Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA.
School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA, USA.
Genet Med. 2019 Dec;21(12):2791-2797. doi: 10.1038/s41436-019-0570-6. Epub 2019 Jun 12.
We describe parental perceptions of and experiences with genomic sequencing (GS) in the care of seriously ill children. Understanding parents' perspectives is vital for clinicians caring for children, given the uptake of genomic technologies into clinical practice.
Longitudinal, semistructured interviews were conducted with parents of pediatric cancer patients who underwent exome sequencing (ES) as a part of the BASIC3 study. Interviews were conducted at baseline, one to eight months after results disclosure, and approximately one year after disclosure. Using thematic qualitative analysis, parent interviews were coded with both inductive and deductive approaches.
Before receiving genomic information, parents indicated that they saw ES as something responsible parents would agree to if their child had cancer. Some parents talked about the possibility of sequencing affecting feelings of culpability for their child's cancer, worrying that they passed on a cancer-causing gene or made parenting decisions that caused the disease. However, after receiving their child's ES results many reported feeling relieved of guilt and worry, and felt they had fulfilled parental duties by agreeing to ES for their child.
These results reveal a layer of meaning that parents associate with GS that may inform clinicians' approach to care.
我们描述了父母对严重患病儿童治疗中基因组测序(GS)的看法和经验。鉴于基因组技术已被纳入临床实践,了解父母的观点对于照顾儿童的临床医生至关重要。
对接受外显子组测序(ES)作为 BASIC3 研究一部分的儿科癌症患者的父母进行了纵向、半结构式访谈。访谈在基线时、结果披露后一至八个月以及披露后大约一年进行。使用主题定性分析,采用归纳和演绎方法对父母访谈进行编码。
在获得基因组信息之前,父母表示,如果他们的孩子患有癌症,他们会同意进行 ES。一些父母谈到了测序可能会影响他们对孩子癌症的内疚感,担心他们遗传了致癌基因或做出了导致疾病的育儿决策。然而,在收到孩子的 ES 结果后,许多父母表示感到内疚和担忧减轻了,并感到他们通过同意为孩子进行 ES 而履行了父母的职责。
这些结果揭示了父母与 GS 相关的一层含义,这可能为临床医生的护理方法提供信息。