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