Piloting a standardized psychosocial assessment tool (BATHE) in genetic counseling

在遗传咨询中试点标准化社会心理评估工具（BATHE）

基本信息

批准号：
10683373
负责人：
Maryann W Campion
金额：
$ 19.68万
依托单位：
STANFORD UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-08-12 至 2025-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10683373
关键词：
Accreditation Address Adoption Adult Affect Anxiety Appointment Area Assessment tool Attention California Cardiology Caring Certification Characteristics Client satisfaction Clinical Competence Consultations Consumption Counseling Data Development Educational workshop Emotional Emotions Ensure Evaluation Exploratory/Developmental Grant Feedback Foundations Funding Genetic Counseling Genomics Goals Health Healthcare Hearing Hereditary Malignant Neoplasm Institution Interview Investigation Learning Literature Malignant Neoplasms Medical Genetics Medicine Methods Modeling Modification National Human Genome Research Institute Neurology Outcome Participant Patient-Centered Care Patient-Focused Outcomes Patients Practice Guidelines Primary Care Process Provider Psychological Impact Psychosocial Assessment and Care Questionnaires Research Sampling Social Work Standardization Strategic vision Structure Surveys Techniques Time Training Transcript acceptability and feasibility anxiety reduction clinical care clinical practice coping empowerment experience genetic counselor genetic testing health care settings impression improved innovation instrument medical specialties person centered prenatal primary care setting psychologic psychological distress psychosocial randomized trial response satisfaction skills social tool

项目摘要

PROJECT ABSTRACT Significant rates of psychological distress have been found in patients across a range of genetic counseling settings, including cancer, cardiology, prenatal and medical genetics. In many cases, these needs are profound and unmet. Such data suggest that genetic counselors providing clinical care should routinely assess patients’ emotions and psychological impact. Accreditation boards for genetic counseling require this skill to achieve certification, but there is no standard definition of a “psychosocial assessment” in genetic counseling nor universal instruments to facilitate it. Those tools that do exist are questionnaire-based or specific to a clinical indication, eg. hereditary cancer. We can look to other healthcare settings, such as social work and primary care, to borrow tools which standardize the psychosocial assessment and which may be applicable in genetic counseling. One such tool developed in primary care is the BATHE method: a structured technique consisting of four questions that explore patients’ main presenting concerns, emotional affect and coping, paired with guidance for empathic responses. Evidence from the primary care literature shows the BATHE method reduces patient anxiety and improves patient empowerment. Providers find it concise and easy-to-learn, allowing for a person-centered interaction without increasing consultation time. These characteristics combined make it an attractive tool to pilot in genetic counseling, which provides patient-centered care while balancing information delivery and support. For these reasons, we request funding through this NHGRI R21 mechanism to better characterize the current state of psychosocial practices and pilot an innovative standardized way to provide such an assessment in genetic counseling. These goals are in line with the NHGRI’s 2020 Strategic Vision to promote patient empowerment around genomic information and train a workforce that is scalable and efficient. First, this study will describe the current practices of psychosocial assessments in genetic counseling, using descriptive content analysis of transcripts of a purposive sample of genetic counseling sessions at Stanford Medicine. Second, this study will pilot a psychosocial assessment tool (the BATHE method) in genetic counseling to assess its feasibility and acceptability by genetic counselors. Exploring patients’ perspectives, patient-related outcomes, and influence of cultural differences are crucial, and the current study lays the groundwork for this subsequent research. At the conclusion of our study, the findings from our aims will inform the development of a genetic counseling-specific standardized psychosocial assessment. The ultimate goal of this research is to build a foundation for investigation of patient outcomes in response to psychosocial counseling approaches.

项目摘要在一系列遗传咨询的患者中，已经发现了心理困扰的率很高设置，包括癌症，心脏病学，产前和医学遗传学。在许多情况下，这些需求是深刻的和未满足。这样的数据表明，提供临床护理的遗传共同点应常规评估患者情绪和心理影响。遗传咨询的认证委员会需要此技能才能实现认证，但没有对遗传咨询的“社会心理评估”的标准定义，也没有促进它的通用工具。确实存在的工具是基于问卷或特定于临床的问卷指示，例如。遗传癌。我们可以寻求其他医疗机构，例如社会工作和主要的机构护理，借用标准化心理心理评估的工具，并且可能适用于通用咨询。在初级保健中开发的一种这样的工具是Bathe方法：一种结构化技术在探讨患者主要提出关注，情感影响和应对的四个问题中，移情反应指南。初级保健文献的证据表明，沐浴方法减少了患者动画并提高赋权。提供者发现它简洁且易于学习，允许以人为中心的互动而没有增加咨询时间。这些特征加在一起使它成为在遗传咨询中进行试验的有吸引力的工具，该工具在平衡信息的同时提供以患者为中心的护理交付和支持。由于这些原因，我们要求通过这种NHGRI R21机制进行资金以更好表征当前的社会心理实践状态，并试行一种创新的标准化方式对遗传咨询的评估。这些目标符合NHGRI的2020年战略愿景促进围绕基因组信息的患者赋权，并培训可扩展有效的劳动力。首先，本研究将描述遗传咨询中的社会心理评估的当前实践斯坦福大学自然遗传咨询会议的成绩单的描述性内容分析药品。其次，这项研究将试用通用的心理社会评估工具（浴方法）咨询以评估其遗传互助者的可行性和可接受性。探索患者的观点，与患者有关的结果和文化差异的影响至关重要，当前的研究表明这项随后的研究的基础。在我们的研究结束时，我们目标的发现将告知遗传咨询特定标准化的社会心理评估的发展。最终目标这项研究是为了响应心理社会的投资，为患者成果的投资奠定了基础咨询方法。