Dataset Information

Anticipated responses of early adopter genetic specialists and nongenetic specialists to unsolicited genomic secondary findings.

ABSTRACT:

Purpose

Secondary findings from genomic sequencing are becoming more common. We compared how health-care providers with and without specialized genetics training anticipated responding to different types of secondary findings.

Methods

Providers with genomic sequencing experience reviewed five secondary-findings reports and reported attitudes and potential clinical follow-up. Analyses compared genetic specialists and physicians without specialized genetics training, and examined how responses varied by secondary finding.

Results

Genetic specialists scored higher than other providers on four-point scales assessing understandings of reports (3.89 vs. 3.42, p = 0.0002), and lower on scales assessing reporting obligations (2.60 vs. 3.51, p < 0.0001) and burdens of responding (1.73 vs. 2.70, p < 0.0001). Nearly all attitudes differed between findings, although genetic specialists were more likely to assert that laboratories had no obligations when findings had less-established actionability (p < 0.0001 in interaction tests). The importance of reviewing personal and family histories, documenting findings, learning more about the variant, and recommending familial discussions also varied according to finding (all p < 0.0001).

Conclusion

Genetic specialists felt better prepared to respond to secondary findings than providers without specialized genetics training, but perceived fewer obligations for laboratories to report them, and the two groups anticipated similar clinical responses. Findings may inform development of targeted education and support.

SUBMITTER: Christensen KD

PROVIDER: S-EPMC6103906 | biostudies-literature | 2018 Oct

REPOSITORIES: biostudies-literature

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Publications

Anticipated responses of early adopter genetic specialists and nongenetic specialists to unsolicited genomic secondary findings.

Christensen Kurt D KD Bernhardt Barbara A BA Jarvik Gail P GP Hindorff Lucia A LA Ou Jeffrey J Biswas Sawona S Powell Bradford C BC Grundmeier Robert W RW Machini Kalotina K Karavite Dean J DJ Pennington Jeffrey W JW Krantz Ian D ID Berg Jonathan S JS Goddard Katrina A B KAB

Genetics in medicine : official journal of the American College of Medical Genetics 20180201 10

<h4>Purpose</h4>Secondary findings from genomic sequencing are becoming more common. We compared how health-care providers with and without specialized genetics training anticipated responding to different types of secondary findings.<h4>Methods</h4>Providers with genomic sequencing experience reviewed five secondary-findings reports and reported attitudes and potential clinical follow-up. Analyses compared genetic specialists and physicians without specialized genetics training, and examined ho ...[more]

PMID: 29388940

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Project description:BackgroundContrary to Missed Nursing Care, some anecdotal data and sparse evidence has documented the tendency of nurses to anticipate some nursing interventions. However, no study has been conducted to date with the purpose of understanding this phenomenon and its underlying mechanisms and consequences. The aim of this study was to describe the phenomenon of delivering anticipated nursing care, its antecedents and consequences as perceived by nurses.MethodA descriptive qualitative study. The Consolidated Criteria for Reporting Qualitative Research guidelines were followed. A purposeful sample of 17 clinical nurses and nurse managers working in three Italian hospitals were interviewed in depth in 2019. The audio-recorded interviews were verbatim transcribed and thematically analysed.Results'Anticipated Nursing Care' is delivered significantly earlier than when expected by nurses in their care plan, by patients, by caregivers and by other members of the team. Medication administration, mobilisation of patients, hygiene care, changes of dressing, vital parameter monitoring, blood sampling and administrative activities were reported as interventions delivered before rather than when expected. Clinically stable patients have been reported to be at risk of receiving anticipated nursing care. Individual values and attitudes, group attitudes of being always ready for the "unexpected", implicit group norms to "leave the patients and the unit in order", high workloads, intertwined activities and work processes inside the units, have been reported as reasons for Anticipated Nursing Care. Effects of this phenomenon have been reported at the patients' and at the nurses' level.ConclusionAnticipated Nursing Care occurs when nurses perform interventions earlier than expected according to an implicit or explicit decision and not as a consequence of a request. The phenomenon requires future studies to detect its diffusion and to accumulate evidence. Its presence in daily practice, if confirmed, suggests that Missed Nursing Care studies should also consider the combined effect of these two phenomena as, on one hand, there may be the tendency to postpone and, on the other hand, the tendency to anticipate interventions.

Dataset Information

Anticipated responses of early adopter genetic specialists and nongenetic specialists to unsolicited genomic secondary findings.

Purpose

Methods

Results

Conclusion

Publications

Anticipated responses of early adopter genetic specialists and nongenetic specialists to unsolicited genomic secondary findings.

Similar Datasets

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