Hicken Bret L, Calhoun David A, Barton James C, Tucker Diane C
Department of Psychology, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
Genet Test. 2004 Summer;8(2):90-7. doi: 10.1089/gte.2004.8.90.
We examined attitudes regarding genetic testing and psychosocial outcomes of HFE genotyping for hemochromatosis. A total of 87 persons with hemochromatosis (patients) (39 women, 48 men), who underwent HFE genotyping, and 50 persons with hypertension (controls) (22 women, 28 men), who had not undergone HFE genotyping, completed a structured interview in which they reported attitudes about benefits and disadvantages of genetic testing and their understanding of genetics and hemochromatosis. Among patients, adherence to treatment for hemochromatosis was assessed. Controls estimated the likelihood of experiencing several potential positive and negative psychosocial outcomes after a positive genetic test. Patients reported their experience pertinent to these outcomes. Patients received information about hemochromatosis when they were diagnosed, and controls read a brief description of hemochromatosis before answering questions. Patients correctly answered 65% of knowledge questions and controls correctly answered 59%. Most participants believed genetic testing is beneficial and described few negative aspects of testing. Controls expected to experience more anxiety, depression, and anger related to a positive genetic test than was reported by patients (p < 0.001). One patient reported discrimination related to the HFE genotype. Most patients were compliant with the iron depletion and maintenance phases of treatment for hemochromatosis. Race, sex, marital status, income, education, barriers to treatment, and knowledge were not significantly associated with adherence to maintenance phlebotomy. We conclude that HFE genotyping appears to be viewed positively and would be generally accepted were it offered as part of a screening program for hemochromatosis. Persons who have not undergone genetic testing may overestimate their emotional responses to a positive test result. In the present hemochromatosis patients, few reported that HFE genotyping was accompanied by negative psychosocial outcomes.
我们研究了关于遗传性血色素沉着症的HFE基因分型的基因检测态度及心理社会结果。共有87例遗传性血色素沉着症患者(39名女性,48名男性)接受了HFE基因分型,50例未接受HFE基因分型的高血压患者(22名女性,28名男性)完成了一项结构化访谈,在访谈中他们报告了对基因检测利弊的态度以及对遗传学和遗传性血色素沉着症的理解。在患者中,评估了对遗传性血色素沉着症治疗的依从性。对照组估计了基因检测呈阳性后经历几种潜在的积极和消极心理社会结果的可能性。患者报告了与这些结果相关的经历。患者在被诊断时获得了有关遗传性血色素沉着症的信息,对照组在回答问题前阅读了一份关于遗传性血色素沉着症的简要描述。患者正确回答了65%的知识问题,对照组正确回答了59%。大多数参与者认为基因检测是有益的,并且很少描述检测的负面方面。对照组预计基因检测呈阳性会比患者报告的经历更多的焦虑、抑郁和愤怒(p<0.001)。一名患者报告了与HFE基因型相关的歧视。大多数患者在遗传性血色素沉着症的铁消耗和维持治疗阶段依从性良好。种族、性别、婚姻状况、收入、教育程度、治疗障碍和知识与维持性放血疗法的依从性无显著相关性。我们得出结论,HFE基因分型似乎被积极看待,如果作为遗传性血色素沉着症筛查项目的一部分提供,通常会被接受。未接受基因检测的人可能高估了他们对阳性检测结果的情绪反应。在目前的遗传性血色素沉着症患者中,很少有人报告HFE基因分型伴随着负面的心理社会结果。