Article Text
Abstract
Introduction Availability and affordability of genetic testing and counselling for gynaecological malignancies remain an unmet clinical need in LMICs. Through KolGoTrg, we started an implementation research project NuGenA to overcome these barriers by training nurses to improve genetic testing uptake and identifying at-risk family members(www.kolgotrg.org/nugena/).Training workshops were held for nurses in India and Nepal. We aimed to explore knowledge attitude practice (KAP) and perceived barriers from the provider end in implementing nurse-led hereditary cancer clinics using an EASE model(table 1).
Methods Gyn Oncology leads interested in setting up genetic clinics in India and Nepal were invited to send nurses for 3-day structured training workshops. The lead nurse, trained in genetic counselling (Co-PI) was the key educator. Pre-and post-training assessment of KAP was done and a survey (27 items) was sent out one month after the workshop to assess success/challenges faced in implementing nurse-led service/family history clinics.
Results 30 nurses participated: 11 from 5 centres in India and 19 from10 centres in Nepal. Significant improvement occurred in post-workshop level of KAP. 11(39%) nurses commenced a service by setting up clinics (6 centres)/starting counselling patients. > 90% expressed interest in further courses, workshops and setting up clinics. Barriers identified included: institutes not interested,lack of awareness amongst doctors (59% respondents), patient overburdening in clinics/lack of clinic time, requirement for administrative approval, staff crisis, cost of genetic tests, lack of local dedicated labs
Conclusion/Implications Continued effort is required for provider training and awareness for scalability of nurse-led genetic counselling services including inclusion in Gyn Oncology nursing curriculums.