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C. Lammens, E. Bleiker, S. Verhoef, M. Ausems, Danielle Majoor-Krakauer, Rolf Sijmons, Frederik Hes, E. Gomez-Garcia, T. Os, Liesbeth Spruijt, R. Luijt, Amw Ouweland, M. Ruijs, C. Gundy, T. Nagtegaal, Neil Aaronson (2011)
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• How others (outside of family) perceive VHL • They don't know what it is. • They exaggerate it
Time (e.g. don't waste time in unpromising relationships
Medical necessity/opportunity (e.g. appointment, physical evidence
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Anticipated reaction based on attributes (e.g. partner's relevant experience with illness)
• Impacts desired attributes of romantic partner (e.g. selection against those who prioritize biological children, selection for certain character traits)
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• Importance of romantic relationship (in general, and change in importance due to VHL)
External • Someone else forced disclosure (e.g. pressure from family, someone else shared)
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Dishonest to withhold (e.g. might impact partner's decisions
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• Perception of future health risks (e.g. risk of cancer, inevitability, life expectancy, hope for future research)
it's part of what makes me who I am, pride
• Interaction with family/friends (as above)
Katie Broekema, Kirsten Weber (2017)
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Utility of support/resources (desired)
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• Characterization of relationship (e.g. long-term/serious, strength of relationship)
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• Perception of current health (e.g. physical impact of surgery, disability, severity compared to others)
• Interaction with VHL/other community (e.g. talking to peers with VHL, utilization of support groups)
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• Ongoing evolution (longitudinal impact of VHL on relationship
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LM Hoskins (2008)
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• Importance in one's life (e.g. it's not going away)
When to share? (e.g. on first date, within certain time period)
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CR Lammens (2011)
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Minimizing risk/impact (e.g. strategies employed, avoid unwanted reactions, avoid worrying others)
How to share? (e.g. in person, via phone, via text)
• Family's experience (e.g. relative's medical history, relative's attitude towards diagnosis)
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Extent of disclosure (e.g. phased approach, inviting questions, censoring information)
R. Hamilton (2012)
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A. Werner‐Lin (2008)
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Worry for self (e.g. anxiety around annual screening, worry about quality of life or reduced life expectancy)
JL Young (2019)
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CR Lammens (2010)
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Use of educational tools (e.g. sharing website, sharing VHLA booklet)
S Mireskandari (2009)
409J Genet Couns, 18
ME Ernst (2016)
154J Pediatr Adolesc Gynecol, 29
• Fear of burdening partner (e.g. partner distress with health challenges, partner as caretaker
• Interaction with family/friends (e.g. talking to affected parent, talking to unaffected parent)
A Werner-Lin (2008)
416Soc Work Health Care, 47
RL Klitzman (2011)
98J Genet Couns, 20
disclosure as test of partner, as test of relationship's potential)
ER Maher (1990)
1151Q J Med, 77
• Impact perception of one's own desirability (e.g. having baggage, decreased physical desirability)
E Jonasch (2021)
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K Broekema (2017)
1575Qual Health Res, 27
A. Werner‐Lin (2008)
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Individuals with genetic disease face unique challenges related to navigating dating relationships. While previous studies have explored the impact of hereditary breast and ovarian cancer syndrome on dating, research investigating psychosocial implications for young adults with early-onset multi-organ tumor predisposition syndromes such as von Hippel-Lindau disease (VHL) is scarce. This study assessed young adults’ attitudes towards dating and decisions related to disclosing a diagnosis of VHL to a dating partner. Twenty-six young adults with VHL participated in semi-structured interviews exploring this issue, using a guide informed by the literature in consultation with providers and an individual with VHL. Interviews were coded with a primarily deductive approach using codes derived from the literature, with inductive coding employed for perspectives unique to VHL. Our results support previous findings that genetic disease contributes to fear of rejection due to decreased desirability. However, participants report that partners’ reactions to VHL uniquely exacerbate this concern due to unfamiliarity with VHL and a perception that it is exceptionally serious, leading to different strategies in disclosure. While many cited negative reactions from partners, participants also described how disclosure can strengthen relationships by deepening trust. Participants discussed a desire for healthcare providers to offer support in this context and described the benefit of speaking with peers about their dating experiences and approaches to disclosure. Our findings provide insight into the diverse needs of young adults with VHL as they approach romantic relationships and decision-making regarding disclosure and highlight the importance of patient-centered support from providers and patient organizations.
Familial Cancer – Springer Journals
Published: Apr 1, 2023
Keywords: Von Hippel-Lindau; VHL; Dating; Disclosure; Young adulthood; Psychosocial support; Genetic
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