Table 2.
Decisional Conflict
| GC Requirement Policy | BRCA1/2 Testing | ||||||
|---|---|---|---|---|---|---|---|
| Total N (%) |
Before N (%) |
After N (%) |
P-value | Tested N (%) |
Not Tested N (%) |
P-value | |
| This decision was hard for me | |||||||
| Strongly Disagree (0 points) | 509 (40.8%) | 127 (42.6%) | 382 (40.3%) | 0.17 | 439 (47.7%) | 70 (31%) | < 0.0001 |
| Disagree (1) | 365 (29.3%) | 90 (30.2%) | 275 (29.0%) | 285 (31%) | 80 (35.4%) | ||
| Neither Disagree nor Agree (2) | 105 (8.4%) | 17 (5.7%) | 88 (9.3%) | 71 (7.7%) | 34 (15%) | ||
| Agree (3) | 127 (10.2%) | 28 (9.4%) | 99 (10.4%) | 96 (10.4%) | 31 (13.7%) | ||
| Strongly Agree (4) | 31 (2.5%) | 7 (2.4%) | 24 (2.5%) | 23 (2.5%) | 8 (3.5%) | ||
| Do Not Know | 9 (0.7%) | 5 (1.7%) | 4 (0.4%) | 6 (0.7%) | 3 (1.3%) | ||
| Missing/declined | 101 (8.1%) | 24 (8.1%) | 77 (8.1%) | 46 (4.8%) | 45 (16.6%) | ||
| Mean Score (SD) | 0.93 (1.10) | 0.83 (1.05) | 0.96 (1.11) | 0.11 | 0.86 (1.08) | 1.22 (1.14) | < 0.0001 |
| I was unsure what to do in this decision | |||||||
| Strongly Disagree (0 points) | 479 (38.4%) | 119 (39.9%) | 360 (37.9%) | 0.24 | 424 (46.2%) | 55 (24.7%) | < 0.0001 |
| Disagree (1) | 402 (32.2%) | 98 (32.9%) | 304 (32.0%) | 323 (35.2%) | 79 (35.4%) | ||
| Neither Disagree nor Agree (2) | 113 (9.1%) | 20 (6.7%) | 93 (9.8%) | 75 (8.2%) | 38 (17%) | ||
| Agree (3) | 105 (8.4%) | 27 (9.1%) | 78 (8.2%) | 66 (7.2%) | 39 (17.5%) | ||
| Strongly Agree (4) | 25 (2.0%) | 2 (0.7%) | 23 (2.4%) | 19 (2.1%) | 6 (2.7%) | ||
| Do Not Know | 16 (1.3%) | 6 (2.0%) | 10 (1.1%) | 10 (1.1%) | 6 (2.7%) | ||
| Missing/declined | 107 (8.6%) | 26 (8.7%) | 81 (8.5%) | 49 (5.1%) | 48 (17.7%) | ||
| Mean Score (SD) | 0.91 (1.03) | 0.81 (0.96) | 0.93 (1.05) | 0.08 | 0.80 (0.98) | 1.36 (1.12) | < 0.0001 |
| I was aware of the choices I had in this decision | |||||||
| Strongly Disagree (4 points) | 35 (2.8%) | 8 (2.7%) | 27 (2.9%) | 0.04 | 24 (2.6%) | 11 (4.9%) | < 0.0001 |
| Disagree (3) | 38 (3.1%) | 11 (3.7%) | 27 (2.9%) | 21 (2.3%) | 17 (7.6%) | ||
| Neither Disagree nor Agree (2) | 82 (6.6%) | 28 (9.4%) | 54 (5.7%) | 57 (6.2%) | 25 (11.1%) | ||
| Agree (1) | 485 (38.9%) | 111 (37.3%) | 374 (39.4%) | 368 (40.3%) | 117 (52%) | ||
| Strongly Agree (0) | 483 (38.7%) | 108 (36.2%) | 375 (39.5%) | 434 (47.5%) | 49 (21.8%) | ||
| Do Not Know | 15 (1.2%) | 8 (2.7%) | 7 (0.7%) | 9 (1%) | 6 (2.7%) | ||
| Missing/declined | 109 (8.7%) | 24 (8.1%) | 85 (9.0%) | 53 (5.5%) | 46 (17.0%) | ||
| Mean Score (SD) | 0.78 (0.91) | 0.81 (0.91) | 0.77 (0.92) | 0.50 | 0.69 (0.88) | 1.16 (0.98) | < 0.0001 |
| I needed more advice and information about the choices | |||||||
| Strongly Disagree (0 points) | 301 (24.1%) | 71 (23.8%) | 230 (24.2%) | 0.22 | 264 (28.8%) | 37 (16.6%) | < 0.0001 |
| Disagree (1) | 378 (30.3%) | 88 (29.5%) | 290 (30.6%) | 318 (34.7%) | 60 (26.9%) | ||
| Neither Disagree nor Agree (2) | 254 (20.4%) | 62 (20.8%) | 192 (20.2%) | 197 (21.5%) | 57 (25.6%) | ||
| Agree (3) | 129 (10.3%) | 31 (10.4%) | 98 (10.3%) | 87 (9.5%) | 42 (18.8%) | ||
| Strongly Agree (4) | 57 (4.6%) | 11 (3.7%) | 46 (4.9%) | 39 (4.3%) | 18 (8.1%) | ||
| Do Not Know | 20 (1.6%) | 10 (3.4%) | 10 (1.1%) | 11 (1.2%) | 9 (4%) | ||
| Missing/declined | 108 (8.7%) | 25 (8.4%) | 83 (8.7%) | 50 (5.2%) | 48 (17.7%) | ||
| Mean Score (SD) | 1.31 (1.12) | 1.28 (1.10) | 1.32 (1.13) | 0.64 | 1.23 (1.10) | 1.66 (1.16) | < 0.0001 |
| I feel I made an informed choice | |||||||
| Strongly Disagree (4 points) | 21 (1.7%) | 6 (2.0%) | 15 (1.6%) | 0.47 | 14 (1.5%) | 7 (3.1%) | < 0.0001 |
| Disagree (3) | 24 (1.9%) | 6 (2.0%) | 18 (1.9%) | 11 (1.2%) | 13 (5.8%) | ||
| Neither Disagree nor Agree (2) | 1 (0.1%) | 0 (0.0%) | 1 (0.1%) | 45 (4.9%) | 51 (22.7%) | ||
| Agree (1) | 386 (31.0%) | 93 (31.2%) | 293 (30.9%) | 290 (31.7%) | 96 (42.7%) | ||
| Strongly Agree (0) | 596 (47.8%) | 135 (45.3%) | 461 (48.6%) | 550 (60%) | 46 (20.4%) | ||
| Do Not Know | 18 (1.4%) | 8 (2.7%) | 10 (1.1%) | 6 (0.7%) | 12 (5.3%) | ||
| Missing/declined | 106 (8.5%) | 23 (7.7%) | 83 (8.7%) | 50 (5.2%) | 46 (17.0%) | ||
| Mean Score (SD) | 0.64 (0.85) | 0.67 (0.88) | 0.62 (0.85) | 0.42 | 0.50 (0.78) | 1.22 (0.94) | < 0.0001 |
| Decisional Conflict Scorea, mean (SD) | 22.8 (18.2) | 22.1 (18.0) | 23.0 (18.3) | 0.46 | 20.5 (17.1) | 33.0 (19.5) | < 0.0001 |
| Adjusted Decisional Conflict Score, mean (SE)b | 22.5 (17.3) | 22.0 (1.31) | 22.6 (0.79) | 0.16 | 20.3 (0.69) | 32.7 (1.36) | < 0.0001 |
aAverage score across all decisional conflict questions multiplied by 25
bAdjusted scores control for GC-mandate period, BRCA1/2 testing completions, and visit with a genetic counselor prior to testing