The evaluation of the `stages of change' model for use in counselling client's undergoing predictive testing for Huntington's disease

Abstract

Nurses are increasingly working in new and novel situations which may be outside the realms of traditional nursing practice. Therefore when evaluating theories and models that may be utilized in these situations it may be necessary to look beyond established nursing theories and concepts. This paper therefore attempts to evaluate Prochaska & DiClemente's (1983) stages of change model for its goodness of fit when counselling people as part of the predictive testing programme for Huntington's disease. The model demonstrates that in order to provide effective communication it is important to recognize the particular stage a client is at in his/her decision-making process concerning predictive testing. The relevance of the model to generic genetic counselling in nursing practice is discussed and the importance of stage-matched nursing interventions is emphasized. The model's non-reliance on the medical model or the concept of illness means that it may also be a useful model when applied to other nursing situations.

The roles of family members, health care workers, and others in decision-making processes about genetic testing among individuals at risk for Huntington disease

“…[16] This woman had to balance desire for the information against several costs entailed and was most swayed by the latter. The cost and time involved in the process of counseling and testing could also deter testing.…”

Decision‐Making About Reproductive Choices Among Individuals At‐Risk for Huntington's Disease

“…Such a model has not been explored with regard to HD reproductive decisions, but may offer insights. With regard to decisions about genetic testing for HD, Stages of Change models have also been suggested: e.g., that individuals enter a precontemplative phase (Houlihan, 1999;Taylor, 2005). With regard to HD reproductive decisions, individuals may indeed undergo a process, including precontemplation stages as well.…”

Referral to cancer genetic counseling: Are there stages of readiness?

“…The DBS construct is intriguing as applied to uptake of genetic counseling and testing. Houlihan suggests applying the model to facilitate decision making about genetic testing for Huntington disease [Houlihan, 1999], while recognizing that genetic testing is a “one‐time” decision and the goal of genetic counseling is not to promote one decision over another. Jacobsen applied it to hypothetical decision making about BRCA1 testing by women with a family history of breast cancer (before the test was actually available).…”