Daly M, Farmer J, Harrop-Stein C, Montgomery S, Itzen M, Costalas J W, Rogatko A, Miller S, Balshem A, Gillespie D
Division of Population Science, Fox Chase Cancer Center, Cheltenham, Pennsylvania 19012, USA.
Cancer Epidemiol Biomarkers Prev. 1999 Apr;8(4 Pt 2):393-8.
The genogram is a tool that has facilitated counseling in family therapy and social work for many years. It is hypothesized that genograms may also be useful in genetic counseling, because they help the counselor to acquire more objective and consistent information from the client, as well as to incorporate family dynamics and psychosocial issues into the counseling approach.
A pilot study of genograms used as an adjunct to genetic counseling was performed at Fox Chase Cancer Center's Family Risk Assessment Program. A questionnaire was developed to elicit genograms from 38 women at risk for familial breast and/or ovarian cancer. After standard pedigree expansion, a series of questions was asked about the consultand's relationship with other family members, communication patterns within the family, attitudes toward genetic testing, family reactions to cancer, roles individuals play in the family, and significant historical or anniversary events. Relationships were defined by the consultand as close, very close, conflictual, fused and conflictual, distant, or estranged.
The majority of relationship types reported by 38 individuals was "very close" or "close." Eighty-one % reported having close/very close relationships with their spouses, 83% reported close/very close relationships with their mothers, and 70% reported close/very close relationships with their fathers. The degree of familial cohesion as depicted by the genogram correlates positively with scores obtained on the standardized Social Adjustment Scale Self-Report (P = 0.01).
Given the family-wide implications of genetic testing, the genogram may offer important guidance in family-targeted interventions.
系谱图作为一种工具，多年来一直在家庭治疗和社会工作中辅助咨询工作。据推测，系谱图在遗传咨询中可能也有用处，因为它们有助于咨询师从客户那里获取更客观、一致的信息，还能将家庭动态和心理社会问题纳入咨询方法中。
在福克斯蔡斯癌症中心的家庭风险评估项目中，开展了一项将系谱图用作遗传咨询辅助手段的初步研究。设计了一份问卷，以获取38名有家族性乳腺癌和/或卵巢癌风险的女性的系谱图。在进行标准的家系扩展后，询问了一系列关于咨询对象与其他家庭成员的关系、家庭内部的沟通模式、对基因检测的态度、家庭对癌症的反应、个体在家庭中所扮演的角色以及重大历史或周年事件的问题。咨询对象将关系定义为亲密、非常亲密、冲突、融合与冲突、疏远或疏离。
38名个体报告的大多数关系类型为“非常亲密”或“亲密”。81%的人报告与配偶关系亲密/非常亲密，83%的人报告与母亲关系亲密/非常亲密，70%的人报告与父亲关系亲密/非常亲密。系谱图所描绘的家庭凝聚力程度与标准化社会适应量表自我报告所得分数呈正相关（P = 0.01）。
鉴于基因检测对整个家庭的影响，系谱图可能在针对家庭的干预措施中提供重要指导。
