Addressing the Psychosocial State of High-Risk Individuals Undergoing Hereditary Cancer Screening by Advanced Practice Registered Nurses (APRNs) in the Community Oncology Setting

Abstract

Abstract Neoteric advances in genetics make it possible to define genetic risk in cancer, and there should be methods in place to provide comprehensive genomic care with oncology advanced practice registered nurses bridging this gap. The current scope of nursing practice stipulates genetic and genomic literacy; however, there remains a deficit among advanced practice registered nurses in identifying and addressing psychosocial distress during the genetic cancer risk assessment process. Oncology advanced practice registered nurses must be equipped with the knowledge that the genetic cancer risk assessment also involves protecting patients from the psychosocial repercussions of carrying a hereditary cancer gene beyond medical assessment. The goals of this study were to identify psychosocial risk factors in individuals with heightened cancer risk, improve psychosocial management plans, increase shared decision-making referrals based on individual risk factors, and determine the appropriate psychosocial risk tool to utilize in clinical practice. The Genetic Psychosocial Risk Instrument and Supportive Care Screening Questionnaire were implemented in utilizing best practice guidelines at an outpatient community oncology practice in San Antonio, Texas. This three-month project used a quantitative comparative design with a randomized convenience sample who received the Genetic Psychosocial Risk Instrument or Supportive Care Screening Questionnaire. The reconceptualized uncertainty of illness theory was the theoretical framework used to guide this project. Discovering the antecedents of uncertainty provided the advanced practice registered nurses with salient clues about the patient’s uncertainty related to the genetic cancer risk assessment process and helped prompt psychosocial referrals. Results revealed that in patients undergoing genetic cancer risk assessment assessments, a certain percentage experienced psychosocial distress, and there is demand for a standardized psychosocial needs identification in this patient population. Keywords: advanced practice registered nurses, Genetic Psychosocial Risk Instrument, hereditary cancer syndromes, genetic cancer risk assessment, psychosocial distress, previvor