How do women at increased risk of breast cancer make sense of their risk? An interpretative phenomenological analysis

IF 3.5 2区 心理学 Q1 PSYCHOLOGY, CLINICAL British Journal of Health Psychology Pub Date : 2023-07-03 DOI:10.1111/bjhp.12678
Victoria G. Woof, Lorna McWilliams, Anthony Howell, D. Gareth Evans, David P. French
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Abstract

Objectives

Offering breast cancer risk prediction for all women of screening age is being considered globally. For women who have received a clinically derived estimate, risk appraisals are often inaccurate. This study aimed to gain an in-depth understanding of women's lived experiences of receiving an increased breast cancer risk.

Design

One-to-one semi-structured telephone interviews.

Methods

Eight women informed that they were at a 10-year above-average (moderate) or high risk in a breast cancer risk study (BC-Predict) were interviewed about their views on breast cancer, personal breast cancer risk and risk prevention. Interviews lasted between 40 and 70 min. Data were analysed using Interpretative Phenomenological Analysis.

Results

Four themes were generated: (i) encounters with breast cancer and perceived personal significance, where the nature of women's lived experiences of others with breast cancer impacted their views on the significance of the disease, (ii) ‘It's random really’: difficulty in seeking causal attributions, where women encountered contradictions and confusion in attributing causes to breast cancer, (iii) believing versus identifying with a clinically-derived breast cancer risk, where personal risk appraisals and expectations influenced women's ability to internalize their clinically derived risk and pursue preventative action and (iv) perceived utility of breast cancer risk notification, where women reflected on the usefulness of knowing their risk.

Conclusions

Providing (numerical) risk estimates appear to have little impact on stable yet internally contradictory beliefs about breast cancer risk. Given this, discussions with healthcare professionals are needed to help women form more accurate appraisals and make informed decisions.

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癌症风险增加的女性如何理解自己的风险?一种解释性的现象学分析。
目标:全球正在考虑为所有筛查年龄的女性提供癌症风险预测。对于接受过临床评估的女性来说,风险评估往往是不准确的。这项研究旨在深入了解女性接受癌症风险增加的生活经历。设计:一对一的半结构化电话采访。方法:对8名在癌症风险研究(BC-Predict)中处于10年平均以上(中等)或高风险的女性进行访谈,了解她们对癌症乳腺癌、个人癌症风险和风险预防的看法。面试时间在40到70之间 min.使用解释性现象学分析对数据进行分析。结果:产生了四个主题:(i)遇到癌症和感知的个人意义,其中女性与其他癌症患者的生活经历的性质影响了她们对疾病意义的看法,(ii)“这真的是随机的”:难以寻求因果归因,妇女在将病因归因于乳腺癌症方面遇到矛盾和困惑,(iii)相信与识别临床衍生的癌症风险,其中个人风险评估和期望影响妇女将临床衍生风险内在化并采取预防行动的能力,以及(iv)癌症风险通知的感知效用,在那里,女性反思了了解自己风险的有用性。结论:提供(数字)风险估计似乎对关于癌症风险的稳定但内部矛盾的信念几乎没有影响。有鉴于此,需要与医疗保健专业人员进行讨论,以帮助女性形成更准确的评估并做出明智的决定。
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来源期刊
British Journal of Health Psychology
British Journal of Health Psychology PSYCHOLOGY, CLINICAL-
CiteScore
14.10
自引率
1.30%
发文量
58
期刊介绍: The focus of the British Journal of Health Psychology is to publish original research on various aspects of psychology that are related to health, health-related behavior, and illness throughout a person's life. The journal specifically seeks articles that are based on health psychology theory or discuss theoretical matters within the field.
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