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基因组赋权量表:对未确诊疾病家庭中父母赋权的评估。

The genome empowerment scale: An assessment of parental empowerment in families with undiagnosed disease.

机构信息

Department of Pediatrics, Division of Medical Genetics, Duke University School of Medicine, Durham, North Carolina.

Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute, Los Angeles, California.

出版信息

Clin Genet. 2019 Dec;96(6):521-531. doi: 10.1111/cge.13635. Epub 2019 Oct 8.

Abstract

While genomic sequencing (ES/GS) has the potential to diagnose children with difficult to diagnose phenotypes, the goal should be not only a diagnosis, but also to empower parents to seek next steps for their children and to emotionally manage the outcome, whether or not a diagnosis is secured. To help achieve this goal, objective measures are needed to assess the process of parental empowerment related to genome sequencing. We present the validity and reliability of the Genome Empowerment Scale (GEmS), developed using a healthcare empowerment theoretical model. To evaluate its psychometric properties, 158 parents of 117 children with an undiagnosed condition undergoing genomic sequencing completed the GEmS, measures for criterion validity and for depression and anxiety. Factor analysis resulted in a four factor solution: (a) meaning of a diagnosis; (b) emotional management of the process; (c) seeking information and support and (d) implications and planning. Reliability and validity analyses show that the GEmS has good psychometric properties. The inter-relationships among the factors revealed a profile that may identify parents at risk for a poorer outcome who may benefit from targeted genetic counseling. The GEmS, an objective measure of parental genomic empowerment, can be utilized for future research and translational applications.

摘要

虽然基因组测序(ES/GS)有可能诊断出具有难以诊断表型的儿童,但目标不仅应该是诊断,还应该使父母能够为其孩子寻求下一步行动,并在获得或未获得诊断时在情感上管理结果。为了帮助实现这一目标,需要客观的措施来评估与基因组测序相关的父母赋权过程。我们介绍了使用医疗保健赋权理论模型开发的基因组赋权量表(GEmS)的有效性和可靠性。为了评估其心理测量特性,158 名 117 名患有未确诊疾病的儿童的父母完成了 GEmS,以及用于标准有效性和抑郁焦虑的测量。因素分析得出了一个四因素解决方案:(a)诊断的意义;(b)过程的情绪管理;(c)寻求信息和支持;(d)影响和计划。可靠性和有效性分析表明,GEmS 具有良好的心理测量特性。因素之间的相互关系揭示了一种可能识别出预后较差的父母的特征,他们可能受益于有针对性的遗传咨询。GEmS 是一种客观的父母基因组赋权衡量标准,可用于未来的研究和转化应用。

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