Skip to main content
Log in

Patients' Knowledge of Cystic Fibrosis: Genetic Determinism and Implications for Treatment

  • Published:
Journal of Genetic Counseling

Abstract

This paper uses the self-regulation model of illness perceptions (Leventhal et al., 1984) to consider the implications of different ways of thinking about the causes of illness. The relationship between anxiety/depression and knowledge or denial of illness is also considered. These issues are explored using adherence to treatment in cystic fibrosis (CF) as an example. Twenty-six CF patients took part in semistructured interviews and completed a standardized anxiety and depression scale (HAD, Zigmond and Snaith, 1983). Interview data were analyzed using Interpretative Phenomenological Analysis (Chapman and Smith, 2002). HAD data were analyzed using SPSS. The respondents displayed widely differing levels of knowledge of their condition. Some deterministic comments were also reported. Findings are discussed in relation to the information that physicians might provide to patients and families in the light of increasing knowledge about genetics in society and the genotyping of individuals with genetic conditions specifically. Any important gaps in patient knowledge could usefully be discussed at transition from pediatric to adult care and issues relating to control and genetic determinism discussed with the patients individually.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

REFERENCES

  • Abbott, J., Dodd, M., Bilton, D., & Webb, A. K. (1994). Treatment compliance in adults with cystic fibrosis. Thorax, 49, 115-120.

    Google Scholar 

  • Abbott, J., Dodd, M., & Webb, A. K. (1995). Different perceptions of disease severity and self care between patients with cystic fibrosis, their close companions, and physician. Thorax, 50, 794-796.

    Google Scholar 

  • Abbott, J., Dodd, M., & Webb, A. K. (1996). Health perceptions and treatment adherence in adults with cystic fibrosis. Thorax, 51, 1233-1238.

    Google Scholar 

  • Abbott, J., & Gee, L. (1998). Contemporary psychosocial issues in cystic fibrosis: Treatment adherence and quality of life. Disabil Rehabil, 20, 262-271.

    Google Scholar 

  • Almquuist, E. W., Bloch, M., Brinkman, R., Craufurd, D., & Hayden, M. R. (1999). A world-wide assessment of the frequency of suicide, suicide attempts, or psychiatric hospitalisation after pre-dictive testing for Huntington disease. Am J Hum Genet, 64, 1239-1304

    Google Scholar 

  • Anderson, D. L., Flume, P. A., & Hardy, K. K. (2001). Psychological functioning of adults with cystic fibrosis. Chest, 119(4), 1079-1084.

    Google Scholar 

  • Axworthy, D., Brock, D., Bobrow, M., & Marteau, T. (1996). Psychological impact of population-based carrier testing for cystic fibrosis: 3 year follow-up. Lancet, 347, 1443-1446.

    Google Scholar 

  • Baumann, L. C. (2003). Culture and illness representation. In L. D Cameron & H. Leventhal (Eds.), The self-regulation of health and illness behaviour (pp. 242-254). London and New York: Routledge.

    Google Scholar 

  • Biesecker-Bowles, B. (1998). Future directions in genetic counseling: Practical and ethical considerations. Kennedy Inst Ethics J, 8, 145-160.

    Google Scholar 

  • Bluebond-Langner, M. (1996). In the shadow of Illness: Parents and siblings of the chronically ill child. Princeton, NJ: Princeton University Press.

    Google Scholar 

  • Bogart, L. M., Catz, S. L., Kelly, J. A., & Benotsch, E. G. (2001). Factors influencing physicians' judgments of adherence and treatment decisions for patients with HIV disease. Med Decis Making, 21, 28-36.

    Google Scholar 

  • Broadstock, M., Michie, S., & Marteau, T. (2000). Psychological consequences of predictive genetic testing: A systematic review. Eur J Hum Genet, 8, 731-738.

    Google Scholar 

  • Chapman, E. (2002). The social and ethical implications of changing genetic technologies. J Health Psychol, 7, 195-206.

    Google Scholar 

  • Chapman, E., & Smith, J. A. (2002). Interpretative phenomenological analysis and the new genetics. J Health Psychol, 7, 125-130.

    Google Scholar 

  • Conway, S. P., Pond, M. N., Hamnett, T., & Watson, A. (1996). Compliance with treatment in adult patients with cystic fibrosis. Thorax, 51, 29-33.

    Google Scholar 

  • Decruyenaere, M., Evers-Kierbooms, G., Boogaerts, A., Cassiman, J. J., Cloostermans, T., Demytte-naere, K., et al. (1996). Prediction of psychological functioning one year after the predictive test for Huntington's disease and the impact of the test result on reproductive decision making. J Med Genet, 33, 737-743.

    Google Scholar 

  • Elborn, S. (1998). The management of young adults with cystic fibrosis: "genes, jeans and genies." Disabil Rehabil, 20, 217-225.

    Google Scholar 

  • Goldbeck, R. (1997). Denial in physical illness. J Psychosom Res, 43, 575-593.

    Google Scholar 

  • Hedgecoe, A. M. (2000). The popularization of genetics as geneticization. Public Underst Sci, 9(2), 183-189.

    Google Scholar 

  • Hedgecoe, A. M. (2003). Expansion and uncertainty: Cystic fibrosis, classification and genetics. Sociol Health Illn, 25(1), 50-70.

    Google Scholar 

  • Juengst, E. T. (1999). Genetic testing and the moral dynamics of family life. Public Underst Sci, 8, 193-205.

    Google Scholar 

  • Koocher, G. P., McGrath, M. L., & Gudas, L. J. (1990). Typologies of non-adherence in cystic fibrosis. J Dev Behav Pediatr, 11, 353-358.

    Google Scholar 

  • Lask, B. (1998). Compliance, adherence, concordance. Br J Psychol, 173, 271-272.

    Google Scholar 

  • Leventhal, H., Benyamini, Y., Brownlee, S., Diefenbach, M., Patrick-Miller, L., & Robitaille, C. (1997). Illness representation: Theoretical foundations. In J. Weinman & K. Petrie (Eds.), Perceptions of health and illness (pp.19-45). London: Harwood.

    Google Scholar 

  • Leventhal, H., Brissette, I., &Leventhal, E. (2003). The Common-Sense model of self-regulation of health and illness. In L. D. Cameron and H. Leventhal (Eds.), The self-regulation of health and illness behaviour(pp. 420-465). London and New York: Routledge.

    Google Scholar 

  • Leventhal, H., Nerenz, D., & Steele, D. J. (1984). Illness representations and coping with health threats. In A. Baum & J. Singer (Eds.), A handbook of psychology and health(Vol. 4, pp. 219-252). Hillsdale, NJ: Erlbaum.

    Google Scholar 

  • Lippman, A. (1991). Prenatal genetic testing and screening: Constructing needs and reinforcing in-equities. J Law Med XVII, 15-50.

  • Loubieres, Y., Grenet, D., Simon-Bouv, B., Medioni, J., Landais, P., Ferec, C., et al. (2002). Association between genetically determined pancreatic status and lung disease in adult cystic fibrosis patients. Chest, 121, 173-180.

    Google Scholar 

  • Marteau, T. M., & Croyle, R. T. (1998). Psychological responses to genetic testing. Br Med J, 316, 693-696.

    Google Scholar 

  • Marteau, T. M., & Lerman, C. (2001). Genetic risk and behavioural change. Br Med J, 322, 1056-1059.

    Google Scholar 

  • Pickard, M., Bates, L., Dorian, M., Greig, H., & Saint, D. (2000). Alcohol and drug use in second-year medical students at the University of Leeds. Med Educ, 34, 148-150

    Google Scholar 

  • Pinkerton, P., Trauer, T., Duncan, F., Hodson, E., & Batten, J. (1985). Cystic fibrosis in adult life-a study of coping patterns. Lancet, 2(8458), 761-763.

    Google Scholar 

  • Richards, M., & Ponder, M. (1996). Lay understanding of genetics: Atest of a hypothesis. J Med Genet, 33, 1032-1036.

    Google Scholar 

  • Senior, V., Marteau, T., & Peters, T. J. (1998). Will genetic testing for predisposition for disease result in fatalism? A qualitative study of parents' responses to neonatal screening for familial hypercholesterolaemia. Soc Sci Med, 48, 1857-1860.

    Google Scholar 

  • Sensky, T. (1997). Causal attributions in physical illness. J Psychosom Res, 42, 565-573.

    Google Scholar 

  • Shaw, C. (1999). A framework for the study of coping, illness behaviour and outcomes. J Adv Nurs, 29, 1246-1255.

    Google Scholar 

  • Smith, J. A., Jarman, M., & Osborn, M. (1999). Doing interpretative phenomenological analysis. In M. Murray & K. Chamberlain <nt>(Eds.)</nt>, Qualitative health psychology. London: Sage.

    Google Scholar 

  • Wainwright, S. P., & Gould, D. (1997). Non-adherence with medications in organ transplant patients: A literature review. J Adv Nurs, 26, 968-977.

    Google Scholar 

  • Zigmond, A. S., & Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatr, 67, 361-370.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Chapman, E., Bilton, D. Patients' Knowledge of Cystic Fibrosis: Genetic Determinism and Implications for Treatment. Journal of Genetic Counseling 13, 369–385 (2004). https://doi.org/10.1023/B:JOGC.0000044199.38694.6c

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/B:JOGC.0000044199.38694.6c

Navigation