Paper
Monday, November 5, 2007
513
Families at Risk for Inherited Breast/Ovarian Cancer: The Use of the Actor-Partner Interdependence Model Analysis
Suzanne Mellon, PhD, RN, College of Health Professions, University of Detroit Mercy and Karmanos Cancer Institute, Detroit, MI, USA, James Janisse, PhD, Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine, Detroit, MI, USA, Robin Gold, MS, CGC, Genetics, Oakwood Hospital, Dearborn, MI, USA, Michael Tainsky, PhD, Molecular Biology and Genetics, Karmanos Cancer Institute, Detroit, MI, USA, and Michael Simon, MD, MPH, Hematology and Oncology, Wayne State University, Detroit, MI, USA.
| Learning Objective #1: identify the use of the Actor-Partner Interdependence Model for family dyadic analysis. |
| Learning Objective #2: identify 4 key findings of family members influencing each other's decision making, risk appraisals, or cancer worries regarding inherited cancer risk information. |
While families play an important role in risk assessment and genetic testing decisions for individuals at risk for inherited breast/ovarian cancer syndrome, little research has been carried out with individuals and their family members
together regarding how they influence each other in their decision making, cancer worries, and risk appraisals about cancer risk information. The purpose of this presentation is to describe the use of the Actor-Partner Interdependence Model of dyadic analysis that assesses the effect of cancer survivors and family relatives on each other in one single analysis. This approach provides a unique perspective of looking at both individual and family factors that influence both dyad members by taking into account both of the dyad's predictor variable scores on each of the family member's outcomes. A descriptive, cross-sectional design was conducted with 146 breast and/or ovarian cancer survivors and 146 unaffected female relatives (
N=292). Using the transtheoretical model of change and a family stress framework, a population-based sample, stratified by race (Caucasian and African-American) and by diagnosis (breast and ovarian), was randomly selected from the NCI SEER Cancer Registry in southeastern Michigan. Standardized instruments with adequate reliability and validity were used to measure study variables: family history of cancer, coping styles, self-efficacy, family communication, social support, perception of cancer risk, cancer worries, and decision making. Results indicated interdependence between family members' cancer worries and several "partner" effects of age, education, communication, and coping style influencing the other family member's decision making. Additionally, sociodemographic family factors of marital status, family member income, family cancer history, and role relationships influenced risk appraisals and cancer worries. These findings support the examination of inherited cancer risk decision making from a family dyadic perspective in order to help families have realistic risk appraisals and make informed decisions about their health surveillance options.