Emily A. Rauscher

Investigating Uncertainty and Emotions in Conversations About Family Health History: A Test of the Theory of Motivated Information Management

Although the importance of being knowledgeable of ones family health history is widely known, very little research has investigated how families communicate about this important topic. This study investigated how young adults seek information from parents about family health history. The authors used the Theory of Motivated Information Management as a framework to understand the process of uncertainty discrepancy and emotion in seeking information about family health history. Results of this study show the Theory of Motivated Information Management to be a good model to explain the process young adults go through in deciding to seek information from parents about family health history. Results also show that emotions other than anxiety can be used with success in the Theory of Motivated Information Management framework.

“It was an Emotional Baby”: Previvors’ Family Planning Decision-Making Styles about Hereditary Breast and Ovarian Cancer Risk

Women who test positive for a BRCA genetic mutation are at an increased risk for developing hereditary breast and ovarian cancer and have a 50% chance of passing on their genetic mutation to their children. The purpose of this study was to investigate how women who test positive for a BRCA mutation but have not been diagnosed with cancer make decisions regarding family planning. Analysis of interviews with 20 women revealed they engage in logical and emotional decision-making styles. Although women want to be logical to reduce their hereditary cancer risk, emotions often complicate their decision-making. Women experience fear and worry about a future cancer diagnosis, yet also desire to create a family, particularly having children through natural conception. That is, women negotiate having preventative surgeries in a logical doctor-recommended timeframe but also organize those decisions around emotional desires of motherhood. Overall, this study demonstrates the complex decisions women who test positive for a BRCA mutation must make in regards to genetic testing timing, family planning, and overall quality of life.

“As Long As You're Sure You Don't Want Any More Children”: Men's Collective Boundary Coordination of Information About Their Affirmative Vasectomy Decision

This study analyzes how men who have undergone a vasectomy manage privacy boundary permeability about this family-planning decision. Twenty-four men who had undergone a vasectomy were interviewed. Communication privacy management (Petronio, 2002) was used as a theoretical framework to understand how and why disclosures occurred. Results showed varying collective boundary patterns were primary influences in how these men managed privacy boundaries related to their vasectomy and fluctuated based on the recipient of the disclosure. These findings contribute to the growing body of knowledge on the management of private information related to family-planning decisions and outcomes.

“I’ve just never gotten around to doing it”: Men’s approaches to managing BRCA-related cancer risks

OBJECTIVE To examine mens approaches to managing BRCA-related cancer risks. METHODS 25 Qualitative interviews were conducted with men who are at risk for BRCA-related cancers. Thematic analysis was conducted using the constant comparison. RESULTS Qualitative analysis revealed two different approaches for how men managed their BRCA-related cancer risks. Men were engaged when: (1) initially seeking information, (2) uptake of genetic testing, and (3) population screening procedures. Men were passively avoidant for: (1) follow-up information seeking, (2) uptake of genetic testing, and (3) BRCA-specific screening. Mens justifications for engaged risk management were to: (1) protect their family, (2) respond to encouragement from others, and (3) get knowledge for themselves. Their justifications for passively avoidant management were due to: (1) limited access to clear risk information, (2) little fear of cancer development, (3) barriers to testing/screening, and (4) reliance on incomplete illness representations. CONCLUSIONS Men at risk for developing BRCA-related cancers approached risk management by primarily using a passive avoidance approach. That approach should be interpreted in context with the inconsistent information available to them, and the minimal NCCN guidelines for their risk surveillance. PRACTICE IMPLICATIONS Findings may assist healthcare providers and family members in helping men manage their BRCA-related cancer risks.

Privacy and Family Communication about Genetic Cancer Risk: Investigating Factors Promoting Women’s Disclosure Decisions

This study explores the family communication of women (N = 175) who have tested positive for a gene alteration that predisposes them to an increased risk for cancer. More specifically, this study utilizes family communication patterns theory and communication privacy management theory to investigate the role of family communication and privacy management in women’s communication about genetic cancer risk with family members. Results found significant direct effects between conversation orientation and both personal and family privacy orientation as well as between conformity orientation and personal privacy orientation. Results also found indirect effects between conversation orientation and communication about genetic cancer risk. Overall this study shows the importance of family communication environment and privacy management in communicating about genetic cancer risk.

Reconceptualizing the Role of Conformity Behaviors in Family Communication Patterns Theory

ABSTRACT Family communication patterns theory is one of the most influential theories in the field of family communication. The current article examines the construct of conformity, arguing that current conceptualizations of conformity paint this behavior as largely a negative familial element. Instead, this research argues for the concept of warm conformity behavior, where parents communicate their ideas in ways that promote warmth and closeness rather than just adherence to hierarchy and rules. This move does not add to the two dimensions of the theory, but rather speaks to the different ways in which parents might communicate the dimension of conformity to their child. To further this idea, our article includes a series of three studies designed to create and validate new measures of warm and cold conformity. Overall, the studies found general support for the validity of the scales. Implications and directions for future research are discussed.

Privacy Tendencies and Revealing/Concealing: The Moderating Role of Emotional Competence

In this study, alexithymia was tested as a moderator of the relationship between individual tendencies toward privacy (i.e., personal privacy orientation and anticipation of boundary turbulence) and the decision to reveal and conceal. Using structural equation modeling, results showed that both personal privacy orientation and anticipation of boundary turbulence were positively related to alexithymia. Alexithymia, in turn, moderated the relationship between personal privacy orientation and concealing, anticipation of boundary turbulence and concealing, and personal privacy orientation and revealing. Implications and directions for future research will be discussed.

Alexithymia and Uncertainty Management

Alexithymia is perceived as a personality trait characterized by impairments in individuals’ ability to identify and describe feelings (Taylor, Bagby, & Parker, 1997). Research has found links between alexithymia and deficiencies in the ability to grow and maintain close relationships. Three hypotheses and one research question tested (H1) an inverse relationship between relational uncertainty and self-disclosure; (H2) a direct relationship between alexithymia and relational uncertainty; (H3) an inverse relationship between alexithymia and self-disclosure; and (RQ1) an interaction between alexithymia and relational uncertainty to predict self-disclosure. Results indicate partial support for the inverse relationship between self-disclosure and both relational uncertainty and alexithymia. Results also showed support for a direct relationship between alexithymia and relational uncertainty. Alexithymia and relational uncertainty interacted to predict levels of intended self-disclosure. The inverse relationship between relational uncertainty and intended self-disclosure was stronger for low rather than high alexithymics. Implications and directions for future research are discussed.

The Relationships Between Doctor-Patient Affectionate Communication and Patient Perceptions and Outcomes

ABSTRACT The current article combines the literature on doctor-patient communication and affectionate communication. Using Affection Exchange Theory (AET), the study predicts that the need for affection and the benefits of affectionate communication translate to the doctor-patient setting, proposing a series of relationships from both perceived doctor affectionate communication and affection deprivation to several patient outcome variables (patient perception of the doctor, patient communication with the doctor, and patient satisfaction/adherence). The results strongly supported the predictions for both affectionate communication and affection deprivation, with affectionate communication positively relating to most outcome measures and affection deprivation negatively relating to most outcome measures. Affection deprivation served as a moderator for the relationship between provider competence and patient satisfaction, although affectionate communication moderated the relationship between provider competence and patient adherence. Implications and possible directions for future research are discussed.

The Importance of Intergenerational Communication in Advance Care Planning: Generational Relationships among Perceptions and Beliefs

This study explores triadic intergenerational perceptions of family members’ beliefs and behaviors that often impact an individual’s willingness to engage in advance care planning. Using data from 189 triads of young adults, their parents, and their grandparents, we examined generational relationships among individuals’ openness about death, death anxiety, knowledge of surrogate decision-making, and advance care planning self-efficacy. Results of this study found significant relationships between grandparents and parents, as well as between parents and children for all variables except self-efficacy. Additionally, results of this study found indirect relationships between grandparents and their grandchildren for three variables. These findings underscore the need to treat advance care planning as a family communication issue. Implications for how advance care planning should be approached in conversations with healthcare providers and within the family are discussed.