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Examining intrafamilial communication of colorectal cancer risk status to family members and kin responses to colonoscopy: a qualitative study

Title: Examining intrafamilial communication of colorectal cancer risk status to family members and kin responses to colonoscopy: a qualitative study
Authors: McGarragle, Kaitlin M; Hare, Crystal; Holter, Spring; Facey, Dorian A; McShane, Kelly; Gallinger, Steven; Hart, Tae L
Publisher Information: University of Toronto
Publication Year: 2019
Collection: University of Toronto: Research Repository T-Space
Description: Background First-degree relatives (FDRs) of probands with colorectal cancer (CRC) may be at increased risk of CRC and require colonoscopy. Proband disclosure about this risk and need for colonoscopy is essential for FDRs to take appropriate action. Low colonoscopy rates are reported among FDRs and little is known about the proband disclosure process. A better understanding of the barriers surrounding colonoscopy and disclosure is needed. Methods CRC probands (n = 16) and FDRs (n = 9), recruited from a Canadian CRC Consortium, completed interviews to determine barriers to disclosure and colonoscopy, respectively. Interviews were analyzed using thematic analysis and participants’ motivation to disclose to FDRs or undertake colonoscopy was categorized into Stages of Change (i.e., Precontemplation, Contemplation, Preparation, Action, or Maintenance) using the transtheoretical model. Results 25% of probands had not disclosed to any first-degree kin and were categorized in the Precontemplation or Contemplation Stage of Change. Barriers to disclosure included lack of information, negative expectations about familial reaction, assuming FDRs were aware of risk or already being screened, dysfunctional family dynamics, and cultural barriers. 75% of FDRs were categorized in the Precontemplation or Contemplation Stage of Change. Barriers included negative perceptions about colonoscopy, health-care provider related factors, practical concerns, and lack of information about CRC, risk, and colonoscopy. Conclusions In the absence of barriers such as cost and accessibility, this Canadian sample still reported several challenges to disclosure and colonoscopy adherence. Future research should explore interventions such as motivational interviewing to improve proband disclosure and to increase FDR adherence to colonoscopy.
Document Type: article in journal/newspaper
File Description: application/pdf
Language: English
Relation: Hereditary Cancer in Clinical Practice. 2019 Jun 26;17(1):16; http://hdl.handle.net/1807/95527
DOI: 10.1186/s13053-019-0114-8
Availability: http://hdl.handle.net/1807/95527; https://doi.org/10.1186/s13053-019-0114-8
Rights: Attribution 4.0 International ; https://creativecommons.org/licenses/by/4.0/ ; The Author(s).
Accession Number: edsbas.3390D40
Database: BASE