Boardman Felicity K, Young Philip J, Griffiths Frances E
Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK.
School of Life Sciences, University of Warwick, Coventry, UK.
J Genet Couns. 2018 Feb;27(1):69-84. doi: 10.1007/s10897-017-0122-7. Epub 2017 Jun 30.
Developments in genetics are rapidly changing the capacity and scope of screening practices. However, people with genetic conditions have been under-represented in the literature exploring their implications. This mixed methods study explores the attitudes of people with Spinal Muscular Atrophy (SMA) towards three different population-level genetic screening programmes for SMA: pre-conception, prenatal and newborn screening. Drawing on qualitative interviews (n = 15) and a survey (n = 82), this study demonstrates that more severely affected individuals with early-onset symptoms (Type II SMA), are less likely to support screening and more likely to view SMA positively than those with milder, later onset and/or fluctuating symptoms (Types III/ IV SMA). Indeed, this clinically milder group were more likely to support all forms of screening and view SMA negatively. This paper highlights that screening is a complex issue for people with genetic conditions, and the nature of impairment experiences plays a critical role in shaping attitudes.
遗传学的发展正在迅速改变筛查实践的能力和范围。然而,在探讨其影响的文献中,患有遗传疾病的人所占比例一直较低。这项混合方法研究探讨了脊髓性肌萎缩症(SMA)患者对三种不同的SMA人群水平基因筛查项目的态度:孕前筛查、产前筛查和新生儿筛查。通过定性访谈(n = 15)和一项调查(n = 82),本研究表明,与症状较轻、发病较晚和/或症状波动的患者(III/IV型SMA)相比,症状早发的重症患者(II型SMA)支持筛查的可能性较小,对SMA持积极看法的可能性更大。事实上,临床症状较轻的这组患者更有可能支持所有形式的筛查,并对SMA持负面看法。本文强调,筛查对患有遗传疾病的人来说是一个复杂的问题,损伤经历的性质在塑造态度方面起着关键作用。