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Worthington AK, Parrott RL, Smith RA. Spirituality, Illness Unpredictability, and Math Anxiety Effects on Negative Affect and Affect-Management Coping for Individuals Diagnosed with Alpha-1 Antitrypsin Deficiency. HEALTH COMMUNICATION 2018; 33:363-371. [PMID: 28059573 PMCID: PMC5533635 DOI: 10.1080/10410236.2016.1266576] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
A growing number of genetic tests are included in diagnostic protocols associated with many common conditions. A positive diagnosis associated with the presence of some gene versions in many instances predicts a range of possible outcomes, and the uncertainty linked to such results contributes to the need to understand varied responses and plan strategic communication. Uncertainty in illness theory (UIT; Mishel, 1988, 1990) guided the investigation of efforts to feel in control and hopeful regarding genetic testing and diagnosis for alpha-1 antitrypsin deficiency (AATD). Participants included 137 individuals with AATD recruited from the Alpha-1 Research Registry who were surveyed about their subjective numeracy, anxiety about math, spirituality, perceptions of illness unpredictability, negative affect regarding genetic testing, and coping strategies about a diagnosis. Results revealed that experiencing more fear and worry contributed both directly and indirectly to affect-management coping strategies, operating through individual perceptions of illness unpredictability. The inability to predict the symptoms and course of events related to a genetic illness and anxiety regarding math heightened fear and worry. Spirituality lessened both illness unpredictability and negative affective responses to a diagnosis. Results affirm the importance of clinician and counselor efforts to incorporate attention to patient spirituality. They also illustrate the complexity associated with strategic efforts to plan communication about the different versions of a gene's effects on well-being, when some versions align with mild health effects and others with severe effects.
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Affiliation(s)
| | - Roxanne L Parrott
- a Communication Arts and Sciences , The Pennsylvania State University
- b Health Policy and Administration , The Pennsylvania State University
| | - Rachel A Smith
- a Communication Arts and Sciences , The Pennsylvania State University
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Smith RA, Sillars A, Chesnut RP, Zhu X. Investigating Married Adults' Communal Coping with Genetic Health Risk and Perceived Discrimination. COMMUNICATION MONOGRAPHS 2017; 85:181-202. [PMID: 29731540 PMCID: PMC5930874 DOI: 10.1080/03637751.2017.1404618] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 02/28/2017] [Indexed: 06/08/2023]
Abstract
Increased genetic testing in personalized medicine presents unique challenges for couples, including managing disease risk and potential discrimination as a couple. This study investigated couples' conflicts and support gaps as they coped with perceived genetic discrimination. We also explored the degree to which communal coping was beneficial in reducing support gaps, and ultimately stress. Dyadic analysis of married adults (N = 266, 133 couples), in which one person had the genetic risk for serious illness, showed that perceived discrimination predicted more frequent conflicts about AATD-related treatment, privacy boundaries, and finances, which, in turn, predicted wider gaps in emotion and esteem support, and greater stress for both spouses. Communal coping predicted lower support gaps for both partners and marginally lower stress.
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Affiliation(s)
| | | | | | - Xun Zhu
- The Pennsylvania State University
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Zhu X, Smith RA, Parrott RL. Living with a Rare Health Condition: The Influence of a Support Community and Public Stigma on Communication, Stress, and Available Support. JOURNAL OF APPLIED COMMUNICATION RESEARCH : JACR 2017; 45:179-198. [PMID: 29398734 PMCID: PMC5793934 DOI: 10.1080/00909882.2017.1288292] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
People affected by rare diseases often have limited coping resources and sometimes face stigma. They build communities with others who share their conditions, but not all members may benefit from these communities. This study investigated how adults with a rare genetic health condition (Alpha-1 antitrypsin deficiency; AATD) think about both the Alpha-1 community and public stigma about AATD, and how these cognitions were associated with their communication responses and well-being. The results showed that people with AATD encountered stigmatization from various sources, including family, employers, healthcare providers, and insurance companies. Stronger public stigma predicted more secrecy, more stress, and less available support. Stronger group identification with the Alpha-1 community predicted less secrecy; stronger group activism predicted more available support and more communication to challenge stigmatizers. Post-hoc analyses showed significant interactions between public stigma and group cognitions on communication to challenge stigmatizers. Practical implications for bolstering communities to improve the well-being of people with rare diseases were discussed.
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Affiliation(s)
- Xun Zhu
- Communication Arts & Sciences, Pennsylvania State University, 316 Sparks Building, University Park, PA 16802
| | - Rachel A Smith
- Communication Arts & Sciences, Pennsylvania State University, 216 Sparks Building, University Park, PA 16802, (814) 865-4201
| | - Roxanne L Parrott
- Communication Arts & Sciences and Health Policy & Administration, Pennsylvania State University
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Reiff M, Bugos E, Giarelli E, Bernhardt BA, Spinner NB, Sankar PL, Mulchandani S. "Set in Stone" or "Ray of Hope": Parents' Beliefs About Cause and Prognosis After Genomic Testing of Children Diagnosed with ASD. J Autism Dev Disord 2017; 47:1453-1463. [PMID: 28229350 DOI: 10.1007/s10803-017-3067-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Despite increasing utilization of chromosomal microarray analysis (CMA) for autism spectrum disorders (ASD), limited information exists about how results influence parents' beliefs about etiology and prognosis. We conducted in-depth interviews and surveys with 57 parents of children with ASD who received CMA results categorized as pathogenic, negative or variant of uncertain significance. Parents tended to incorporate their child's CMA results within their existing beliefs about the etiology of ASD, regardless of CMA result. However, parents' expectations for the future tended to differ depending on results; those who received genetic confirmation for their children's ASD expressed a sense of concreteness, acceptance and permanence of the condition. Some parents expressed hope for future biomedical treatments as a result of genetic research.
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Affiliation(s)
- Marian Reiff
- Division of Translational Medicine and Human Genetics, Perelman School of Medicine, University of Pennsylvania, 3624 Market Street, Philadelphia, PA, 19104, USA. .,Counseling and Psychological Services, University of Pennsylvania, Philadelphia, PA, USA.
| | - Eva Bugos
- Mixed Methods Research Lab, University of Pennsylvania, Philadelphia, PA, USA.,Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Ellen Giarelli
- College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
| | - Barbara A Bernhardt
- Division of Translational Medicine and Human Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Nancy B Spinner
- Division of Genomic Diagnostics and the Division of Human Genetics, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA
| | - Pamela L Sankar
- Department of Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia, PA, USA
| | - Surabhi Mulchandani
- Division of Genomic Diagnostics and the Division of Human Genetics, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA
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