Schroeder Dawn, Duggleby Wendy, Cameron Brenda L
Author Affiliations: Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
Cancer Nurs. 2017 Sep/Oct;40(5):386-393. doi: 10.1097/NCC.0000000000000438.
In families where genetic testing for the breast cancer 1 and 2 genes (BRCA1/2) has not identified a deleterious mutation, the risk for hereditary breast cancer (HBC) can still be high when there is a strong family history. Little is known about how an awareness of risk for HBC impacts the everyday lives of unaffected women (no personal history for breast and/or ovarian cancer) in these families.
The aim of this study is to explore how unaffected women, living in BRCA1/2-negative families, experience living with risk for HBC.
van Manen's hermeneutic phenomenological approach guided this study. Unaffected at-risk women were recruited from a hereditary breast and ovarian cancer clinic in Western Canada.
Nine women participated in 20 open-ended conversations. Phenomenological reflection on the 4 life existentials (lived space, body, time, and relations) revealed "Moving In and Out of the What-Ifs" as an overarching description that was communicated through the following themes: "Just Moving Along: Living a Normal Life," "Moving Into Those Dark Spaces," "Is there Something Wrong With Me"? "Markings in Time," "Living in the Moment," "Being Cared For," and "Keeping Me Grounded."
The findings reveal how knowledge from predictive medicine impacts the lives of women and the importance of supportive relations and provides a foundation for future research into how health is perceived.
The findings inform the practices of healthcare professionals as they engage in discussions with women living with risk for HBC and highlight the importance of a supportive relationship.
在那些对乳腺癌1号和2号基因(BRCA1/2)进行基因检测却未发现有害突变的家庭中,若家族病史强烈,遗传性乳腺癌(HBC)的风险仍可能很高。对于HBC风险意识如何影响这些家庭中未受影响女性(无乳腺癌和/或卵巢癌个人病史)的日常生活,我们知之甚少。
本研究旨在探讨生活在BRCA1/2基因检测呈阴性家庭中的未受影响女性如何体验HBC风险。
本研究采用范曼的诠释现象学方法。从加拿大西部一家遗传性乳腺癌和卵巢癌诊所招募未受影响的高危女性。
9名女性参与了20次开放式对话。对4种生活存在要素(生活空间、身体、时间和关系)的现象学反思揭示了“穿梭于假设之中”这一总体描述,它通过以下主题得以体现:“照常生活:过正常生活”“走进那些黑暗空间”“我有什么问题吗?”“时间印记”“活在当下”“被关爱”以及“让我脚踏实地”。
研究结果揭示了预测医学知识如何影响女性生活以及支持性关系的重要性,并为未来关于健康认知的研究奠定了基础。
这些发现为医疗保健专业人员与有HBC风险的女性进行讨论时的实践提供了参考,并突出了支持性关系的重要性。