The impact of genetic counselors' use of facilitative strategies on cognitive and emotional processing of genetic risk disclosure for Alzheimer's disease.

Patient Educ Couns
Authors
Keywords
Abstract

OBJECTIVES: To determine the impact of genetic counselor (GC) communication on cognitive and emotional processing of Alzheimer's disease (AD) risk information during discussions with patients with clinical diagnoses of mild cognitive impairment and their companion.

METHODS: 79 recordings and transcripts of AD risk disclosure sessions collected as part of the fourth REVEAL Trial were coded using the Roter Interaction Analysis System (RIAS) and the Linguistic Inquiry Word Count (LIWC). Multilevel analyses were used to determine the association between GCs' use of communication facilitation strategies and patient and companion use of words indicative of cognitive and emotional processing.

RESULTS: GC used somewhat more cognitive (14%) than emotional (10%) facilitation strategies. Both patients and companions used more words indicative of cognitive (18% and 17%) than emotional (6% and 5%) processing. GC use of facilitative strategies and patient and companion use of cognitive and emotional processing words were significantly associated in both unadjusted and adjusted models (all p-values

CONCLUSIONS: GCs' use of facilitative strategies assist in cognitive and emotional processing in a way that may be linked to therapeutic benefit.

PRACTICE IMPLICATIONS: These findings highlight mechanisms through which GCs may assist patients and companions to better understand and cope with risk information.

Year of Publication
2018
Journal
Patient Educ Couns
Volume
101
Issue
5
Pages
817-823
Date Published
2018 05
ISSN
1873-5134
DOI
10.1016/j.pec.2017.11.019
PubMed ID
29203084
PubMed Central ID
PMC5911203
Links
Grant list
P30 AG053760 / AG / NIA NIH HHS / United States
M01 RR000533 / RR / NCRR NIH HHS / United States
P30 AG013846 / AG / NIA NIH HHS / United States
U19 HD077671 / HD / NICHD NIH HHS / United States
K01 HG009173 / HG / NHGRI NIH HHS / United States
U01 HG006500 / HG / NHGRI NIH HHS / United States
R01 HG002213 / HG / NHGRI NIH HHS / United States
M01 RR010284 / RR / NCRR NIH HHS / United States
UL1 TR001102 / TR / NCATS NIH HHS / United States