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Patient empowerment has been identified as a key outcome goal in genetic counselling, and a patient reported outcome measure (PROM) has been developed to measure empowerment in genetic services: the Genetic Counselling Outcome Scale (GCOS). Here we validate the GCOS for a large and diverse Dutch study sample of 2194 patients referred to two clinical genetic centres for counselling about a wide range of conditions (heart disease, neurological disorders, cancer, congenital syndromes, intellectual disability and prenatal pathology). Our results suggest that the GCOS consists of a hierarchical 6-factor structure, with a main scale for empowerment and six subscales: uncertainty about heredity, hope, negative emotions, knowledge about the condition, knowledge about genetic services and uncertainty about the treatment. Six of the original 24 GCOS items were removed due to low factor loadings and small inter-item correlations. Internal consistency and test-retest reliability of the main scale and most subscales were satisfactory. Convergent validity was confirmed by moderate positive and moderate/strong negative associations between the GCOS main scale and other validated outcome measures. Responsiveness was comparable to that of other validated outcome measures. We saw significant improvement in the GCOS main scale and all the subscales after the first genetic counselling session. This study contributes to the international validation process of the GCOS, with the ultimate goal of using this instrument as a PROM, with empowerment as an outcome measure, to evaluate and improve the quality of genetic counselling in various clinical genetics settings.

Original publication

DOI

10.1038/s41431-018-0318-9

Type

Journal article

Journal

European journal of human genetics : EJHG

Publication Date

05/2019

Volume

27

Pages

681 - 690

Addresses

Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. j.s.voorwinden@umcg.nl.

Keywords

Humans, Factor Analysis, Statistical, Reproducibility of Results, Psychometrics, Genetic Counseling, Middle Aged, Netherlands, Female, Male, Surveys and Questionnaires, Patient Reported Outcome Measures