Abstract
This research and development aimed to describe the situation, develop and evaluate a cancer
genetic counseling model at Ubonratchathani Cancer Hospital, Thailand. This study was conducted
between February 2022 to December 2023. The research comprised two phases. Phase 1 studied the
situation. The sample consisted of 2 physicians, 7 registered nurses, 2 medical technologists and
17 cancer patients by using questionnaires and semi-structured interviews. Phase 2 was developing a model, conducting an implementation and evaluating the cancer genetic counseling
model. The sample consisted of 5 physicians and 31 registered nurses. In addition, 88 counseling
service recipients selected by a simple random quota sampling method who met the inclusion
criteria also evaluated the counseling model. Divided into an experimental group of 44 people who
were at high risk for hereditary breast and ovarian cancer syndrome (HBOC) received an individual
cancer genetic counseling program in Ubonratchathani Cancer Hospital. Comparison or control group
was 44 people who received treatment as usual. Data were collected using knowledge, attitude,
skills assessment form, satisfaction assessment form, Thai hospital anxiety and depression scale (ThaiHAD), and the cancer worry scale. The gathered data were analyzed using descriptive statistics,
content analysis, thematic analysis, and t-test statistics.
The study revealed that existing cancer genetic counseling service was unclear. Medical personnel
had insufficient knowledge and competence about the cancer genetic counseling. In terms of model
development results, three main operational components were the structure, staff and system. The
nurses’ knowledge, attitude, and skills after the training for setting up the counseling service increased
significantly (p-value < 0.05). Satisfaction with the overall service was at the highest level. The knowledge
and attitude of the service recipients after the consultation increased and were higher than the control
group (p-value < 0.05). As for the Thai-HAD, the level of cancer worry of clients after the model set up was lower than before and was significantly lower than the control group (p-value < 0.05). Overall, the
satisfaction of receiving the counseling service was at the highest level.
In conclusion, genetic counseling was a communication process that helped patients or families
understand the disease, its causes, treatment, and prevention methods, as well as making the most
possible and appropriate risk management options. It also helped the patients and family members to
accommodate the disease. Therefore, this cancer genetic counseling model should be applied to be the
standard of cancer genetic counseling service for the cancer health service unit.
