Exploring factors that influence patient satisfaction in genetic counseling: a post-hoc qualitative analysis of perceived empathy by patients with hereditary breast and ovarian cancer in Japan.

BACKGROUND

Patient satisfaction is essential for the effective delivery and expansion of genetic counseling services in Japan, yet patients' perspectives remain underexplored. This study examined factors shaping satisfaction with cancer genetic counseling using expectation-disconfirmation theory (EDT), which conceptualizes satisfaction as the interaction between prior expectations and perceived performance, offers a useful framework for understanding these experiences.

METHODS

Semi-structured interviews were conducted with thirteen participants (mean age 48 ± 10 years) diagnosed with hereditary breast and ovarian cancer (HBOC) or with family members affected by HBOC. Data analysis involved inductive thematic analysis followed by conceptual and interpretative analysis within the EDT framework.

RESULTS

Two themes emerged: (i) expectations of genetic counseling and its perceived usefulness, and (ii) trust in medical staff cultivated through the follow-up process. When counseling met or exceeded expectations, participants recalled empathic care positively, whereas unmet expectations diminished recall of empathic elements. Trust built through sustained interactions contributed to satisfaction regardless of whether expectations were fulfilled. Participants valued repeated, informal encounters -such as conversations during blood draws or frequent check-ins-which conveyed compassion beyond the formal counseling session.

CONCLUSION

Satisfaction with genetic counseling is shaped by expectation confirmation or disconfirmation and by trust established through long-term relationships with healthcare providers. While EDT explains part of this process, a complementary framework emphasizing interpersonal care and implicit hospitality may better account for satisfaction in cases of negative disconfirmation. These findings highlight the importance of clear communication regarding the scope of genetic counseling and suggest that integrating opportunities for ongoing patient-provider interactions may enhance genetic service delivery.