Group visits for women at high risk for breast cancer: Facilitated education and support sessions.

30 Background: Women at increased risk for breast cancer frequently have anxiety and stress. They often have questions and concerns that are not discussed at their medical appointment. Methods: The Duke High-Risk Breast Clinic consists of over 1,110 women undergoing high-risk screening due to 1) BRCA-mutation, 2) familial pattern of breast cancer inheritance, 3) prior abnormal biopsy, or 4) > 20% lifetime risk of breast cancer. Approximately 31% of clinic participants are African-American and 65% are European-American. Women participating in the Duke High-Risk Breast Clinic were offered a monthly, hour-long education and support session at no charge. The goal was to help women answer key questions and provide a supportive environment. A five-month pilot was initiated in 02/2015. The NP adapted the Centering Healthcare Institute’s group visit model (www.centeringhealthcare.org). Attendees completed a Self-Assessment Sheet (SAS) on arrival. A clinic conference room was used, with chairs arranged in a circle, and refreshments available. After an icebreaker opening, the NP led a facilitated discussion on timely topics, which the patients actively prioritized. Guest experts (radiologist, geneticist, gynecologist, mental health provider) also participated. A participant or the team navigator led the closing activity, and then a brief patient satisfaction survey was completed. Patient support persons were welcomed. Results: 100% of the participants (N = 38) strongly agreed that the educational session was a resourceful way of addressing healthcare concerns, and 92% agreed that they would attend more educational sessions. Several women came at least 3 of the sessions with 30% traveling 1-3 hours. Comments were positive. Common topics on the SAS were: genetic risk/testing, risk factors for breast cancer, screening tests/tools, and nutrition. Further topics requested: “When to be concerned about aches, pains, ‘lumps’, and how not to over react”, research updates, 3D imaging, and stress. Conclusions: Women found this group visit model highly informative and helpful. Several commented they would like the sessions to be longer, or be offered in the evening. Further commitment to this group visit format is warranted.

Duke Scholars

Author Kathryn Jane Trotter School of Nursing