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新生儿筛查的同意:父母和医疗保健专业人员在实践中的同意经历。

Consent for newborn screening: parents' and health-care professionals' experiences of consent in practice.

作者信息

Etchegary Holly, Nicholls Stuart G, Tessier Laure, Simmonds Charlene, Potter Beth K, Brehaut Jamie C, Pullman Daryl, Hayeems Robyn, Zelenietz Sari, Lamoureux Monica, Milburn Jennifer, Turner Lesley, Chakraborty Pranesh, Wilson Brenda

机构信息

Clinical Epidemiology Unit, Faculty of Medicine, Memorial University, St John's, Newfoundland and Labrador, Canada.

School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada.

出版信息

Eur J Hum Genet. 2016 Nov;24(11):1530-1534. doi: 10.1038/ejhg.2016.55. Epub 2016 Jun 15.

Abstract

Consent processes for newborn bloodspot screening (NBS) are variable, with a lack of descriptive research that depicts how the offer of NBS is made to parents. We explored the experience, in practice, of consent for NBS. Semistructured interviews in two Canadian provinces were held with: (1) parents of children offered NBS (n=32); and (2) health-care professionals involved in the NBS process (n=19). Data on recollections of NBS, including consent processes, were utilized to identify emerging themes using the method of constant comparison. Three themes were relevant to NBS consent: (1) The 'offer' of NBS; (2) content and timing of information provision; and (3) the importance of parental experiences for consent decisions. Recollections of consent for NBS were similar between jurisdictions. Excepting midwives and their patients, NBS was viewed as a routine part of giving birth, with little evidence of an informed consent process. Although most parents were satisfied, all respondents suggested information about NBS be provided long before the birth. Accounts of parents who declined screening highlight the influence of parental experiences with the heel prick process in screening decisions. Findings further our understanding of consent in practice and highlight areas for improvement in parent-provider interactions.

摘要

新生儿血斑筛查(NBS)的同意程序各不相同,且缺乏描述向父母提供NBS提议方式的研究。我们探讨了NBS同意程序在实际中的情况。在加拿大的两个省份进行了半结构化访谈,访谈对象包括:(1)其子女接受NBS的父母(n = 32);以及(2)参与NBS程序的医疗保健专业人员(n = 19)。利用关于NBS回忆的数据,包括同意程序,采用持续比较法来确定新出现的主题。与NBS同意相关的三个主题是:(1)NBS的“提议”;(2)信息提供的内容和时机;以及(3)父母经历对同意决定的重要性。不同司法管辖区对NBS同意的回忆相似。除了助产士及其患者外,NBS被视为分娩的常规部分,几乎没有知情同意程序的证据。尽管大多数父母感到满意,但所有受访者都建议在分娩前很久就提供有关NBS的信息。拒绝筛查的父母的叙述突出了父母足跟采血经历对筛查决定的影响。研究结果增进了我们对实际同意情况的理解,并突出了父母与提供者互动中需要改进的领域。

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