Dissertations, Theses, and Capstone Projects

Date of Degree

2-2024

Document Type

Dissertation

Degree Name

Ph.D.

Program

Nursing

Advisor

Steven Baumann

Committee Members

Juan Battle

Elizabeth Cohn

Subject Categories

Community Health and Preventive Medicine | Family Practice Nursing | Medicine and Health Sciences | Nursing | Public Health and Community Nursing

Keywords

Precision Health, Genomics and/or Genetics, Social Epigenomics, Immigration and Health, Dialysis, Colonialism

Abstract

Exploring family health histories (FHHs) has emerged in recent years as an inexpensive genomic tool in public health. Families and clinicians can also use them to uncover family histories and experiences, which could inform better lifestyle choices to prevent or delay the onset of diseases. Exploring family health histories focuses on an individual’s genetic makeup and considers differences in lifestyle and environment. Despite national campaigns, it is an underutilized tool that could lead to engagement in effective strategies and better health outcomes. One important and serious condition that families should be more aware of is chronic kidney disease (CKD). One of the goals of this study is to understand the experience of families and communities living at risk of CKD, which could lead to reducing barriers to effective prevention and treatment. Guyanese Americans are an understudied community that has high prevalence of CKD.

This analytic autoethnography investigated the meaning of FHH within the Guyanese American population, with a particular attention to CKD. With four family dyads representing three degrees of biological relationships, this autoethnography explored two classification schemes of internal and external awareness of FHH and revealed six themes. Internal awareness revealed three themes: We Think We Young Yet, Soap or Rope, and It’s in Your Blood. External awareness revealed three more themes: It is Written, Nobody Told Me Anything, and You are Going to be a Liability for Other People. The results of this study can address barriers to the use of FHH by investigating familial clustering and its impact on familial discussion of health. Key concepts of Anderson’s analytic autoethnography and Elder’s Life Course Theory lay framework for the discussion of understanding one’s FHH and risk for illness. The discovered themes from the voices of an ethnic minority can assist in the further development of genomics and genetics in nursing. Listening to minority communities opens the conversation of precision health and connecting them to the right intervention at the right time.

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