'The family is part of the treatment really’ : a qualitative exploration of collective health narratives in families

Health professionals in primary care are increasingly being urged to ask about family history, and possibilities to use this information systematically to discuss illness prevention with patients are currently being explored (Qureshi et al., 2009). However, discussions about family history in a health care context can be problematic. Health professionals may focus on extracting numerical information and sideline contextual narratives. For example, in consultations about heart disease, general practitioners may concentrate on the number of affected relatives and how old they were when diagnosed, avoiding engagement with patients about why they thought their relatives had heart disease (Hall, Saukko, Evans, Qureshi and Humphries, 2007). Clinicians are increasingly asking questions about family history of illness, prompted by guidance (see e.g. Joint British Societies (2005)). The information they glean becomes part of decision making, such as the decision by the doctor to prescribe a statin to reduce cholesterol level in the blood and so reduce the risk of cardiovascular disease, while the patient's understanding of their family history may influence the decision to take the statin or not (Frich, Ose, Malterud and Fugelli, 2006)