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关于先天性肾上腺皮质增生症的交流:菲律宾家庭的视角

Communication about Congenital Adrenal Hyperplasia: Perspective of Filipino Families.

作者信息

Abad Peter James B, Anonuevo Cora A, Daack-Hirsch Sandra, Abad Lorna R, Padilla Carmencita D, Laurino Mercy Y

机构信息

College of Nursing, University of the Philippines Manila, Manila, Philippines.

Department of Pediatrics, College of Medicine, University of the Philippines Manila, Manila, Philippines.

出版信息

J Genet Couns. 2017 Aug;26(4):763-775. doi: 10.1007/s10897-016-0043-x. Epub 2016 Nov 10.

Abstract

Congenital adrenal hyperplasia (CAH), like other genetic conditions, is a relational disease from both the biological and psychosocial perspectives since the diagnosis gives rise to a variety of health, reproductive, and psychosocial implications. It is in these contexts that family communication of genetic information is important to study. Hence, this research aimed to explore genetic information communication in Filipino families affected with CAH. Using a qualitative descriptive design, families with a child affected with CAH were recruited through the CAH parent support group and were interviewed. Semi-structured interviews explored flow and content of genetic information communicated, the meanings the families attach to the communicated information, and the motivating and hindering factors in communication. Thematic analysis was used to analyze the findings. A total of five families participated, which included 11 individuals. Findings revealed that the diagnosis of CAH is not kept secret and it is openly shared with the family. The decision to communicate is influenced by several factors including the family's desire to seek further information about their family history. Initially, the focus of the communicated information is on the health implications and while communication about genetics occurs, this is almost always confined to the immediate family. The mother and grandmother serve as primary communicators in the family. The families have limited understanding of CAH especially its genetic implications including recurrence risk and carrier status. The findings can guide genetic counselors in supporting families in communicating information about CAH with the rest of the family.

摘要

先天性肾上腺皮质增生症(CAH)与其他遗传疾病一样,从生物学和社会心理角度来看都是一种涉及多方关系的疾病,因为该诊断会引发各种健康、生殖和社会心理方面的影响。正是在这些背景下,研究家庭中遗传信息的交流变得很重要。因此,本研究旨在探索受CAH影响的菲律宾家庭中的遗传信息交流情况。采用定性描述性设计,通过CAH家长支持小组招募了有患CAH孩子的家庭并进行访谈。半结构化访谈探讨了所交流的遗传信息的流程和内容、家庭对所交流信息赋予的意义以及交流中的促进因素和阻碍因素。采用主题分析法对研究结果进行分析。共有五个家庭参与,包括11名个体。研究结果显示,CAH的诊断并未保密,而是在家庭中公开分享。交流的决定受到多种因素影响,包括家庭寻求家族病史更多信息的愿望。最初,所交流信息的重点是对健康的影响,虽然也会进行关于遗传学的交流,但几乎总是局限于直系亲属。母亲和祖母是家庭中的主要信息传播者。这些家庭对CAH的了解有限,尤其是对其遗传影响,包括复发风险和携带者状态。这些研究结果可以指导遗传咨询师帮助家庭与其他家庭成员交流有关CAH的信息。

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