Perceptions of family history across common diseases: a qualitative study in primary care.
BACKGROUND
Having an affected relative is a strong predictor of an individual's lifetime risk of developing many diseases. In primary care this is of importance in preventive healthcare.


OBJECTIVE
To compare and contrast perceptions of family history across common diseases among primary care patients using the theoretical framework of Leventhal's Common Sense Model (CSM).


METHODS
Thirty semi-structured interviews were conducted with patients identified in general practice, who had a family history of either cancer, heart disease or diabetes. We performed qualitative constant comparative analysis of transcript data.


RESULTS
People with a family history of cancer had a greater sense of personal vulnerability than people with a family history of heart disease: family history of diabetes was generally viewed as the least threatening. Using the CSM constructs we identified factors which determine individual perceptions of family history. Beliefs about consequences and timeline were influenced by witnessing painful, lingering or sudden familial death; people who felt their risk was determined by inheritance were more likely to feel vulnerable and have less control, while those who felt able to change lifestyle or behaviour felt more able to control their perceived risk.


CONCLUSIONS
Factors influencing perceptions of family history may vary between individuals and between diseases. To use the family history as a tool in preventive healthcare we will need to consider the individual's personal understanding of disease risk and their ideas about cause and controllability of the familial illness. Perceived risk may then be used to motivate preventive health behaviours.
Walter
Fiona M
FM
General Practice and Primary Care Research Unit, Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge Cambridge CB2 2SR, UK. fmw22@medschl.cam.ac.uk
Emery
Jon
J
D000328:Adult; D001294:Attitude to Health; D003920:Diabetes Mellitus / Q000235:genetics; D005192:Family Health; D005260:Female; D015438:Health Behavior; D006331:Heart Diseases / Q000235:genetics; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D009369:Neoplasms / Q000235:genetics; D011315:Preventive Medicine / Q000379:methods; D011320:Primary Health Care; D036301:Qualitative Research; D018570:Risk Assessment; D040242:Risk Reduction Behavior; D006113:United Kingdom