Rothwell Erin, Johnson Erin, Mathiesen Amber, Golden Kylie, Metcalf Audrey, Rose Nancy C, Botkin Jeffrey R
Division of Health Systems and Community-Based Care, College of Nursing, School of Medicine, University of Utah, 10 South 2000 East, Salt Lake City, UT, 84112, USA.
Division of Medical Ethics and Humanities, University of Utah, Salt Lake City, UT, USA.
J Genet Couns. 2017 Aug;26(4):690-696. doi: 10.1007/s10897-016-0037-8. Epub 2016 Oct 29.
The offering and acceptance of expanded carrier screening is increasing among pregnant women including women without an increased risk based on race, ethnicity or family history. The chances of a positive screening test have been reported to be as high as 24 % when multiple conditions are screened. Yet, little is known about the way these tests are offered and how patients are affected by a positive test result. To explore this area of genetic testing, interviews (n = 17) were conducted among women who received positive expanded carrier results in the context of obstetric care. A content analysis was conducted on the transcript data from the interviews. Outcomes of this research suggest that educational interventions are needed to improve maternal understanding of positive carrier screening results. Most of the participants in this study confused the results with other prenatal screening test options. In addition, the way the results were discussed varied greatly, and influenced participants' thoughts about reproductive decisions that led to a range of emotional uncertainty. Our data suggests that genetic counseling improved participants' understanding of positive results. More research is needed to further understand if our results are consistent within a larger, more diverse sample, and to explore how to best provide education about expanded carrier screening.
包括那些基于种族、族裔或家族病史无风险增加的孕妇在内,越来越多的孕妇接受并进行了扩展携带者筛查。据报道,当对多种疾病进行筛查时,筛查呈阳性的几率高达24%。然而,对于这些检测的提供方式以及患者如何受到阳性检测结果的影响,人们却知之甚少。为了探索这一基因检测领域,我们对在产科护理中收到扩展携带者阳性结果的女性进行了访谈(n = 17)。对访谈的文字记录数据进行了内容分析。这项研究的结果表明,需要开展教育干预措施,以提高孕妇对携带者阳性筛查结果的理解。本研究中的大多数参与者将这些结果与其他产前筛查测试选项相混淆。此外,结果的讨论方式差异很大,并影响了参与者对生殖决策的想法,从而导致一系列情绪上的不确定性。我们的数据表明,遗传咨询提高了参与者对阳性结果的理解。需要进行更多研究,以进一步了解我们的结果在更大、更多样化的样本中是否一致,并探索如何最好地提供有关扩展携带者筛查的教育。