Chudleigh Jane, Chinnery Holly
School of Health Sciences, City, University of London, London EC1V 0HB, UK.
Faculty of Sports, Health and Applied Science, St Mary's University, London TW1 4SX, UK;
Int J Neonatal Screen. 2020 Mar 30;6(2):27. doi: 10.3390/ijns6020027. eCollection 2020 Jun.
Newborn screening for cystic fibrosis has resulted in diagnosis often before symptoms are recognised, leading to benefits including reduced disease severity, decreased burden of care, and lower costs. The psychological impact of this often unsought diagnosis on the parents of seemingly well children is less well understood. The time during which the screening result is communicated to families but before the confirmatory test results are available is recognised as a period of uncertainty and it is this uncertainty that can impact most on parents. Evidence suggests this may be mitigated against by ensuring the time between communication and confirmatory testing is minimized and health professionals involved in communicating positive newborn screening results and diagnostic results for cystic fibrosis to families are knowledgeable and able to provide appropriate reassurance. This is particularly important in the case of false positive results or when the child is given a Cystic Fibrosis Screen Positive, Inconclusive Diagnosis designation. However, to date, there are no formal mechanisms in place to support health professionals undertaking this challenging role, which would enable them to meet the expectations set out in specific guidance.
新生儿囊性纤维化筛查常常能在症状出现之前就实现诊断,带来诸多益处,包括减轻疾病严重程度、降低护理负担以及降低成本。然而,对于那些表面健康的孩子的父母而言,这种往往是意外获得的诊断所产生的心理影响却鲜为人知。从筛查结果告知家庭到确诊检测结果出来之前的这段时间,被视为充满不确定性的时期,而正是这种不确定性对父母影响最大。有证据表明,通过尽量缩短告知与确诊检测之间的时间,并确保参与向家庭传达囊性纤维化新生儿筛查阳性结果和诊断结果的医护人员知识渊博且能够提供适当的安慰,可以缓解这种情况。在出现假阳性结果或孩子被判定为囊性纤维化筛查阳性、诊断不确定的情况下,这一点尤为重要。然而,迄今为止,尚无正式机制来支持承担这一具有挑战性角色的医护人员,以使他们能够满足特定指南中提出的期望。