Background Genetic counselling (GC) is an integral component in the care of individuals at risk for hereditary cancer predisposition syndromes (CPS). In many jurisdictions, access to timely counselling and testing is limited by financial constraints, by the shortage of genetics professionals and by labor-intensive traditional models of individual pre and post-test counselling. There is a need for further research regarding alternate methods of GC service delivery and implementation. This quality improvement project was initiated to determine if pretest group GC followed immediately by a ‘mini’ individual session, would be acceptable to patients at risk for hereditary breast and colon cancer. Methods Patients on waitlists for GC at the Provincial Medical Genetics Program in St. John’s, NL, Canada ( n = 112), were contacted by telephone and offered the option of a group counselling session (GGC), followed by a “mini” individual session, versus (TGC) traditional private appointments. GGC sessions consisted of a cancer genetics information session given to groups of 6–20 followed by brief 20 min “mini” individual sessions with the patient and genetic specialist. TGC individual appointments provided the same cancer genetics information and counselling to one patient at a time in the classic model. All but 2 participants selected group+mini session. A de-identified confidential 12-item, Likert scale survey was distributed at the conclusion of mini-sessions to measure perceptions of GGC and satisfaction with this counselling model. Results Sixty participants completed questionnaires. The majority of participants strongly agreed that they were comfortable with the group session (58/60); the explanation of cancer genetics was clear (54/59); they understood their cancer risks (50/60); and they would recommend such a session to others (56/59). 38/53 respondents disagreed or strongly disagreed that they would prefer to wait for a traditional private appointment. All 5 participating genetic counselors reported a preference for this model. At the end of the pilot project, the waitlist for counselling/testing was reduced by 12 months. Conclusions Group pre-test genetic counselling combined with immediate “mini” individual session is strongly supported by patients and reduces wait times. Additional formal investigation of this approach in larger numbers of patients is warranted.

中文翻译：

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针对遗传性癌症的团体加“迷你”个人预测试遗传咨询课程缩短了提供者时间并提高了患者满意度


背景 遗传咨询（GC）是遗传性癌症易感综合征（CPS）风险个体护理中不可或缺的组成部分。在许多司法管辖区，获得及时咨询和检测的机会受到财务限制、遗传学专业人员短缺以及个人检测前和检测后咨询的劳动密集型传统模式的限制。需要对 GC 服务提供和实施的替代方法进行进一步研究。该质量改进项目的启动是为了确定预测试组 GC 后立即进行“迷你”个体治疗是否可以被有遗传性乳腺癌和结肠癌风险的患者接受。方法 通过电话联系加拿大荷兰圣约翰省省级医学遗传学项目中 GC 候补名单上的患者（n = 112），并提供团体咨询课程 (GGC) 的选择，随后由“迷你”个人进行咨询会议，与 (TGC) 传统的私人约会。 GGC 会议包括为 6-20 人的小组提供癌症遗传学信息会议，然后是与患者和遗传专家进行的 20 分钟简短的“迷你”个人会议。 TGC 个人预约在经典模式中一次为一名患者提供相同的癌症遗传学信息和咨询。除 2 名参与者外，所有参与者都选择了小组 + 迷你会议。在小型会议结束时分发了一份包含 12 个项目的去识别化机密李克特量表调查，以衡量对 GGC 的看法以及对这种咨询模式的满意度。结果 60 名参与者完成了问卷调查。 大多数参与者强烈同意他们对小组会议感到满意（58/60）；对癌症遗传学的解释很清楚（54/59）；他们了解自己的癌症风险 (50/60)；他们会向其他人推荐这样的会议（56/59）。 38/53 的受访者不同意或强烈不同意他们更愿意等待传统的私人预约。所有 5 名参与的遗传咨询师都报告了对该模型的偏好。试点项目结束时，咨询/测试的候补名单减少了 12 个月。结论 团体检测前遗传咨询与即时“迷你”个体咨询相结合，得到了患者的强烈支持，并减少了等待时间。有必要在大量患者中对这种方法进行进一步的正式研究。