Expectations versus reality: The impact of men's expectancy violations in conversations with healthcare providers about BRCA-related cancer risks. Issue 9 (September 2019)

• Record Type: Journal Article
• Authors: Dean, Marleah; Rauscher, Emily; Gomez, Emily; Fischer, Cierra
• Is Part Of: Patient education and counseling. Volume 102:Issue 9(2019)
• Page Start: 1650
• Page End: 1655
• Publication Date: 2019-09
• Subjects: BRCA -- Hereditary cancer -- Genetics -- Information -- Expectations -- Risk management; Patient education -- Periodicals; Health counseling -- Periodicals; Health education -- Periodicals; Counseling -- Periodicals; Patient Education -- Periodicals; Éducation des patients -- Périodiques; Counseling -- Périodiques; Éducation sanitaire -- Périodiques; 615.5071
• DOI: 10.1016/j.pec.2019.04.010
• Languages: English
• ISSNs: 0738-3991

Abstract

Graphical abstract: Highlights: Like women, men are at risk for hereditary cancers due to genetic variants. Qualitative interviews were conducted regarding men's doctor-patient interactions. Violations of men's expectations for such interactions influence their outcomes. Abstract: Objective: To investigate the experiences of men with germline pathogenic BRCA variants or who have a first-degree family member who tested positive for BRCA regarding their interactions with healthcare providers about their cancer risks. Methods: 25 phone interviews were conducted with men at risk for hereditary cancer. Data were analyzed using an iterative approach where emergent themes were compared to existing research and theories. Results: Informed by Expectancy Violation Theory (EVT), a model for understanding men's experiences when interacting with healthcare providers about their BRCA-related cancer risks—comprised of three stages including expectation, violation, and outcomes—was developed. Conclusions: These findings show the importance of men's basic expectations for patient-provider interactions and how violations of expectations impact perceptions, communication, and behavior. Outcomes of negative expectancy violations may impact not only men with BRCA-related cancer risks but also their family members. Practice Implications: Healthcare providers can be mindful about the ways in which they positively and negatively violate patients' expectations. Patients can engage in self-advocacy behaviors, and advocacy organizations can design resources for patients and healthcare providers to encourage and support effective communication between providers, patients, and their family members.