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.