Concerns and coping during cancer genetic risk assessment

Objective To gain an in-depth understanding of patients' concerns and their related coping strategies during the genetic risk assessment process. Methods Participants were the usual care arm of a trial of a coping intervention targeted at men and women undergoing assessment of genetic risk for familial cancer. Participants completed questionnaires measuring the degree to which they experienced up to 11 concerns and which of 8 coping strategies they used to respond to each of them at entry into the programme and 1 month subsequently (before they received their risk information). Findings A majority of participants were at least quite worried about all the identified concerns, although the levels of concern fell over the waiting period. Participants used several strategies in response to their varying concerns although a primary coping strategy for each concern was identifiable. The emotion-focused strategies of acceptance and positive appraisal were generally used in response to concerns they could not change, and seeking social support was used primarily to gain information, but not emotional support from their family. Cluster analysis identified three unique clusters of coping responses. Conclusions Genetic risk assessment comprises a number of different stressors each of which is coped with using different strategies. Copyright (C) 2011 John Wiley & Sons, Ltd.