ABSTRACT
One barrier to genetic testing is the lack of access to genetic counselors. We provided cancer genetic counseling via telephone, through a pilot project for employees of a national health insurer, Aetna, Inc. Knowledge transfer, behavioral intentions, and patient satisfaction were assessed by survey after genetic counseling. Aetna sent an individual email to its employees nationwide notifying them of the availability of a new telephone genetic counseling and testing program and providing a link to take a brief screening questionnaire to determine whether they may be at risk of hereditary cancer. Employees completing the questionnaire received immediate feedback regarding whether there appeared to be a risk of hereditary cancer. If so, they were invited to schedule a telephonic genetic counseling session. After the session, respondents completed an online survey. 397 individuals completed the questionnaire. 39 proceeded with telephone genetic counseling, and 22 completed the follow-up survey, including all 11 women with family history warranting genetic testing. One third reported prior discussion about inherited cancer risk with their primary care provider (PCP); 12% were referred to a geneticist; 20% had an accurate perception of their own cancer risk. After counseling, 94% reported understanding their risk for cancer and 87% were aware of available risk-reduction strategies. 87% of high-risk respondents intended to engage in risk-management interventions. 93% reported high satisfaction. 66% indicated they would not have pursued genetic counseling if it had not been available by phone. Results suggest telephone counseling is a viable option for increasing access to genetic experts. In this sample, telephone counseling increases knowledge of cancer risk, motivates intention to change health-related behaviors, and elicits a high satisfaction level. Consequently, Aetna now offers telephone cancer genetic counseling nationwide as a covered benefit.
Subject(s)
Genetic Counseling/psychology , Genetic Predisposition to Disease , Neoplasms/psychology , Telephone , Adult , Aged , Female , Health Knowledge, Attitudes, Practice , Humans , Male , Middle Aged , Pilot Projects , Surveys and Questionnaires , Young AdultABSTRACT
O presente trabalho teve como objetivo criar uma cartilha para acompanhamento e prevenção da doença renal crônica em pacientes com Diabetes mellitus do município de Feliz RS. A cartilha foi baseada em informações obtidas por revisão bibliográfica, por meio de artigos e dissertações publicados a partir de 2007, em bases de dados como Scielo e Jornal Brasileiro de Nefrologia, utilizando-se descritores como doença renal crônica, diabetes mellitus, dieta para diabéticos, taxa de filtração glomerular, proteinúria. Desta forma, conclui-se que através da cartilha disponibilizada aos profissionais de saúde e pacientes da unidade básica de saúde de Feliz, os mesmos terão acesso a informações importantes sobre Diabetes Mellitus e Doença Renal Crônica, e a partir destas informações será possível conscientizá-los sobre a necessidade do controle glicêmico, a mudança de hábitos, a adesão ao tratamento e a progressão da doença, que pode ser bastante favorável, quando seguidas as orientações médicas.
