Department of Communication, University of South Florida, Tampa, FL, USA.
Vanderbilt-Ingram Cancer Center in the Department of Medicine, Division of Genetic Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
Patient Educ Couns. 2021 Apr;104(4):720-725. doi: 10.1016/j.pec.2020.12.019. Epub 2021 Jan 5.
This study explored motivators and challenges/barriers to sharing personal genetic test results (GTR) with family members (FM).
Semi-structured, in-depth interviews were conducted with 62 women who had a pathogenic or likely pathogenic (P/LP) variant in aBRCA, PALB2, CHEK2, or ATM gene. Selective qualitative data analysis focused on eliciting motivators and challenges/barriers identified by participants when sharing their GTR with FM.
Motivators to sharing personal GTR with FM included: health protection and prevention; moral obligation; decisional empowerment; familial ties; written resources; and contextualization for a familial cause for cancer. Challenges/barriers to family sharing included: concern for FM reactions; complexities of information; lack of closeness; perceived relevance; and emotional impact.
All motivators and challenges/barriers were identified across BRCA and non-BRCA carriers, demonstrating commonalities in family sharing of GTR among high- to moderate-penetrance hereditary BC (breast cancer) genes. Despite challenges/barriers, participants disclosed their GTR with most close FM, yet restrictions in communication and/or strain on the timing, manner of disclosing, and strategies used varied across certain FM.
These findings offer healthcare providers and researchers preliminary practical implications for broadly improving family sharing interventions across P/LP variants in BC risk genes by demonstrating important elements to include in family sharing letters.
本研究探讨了与家庭成员(FM)分享个人基因检测结果(GTR)的动机以及挑战/障碍。
对 62 名携带致病性或可能致病性(P/LP)BRCA、PALB2、CHEK2 或 ATM 基因突变的女性进行了半结构化深入访谈。选择定性数据分析重点在于引出参与者在与 FM 分享 GTR 时确定的动机和挑战/障碍。
与 FM 分享个人 GTR 的动机包括:健康保护和预防;道德义务;决策赋权;家庭关系;书面资源;以及为癌症的家族原因进行背景化。家庭分享的挑战/障碍包括:担心 FM 的反应;信息的复杂性;缺乏亲近感;感知相关性;以及情绪影响。
所有动机和挑战/障碍在 BRCA 和非 BRCA 携带者中均被识别,这表明在高到中度外显率遗传性 BC(乳腺癌)基因中,GTR 在 FM 之间的家族共享具有共同性。尽管存在挑战/障碍,参与者还是向大多数近亲 FM 透露了他们的 GTR,但在沟通方面存在限制,或者在透露的时间、方式、策略使用上存在压力,这些在某些 FM 中有所不同。
这些发现为医疗保健提供者和研究人员提供了初步的实践意义,通过展示在 BC 风险基因中包含 P/LP 变体的家庭共享信件中包含的重要元素,广泛改善家庭共享干预措施。