Document Type

Dissertation

Degree

Doctor of Philosophy

Major

Nursing

Date of Defense

11-26-2018

Graduate Advisor

Roxanne Vandermause, Ph.D.

Committee

Roxanne Vandermause, Ph.D.

Wilma Calvert, Ph.D.

Sheila Grigsby, Ph.D.

Roberta Lavin, Ph.D.

Abstract

The purpose of this study is to understand the meaning of a family history of colorectal cancer (CRC) for first-degree relatives of Blacks diagnosed with CRC. Even though CRC is more preventable than other cancers because of effective screening tests for prevention and early detection, Blacks experience a disproportionate burden of CRC compared to other groups. Interventions to increase CRC screening among Blacks have not produced a significant reduction in CRC disparity. Underutilization of CRC screening and low perceived risk of CRC are major factors contributing to CRC disparity. The informing methodological approach employed in this study was hermeneutic phenomenology, an interpretative paradigm based on the philosophy of Martin Heidegger and Hans Gadamer. In hermeneutic phenomenology, preunderstandings of the researcher, such as behavioral theories, are accounted for as research data but do not guide the research approach as in traditional empirical studies. After employing a hermeneutic phenomenological design and collecting in-depth narratives from family members (n=8), a hermeneutic team analyzed, transcribed, and de-identified interviews to construct patterns across texts. The results of the study revealed that a family history of CRC shows itself as a shortened illness trajectory involving several overlapping sub-patterns: facing a dreaded diagnosis, caregiving with gusto, preparing for the untimely death of a parent, coping with a burden too great, and dealing with emotional turmoil. A second showing was mobilizing the family against CRC, including the sub-patterns: asking questions about heredity, realizing one’s own mortality, and increasing awareness about CRC. Nurses encounter family members of CRC cases across the cancer continuum and are well-situated to promote the translation of evidence into practice by intervening with families to promote awareness of risk and early detection activities.

Included in

Nursing Commons

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