Expectations versus reality: The impact of men’s expectancy violations in conversations with healthcare providers about BRCA-related cancer risks

Abstract

ObjectiveTo investigate the experiences of men with germline pathogenic BRCA variants or who have a first-degree family member who tested positive for BRCA regarding their interactions with healthcare providers about their cancer risks. Methods25 phone interviews were conducted with men at risk for hereditary cancer. Data were analyzed using an iterative approach where emergent themes were compared to existing research and theories. ResultsInformed by Expectancy Violation Theory (EVT), a model for understanding men’s experiences when interacting with healthcare providers about their BRCA-related cancer risks—comprised of three stages including expectation, violation, and outcomes—was developed. ConclusionsThese findings show the importance of men’s basic expectations for patient-provider interactions and how violations of expectations impact perceptions, communication, and behavior. Outcomes of negative expectancy violations may impact not only men with BRCA-related cancer risks but also their family members. Practice ImplicationsHealthcare providers can be mindful about the ways in which they positively and negatively violate patients’ expectations. Patients can engage in self-advocacy behaviors, and advocacy organizations can design resources for patients and healthcare providers to encourage and support effective communication between providers, patients, and their family members.