University of Warwick, UK.
Health (London). 2011 Jul;15(4):401-15. doi: 10.1177/1363459310384493. Epub 2010 Dec 15.
Clinicians are increasingly asking questions about family history to inform decision making, but the quality of decisions rests on the quality of information provided by the patient. In families with genetically transmitted diseases, research has found a strong collective understanding of inheritance and risk, developed through constant communication between family members. Here, we explore whether there are similar processes in families with more common conditions like heart disease, asthma or osteo-arthritis. From in-depth interviews with lay people, we found that families created a culture of 'health talk', especially between sisters. Caring for other family members was demonstrated through sharing vital health information; on the other hand care could be shown by not worrying family members by talking about possibly inherited illness. Patterns of inheritance and health were talked about in participants' families (resemblance, similar conditions and affected body areas). From these, a picture developed of what the family was 'like' in health terms. Overall, experiential knowledge and family narrative was interwoven with expert discourse to form a complex understanding of medical family histories.
临床医生越来越多地询问家族史以做出决策，但决策的质量取决于患者提供的信息的质量。在具有遗传疾病的家庭中，通过家庭成员之间的不断交流，已经发现了对遗传和风险的强烈集体理解。在这里，我们探讨了在心脏病、哮喘或骨关节炎等更为常见的情况下，家庭中是否存在类似的过程。通过对非专业人士的深入访谈，我们发现家庭中形成了一种“健康谈话”的文化，尤其是姐妹之间。通过分享重要的健康信息来照顾其他家庭成员；另一方面，通过不谈论可能遗传的疾病来不让家人担心，也可以表现出关怀。在参与者的家庭中讨论了遗传和健康模式（相似之处、相似的病症和受影响的身体部位）。由此，形成了一幅关于家庭在健康方面“是什么样”的画面。总的来说，经验知识和家庭叙事与专业话语交织在一起，形成了对医学家族史的复杂理解。
