Hopefulness predicts residence after hereditary colorectal cancer genetic testing in Hong Kong Chinese: results of a longitudinal study

Abstract

BACKGROUND: Genetic testing for hereditary colorectal cancer (HCRC) had significant psychological consequences for test recipients. METHOD: A longitudinal study was carried out from April 2003 to August 2006 on Hong Kong Chinese HCRC family members recruited and offered genetic testing by the Hereditary Gastrointestinal Cancer Registry to determine psychological outcome after genetic testing. Self-completed questionnaires were administered immediately before (baseline) as well as 1 week, 4 months and 1 year after result disclosure. Using validated psychological inventories, the cognitive style of hope was measured at baseline and psychological distress of depression and anxiety was measured at all time points. RESULTS: Seventy-six subjects participated among whom 71 persons (43 men and 28 women; mean age 38.9 9.2 years) from 9 FAP and 24 HNPCC families completed the study including 39 mutated gene carriers. Four patterns of outcome trajectories were created using established norms for the specified outcome measures of depression and anxiety. These included chronic dysfunction (13% and 8.7%), recovery (0% and 4.3%), delayed dysfunction (13% and 15.9%) and resilience (76.8% and 66.7%). Because of the small number of participants, the chronic dysfunction, recovery and delayed dysfunction groups were combined into a non-resilient group to compare with the resilient group in all subsequent analysis. Two logistic regression analyses were conducted using hope at baseline to predict resilience with depression and anxiety as outcome indicators. Both regression equations were significant. Baseline hope was a significant individual predictor in both equations (p = 0.012 for depression; and p = 0.009 for anxiety). CONCLUSION: Hopefulness predicted resilience after HCRC genetic testing in Hong Kong Chinese. Increasing the level of hope may improve psychological adjustment of HCRC genetic testing recipients. Current hope intervention strategies at the Hereditary Gastrointestinal Cancer Registry will be shared.