: 10.1136/jmg.34.3.237

Genetic counselling: the psychological impact of meeting patients' expectations.

S Michie 1, T M Marteau 1, M Bobrow 1
PMCID: PMC1050900  PMID: 9132497

Abstract

We know little about patients' expectations of genetic counselling, the extent to which these are met, and whether meeting expectations is associated with improved patient outcome. This study describes 131 consultations of patients referred to a regional genetics centre, and documents their expectations, the extent to which these are met, and the predictors and consequences of expectations being met. The outcomes assessed were state anxiety, concern about the problem for which the patient was referred, and satisfaction with information given. Patients came to genetic counselling expecting information (79%), explanation (63%), reassurance (50%), advice (50%), and help in making decisions (30%). The majority got what they were expecting: 74% had their expectation for information met, 56% had their expectation for explanation met, 60% had their expectation for reassurance met, 61% had their expectation for advice met, and 73% had their expectation for help with making decisions met. Patient expectations, and whether or not these were met, were not predicted by any of the patient or counsellor variables measured. When patients' expectations for reassurance and advice were met, patients were less concerned and their anxiety level was more reduced than when such expectations were not met. Meeting patients' expectations for information, explanation, or help with decision making were not associated with better outcomes. Explanations for these results and implications for the practice of genetic counselling are discussed.

Full text

PDF
237

Images in this article

239Image
on p.239

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Blanchard C. G., Labrecque M. S., Ruckdeschel J. C., Blanchard E. B. Physician behaviors, patient perceptions, and patient characteristics as predictors of satisfaction of hospitalized adult cancer patients. Cancer. 1990 Jan 1;65(1):186–192. doi: 10.1002/1097-0142(19900101)65:1<186::aid-cncr2820650136>3.0.co;2-4. [DOI] [PubMed] [Google Scholar]
  2. Campion P. D., Butler N. M., Cox A. D. Principle agendas of doctors and patients in general practice consultations. Fam Pract. 1992 Jun;9(2):181–190. doi: 10.1093/fampra/9.2.181. [DOI] [PubMed] [Google Scholar]
  3. Clarke A. Genetics, ethics, and audit. Lancet. 1990 May 12;335(8698):1145–1147. doi: 10.1016/0140-6736(90)91139-2. [DOI] [PubMed] [Google Scholar]
  4. Clarke A. Is non-directive genetic counselling possible? Lancet. 1991 Oct 19;338(8773):998–1001. doi: 10.1016/0140-6736(91)91849-p. [DOI] [PubMed] [Google Scholar]
  5. Fraser F. C. Genetic counseling. Am J Hum Genet. 1974 Sep;26(5):636–659. [PMC free article] [PubMed] [Google Scholar]
  6. Henbest R. J., Stewart M. Patient-centredness in the consultation. 2: Does it really make a difference? Fam Pract. 1990 Mar;7(1):28–33. doi: 10.1093/fampra/7.1.28. [DOI] [PubMed] [Google Scholar]
  7. Kessler S., Jacopini A. G. Psychological aspects of genetic counseling. II: Quantitative analysis of a transcript of a genetic counseling session. Am J Med Genet. 1982 Aug;12(4):421–435. doi: 10.1002/ajmg.1320120406. [DOI] [PubMed] [Google Scholar]
  8. Koehler W. F., Fottler M. D., Swan J. E. Physician-patient satisfaction: equity in the health services encounter. Med Care Rev. 1992 Winter;49(4):455–484. doi: 10.1177/002570879204900404. [DOI] [PubMed] [Google Scholar]
  9. Korsch B. M., Negrete V. F. Doctor-patient communication. Sci Am. 1972 Aug;227(2):66–74. doi: 10.1038/scientificamerican0872-66. [DOI] [PubMed] [Google Scholar]
  10. Landis J. R., Koch G. G. The measurement of observer agreement for categorical data. Biometrics. 1977 Mar;33(1):159–174. [PubMed] [Google Scholar]
  11. Lippman-Hand A., Fraser F. C. Genetic counseling: provision and reception of information. Am J Med Genet. 1979;3(2):113–127. doi: 10.1002/ajmg.1320030202. [DOI] [PubMed] [Google Scholar]
  12. Marteau T. M., Bekker H. The development of a six-item short-form of the state scale of the Spielberger State-Trait Anxiety Inventory (STAI). Br J Clin Psychol. 1992 Sep;31(Pt 3):301–306. doi: 10.1111/j.2044-8260.1992.tb00997.x. [DOI] [PubMed] [Google Scholar]
  13. Michie S., Bron F., Bobrow M., Marteau T. M. Nondirectiveness in genetic counseling: an empirical study. Am J Hum Genet. 1997 Jan;60(1):40–47. [PMC free article] [PubMed] [Google Scholar]
  14. Pascoe G. C. Patient satisfaction in primary health care: a literature review and analysis. Eval Program Plann. 1983;6(3-4):185–210. doi: 10.1016/0149-7189(83)90002-2. [DOI] [PubMed] [Google Scholar]
  15. Strasser S., Aharony L., Greenberger D. The patient satisfaction process: moving toward a comprehensive model. Med Care Rev. 1993 Summer;50(2):219–248. doi: 10.1177/107755879305000205. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Medical Genetics are provided here courtesy of BMJ Publishing Group

RESOURCES