The Effect of BRCA Gene Testing on Family Relationships: A Thematic Analysis of Qualitative Interviews
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Discovery of mutations in the breast and ovarian cancer susceptibility genes BRCA1 and BRCA2 can have emotional consequences for both the tested individual and his or her relatives. This secondary analysis study investigated how BRCA testing impacts family dynamics and relationships. For the original study, a grounded theory inquiry, participants were recruited from a hereditary breast/ovarian cancer syndrome support website and open-ended interviews were performed asking about individual and family experiences after BRCA testing. All 12 participants whose interviews were included in the secondary analysis had a BRCA mutation. For the secondary analysis, thematic analysis was conducted and revealed three main themes characterizing the effect of BRCA testing on family relationships: 1. That the first in the family to have testing or seek genetic counseling takes on a special family role that can be difficult for them; 2. That discussions in the family often change; and 3. That individuals may feel more or less connected to certain family members. These changes seemed to relate to family cancer history, relationships, coping strategies, communication patterns, and mutation status. Genetic counselors might find it useful to explore these issues in order to prepare clients before BRCA testing and to support them through shifts in family dynamics after disclosure of results.
KeywordsQualitative research BRCA Hereditary cancer Family relationships Psychosocial Genetic testing Secondary analysis
We thank the research participants for sharing their time and insight during the original study. This research was supported financially by a grant from Sigma Theta Tau International for 2004 and 2005. We also thank Elizabeth (Betsy) Gettig, MS, CGC and Darcy Thull, MS, CGC for helpful comments on the manuscript. This secondary analysis was conducted in partial fulfillment of author HAD’s Master of Science degree from the University of Pittsburgh. This work was presented at the National Society of Genetic Counselors 27th Annual Education Conference, October 23–28, 2008.
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