Coping Self-Efficacy and Its Relationship with Psychological Morbidity after Genetic Test Result Disclosure: Results from Cancer-Unaffected BRCA1/2 Mutation Carriers
Abstract
:1. Introduction
2. Materials and Methods
2.1. Setting and Eligibility Criteria
2.2. Data Collection and Measures
- Coping self-efficacy. Self-efficacy to cope with the genetic test result was measured using the Coping Self-Efficacy Scale (CSE) [29]. The 13-item CSES consists of three subscales: problem-focused coping (6 items); stopping unpleasant emotions and thoughts (4 items); and support from friends and family (3 items). Higher scores indicate feeling better equipped to handle the genetic test result, whereas lower scores indicate worry that one might not be able to cope with the test result well.
- Anxiety and depression. The German version of the Hospital Anxiety and Depression Scale (HADS) was used to assess the level of psychological distress following disclosure of the genetic test result [30,31]. The HADS is comprised of 14 items that form two scales measuring levels of depression and anxiety, respectively. For both scales, a sum score of 0 to 7 for either subscale is considered nonelevated by the authors, sum scores between 8 and 10 are considered conspicuous, suggesting borderline clinically relevant levels of depression and anxiety, while a score ≥11 indicates clinically relevant depression or anxiety on their respective scale.
- Impact of genetic test result. To measure the subjective distress of the genetic test result, the Impact of Event Scale (IES) was used [32,33]. The 22-item scale is used to evaluate the impact of potentially traumatic events and consists of three subscales: intrusion, avoidance, and hyperarousal. The total score can range from 0 to 88 with high scores indicating symptoms of post-traumatic stress. A cut-off score of 33 is usually recommended for a case of post-traumatic stress. An equation to detect those with symptoms severe enough to fulfill criteria for a suspected diagnosis of post-traumatic stress disorder (PTSD) from the three subscales has been published and was utilized [34].
- Status of decision. The Stage of Decision-Making Scale (SDMS) is a single-item scale that assessed how far along women were in their decision-making process on how to deal with their cancer risk [35]. The scale has four response options ranging from “I haven’t begun to think about the choices” to “I have already made my choice”.
- Decisional conflict. Decisional conflict captures the uncertainty in health- or treatment-related decisions. It was measured using the German translation of the Decisional Conflict Scale (DCS) [36,37]. The scale comprises five subscales: feeling uninformed, uncertainty about the best choice, lack of support, unclarity about personal values, and effective decision. Subscales are summarized to yield an overall score. The total score can range from 0 to 100 with higher values indicating higher decisional conflict. The authors suggest that a total score under 25 indicates no decisional conflict and is associated with decision implementation, whereas scores ≥ 37.5 indicate insecurity about decision implementation and may result in decision delay.
2.3. Statistical Methods
3. Results
3.1. Demographic Data
3.2. Anxiety and Coping Self-Efficacy
3.3. Depression and Coping Self-Efficacy
3.4. Impact of Event Scale
3.5. Decision Making and Coping Self-Efficacy
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Total | n | % |
---|---|---|
130 | 100 | |
Education | ||
Secondary education (9 or 10 years) | 32 | 24.6 |
High school degree/A-Levels Abitur | 36 | 27.7 |
University degree | 62 | 47.7 |
Marital status (n = 2 missing) | ||
Single | 48 | 36.9 |
Married or in a long-term relationship | 72 | 55.4 |
Divorced | 8 | 6.2 |
Parity (n = 2 missing) | ||
No children | 64 | 49.2 |
1 child | 26 | 20.0 |
2 children | 30 | 23.1 |
3+ children | 8 | 6.2 |
Family planning completed (n = 15 missing) | ||
Yes | 57 | 43.8 |
No | 58 | 44.6 |
Variables | M | SD | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 | 15 |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 3.40 | 3.08 | 1 | ||||||||||||||
| 7.81 | 3.55 | 0.70 ** | 1 | |||||||||||||
| 31.60 | 17.23 | 0.04 | 0.03 | 1 | ||||||||||||
| 38.04 | 22.71 | 0.05 | 0.18 * | 0.56 ** | 1 | |||||||||||
| 36.95 | 19.08 | 0.11 | 0.20 * | 0.53 ** | 0.63 ** | 1 | ||||||||||
| 46.29 | 23.89 | 0.08 | 0.23 ** | 0.54 ** | 0.77 ** | 0.71 ** | 1 | |||||||||
| 37.87 | 17.95 | 0.07 | 0.19 * | 0.73 ** | 0.88 ** | 0.84 ** | 0.91 ** | 1 | ||||||||
| 41.28 | 9.45 | −0.45 ** | −0.37 ** | −0.14 | −0.17 | −0.06 | −0.09 | −0.13 | 1 | |||||||
| 22.65 | 5.71 | −0.52 ** | −0.31 ** | −0.05 | 0.01 | −0.03 | 0.10 | 0.02 | 0.59 ** | 1 | ||||||
| 20.32 | 8.65 | −0.46 ** | −0.52 ** | −0.07 | −0.15 | −0.18 * | −0.13 | −0.15 | 0.58 ** | 0.40 ** | 1 | |||||
| 84.43 | 19.80 | −0.57 ** | −0.51 ** | −0.11 | −0.14 | −0.13 | −0.07 | −0.12 | 0.90 ** | 0.74 ** | 0.82 ** | 1 | ||||
| 11.57 | 6.48 | 0.40 ** | 0.53 ** | −0.03 | 0.01 | 0.09 | 0.07 | 0.04 | −0.19 * | −0.19 * | −0.33 ** | −0.29 ** | 1 | |||
| 12.09 | 7.34 | 0.36 * | 0.42 ** | 0.09 | 0.06 | 0.18 * | 0.07 | 0.12 | −0.31 ** | −0.30 ** | −0.33 ** | −0.38 ** | 0.38 ** | 1 | ||
| 8.54 | 7.39 | 0.62 ** | 0.69 ** | 0.03 | 0.07 | 0.10 | 0.13 | 0.09 | −0.35 ** | −0.35 ** | −0.45 ** | −0.47 ** | 0.66 ** | 0.46 ** | 1 | |
| 31.95 | 17.31 | 0.57 ** | 0.66 ** | 0.04 | 0.06 | 0.17 * | 0.12 | 0.11 | −0.35 ** | −0.34 ** | −0.47 ** | −0.47 ** | 0.80 ** | 0.76 ** | 0.87 ** | 1 |
Groups | ||||||
---|---|---|---|---|---|---|
Non-Elevated Anxiety HADS-A Score ≤ 7 n = 59 | Borderline Clinical Anxiety HADS-A Score ≥ 8 ≤ 10 n = 42 | Clinical Anxiety HADS-A Score ≥ 11 n = 29 | ||||
M | SD | M | SD | M | SD | |
CSE-PF | 44.20 | 8.98 | 40.71 | 8.72 | 36.14 | 9.33 |
CSE-SFF | 24.56 | 4.18 | 21.83 | 6.04 | 19.97 | 6.65 |
CSE-SUE | 24.34 | 8.44 | 18.31 | 6.58 | 15.03 | 8.01 |
CSE-T | 93.66 | 16.13 | 80.86 | 16.85 | 71.14 | 21.62 |
Groups | ||||
---|---|---|---|---|
Nonelevated Depression HADS-D Score ≤ 7 n = 117 | Elevated Depression HADS-D Score ≥ 8 n = 13 | |||
M | SD | M | SD | |
CSE-PF | 42.59 | 8.70 | 29.46 | 7.78 |
CSE-SFF | 23.51 | 4.98 | 14.92 | 6.22 |
CSE-SUE | 21.17 | 8.47 | 12.62 | 6.21 |
CSE-T | 87.50 | 17.63 | 57.00 | 17.21 |
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Isselhard, A.; Lautz, Z.; Töpper, M.; Rhiem, K.; Schmutzler, R.; Vitinius, F.; Fischer, H.; Berger-Höger, B.; Steckelberg, A.; Beifus, K.; et al. Coping Self-Efficacy and Its Relationship with Psychological Morbidity after Genetic Test Result Disclosure: Results from Cancer-Unaffected BRCA1/2 Mutation Carriers. Int. J. Environ. Res. Public Health 2023, 20, 1684. https://doi.org/10.3390/ijerph20031684
Isselhard A, Lautz Z, Töpper M, Rhiem K, Schmutzler R, Vitinius F, Fischer H, Berger-Höger B, Steckelberg A, Beifus K, et al. Coping Self-Efficacy and Its Relationship with Psychological Morbidity after Genetic Test Result Disclosure: Results from Cancer-Unaffected BRCA1/2 Mutation Carriers. International Journal of Environmental Research and Public Health. 2023; 20(3):1684. https://doi.org/10.3390/ijerph20031684
Chicago/Turabian StyleIsselhard, Anna, Zoe Lautz, Maren Töpper, Kerstin Rhiem, Rita Schmutzler, Frank Vitinius, Hannah Fischer, Birte Berger-Höger, Anke Steckelberg, Karolina Beifus, and et al. 2023. "Coping Self-Efficacy and Its Relationship with Psychological Morbidity after Genetic Test Result Disclosure: Results from Cancer-Unaffected BRCA1/2 Mutation Carriers" International Journal of Environmental Research and Public Health 20, no. 3: 1684. https://doi.org/10.3390/ijerph20031684
APA StyleIsselhard, A., Lautz, Z., Töpper, M., Rhiem, K., Schmutzler, R., Vitinius, F., Fischer, H., Berger-Höger, B., Steckelberg, A., Beifus, K., Köberlein-Neu, J., & Stock, S. (2023). Coping Self-Efficacy and Its Relationship with Psychological Morbidity after Genetic Test Result Disclosure: Results from Cancer-Unaffected BRCA1/2 Mutation Carriers. International Journal of Environmental Research and Public Health, 20(3), 1684. https://doi.org/10.3390/ijerph20031684