Qian Emily, Thong Meow-Keong, Flodman Pamela, Gargus Jay
Department of Genetic and Genomic Medicine, University of California Irvine, Irvine, CA, 92697, USA.
Department of Paediatrics, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
J Community Genet. 2019 Jul;10(3):351-361. doi: 10.1007/s12687-018-0399-8. Epub 2018 Dec 3.
In the era of personalized and genomic medicine, awareness of patients with rare diseases is increasing as new approaches to diagnosis and treatment are developed. This study examined perceived barriers experienced by families with rare diseases and explored possible differences between participants in Malaysia and California, USA. The study involved N = 108 participants recruited in genetics clinic appointments at the University of Malaya Medical Center and three sites in Southern California. Participants completed a survey involving multiple choice and Likert scale items pertaining to perceived barriers to access genetics-related healthcare. Results from this study provide evidence of similar perceived barriers, despite differences in the two populations. Participants selected the expansion of healthcare provider knowledge of rare diseases to be the most beneficial approach to overcome perceived barriers. In both locations, it was also noted that travel distance to clinic was not perceived as a large stress factor. Taking these observations together, a healthcare model with a central location of providers well-versed in medical genetics may be considered if further data support our findings. The data from this study support a need for improving healthcare provider knowledge of genetics. Future studies exploring how these perceived stress factors are impacting families as well as different methods of educating providers are suggested by findings from the study, as well as studies querying the opinions of those who are unable to access genetics services.
在个性化和基因组医学时代,随着新的诊断和治疗方法的开发,罕见病患者的认知度正在提高。本研究调查了罕见病家庭所面临的感知障碍,并探讨了马来西亚和美国加利福尼亚州参与者之间可能存在的差异。该研究涉及在马来亚大学医学中心和南加利福尼亚州三个地点的遗传学门诊预约中招募的N = 108名参与者。参与者完成了一项调查,其中包括多项选择题和李克特量表项目,这些项目与获得遗传学相关医疗保健的感知障碍有关。尽管这两个人口群体存在差异,但本研究结果提供了类似感知障碍的证据。参与者选择扩大医疗保健提供者对罕见病的了解是克服感知障碍的最有益方法。在这两个地点,还指出到诊所的旅行距离不被视为一个很大的压力因素。综合这些观察结果,如果进一步的数据支持我们的发现,可以考虑采用一种医疗模式,即让精通医学遗传学的提供者集中在一个地点。本研究的数据支持了提高医疗保健提供者遗传学知识的必要性。研究结果表明,未来需要开展研究,探索这些感知到的压力因素如何影响家庭,以及教育提供者的不同方法,同时还需要开展研究,询问那些无法获得遗传学服务的人的意见。