Development of a Nursing Practice Guideline for Gene Mutations Counseling to Enhance Gene Mutations Knowledge and Reduce Anxiety among Breast Cancer Patients at Risk for Genetic Mutations: A Pilot Study
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Abstract
Background: Breast cancer is associated with hereditary BRCA1 or BRCA2 genetic mutations, which significantly increase the risk of cancer recurrence and contribute to anxiety among patients. Although systematic genetic mutation counseling has been shown to reduce anxiety throughout the screening process, standardized practice guidelines addressing this issue remain limited within the Thai context.
Objective: To develop and evaluate the effects of a pilot nursing practice guideline for genetic mutation counseling on knowledge and anxiety among breast cancer patients at risk for genetic mutations.
Methods: The nursing practice guideline was developed using Soukup's conceptual framework across three phases: situational analysis, evidence review and guideline development, and pilot implementation among 30 breast cancer patients at the Cancer and General Medicine Clinic, Surin Hospital. Outcomes were evaluated using a genetic mutation knowledge assessment and an anxiety assessment tool, and data were analyzed using descriptive statistics, the Friedman test, and the Wilcoxon signed-rank test.
Results: Before counselling, the participants had a mean knowledge score was 14.5 ± 2.8. The mean score increased to 16.4 ± 1.9 immediately after counseling and to 18.2 ± 1.0 at the one-month follow-up. Knowledge scores differed significantly across the three time points (χ² = 34.137, p < 0.001). For anxiety, the mean score was 38.4 ± 11.3 before counseling, 35.9 ± 11.6 immediately after counseling, and 24.8 ± 6.1 at the one-month follow-up. Anxiety scores also differed significantly across the three time points (χ² = 14.708, p =0 .001).
Conclusions: The developed nursing practice guideline enhanced genetic mutation knowledge and reduced anxiety among breast cancer patients at risk for genetic mutations. However, further studies with larger sample sizes and control groups are warranted to compare and confirm the effectiveness of this guideline.
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