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父母与受遗传性疾病影响的孩子的兄弟姐妹之间的沟通。

Parents' communication with siblings of children affected by an inherited genetic condition.

作者信息

Plumridge Gillian, Metcalfe Alison, Coad Jane, Gill Paramjit

机构信息

School of Health & Population Science, Primary Clinical Sciences, University of Birmingham, Birmingham, UK.

出版信息

J Genet Couns. 2011 Aug;20(4):374-83. doi: 10.1007/s10897-011-9361-1. Epub 2011 Apr 19.

Abstract

The objective of this study was to explore parents' communication about risk with siblings of children affected by an inherited genetic condition, and to ascertain what level of support, if any, is required from health professionals. Semi-structured interviews were conducted with affected and unaffected children and their parents. Families were affected by one of six genetic conditions representing different patterns of inheritance and variations in age of onset, life expectancy and impact on families. Interviews were analysed using constructivist grounded theory and informed by models which focused on three different aspects of family communication. Interviews with 33 families showed that siblings' information and support needs go largely unrecognized by health professionals and sometimes by parents. Some siblings were actively informed about the genetic condition by parents, others were left to find out and assimilate information by themselves. Siblings were given information about the current symptoms and management of the genetic condition but were less likely to know about its hereditary nature and their own potential risk. When siblings were fully informed about the condition and included in family discussion, they had a better understanding of their role within their family, and family relationships were reported to be more harmonious. The information and support needs of siblings can be overlooked. Parents with the responsibility for caring for a child affected by a genetic condition may require support from health professionals to understand and respond to their unaffected children's need for more information about the genetic condition and its implications for the children's own future health and reproductive decision-making.

摘要

本研究的目的是探讨父母与受遗传性疾病影响儿童的兄弟姐妹之间关于风险的沟通情况,并确定卫生专业人员需要提供何种程度的支持(如有)。对患病和未患病的儿童及其父母进行了半结构化访谈。这些家庭受六种遗传疾病之一的影响,这些疾病代表了不同的遗传模式、发病年龄差异、预期寿命以及对家庭的影响。访谈采用建构主义扎根理论进行分析,并以关注家庭沟通三个不同方面的模型为依据。对33个家庭的访谈表明,卫生专业人员有时甚至父母很大程度上未认识到兄弟姐妹的信息和支持需求。一些兄弟姐妹由父母主动告知遗传疾病情况,另一些则需自行去了解和吸收信息。兄弟姐妹了解到了遗传疾病的当前症状和治疗情况,但不太可能知晓其遗传性质以及自身的潜在风险。当兄弟姐妹充分了解病情并参与家庭讨论时,他们对自己在家庭中的角色有了更好的理解,据报告家庭关系也更加和谐。兄弟姐妹的信息和支持需求可能被忽视。负责照顾受遗传疾病影响儿童的父母可能需要卫生专业人员的支持,以理解并回应未患病子女对于更多有关遗传疾病信息的需求,以及该疾病对子女自身未来健康和生殖决策的影响。

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