Addressing the Support Needs of Women at High Risk for Breast Cancer: Evidence-Based Care by Advanced Practice Nurses

PURPOSE/OBJECTIVES: To identify support needs of women at high risk for breast cancer and enhance an evidence-based service. DESIGN: Descriptive study. SETTING: A comprehensive, breast-health service for high-risk women. SAMPLE: 97 high-risk women with a 1.66% or greater five-year risk of breast cancer, atypical hyperplasia, lobular carcinoma in situ, or positive genetic screen. METHODS: A self-assessment questionnaire completed previsit and a satisfaction survey completed postvisit. MAIN RESEARCH VARIABLES: Women's perceived informational, emotional, and decisional support needs, current self-care practices, and satisfaction with the service provided. FINDINGS: Women under age 50 (n = 54) wanted information on breast cancer screening, risk of breast cancer, lifestyle options to lower risk, and hormone replacement therapy; older women (n = 43) wanted information on risk of breast cancer, lifestyle options, breast cancer screening, and chemoprevention. More than 75% of all women wanted information to help them make decisions on breast cancer prevention options, benefits, and risks. The satisfaction survey (N = 61) revealed that most women's needs were met. CONCLUSIONS: Support needs were consistent with the literature that focused primarily on younger women seeking genetic counseling. Proactive planning assisted with addressing the needs of these women. IMPLICATIONS FOR NURSING: A previsit questionnaire facilitates individualized proactive planning before the visit. However, further assessment of self-care practices and emotional needs is required. Interventions should evaluate outcomes, such as accurate risk perception, lifestyle changes, screening follow-through, and decision quality. Advanced practice nurses require specialized skills, including evidence-based risk communication, behavior modification, and decision support.