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PubMedDate not supplied

Evaluation of a "formal" endocrinology curbside consultation service: advice by means of internet, fax, and telephone.

OBJECTIVE: To describe the development, implementation, and assessment of an Internet- and fax-based endocrinology curbside consultation service. METHODS: An Internet- and fax-based endocrinology consultation service was designed by developing a simple Web site so that requesting physicians could complete a form about the patient. Community and academic-based primary-care physicians were invited to use the service. One month after each consultation, a follow-up questionnaire about the effectiveness and use of the Internet and fax consultation service was sent to each physician who had requested the consultation. RESULTS: During the 5-month period in which the service was offered, 67 physicians requested a total of 85 "formal" endocrinology curbside consultations. Of these 85 requests, 46 were by e-mail, 31 by fax, and 8 by telephone. Follow-up questionnaires were returned by 61 of the 67 physicians who used the service. One hundred percent of the physicians found the service to be useful, and about 33% noted formal consultation had been avoided. In approximately 55% of the consultations, physicians indicated that the response caused them to alter the treatment of their patient. Consultation questions encompassed the full spectrum of endocrinology. The issues were approximately equally distributed among test interpretation, medication, and management. CONCLUSION: We successfully designed and implemented an Internet- and fax-based endocrinology curbside consultation service. This form of consultation was used by physicians and brought about change in the management of their patients.

Attitude of Health Personnel↗
PubMed1997

Characteristics of longer consultations in Australian general practice.

OBJECTIVE: To assess the association between general practitioner (GP) billing for "longer" consultations, patient factors linked with health care need, and other consultation characteristics. DESIGN: Retrospective analysis of data from Medicare (1984-1992), Australian Morbidity and Treatment Survey (1990-1991) and Australian Capital Territory Record Linkage Study (1988-1992). SETTING: Australian general practice, 1984 (introduction of Medicare) to 1992. MAIN OUTCOME MEASURES: Consultations billed as longer (> or = 20 or > 25 minutes) compared with standard; type of billing (bulk or private); patient health care need (defined as health and sociodemographic factors linked to worse health outcomes); consultation continuity, type of care given and number of problems managed. RESULTS: Longer billed consultations increased between 1984 and 1992, from 2.8% to 6.7% of all standard and longer consultations. Longer consultations were more likely to be bulk-billed than privately billed (odds ratio [OR], 1.74). They were more likely than standard consultations to deal with psychological diagnoses (OR, 2.06; 95% confidence interval [95% Cl], 1.83-2.32) or multiple problems (OR for four versus one diagnosis, 5.18; 95% Cl, 4.31-6.22) and to involve patients aged under 50 years, new to the practice or with new problems, but not chronic disease. In the ACT, those billed for longer consultations were more commonly tertiary educated (OR, 1.99; 95% Cl, 1.35-2.94), bulk-billed (OR, 2.75; 95% Cl, 2.51-3.10), aged 40-49 years and non-obese. CONCLUSION: Longer billed consultations were not associated with greater patient need, other than psychosocial need, but with bulk billing and patient socioeconomic advantage. However, evaluation was complicated by the effects of continuity of care and number of problems managed in the consultation.

Aged↗
PubMed2001

[Dermatological consultation behind bars: an analysis on a three-year period in a French prison].

BACKGROUND: Since 1994, health care in French prisons is managed by the public hospital system. The hospitals created ambulatory consultation units for prisons and detention centers. Skin problems rapidly became a frequent reason for consultation. This is the first systematic assessment of needs concerning dermatological consultation in prisons. MATERIAL AND METHODS: A monthly dermatology consultation was established at the Colmar detention center in May 1996. We reviewed the files of all prisoners who attended between May 1996 and May 1999. Data collected concerned motivation for the consultation, drug use and serology for HIV and hepatitic C virus. RESULTS: There were 280 consultations for 180 prisoners. All were men, mean age 30 years, who represented 16% of the total prisoner population. Most consulted for one or more benign skin conditions. The two most frequent conditions were acne (29%) and mycoses (13%). Drug use was found in 36% of the consulting prisoners (64/180). One was HIV-positive. Hepatitis C virus serology was positive in 19% of those tested (28/149), and in 39% of the drug users and 2% of the non-drug users. Motivation for consultation did not differ between drug users and non users, neither between seropositive and seronegative patients for hepatitis C virus. DISCUSSION: This survey confirms the demand for dermatology consultation in the prison population and points out the frequency of hepatitis C virus in prisoners. A monthly specialized consultation was able to meet the basic demands concerning dermatology. Adapted management of hepatitis C virus in the prison population setting remains a difficult challenge.

Adolescent↗
PubMedDate not supplied

Role of external management consultants in health-care organizations implementing TQM.

The reliance of organizations on consultants generally is increasing. Although the efficacy of the use of consultants in implementing change programs has been questioned, there have been limited attempts to systematically analyze the contribution of consultants. This article reports observations on the use of consultants in health-care organizations implementing total quality management (TQM). The relationship between the use of external management consultants and successful TQM implementation is not simple. There appears to be a difference in the way consultants are used by the public and private sectors, with the private organizations forming long-term relationships with their consultants. The perceived value of consultants to the private organizations was higher. Consultants are not a substitute for leadership, and the success of outside consultants probably depends on the commitment of senior management. External management consultants appeared to be linked to the successful implementation of TQM. Further, despite the conventional wisdom to the contrary, some prepackaged programs may be beneficial for the introduction of TQM into an organization.

Consultants↗
PubMed2003

Impact of national consultants on successful expansion of effective tuberculosis control in India.

SETTING: India, during a period of rapid expansion of DOTS services. DOTS expansion has been slow in many countries. OBJECTIVE: To document use of consultants to expand DOTS effectively. DESIGN: Staff were contracted to monitor DOTS expansion and implementation. To estimate the impact of these staff, we compared areas with and without consultants, and individual areas before and after consultants were assigned. Consultants were preferentially assigned to the more difficult areas; the temporary absence of consultants reflected non-availability of candidates. RESULTS: Areas with consultants met pre-defined criteria and began DOTS service delivery faster (median 9 vs. 18 months of preparation) than areas without consultants. Rates of sputum conversion (87% vs. 83%, P < 0.001) and treatment success (83% vs. 78%, P < 0.001) were significantly higher in areas with consultants present. CONCLUSION: Assignment of consultants resulted in much more rapid implementation of the DOTS strategy, and better quality performance. Continued effective performance in these areas will rely on many factors, but the need for consultants appears to be decreasing, suggesting that they have provided sustainable improvements. The effectiveness of local consultants may have important implications for efforts to scale up public health interventions for tuberculosis, malaria, AIDS and other diseases in developing countries.

Communicable Disease Control↗
PubMed1986

Role perception of consultants in Iowa nursing homes.

A study comparing the differences between consultant dietitians' and foodservice supervisors' perceptions of the role of the consultant dietitian was conducted. Since it was believed that the role of the consultant could vary with the nursing home, 150 facilities were randomly selected from the population of 419 licensed intermediate-care facilities in Iowa. The administrator of each of the nursing homes was contacted by mail and was asked to distribute questionnaires to the consultant dietitian and foodservice supervisor in the facility. Consultant dietitians (no. = 69) indicated desired and actual frequency of performance of 46 selected duties. Foodservice supervisors (no. = 84) indicated desired frequency for consultant dietitian performance for the same 46 duties. Significant differences were found between actual and desired frequency of performance for 32 duties. For all of those duties except one, the desired mean was greater than the actual mean. The reasons for those differences need to be determined. Significant differences were found between the means for frequency of performance for 21 duties desired by the foodservice supervisors and desired by the consultant dietitians. The one duty with a higher foodservice supervisor mean could indicate an area in which assistance is needed from the consultants. When means for frequency of performance of duties desired by foodservice supervisors and actually carried out by consultant dietitians were compared, significant differences were found for 13 duties. Of them, 6 had a higher foodservice supervisor mean. That could also indicate areas in which consultants need to provide assistance to the supervisors. With additional data, the role of the consultant dietitian may be defined in terms of the 46 duties in this study.

Consultants↗
PubMed1994

Effect of a clinical psychopharmacy consultation service on patient outcomes.

The effect of a psychopharmacy consultation service on outcomes in patients with psychiatric disorders was studied. The medical records of 30 randomly selected patients who had been hospitalized between August 1990 and July 1992 at a private psychiatric institution and who had been seen by the psychopharmacy consultation service during that period were reviewed. Data obtained included (1) patient demographics, (2) patient information generated by the psychopharmacy consultation, (3) the types of recommendations made by the psychopharmacy specialist and whether the recommendations were accepted by the physician, and (4) the clinical outcome. Forty-three psychopharmacy consultations for the 30 patients were evaluated. A total of 125 recommendations were made by the consultation service; of these, 75 (60%) were accepted. The consultations were divided into consultations for which at least a majority of the resulting recommendations were accepted by the physician (n = 29) and consultations for which less than a majority of the recommendations were accepted (n = 14). For the majority group, 23 (79%) of the 29 consultations were associated with a positive outcome, compared with 2 (14%) of the 14 consultations in the less-than-majority group. Similarly, positive outcomes were significantly more frequent in the majority-group patients (16/21 [76%]) than in the less-than-majority-group patients (2/9 [22%]). The frequency of positive outcomes was higher among patients for whom most of the recommendations of a clinical psychopharmacy consultation service were accepted than among patients for whom most recommendations were not accepted.

Adolescent↗
PubMed1993

Effectiveness of an ethics consultation service.

BACKGROUND: Ethics consultation is a relatively new service in clinical medicine. Most such services have been developed in departments of internal medicine. Few studies have evaluated the results of such consultations, and none have examined whether a family practice perspective enhances the consultation process. METHODS: An ethics consultation service was established in the Department of Family Medicine at Loma Linda University School of Medicine in 1990. Data were collected from the consultations performed during the first year. A questionnaire was sent to the attending physicians for their evaluation of the service. RESULTS: Ethics consultations were provided to the health care teams of 46 patients in five clinical departments. The attending physicians found the consultations to be important in clarifying ethical issues, educating the team, increasing confidence in decisions, and in patient management in more than 90% of the cases; however, the consultations resulted in significant changes in patient management only 36% of the time. CONCLUSIONS: It is feasible to establish an ethics consultation service within a department of family medicine in a university hospital and to provide consultations to physicians in other specialties.

Academic Medical Centers↗
PubMed2001

Recurrent abdominal pain and consulting behaviour among children in a rural community in Malaysia.

AIM: To look at predictors of consulting behaviour among children with recurrent abdominal pain in a rural community in Malaysia. SUBJECTS AND METHODS: A sample of 1462 school-children aged between 9 and 15 years were randomly selected from all schools in Kuala Langat, a rural district in Malaysia. Those with recurrent abdominal pain, defined according to Apley's criteria, were recruited and divided into consulters and non-consulters. A consulter was defined as a child who had sought the help of a medical practitioner at least once in the past year for recurrent abdominal pain. A detailed clinical, social and family history was obtained in all recruited children. RESULTS: A total of 161 children were recruited: 78 (48.4%) consulters, 83 (51.6%) non-consulters. Of the consulters, 40 were boys, 38 were girls (male:female ratio = 1.1:1). The two sexes did not show a significant difference in prevalence of consulters [p=0.189). Of the ethnic groups, only Indians had a significantly higher likelihood to consult a doctor (Indians, p=0.006; Malays, p=0.742; Chinese, p=0.050]. Younger children (under 12 years) had a significantly higher chance of having been brought to see a medical practitioner (p=0.014). Children in whom age of onset of abdominal pain was below ten years were also more likely to have been seen by a doctor (p=0.012). Children who had consulted a doctor were more likely to be missing school because of abdominal pain (p<0.001). Pain severity was not a significant factor (p=0.429). Multiple logistic regression analysis revealed that the only variable that remained significantly associated with health-care consultation was school absence (p<0.001). CONCLUSIONS: Children who saw their doctors for recurrent abdominal pain were also more likely to be those who missed school on account of abdominal pain. Following multiple regression analysis, other factors were no longer significant.

Abdominal Pain↗
PubMed2004

Psychosocial and illness related predictors of consultation rates in primary care--a cohort study.

BACKGROUND: Despite extensive research, the reasons why patients consult their doctors are unclear. The aim of the current study was to identify the psychosocial and illness related factors that independently predicted primary care consultation over a 5-year period. METHOD: We carried out a prospective, population-based cohort study with three waves of data collection by postal questionnaire in one general practice in Greater Manchester (UK). Consultation data were sought from primary care records on a random subsample of 800 adult patients. The main outcome measure was the number of consultations (including surgery and home visits) over the 5 years of the study as determined by raters blind to questionnaire responses. Questionnaire measures included the 12-item version of the General Health Questionnaire, the Illness Attitude Scales, a somatic symptom scale, a fatigue scale, a functional assessment of disability. RESULTS: Consultation data were obtained on 738 patients (92% of selected subjects), who accounted for 12182 consultations. Negative illness attitudes, the presence of physical and psychiatric disorder, health anxiety, changes in psychological distress, reported physical symptoms and demographic factors such as age and sex were independently associated with consultation over a 5-year period. These variables together accounted for a difference of ten consultations per year between groups. CONCLUSION: Consultation in primary care is a complex behaviour with a complex aetiology. Terms such as 'frequent attenders' may be less helpful than recognizing a number of dimensions that operate across the whole spectrum of consultation frequency. Future research should consider the wider context of consultation.

Adolescent↗
PubMed1998

Perceived gender differences in physician consulting behaviour during internal examination.

OBJECTIVE: Our aim was to investigate gender-related differences in consulting behaviour among family doctors in Belgium. METHODS: The study was conducted among 32 family physicians and 303 patients. The family physician consulting behaviour was studied during consultations which included either an anal or a vaginal examination on three dimensions: a cure dimension, a care dimension and a dimension of consulting behaviour specific for consultations which included an internal examination. RESULTS: It was found that female family physicians were perceived by both male and female patients as showing more cure behaviour during consultations which included an anal examination. Female family doctors were also perceived as showing significantly more cure behaviour, more care behaviour and more consulting behaviour specific for an internal examination during consultations which included a vaginal examination. Furthermore, it was found that less-well-educated patients perceived more care behaviour during consultations which included an anal examination than did better-educated patients. Finally, less-well-educated patients perceived more cure behaviour and more behaviour specific for an internal examination in their doctor's consulting behaviour during consultations which included a vaginal examination.

Anal Canal↗
PubMed1997

Mortality of doctors in different specialties: findings from a cohort of 20000 NHS hospital consultants.

OBJECTIVES: To examine patterns of cause specific mortality in NHS hospital consultants according to their specialty and to assess these in the context of potential occupational exposures. METHODS: A historical cohort assembled from Department of Health records with follow up through the NHS Central Register involving 18,358 male and 2168 female NHS hospital consultants employed in England and Wales between 1962 and 1979. Main outcome measures examined were cause specific mortality during 1962-92 in all consultants combined, and separately for 17 specialty groups, with age, sex, and calendar year adjusted standardised mortality ratios (SMRs) for comparison with national rates, and rate ratios (RRs) for comparison with rates in all consultants combined. RESULTS: The 2798 deaths at ages 25 to 74 reported during the 30 year study period were less than half the number expected on the basis of national rates (SMR 48, 95% confidence interval (95% CI) 46 to 49). Low mortality was evident for cardiovascular disease, lung cancer, other diseases related to smoking, and particularly for diabetes (SMR 14, 95% CI 6 to 29). Death rates from accidental poisoning were significantly raised among male consultants (SMR 227, 95% CI 135 to 359), the excess being most apparent in obstetricians and gynaecologists (SMR 934); almost all deaths from accidental poisoning involved prescription drugs. A significantly raised death rate from injury and poisoning among female consultants was due largely to a twofold excess of suicide (SMR 215, 95% CI 93 to 423), the rate for this cause being significantly raised in anaesthetists (SMR 405). Compared with all consultants, significantly raised mortality was found in psychiatrists for all causes combined (RR 1.12), ischaemic heart disease (RR 1.18), and injury and poisoning (RR 1.46); in anaesthetists for cirrhosis (RR 2.22); and in radiologists and radiotherapists for respiratory disease (RR 1.68). There were significant excesses of colon cancer in psychiatrists (RR 1.67, compared with all consultants) and ear, nose, and throat surgeons (RR 2.25); melanoma in anaesthetists (RR 3.33); bladder cancer in general surgeons (RR 2.40); and laryngeal cancer in ophthalmologists (RR 7.63). CONCLUSIONS: Lower rates of smoking will have contributed substantially to the low overall death rates found in consultants, but other beneficial health related behaviours, and better access to health care, may have also played a part. The increased risks of accidental poisoning in male consultants, and of suicide in female consultants are of concern, and better preventive measures are needed. The few significant excesses of specific cancers found in certain specialties have no obvious explanation other than chance. A significant excess mortality from cirrhosis in anaesthetists might reflect an occupational hazard and may warrant further investigation.

Adult↗
PubMed2006

The influence of completing a health-related questionnaire on primary care consultation behaviour.

BACKGROUND: Surveys of the population are commonly used to obtain information on health status. Increasingly, researchers are linking self-reported health status information to primary care consultation data. However, it is not known how participating in a health-related survey affects consultation behaviour. The objective of this study was to assess whether completion of a health-related questionnaire changes primary care consultation behaviour. METHODS: Participants were 3402 adults aged 50 and over from the general population in North Staffordshire, UK, who completed a health-related postal survey received in April 2003. The survey was predominantly about occurrence and severity of knee pain in the last year. Primary care attendance for the three months following response was compared to three control periods: i) the three months prior to the survey, ii) the same time period in the previous year and iii) the same time period in the following year. Comparisons were made on consultations for any problem, consultations for musculoskeletal disorders and consultations for knee problems. RESULTS: The percentage of subjects consulting for any condition was marginally higher for the three months directly after receipt of the questionnaire but the difference was only statistically significant in comparison to the three months before the survey (64% v. 62%, p = 0.05). There was little difference in consultation prevalence for musculoskeletal problems immediately after the survey compared to the three control periods. There was an increase of 37% in knee disorder consultations for the three months after the survey compared to the three months directly before the survey (p = 0.02). However, consultation prevalence for knee problems was identical for the three months after the survey to the same time periods in the years prior to and following the survey (both p = 0.94). CONCLUSION: The results from this study suggests that questionnaires related to physical health do not affect the standard consulting behaviour of patients, even for the symptom under investigation. This should reassure researchers who wish to link self-reported health status and medical care utilisation and clinicians whose patients are involved in such research.

Aged↗
PubMed2000

Frequent attenders' consulting patterns with general practitioners.

BACKGROUND: Despite the growing literature on frequent attendance, little is known about the consulting patterns of frequent attenders with different doctors. To develop appropriate intervention strategies and to improve the clinical care of frequent attenders, a full understanding of these consulting patterns is essential. AIMS: This paper has three aims: to determine whether frequent attenders consult more with some doctors than others; to determine how many different doctors frequent attenders consult with; and to determine whether frequent attenders exhibit greater continuity of care than non-frequent attenders. METHOD: Analysis of a validated dataset of 592,028 consultations made by 61,055 patients from four practices over 41 months. Comparisons between the consulting patterns of the frequent attenders, defined as the most frequently consulting 3% of the population by practice, with non-frequent attenders and the overall practice populations. RESULTS: There was considerable variation in the numbers and proportions of consultations with frequent attenders between individual doctors. Most of the frequent attenders consulted with most or all of the doctors within practices over the timeframe. Frequent attenders exhibited more continuity of care than non-frequent attenders. CONCLUSION: The reasons why some doctors have more consultations with frequent attenders is unclear. Some doctors may actively encourage frequent attendance. While many frequent attenders have clear allegiances to one doctor, many also consult widely with a large number of doctors. The consequences of such behaviour are unknown. These findings have important implications in the development of appropriate interventions for reducing problematic frequent attendance.

Continuity of Patient Care↗
PubMed2001

Deprivation, psychological distress, and consultation length in general practice.

BACKGROUND: Recent research has shown the benefits of longer consultations in general practice. Approximately 40% of patients presenting to general practitioners (GPs) are psychologically distressed. Studies have shown that psychological morbidity increases with increasing socioeconomic deprivation. The combined effects of psychological morbidity and socioeconomic deprivation on consultation length are unknown. In addition, though it is known that doctors correctly identify half their distressed patients as such, the effect of consultation length on identification is unknown. AIM: To examine factors associated with presentation and recognition of psychological distress in GPs' surgeries and the interaction of these factors with consultation length. DESIGN OF STUDY: A cross-sectional study. SETTING: Nine general practices in the West of Scotland, involving 1075 consultations of 21 full-time GPs. METHOD: The main outcome measures were patient psychological distress (measured by General Health Questionnaire-12), doctors' identification of psychological distress, consultation length, and Carstairs deprivation category scores. RESULTS: The mean consultation length was 8.71 minutes (SD = 4.40) and the prevalence of positive GHQ scores was 44.7%. Increasing GHQ (greater psychological distress) and lower deprivation category scores (greater affluence) were associated with longer consultations. Positive GHQ scoring increased with greater socioeconomic deprivation and also peaked in the 30 to 39 years age group. Recognition of psychological distress was greater in longer consultations (50% increase in consultation length associated with 32% increase in recognition). CONCLUSION: Increasing socioeconomic deprivation is associated with higher prevalence of psychological distress and shorter consultations. This provides further evidence to support Tudor Hart's 'inverse care law' and has implications for the resourcing of primary care in deprived areas.

Adolescent↗
PubMed2005

Primary care consultation predictors in men and women: a cohort study.

BACKGROUND: Women visit their doctors more than men, but comparatively few studies have explored gender differences in consultation in detail. AIMS: To identify the factors that predicted the number of primary care consultations in men and women over a 5-year period. DESIGN OF STUDY: Prospective cohort study with three waves of data collection by postal questionnaire. SETTING: A single suburban general practice in Greater Manchester, UK. METHOD: Consultation data were sought from primary care records on a random sample of 800 adults. The main outcome measure was the number of consultations over the 5 years of the study. Questionnaire measures included the 12-item version of the General Health Questionnaire, the Illness Attitude Scales, a somatic symptom scale, a fatigue scale, and a functional assessment of disability. RESULTS: Consultation data were obtained on 738 patients (445 women, 293 men, 92% of selected subjects). Longitudinal models of consultation over 5 years showed that changes in psychological distress were more strongly associated with consultation in women than in men, whereas cognitive factors (negative illness attitudes) were more strongly associated with the consultation rate in men than women. CONCLUSION: The predictors of consultation in primary care may be different for men and women. A fuller understanding of the reasons for consultation may enable primary care doctors to better help individual patients, as well as perhaps contributing more generally to the development of gender specific interventions for those who consult unusually frequently.

Adolescent↗
PubMed1994

Repeat consultations after antibiotic prescribing for respiratory infection: a study in one general practice.

BACKGROUND: Several new antibacterial drugs have been introduced in the last 10 years with the aim of improved treatment of respiratory tract infection. AIM: The study set out to use repeat consultations as a measure of the outcome of antibiotic treatment for respiratory tract infection, and to develop a simple model for discussion of the cost effectiveness of alternative antibiotic treatments. METHOD: All consultations to one practice during a single winter were reviewed by one general practitioner. RESULTS: A total of 1140 patients had acute symptoms suggestive of respiratory infection. Of these, 899 patients (79%) were prescribed antibiotics at the first consultation and 160 of the 899 patients (18%) returned for one or more repeat consultations; only nine repeat consultations were due to adverse effects of the antibiotics prescribed. Only two patients were admitted to hospital for respiratory symptoms following initial antibiotic therapy and both patients had additional reasons for their admission. Using the highest estimates, the cost of a repeat consultation was found to be 28.54 pounds. These data were used to calculate how much more might be spent on more effective antibiotics at the first consultation. It would be difficult to justify increasing the cost of antibiotic treatment by more than 5 pounds per patient, even if the new treatment were 100% effective and all repeat consultations were due to treatment failure (5 pounds is equal to 28.54 pounds x 0.18, which is the maximum cost of a repeat consultation multiplied by the proportion of patients prescribed antibiotics who make repeat consultations). CONCLUSION: From these results and a review of the literature it can be concluded that new antibacterial drugs will have to be carefully targeted if they are to prove cost effective in practice. Other methods for reducing repeat consultation merit investigation.

Adolescent↗
PubMed1998

[Psychosocial impact of the first oncogenetic consultation in a familial context of cancers of the breast and the ovary].

The purpose of the oncogenetic consultation, is to respond to persons who wonder about their risk of developing a tumour and wish to learn about ways of prevention and detection. The object of this investigation is (1) to study the impact of a first consultation in genetics on the quality of life and the psychology of women with a family history of cancer, and women with or without family antecedents but who suffered themselves from breast cancer at an early age (< or = 35 years); (2) to evaluate their risk perception and their comprehension of the information after the consultation. The study was performed on 200 women attending a first consultation at Institut Curie. Fifty-nine of them had no cancer. Among the 141 consultants with cancer, 54 had developed breast cancer at an early age (< or = 35 years). Their quality of life, their psychological state and their knowledge of the risk of breast tumour were evaluated before consulting and 6-8 months afterwards. Before consulting, their quality of life was altered in some (non-relational) fields but their psychic condition was relatively maintained. Six-nine months after consulting, their quality of life had not deteriorated, but tests results on their psychological state were not as good. The initial psychic condition, itself related to the medical status of the consulting women, was the most significant predictor of their quality of life a few months after their first genetics consultation. After consulting, the women expressed satisfaction with the information delivered by the genetician and their appreciation of tumour risks was improved.

Adult↗