Mesters Ilse, Ausems Marlein, Eichhorn Sophie, Vasen Hans
Department of Health Education and Health Promotion, University Maastricht, P.O. Box 616, 6200 Maastricht, The Netherlands.
Fam Cancer. 2005;4(2):163-7. doi: 10.1007/s10689-004-7992-1.
The family-link approach of case finding is considered the fastest and most efficient approach to trace people with hereditary disease. Therefore, there is a need to understand if, why, and how people with hereditary non-polyposis colorectal cancer (HNPCC) inform their biological family.
To explore people's perspective on informing one's biological family regarding a hereditary predisposition for HNPCC.
In-depth interviews were conducted with 30 people recruited from the database of the Netherlands Foundation for Detection of Hereditary Tumours (STOET). Interviews were transcribed and analyzed thematically.
Disclosure was stimulated if people felt morally obliged to do so or when they anticipated regret if something happened because it is preventable. Motivation to disclose seemed to increase if there were, especially fatal, cancer cases in the family. Presence of external cues (e.g. professionals) appeared important for disclosure as well. Disrupted and tense family relations were reasons not to disclose, as well as young age of the message recipients and negative experiences at their first attempt to disclose (a novel finding). Disclosure was merely restricted to the nuclear family. A personal approach in this respect was preferred. With respect to content of the disclosure, participants reported to solely announce the presence of the hereditary defect and the possibility of testing. It was mostly considered the recipients' responsibility and own choice to obtain further (technical/medical) information.
病例发现的家族联系方法被认为是追踪遗传性疾病患者最快且最有效的方法。因此,有必要了解遗传性非息肉病性结直肠癌(HNPCC)患者是否、为何以及如何告知其生物学家族成员。
探讨人们对于向生物学家族成员告知HNPCC遗传易感性的看法。
对从荷兰遗传性肿瘤检测基金会(STOET)数据库招募的30人进行了深入访谈。访谈内容进行了转录并进行了主题分析。
如果人们觉得有道德义务这样做,或者当他们预计如果因为可预防的事情发生而会感到后悔时,就会促使他们进行披露。如果家族中存在尤其是致命的癌症病例,披露的动机似乎会增加。外部线索(如专业人员)的存在对披露也显得很重要。家庭关系破裂和紧张是不进行披露的原因,信息接收者年龄小以及首次披露时的负面经历(一项新发现)也是如此。披露仅局限于核心家庭。在这方面,人们更喜欢采用个性化的方式。关于披露的内容,参与者报告说只宣布存在遗传缺陷以及检测的可能性。大多数人认为获取进一步(技术/医学)信息是信息接收者的责任和个人选择。