Communication Patterns in Korean Families during BRCA Genetic Testing for Breast Cancer
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Purpose: The purpose of this micro-ethnography is to examine whether science and societal changes impact family communication patterns among a convenience sample of 16 Korean women. Methods: The authors observed family communication in the context of a new breast cancer genetic screening and diagnostic testing program to detect BRCA gene mutations in Korean women at highest risk. Results: Analysis of in-depth interviews and field notes taken during participant observation illustrated that communication patterns in families vary according to a woman’s position in the family. If a grandmother tests positive for a gene mutation, her daughters make decisions on her behalf; they open and maintain the communication channel among family members. If a housewife is diagnosed with cancer and a genetic mutation, she immediately consults her husband and her sisters. The husband creates an open communication channel between his wife, his parents and his siblings. As a result, a woman’s cancer is a concern for the whole family not merely a woman’s secret or crisis. Conclusion: Cultural differences are important to consider when designing new genetic service programs in different countries.
Abstract
Purpose: The purpose of this micro-ethnography is to examine whether science and societal changes impact family communication patterns among a convenience sample of 16 Korean women. Methods: The authors observed family communication in the context of a new breast cancer genetic screening and diagnostic testing program to detect BRCA gene mutations in Korean women at highest risk. Results: Analysis of in-depth interviews and field notes taken during participant observation illustrated that communication patterns in families vary according to a woman’s position in the family. If a grandmother tests positive for a gene mutation, her daughters make decisions on her behalf; they open and maintain the communication channel among family members. If a housewife is diagnosed with cancer and a genetic mutation, she immediately consults her husband and her sisters. The husband creates an open communication channel between his wife, his parents and his siblings. As a result, a woman’s cancer is a concern for the whole family not merely a woman’s secret or crisis. Conclusion: Cultural differences are important to consider when designing new genetic service programs in different countries.
참고문헌 (28)
- Rothemund Y, "Perception of risk, anxiety, and health behaviors in women at high risk for breast cancer", Int J Behav Med, 8, pp.230~239 (2001)
- Anderson G, "Breast cancer screening for Korean women must consider traditional risks as well as two genetic risk factors: genetic polymorphisms and inheritable gene mutations", Cancer Nurs, 30, pp.1~10 (2007)
- Han SA, "Korean Breast Cancer Study Group. The Korean Hereditary Breast Cancer (KOHBRA) study: protocols and interim report", Clin Oncol (R Coll Radiol), 23, pp.434~441 (2011)
- Lee EH, "Effect of BRCA1", 2 mutation on short-term and long-term breast cancer survival: a systematic review and meta-analysis, 2010, pp.122, 11~25[DOI]
- Ahn SH, "BRCA1 and BRCA2 germline mutations in Korean breast cancer patients at high-risk of carrying mutations", Cancer Letter, 245, pp.90~95 (2007)
- Crotser CB, "Women receiving news of a family BRCA1", 2 mutation:messages of fear and empowerment, 2010, pp.42, 368~378
- Vos J, "Family communication matters: the impact of telling relatives about unclassified variants and uninformative DNA-test results", Genet Med, 13, pp.333~341 (2011)
- Welkenhuysen M, "The language of uncertainty in genetic risk communication: Framing verbal versus numerical information", Patient Educ Couns, 43, pp.179~187 (2001)
- 전명희, "국내 고위험 유전성 유방암 환자의 유전자검사 경험*", Asian Oncology Nursing, 5(2), pp.146~158 (2005), 대한종양간호학회
- Ropper J, "Ethnography in nursing research" (2000), Sage Publication
- Agar M, "The professional stranger" (1980), Academic Press
- 박통희, "The Influences of Familism on Interpersonal Trust of Korean Public Officials", International Review of Public Administration, 9(1), pp.121~134 (2004), 한국행정학회
- DudokdeWit AC, "BRCA1 in the family: A case description of the psychological implications", Am J Med Genet, 71, pp.63~71 (1997)
- Marteau T, "The troubled helix: Social and psychological implications of the new human genetics" (1996), Cambridge Univ
- Claes E, "Communication with close and distant relatives in the context of genetic testing for hereditary breast and ovarian cancer in cancer patients", Am J Med Genet, 116A, pp.11~19 (2003)
- Kenen R, "Health women form suspected hereditary breast and ovarian cancer families: The significant others in their lives", Eur J Cancer Care, 13, pp.169~179 (2003)
- Gu BK, "Comparison of Knowledge According to the Risk of Hereditary Breast Cancer", 박사, pp.2007
- Friesen P, "Interactive family learning following a cancer diagnosis", Oncol Nurs Forum, 통권 : 29, pp.981~987 (2002)
- Powe BD, "Cancer fatalism", Cancer Nurs, 26, pp.454~465 (2003)
- Chapman E, "Ethical dilemmas in testing for late-onset conditions: Reactions to testing and perceived impact on other family members", J Genet Couns, 11, pp.351~367 (2002)
- Doukas D, "The family covenant and genetic testing", Am J Bioeth, 1, pp.2~10 (2001)
- Loewy R, "Families, communities, and making medical decisions", J Clin Ethics, 2, pp.150~153 (1991)
- Douglas HA, "The effect of BRCA gene testing on family relationships: A thematic analysis of qualitative interviews", J Genet Couns, 18, pp.418~435 (2009)
- Ersig AL, "Understanding patterns of health communication in families at risk for hereditary nonpolyposis colorectal cancer: examining the effect of conclusive versus indeterminate genetic test results", Health Commun, 26, pp.587~594 (2011)
- Hall M, "Patients’ fear of genetic discrimination by health insurance: The impact of legal protections", Genet Med, 2, pp.214~221 (2000)
- Hall M, "Laws restricting health insurers’ use of genetic information: Impact on genetic discrimination", Am J Med Genet, 66, pp.293~307 (2000)
- Hurst M, "Family stories: narrative genetics and conceptions of heritability in pregnant women", J Midwifery Womens Health, 56, pp.26~32 (2011)
- Boylan, M, "Autonomy: The delicate balance: Genetic testing", Camb Q Healthc Ethics, 11, pp.246~256 (2002)