Peay Holly L, Meiser Bettina, Kinnett Kathleen, Tibben Aad
RTI International, 3040 E Cornwallis Rd, P.O. Box 12194, Research Triangle Park, NC, USA.
Parent Project Muscular Dystrophy, Hackensack, NJ, USA.
J Genet Couns. 2018 Feb;27(1):197-203. doi: 10.1007/s10897-017-0141-4. Epub 2017 Aug 12.
Care guidelines for Duchenne/Becker muscular dystrophy (DBMD) include recommendations for assessment of caregivers of patients with DBMD followed by proactive psychosocial interventions. To inform clinical assessment, this study described appraisals of psychosocial needs and caregiving facilitators of mothers of individuals with DBMD. Two hundred and five mothers completed an online survey. More than 50% endorsed unmet needs for managing uncertainty about the future and managing DBMD fears. Higher levels of unmet need were associated with less disease progression/earlier stage of DBMD (rho = -0.166 p = 0.02). Twenty-one percent regularly used respite care and 57% worried about allowing others to care for their child. Highly-endorsed care facilitators included partner relationships (63%), child's approach to life (59%), and family relationships (49%). Our findings highlight the importance of psychological and social support for caregivers. Starting when children are young, clinicians should assess caregivers' unmet psychological needs, particularly uncertainty and fear. Exploring needs and facilitators may allow clinics to target and customize interventions that build upon existing strengths and supports. Our findings have implications for efforts to promote early diagnosis and newborn screening, in that increased needs in mothers of younger children should be anticipated and built into counseling. Further research can assess whether and how unmet needs change as new therapies become available.
杜兴氏/贝克氏肌营养不良症(DBMD)的护理指南包括对DBMD患者护理人员进行评估的建议,随后进行积极的心理社会干预。为了为临床评估提供参考,本研究描述了对DBMD患者母亲心理社会需求和护理促进因素的评估。205名母亲完成了一项在线调查。超过50%的人认可在应对未来不确定性和应对DBMD恐惧方面存在未满足的需求。未满足需求的较高水平与疾病进展较少/DBMD早期阶段相关(rho = -0.166,p = 0.02)。21%的人经常使用临时护理服务,57%的人担心让他人照顾自己的孩子。高度认可的护理促进因素包括伴侣关系(63%)、孩子的生活态度(59%)和家庭关系(49%)。我们的研究结果强调了为护理人员提供心理和社会支持的重要性。从孩子年幼时开始,临床医生就应该评估护理人员未满足的心理需求,尤其是不确定性和恐惧。探索需求和促进因素可能使诊所能够针对并定制基于现有优势和支持的干预措施。我们的研究结果对促进早期诊断和新生儿筛查的努力具有启示意义,因为应该预见到年幼儿童母亲的需求增加,并将其纳入咨询内容。进一步的研究可以评估随着新疗法的出现,未满足的需求是否以及如何发生变化。