Affiliation:
1. School of Languages and Linguistics The University of Melbourne Parkville Victoria Australia
2. Genomic Medicine & Familial Cancer Centre Royal Melbourne Hospital & Peter MacCallum Cancer Centre Melbourne Victoria Australia
3. Discipline of Genetic Counselling, Graduate School of Health The University of Technology Sydney Sydney New South Wales Australia
4. Department of Medicine – Royal Melbourne Hospital The University of Melbourne Parkville Victoria Australia
5. Genetics in the North East, The Mercy Hospital for Women Victoria Heidelberg Australia
Abstract
AbstractGenetic testing for breast cancer genes is an experience which is inextricably linked with health communication practices and the broader social context in which it occurs. Linguistic approaches can provide perspective on how women seeking self‐funded BRCA1/2 gene testing represent their experiences, knowledge, roles, choices and emotions through the way they talk. A discursive constructionist epistemology and narrative theoretical framework informed the applied linguistics methodology. Analysis of ‘small stories’ and stance‐taking was performed on eight transcripts of audio‐recorded telephone interviews with women at low to moderate risk of carrying BRCA1/2 pathogenic variants who self‐funded genetic testing. We found a high prevalence of ‘small stories’ including accounts of events, hypotheticals, habitual narratives, and stories which combined multiple genres. Stance‐taking was a means by which participants constructed personal identities in the conversational context, such as that of a responsible person. Via stance‐taking strategies, participants also actively negotiated the conversational agenda, for example expressing different degrees of alignment with the interviewer's orientation towards emotions. This study provides a basis for recognizing linguistic markers in genetic counseling interactions about genetic testing for breast cancer genes. Enhanced awareness of client language choice, and the ways in which small stories and stance can signify the client's evaluation of experience and choices, alignment with the genetic counselor's questions/statements, and investment in the conversation, has potential to improve the therapeutic interaction.