{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T11:00:07Z","timestamp":1785322807177,"version":"3.55.0"},"reference-count":47,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Clinical Nursing"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To explore the experiences and challenges associated with genetic testing decisions among untested individuals from hereditary breast and ovarian cancer (HBOC) or Lynch syndrome (LS) families.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Qualitative descriptive study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Semi\u2010structured telephone interviews were conducted between 2022 and 2024 with 56 untested at\u2010risk relatives drawn from the Israeli CASCADE cohort of HBOC and LS families, which comprises carriers of pathogenic\/likely pathogenic variants, true negatives (non\u2010carriers) and untested individuals. Interview narratives were analysed using thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>\n                      Two overarching themes were generated. (1)\n                      <jats:italic>Illusion of Mastery<\/jats:italic>\n                      , encompassing four categories reflecting internal coping strategies participants employed to maintain perceptions of control, resulting in avoidance of genetic testing: choosing uncertainty as a psychological shield; avoiding anxiety; controlling health through lifestyle; and protecting life stages. (2)\n                      <jats:italic>Lost in the System<\/jats:italic>\n                      , encompassing five categories across two subthemes: (2.1) perceived deficiencies in informational, emotional and familial guidance from the healthcare system; and (2.2) active withdrawal from the system to avoid medical entrapment and preserve personal values, both resulting in avoidance of genetic testing.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Findings suggest avoidance rather than denial or outright refusal of genetic testing, reflecting active decision\u2010making. This avoidance was shaped by a convergence of personal,familial and systemic factors, centered on autonomy, uncertainty management and psychological self\u2010protection, in the context of inadequate informational and emotional support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for the Profession and\/or Patient Care<\/jats:title>\n                    <jats:p>These findings highlight nurses' potential to support informed, person\u2010 and family\u2010centered genetic testing decision\u2010making. Given their accessibility to at\u2010risk families across diverse clinical settings, nurses can address emotional needs, provide clear guidance and acknowledge the psychological complexity underlying testing avoidance. Future studies should explore nurse\u2010led interventions that facilitate informed decision\u2010making while respecting individual autonomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Reporting Method<\/jats:title>\n                    <jats:p>This study adhered to the Consolidated Criteria for Reporting Qualitative Studies (COREQ) guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution<\/jats:title>\n                    <jats:p>No patient or public contribution.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jocn.70474","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T10:10:01Z","timestamp":1785319801000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Staying in the Unknown: Avoidance of Genetic Testing in Families With Hereditary Cancer Syndromes\u2014A Qualitative Study"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4266-5193","authenticated-orcid":false,"given":"Ronit G.","family":"Tsemach","sequence":"first","affiliation":[{"name":"Department of Nursing Sciences School of Health Profession, Tel Aviv University  Tel Aviv Israel"},{"name":"Tel Aviv\u2010Sourasky University Medical Center  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth E.","family":"Half","sequence":"additional","affiliation":[{"name":"GI Malignancy Unit Familial Cancer Syndromes, Rambam Health Care Campus  Haifa Israel"},{"name":"The Ruth and Bruce Rappaport Faculty of Medicine Technion Institute of Technology  Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4065-7560","authenticated-orcid":false,"given":"Hagit","family":"Baris\u2010Feldman","sequence":"additional","affiliation":[{"name":"Tel Aviv\u2010Sourasky University Medical Center  Tel Aviv Israel"},{"name":"Gray Faculty of Medical and Health Sciences Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anastasia","family":"Weis","sequence":"additional","affiliation":[{"name":"GI Malignancy Unit Familial Cancer Syndromes, Rambam Health Care Campus  Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Simchoni","sequence":"additional","affiliation":[{"name":"Tel Aviv\u2010Sourasky University Medical Center  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3785-2445","authenticated-orcid":false,"given":"Sue","family":"Kim","sequence":"additional","affiliation":[{"name":"College of Nursing, Yonsei University  Seoul Republic of South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3903-3750","authenticated-orcid":false,"given":"Maria C.","family":"Katapodi","sequence":"additional","affiliation":[{"name":"Department of Clinical Research University of Basel  Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9358-3422","authenticated-orcid":false,"given":"Sivia","family":"Barnoy","sequence":"additional","affiliation":[{"name":"Department of Nursing Sciences School of Health Profession, Tel Aviv University  Tel Aviv Israel"},{"name":"Gray Faculty of Medical and Health Sciences Tel Aviv University  Tel Aviv 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