Date of Award

1-1-2012

Document Type

Campus Access Thesis

Department

Genetic Counseling

First Advisor

Crystal R Hill-Chapman

Abstract

Purpose: Telemedicine and in-person counseling are two modalities of genetic counseling service delivery. This research sought to identify anxiety and life-stressors surrounding the appointments of prenatal patients referred for an indication of advanced maternal age (AMA) in either a traditional genetic counseling or telemedicine setting. Methods: Fifteen patients seen in-person or through telemedicine completed surveys regarding their experiences. Responses to the State Trait Anxiety Inventory were analyzed via t-tests for comparison between the groups of respondents. Combining items that were rated on a Likert-scale created the patient satisfaction factor. Categorical data was summarized with proportions or percentages. For statistical comparisons, SPSS version 19.0 was used. Fisher's exact test was also utilized. All comparisons were considered significant at p < .05 level. Qualitative data and themes were defined by participants' responses using grounded theory principles. This data was coded and analyzed based on themes pertaining to reported life-stressors and anxiety. Results: Correlations were observed between commute distance to and from the appointment site and pre-counseling anxiety, as well as patient-reported satisfaction and likeliness to recommend genetic counseling services with understanding of the material post-counseling. Patients also reported preference to the specific modality in which they received genetic counseling. Conclusions: This study supports findings that suggest telemedicine and traditional counseling methods of delivery are equally likely to be preferred by patients. It broaches the subject of the negative impact of outside stressors on the patient, such as those related to distance traveled to reach the appointment site, and suggests acknowledgement of such life-stressors at the commencement of the appointment to establish rapport, alleviate patient anxiety prior to the onset of genetics education delivery, and support the patient decision-making process, consistent with the American Board of Genetic Counseling practice analysis.

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