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长QT综合征患者父母对遗传风险知识的看法以及他们对了解或不了解其子女携带者状态的需求。

LQTS parents' reflections about genetic risk knowledge and their need to know or not to know their children's carrier status.

作者信息

Mangset Margrete, Hofmann Bjørn

机构信息

University of Oslo, Faculty of Medicine, Institute of Health and Society, Centre for Medical Ethics, Postboks 1130, Blindern, 0318, Oslo, Norway,

出版信息

J Genet Couns. 2014 Dec;23(6):1022-33. doi: 10.1007/s10897-014-9727-2. Epub 2014 May 1.

Abstract

Long QT syndrome (LQTS) is a contributor to unexplained deaths in infants (SIDS), children, teenagers and young adults. A gene test result may allow for individual tailored treatment, but also pose a burden of knowing one's carrier status, with no treatment recommendation. Genetic risk knowledge in the case of LQTS can promote adjustment and coping, but also fear anxiety, ambivalence and moral dilemmas. This makes it challenging to respect both the right to know and the right not to know. The purpose of this study was to explore LQTS parents' perception of genetic knowledge, and their need to know or not to know about their children's carrier status. Qualitative, semi structured interviews were conducted with thirteen parents of LQTS-children. Results show that parents found it important to know the result of a gene test for LQTS including their children's carrier status. The risk was framed and incorporated into their everyday life and their life perspectives. Pertinent moral dilemmas concerned information disclosure to children and relatives. Parents thought that early and gradual disclosure to children would promote coping. Parents' moral dilemmas were rarely addressed during encounters with healthcare providers. The participants had several suggestions for improvement in that regard.

摘要

长QT综合征(LQTS)是导致婴儿(婴儿猝死综合征)、儿童、青少年和年轻人不明原因死亡的一个因素。基因检测结果可能有助于进行个性化的针对性治疗,但也会带来知晓自身携带状态的负担,且没有治疗建议。对于LQTS而言,基因风险知识既能促进适应和应对,也会引发恐惧、焦虑、矛盾心理和道德困境。这使得尊重知情权和不知情权都具有挑战性。本研究的目的是探讨LQTS患儿家长对基因知识的认知,以及他们了解或不了解孩子携带状态的需求。对13位LQTS患儿的家长进行了定性的半结构式访谈。结果显示,家长们认为了解LQTS基因检测结果包括孩子的携带状态很重要。风险被纳入他们的日常生活和生活观念中。相关的道德困境涉及向孩子和亲属披露信息。家长们认为尽早并逐步向孩子披露信息有助于应对。在与医疗服务提供者的接触中,家长们的道德困境很少被提及。参与者对此提出了一些改进建议。

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