Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada.
Am J Med Genet A. 2014 Jun;164A(6):1496-502. doi: 10.1002/ajmg.a.36525. Epub 2014 Apr 4.
Little is currently known about how parents experience the medical genetics appointment at which their child receives a genetic diagnosis. We conducted semi-structured in-person interviews with 13 parents of 10 index children to explore their experience in the medical genetics appointment in which they received their child's genetic diagnosis. Guided by grounded theory, we used a constant comparative approach to data analysis. Transcribed interviews were coded and sorted, and thematic categories identified. Sixty-one and a half percent of parents experienced the diagnosis session as negative, 23% felt the experience was positive, and 15.5% were ambivalent. Receiving emotional support, an outline of the follow-up plans, and messages of hope and perspective during the session seemed to positively influence parents' experience, while feeling that their role was as a passive receiver of information and the use of difficult medical terminology negatively influenced parents' overall experience. Parental preparedness for the information, and the parents' emotional reaction to the diagnosis were also factors that influenced the parental experience. Few participants understood the role of the genetic counselor. Our results provide in-depth insight into the parental experience of the pediatric medical genetics diagnosis session. We propose a mechanism through which parental experience shapes their perception of the medical genetics session.
目前人们对于父母在孩子接受基因诊断时的医学遗传学预约体验知之甚少。我们对 10 名指标儿童的 13 名父母进行了半结构化的面对面访谈,以探讨他们在获得孩子基因诊断的医学遗传学预约中的体验。我们以扎根理论为指导,采用恒定比较的方法进行数据分析。对转录的访谈进行编码和分类,并确定主题类别。61.5%的父母认为诊断过程是负面的,23%的父母觉得这个过程是积极的,15.5%的父母则持矛盾态度。在就诊过程中获得情感支持、了解后续计划的概要以及收到希望和观点的信息似乎对父母的体验产生了积极影响,而感到自己的角色只是被动地接受信息以及使用困难的医学术语则对父母的整体体验产生了负面影响。父母对信息的准备程度以及对诊断的情绪反应也是影响父母体验的因素。很少有参与者理解遗传咨询师的角色。我们的研究结果深入了解了父母在儿科医学遗传学诊断过程中的体验。我们提出了一种机制,通过该机制,父母的体验塑造了他们对医学遗传学就诊过程的看法。