Paving the Way: A Grounded Theory of Discovery and Decision Making for Individuals With the CDH1 Marker

Purpose: To understand the process of discovery and decision making for adults with the CDH1 marker for hereditary diffuse gastric cancer and inherited breast cancer.

Participants & Setting: Purposeful sampling included 20 participants: 17 adults (11 women and 6 men aged 23–77 years) recruited through the No Stomach for Cancer organization and 3 healthcare providers. Six participants were interviewed two times. Nineteen interviews were done via telephone, and one was conducted in person.

Methodologic Approach: Grounded theory with constant comparison was used.

Findings: The decision-making process of Paving the Way addresses the challenges for individuals diagnosed with the CDH1 marker. The theory explains the process of learning the risk, discerning testing, choosing iterative individual interventions, and adjusting postoperatively while normalizing to live longer.

Implications for Nursing: The process explains and describes the nine factors for decision making and predicts the timing for nursing interventions for genetic testing and pre- and postoperative assessment and planning.