Division of General and Community Pediatrics, Children's National Hospital, Washington, District of Columbia.
Department of Pediatrics, The George Washington University School of Medicine, Washington, District of Columbia.
Pediatrics. 2022 May 1;149(5). doi: 10.1542/peds.2021-053454.
Sickle cell trait (SCT) has reproductive implications and can rarely cause health problems. SCT counseling improves parent knowledge but is infrequently received by children with SCT compared with children with cystic fibrosis carrier status. There are no national guidelines on SCT disclosure timing, frequency, or counseling content. Parents' experiences with SCT disclosure and counseling are poorly understood but could inform the development of guidelines. We explored parents' experiences with and desires for SCT disclosure and counseling for their infants with SCT identified via newborn screening.
Parents of infants 2 to 12 months old with SCT were recruited through a state newborn screening program for semistructured interviews to explore their experiences with and desires for SCT disclosure and counseling. Inductive thematic analysis was conducted.
Sixteen interviews were completed from January to August 2020. Most parents reported that SCT disclosure occurred soon after birth, in person, and by the child's physician. Five themes were identified: parent knowledge before child's SCT disclosure, family planning, the dynamics of SCT disclosure and counseling, emotions and actions after SCT disclosure, and parent desires for the SCT disclosure and counseling process. Two primary parent desires were revealed. Parents want more information about SCT, particularly rare symptomatology, and they want SCT counseling repeated once the child approaches adolescence.
Parents report receiving their child's SCT diagnosis in the early newborn period from their child's doctor but indicate they receive incomplete information. Opportunities exist in primary care pediatrics to better align SCT disclosure timing and counseling content with parent desires.
镰状细胞特质(SCT)对生育有影响,且很少引发健康问题。SCT 咨询可提高家长的认知,但与囊性纤维化携带者相比,患有 SCT 的儿童接受的咨询较少。目前尚无关于 SCT 披露时间、频率或咨询内容的国家指南。尽管家长对 SCT 披露和咨询的经验了解甚少,但这些经验可能为指南的制定提供信息。我们通过新生儿筛查,对 SCT 患儿的家长进行调查,以了解他们对 SCT 披露和咨询的经验和期望。
通过州新生儿筛查计划招募了 2 至 12 个月大的 SCT 患儿的家长,进行半结构化访谈,以探索他们对 SCT 披露和咨询的经验和期望。采用归纳主题分析方法。
2020 年 1 月至 8 月完成了 16 次访谈。大多数家长报告称,SCT 披露发生在孩子出生后不久,是由孩子的医生亲自进行的。确定了五个主题:SCT 披露前家长的知识、计划生育、SCT 披露和咨询的动态、SCT 披露后的情绪和行动,以及家长对 SCT 披露和咨询过程的期望。揭示了两个主要的家长期望。家长希望获得更多关于 SCT 的信息,特别是罕见的症状,他们希望在孩子接近青春期时再次接受 SCT 咨询。
家长报告说在新生儿期不久就从孩子的医生那里得知了孩子的 SCT 诊断,但表示他们获得的信息不完整。初级保健儿科有机会更好地调整 SCT 披露时间和咨询内容,以满足家长的期望。