Faculty of Medicine, Clinical Ethics and Law, University of Southampton, Southampton, UK.
Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK.
Arch Dis Child. 2019 Jan;104(1):76-82. doi: 10.1136/archdischild-2018-314952. Epub 2018 Jun 28.
There is limited information on the psychosocial impact of growing up with Silver-Russell syndrome (SRS), characterised by slow growth in utero leading to short stature in adulthood. Such information could aid families in making difficult treatment decisions and guide management strategies for health professionals. We aimed to explore the lived experience of people with SRS across the lifespan.
DESIGN/SETTING/PATIENTS: In-depth, semi-structured interviews were conducted between January 2015 and October 2016 with a sample of 15 adults (six women) with genetically confirmed SRS from the UK. Qualitative interviews were transcribed and coded to identify similarities and differences: codes were then grouped to form overarching themes.
Four themes were identified from participant accounts: (1) appearance-related concerns extending beyond height; (2) strategies to deal with real and perceived threats; (3) women's experiences of pain, disability and feeling older than their years; and (4) feeling overlooked in romantic relationships. These themes show that other factors, beyond short stature, affect patient well-being and indicate a mismatch between patient need and healthcare provision.
Challenges in SRS during childhood and adolescence were central to the psychosocial impact of SRS, and were not limited to height. These challenges, as well as symptoms such as pain and fatigue for women, have not previously been documented. To help individuals with SRS develop strategies to manage psychosocial issues, we recommend clinicians incorporate psychological services as an integral part of multidisciplinary teams managing individuals with SRS during childhood, adolescence and adulthood.
关于在 Silver-Russell 综合征(SRS)中成长的心理社会影响的信息有限,其特征是宫内生长缓慢导致成年后身材矮小。这些信息可以帮助家庭做出困难的治疗决策,并为卫生专业人员指导管理策略。我们旨在探索 SRS 患者在整个生命周期中的生活体验。
设计/设置/患者:2015 年 1 月至 2016 年 10 月期间,从英国采集了 15 名成年患者(6 名女性)的样本,他们均经基因证实患有 SRS,采用深入的半结构化访谈。对定性访谈进行转录和编码,以识别相似之处和差异:然后将代码分组形成总体主题。
从参与者的描述中确定了四个主题:(1)超出身高的与外貌相关的担忧;(2)应对真实和感知威胁的策略;(3)女性的疼痛、残疾和感觉比实际年龄大的经历;(4)在浪漫关系中感到被忽视。这些主题表明,除了身材矮小之外,还有其他因素会影响患者的幸福感,并表明患者的需求与医疗保健提供之间存在不匹配。
儿童期和青春期 SRS 的挑战是 SRS 心理社会影响的核心,不仅限于身高。这些挑战以及女性的疼痛和疲劳等症状以前尚未记录。为了帮助 SRS 患者制定管理心理社会问题的策略,我们建议临床医生将心理服务纳入管理儿童期、青春期和成年期 SRS 患者的多学科团队的重要组成部分。