Development of a support program to determine in consultation with nurses whether cancer patients should undergo genetic testing or not

• Project/Area Number: 15K15839
• Research Category: Grant-in-Aid for Challenging Exploratory Research
• Allocation Type: Multi-year Fund
• Research Field: Clinical nursing
• Research Institution: Keio University
• Principal Investigator: TSUJI Keiko 慶應義塾大学, 看護医療学部(藤沢), 准教授 (30338206)
• Co-Investigator(Kenkyū-buntansha): 角田 美穂 埼玉県立がんセンター(臨床腫瘍研究所), 病院 腫瘍診断・予防科, 研究員 (60347359)
• Research Collaborator: AKAGI Kiwamu
• Project Period (FY): 2015-04-01 – 2019-03-31
• Project Status: Completed (Fiscal Year 2018)
• Budget Amount: ¥3,770,000 (Direct Cost: ¥2,900,000、Indirect Cost: ¥870,000); Fiscal Year 2017: ¥520,000 (Direct Cost: ¥400,000、Indirect Cost: ¥120,000); Fiscal Year 2016: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000); Fiscal Year 2015: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
• Keywords: がん / 遺伝 / ゲノム医療 / 包括的遺伝子検査 / プログラム開発 / hared decision making / 遺伝看護 / shared decision making

Outline of Final Research Achievements

The first, two leaflets for use in the support program and the education program for nurses were created, and the validity and feasibility of the content were evaluated. The validity and feasibility of the support program were investigated for consented Health care providers. The result suggests that this program has highly validity and feasibility.
Through the present pilot study, it was suggested that nurse intervention helps to provide patient readiness, and improve the rate of genetic counseling. Ongoing follow-up for patients in whom genetic counselling is delayed, and re-evaluation of the timing should be examined. We found a clear problem in the implementation of practices caused by doctor-nurse cooperation. In order to implement and manage nursing intervention efficiently, a system needs to be established that includes cooperating medical professions.

Academic Significance and Societal Importance of the Research Achievements

現在、がん診療に関わる看護職は、通常診療においてゲノム医療に特化した患者ケアを提供するシステムの中で役割を遂行することが求められている。当該プログラムを活用することにより、看護師は期待される役割を実践することが可能となる。当事者は看護師とのパートナーシップのもと、必要な情報にアクセスすることが可能となり、その後に起こりうる状況に見通しをもちながら、遺伝的リスク情報を考慮した医療的対応の選択が可能となることが期待できる。

Research Products

• [Presentation] Process evaluation of the educational program targeted for nurses supporting the patients with suspected hereditary cancer (2018)
  • Author(s): Miho Kakuta, Keiko Tsuji, Reiko Yokomakura, Mitsue Simizu, Yukiko Osanai, Kazumi Takahashi, Michiko Mizoguchi, Syunichiro Izumi, Kiwamu Akagi
  • Organizer: 2018 International Society of Nurses in Genetics (ISONG) World Congress
  • Int'l Joint Research
• [Presentation] リンチ症候群が疑われる婦人科腫瘍患者を対象としたサポートプログラム 説明用媒体（2種）と看護師用教育プログラムの紹介 (2018)
  • Author(s): 角田美穂
  • Organizer: 第２回AMED臨床ゲノム情報統合データベース整備事業 中釜班赤木グループ班会議（講演）
• [Presentation] 遺伝子検査を考慮するがん患者のための決定支援プログラム－ 文献レビュー (2017)
  • Author(s): 辻恵子, 角田美穂, 近藤好枝, 原田通予, 溝口満子, 高橋千果, 和泉俊一郎, 赤木究
  • Organizer: 日本遺伝看護学会第16回学術大会 2017.9.23-9.24 宮崎
• [Presentation] Development of a Support Program to Determine in Consultation with Nurses Whether Cancer Patients Should Undergo Genetic Testing or Not (2017)
  • Author(s): Kakuta M, Tsuji K, Yokomakura R , Simizu M, Osanai Y, Takahashi K, Mizoguchi M, Izumi S, Akagi K,
  • Organizer: 2017 ISONG World Congress, Hyatt Regency Reston (Reston,Virgina USA), 2017/11/3~5
  • Int'l Joint Research
• [Presentation] Development of a Support Program to Assist Hereditary Cancer Patients’ Communication about Genetic Risk Information to Family Members (2017)
  • Author(s): Kakuta M, Tsuji K, Yokomakura R , Simizu M, Osanai Y, Takahashi K, Mizoguchi M, Izumi S, Akagi K,
  • Organizer: 2017 ISONG World Congress, Hyatt Regency Reston (Reston,Virgina USA), 2017/11/3~5
  • Int'l Joint Research