Eisler Ivan, Ellison Matthew, Flinter Frances, Grey Jo, Hutchison Suzanne, Jackson Carole, Longworth Louise, MacLeod Rhona, McAllister Marion, Metcalfe Alison, Murrells Trevor, Patch Christine, Pritchard Stuart, Robert Glenn, Rowland Emma, Ulph Fiona
South London and Maudsley NHS Foundation Trust, London, UK.
Huntington's Disease Youth Organisation, London, UK.
Eur J Hum Genet. 2016 Jun;24(6):794-802. doi: 10.1038/ejhg.2015.215. Epub 2015 Oct 7.
Many families experience difficulty in talking about an inherited genetic condition that affects one or more of them. There have now been a number of studies identifying the issues in detail, however few have developed interventions to assist families. The SPRinG collaborative have used the UK Medical Research Council's guidance on Developing and Evaluating Complex Interventions, to work with families and genetic counsellors (GCs) to co-design a psycho-educational intervention to facilitate family communication and promote better coping and adaptation to living with an inherited genetic condition for parents and their children (<18 years). The intervention is modelled on multi-family discussion groups (MFDGs) used in psychiatric settings. The MFDG was developed and tested over three phases. First focus groups with parents, young people, children and health professionals discussed whether MFDG was acceptable and proposed a suitable design. Using evidence and focus group data, the intervention and a training manual were developed and three GCs were trained in its delivery. Finally, a prototype MFDG was led by a family therapist and co-facilitated by the three GCs. Data analysis showed that families attending the focus groups and intervention thought MFDG highly beneficial, and the pilot sessions had a significant impact on their family' functioning. We also demonstrated that it is possible to train GCs to deliver the MFDG intervention. Further studies are now required to test the feasibility of undertaking a definitive randomised controlled trial to evaluate its effectiveness in improving family outcomes before implementing into genetic counselling practice.
许多家庭在谈论影响其一名或多名成员的遗传性疾病时都遇到困难。目前已有多项研究详细确定了相关问题,然而很少有研究开发出帮助家庭的干预措施。SPRinG合作团队利用英国医学研究理事会关于开发和评估复杂干预措施的指南,与家庭和遗传咨询师(GCs)合作,共同设计了一种心理教育干预措施,以促进家庭沟通,并帮助父母及其子女(未满18岁)更好地应对和适应遗传性疾病。该干预措施以精神科环境中使用的多家庭讨论小组(MFDGs)为蓝本。MFDG分三个阶段进行开发和测试。首先,与父母、年轻人、儿童和健康专业人员进行焦点小组讨论,探讨MFDG是否可行,并提出合适的设计方案。利用相关证据和焦点小组数据,开发了干预措施和培训手册,并对三名遗传咨询师进行了实施培训。最后,由一名家庭治疗师主持,三名遗传咨询师共同协助,开展了一次MFDG原型活动。数据分析表明,参加焦点小组和干预活动的家庭认为MFDG非常有益,试点活动对他们家庭的功能产生了重大影响。我们还证明了培训遗传咨询师实施MFDG干预措施是可行的。现在需要进一步研究,以测试进行确定性随机对照试验的可行性,从而在将其应用于遗传咨询实践之前评估其改善家庭状况的有效性。