학술논문

Family Health Leaders: Lessons on Living with Li-Fraumeni Syndrome across Generations
Document Type
Report
Source
Family Process. Dec 2020, Vol. 59 Issue 4, p1648, 16 p.
Subject
Health care industry
Family
Cancer research
Epidemiology
Family relations
Cancer screening
Cancer -- Diagnosis
Cancer -- Research
Oncology, Experimental
Domestic relations
Language
English
ISSN
0014-7370
Abstract
Keywords: Family; Psychosocial; Roles; Hereditary Cancer; Li-Fraumeni Syndrome Li-Fraumeni Syndrome (LFS) is a hereditary disorder that confers an approximately 90% lifetime risk of cancer and requires comprehensive lifetime cancer screening. We explored healthcare roles for managing LFS-related cancer risks and treatments that were assumed by parents, adolescents, and adult children. Semi-structured interviews were conducted with 23 families. Family groupings were comprised of 2-5 members, with the younger generation in each family ranging in age from 7 to 40 years. Using grounded theory methods, we conducted open and focused coding of interview transcript content. Family members described how the role of health leader was implemented in their family, as well as factors such as maturation of a child or death of a member that determined who assumed particular roles and how these roles shifted over time. They often expressed collective responsibility for helping relatives understand LFS and implement appropriate cancer risk management. Members demonstrated their health role by attending others' medical appointments for support or information gathering. The health leader role was intergenerational and provided the family necessary support in navigating complicated healthcare decisions. Our findings provide insight into healthcare providers regarding how LFS patients and their relatives develop unique medical decision-making and caring roles influenced by the hereditary nature of LFS, and how these roles change over time. Providers who are attuned to family role dynamics may be better able to meet relatives' psychosocial and medical needs by understanding how living with LFS influences the family system's functioning and facilitating members' support for each other. Article Note: This study was funded by the Intramural Research Program of the Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health and through contract HHSN261201300003C with Westat, Inc. This work was supported by the Clinical Genetics Branch, National Cancer Institute. We also sincerely thank the families that participated in these interviews. Byline: Ashley Pantaleao, Jennifer L. Young, Norman B. Epstein, Mae Carlson, Renee C. Bremer, Payal P. Khincha, June A. Peters, Mark H. Greene, Kevin Roy, Maria Isabel Achatz, Sharon A. Savage, Allison Werner-Lin