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与罕见疾病共存:对定性文献的系统综述

Living with a rare disorder: a systematic review of the qualitative literature.

作者信息

von der Lippe Charlotte, Diesen Plata S, Feragen Kristin B

机构信息

Centre for Rare Disorders, Oslo University Hospital, Rikshospitalet, P.B. 4950 Nydalen, Oslo, 0424, Norway.

出版信息

Mol Genet Genomic Med. 2017 Nov;5(6):758-773. doi: 10.1002/mgg3.315. Epub 2017 Jul 23.

Abstract

BACKGROUND

Individuals with rare diseases may face challenges that are different from those experienced in more common medical conditions. A wide range of different rare conditions has resulted in a myriad of studies investigating the specificities of the diagnosis in focus. The shared psychological experiences of individuals with a rare condition, however, have not been reviewed systematically.

METHODS

We performed a systematic review, including qualitative studies on adults, published between 2000 and 2016. Papers including more than one rare genetic or nongenetic diagnosis were included. Studies based on single diagnoses were excluded except for four specific conditions: hemophilia (bleeding disorder), phenylketonuria (metabolic disorder), Fabry disease (lysosomal storage disorder), and epidermolysis bullosa (skin disorder).

RESULTS

The review identified 21 studies. Findings were synthesized and categorized according to three main themes: (1) Consequences of living with a rare disorder, (2) Social aspects of living with a rare disorder, and (3) Experiences with the health care system. Findings point to several unique challenges, such as the psychological, medical, and social consequences of a lack of knowledge about the condition in health care and social settings.

CONCLUSION

The findings highlight the need for more research on the shared psychological and social impact of living with a rare diagnosis across conditions, in order to identify risk factors and inform clinical practice.

摘要

背景

患有罕见病的个体可能面临与常见疾病患者不同的挑战。多种不同的罕见病导致了大量针对重点诊断特异性的研究。然而,患有罕见病个体的共同心理体验尚未得到系统回顾。

方法

我们进行了一项系统回顾,纳入了2000年至2016年间发表的关于成年人的定性研究。纳入包含一种以上罕见遗传或非遗传诊断的论文。除了四种特定疾病(血友病(出血性疾病)、苯丙酮尿症(代谢性疾病)、法布里病(溶酶体贮积症)和大疱性表皮松解症(皮肤病))外,基于单一诊断的研究被排除。

结果

该回顾确定了21项研究。研究结果根据三个主要主题进行综合和分类:(1)患有罕见病的后果,(2)患有罕见病的社会方面,以及(3)与医疗保健系统的经历。研究结果指出了几个独特的挑战,例如在医疗保健和社会环境中对疾病缺乏了解所带来的心理、医学和社会后果。

结论

研究结果强调需要更多地研究患有罕见病的共同心理和社会影响,以识别风险因素并为临床实践提供信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a2a/5702559/d1e830d6f514/MGG3-5-758-g001.jpg

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