Thomas S, Herbert D, Street A, Barnes C, Boal J, Komesaroff P
Centre for Ethics in Medicine and Society, Faculty of Medicine, Nursing and Health Sciences, Monash Medical School, Monash University, Melbourne, Victoria, Australia.
Haemophilia. 2007 Sep;13(5):633-41. doi: 10.1111/j.1365-2516.2007.01454.x.
Widespread genetic testing for haemophilia has recently been introduced in Victoria, Australia. While attitudes towards predictive testing have been studied in other conditions, such as cancer, there is limited knowledge about the attitudes of members of the haemophilia community towards predictive testing. This study aimed at exploring attitudes towards, and beliefs about, genetic testing amongst members of the haemophilia community in Victoria prior to the widespread introduction of testing. The study was qualitative and descriptive. In-depth face to face interviews were held with a sample of 39 individuals, including men with haemophilia, female carriers and family members. Data were analysed thematically using cross-case analysis techniques. There was considerable knowledge about the proposed introduction of widespread genetic testing. However, not everyone thought that testing was accessible or user friendly, and there was confusion about who needed to be tested. Most thought that testing was necessary for adolescent girls to determine carrier status to help prepare families for a child with haemophilia, rather than leading them to choose to terminate a pregnancy or not to have children. A minority of women stated that if there was a history of inhibitors in a family then a termination might be considered. The study revealed strong religious beliefs among those studied, which may have influenced attitudes and approaches towards testing. Further investigation is needed into how people with a possible haemophilia genotype negotiate decisions about their further identification, and how this knowledge is placed within cultural, religious and family contexts.
澳大利亚维多利亚州最近开始广泛开展血友病基因检测。虽然针对癌症等其他病症的预测性检测的态度已得到研究,但对于血友病群体成员对预测性检测的态度却知之甚少。本研究旨在探讨在广泛开展检测之前,维多利亚州血友病群体成员对基因检测的态度和看法。该研究采用定性描述性方法。对39名个体进行了深入的面对面访谈,包括血友病男性患者、女性携带者及其家庭成员。运用跨案例分析技术对数据进行了主题分析。对于即将广泛开展的基因检测,人们有相当多的了解。然而,并非所有人都认为检测易于获取或对用户友好,而且对于谁需要接受检测也存在困惑。大多数人认为,检测对于青春期女孩确定携带者身份很有必要,以便帮助家庭为血友病患儿做好准备,而不是促使她们选择终止妊娠或不生育。少数女性表示,如果家族中有抑制剂病史,可能会考虑终止妊娠。研究显示,被研究对象中有强烈的宗教信仰,这可能影响了他们对检测的态度和方式。需要进一步调查具有血友病潜在基因型的人如何就进一步确诊做出决策,以及这一认知如何置于文化、宗教和家庭背景之中。