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儿科肾脏病诊所中的基因检测:了解家庭的经历

Genetic Testing in the Pediatric Nephrology Clinic: Understanding Families' Experiences.

作者信息

Nevin Suzanne M, McLoone Jordana, Wakefield Claire E, Kennedy Sean E, McCarthy Hugh J

机构信息

School of Women's and Children's Health, University of New South Wales Medicine, University of New South Wales Sydney, Australia.

Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia.

出版信息

J Pediatr Genet. 2020 Dec 15;11(2):117-125. doi: 10.1055/s-0040-1721439. eCollection 2022 Jun.

Abstract

Genomics is rapidly being integrated into the routine care of children and families living with renal disease, principally as a diagnostic tool but also to direct therapy, identify at-risk relatives, and facilitate family planning. However, despite significant progress in understanding the genetic heterogeneity of inherited renal disease, the impact of genetic testing on parents and families of affected children is not well understood. This study aimed to investigate the experiences of families undergoing genetic testing, the psychosocial impact of receiving a genetic test result, and parent information and support needs. In-depth semistructured interviews were conducted with 26 parents of pediatric patients (<18 years of age) who had undergone genomic investigation for a suspected genetic renal disease at two tertiary pediatric nephrology services. Interviews were transcribed verbatim, coded, using NVivo software, and thematic analysis was undertaken. Key themes included emotional adjustment to a genetic diagnosis, the importance of parent-provider relationships, empowerment through social connection, and the value of family-centered care. Results highlighted the wide-ranging psychosocial impact of genetic testing on parents, as well as the importance of patient-support networks in enabling parents/families to cope and adapt. Targeted approaches to enhance communication of genetic information and the development of tailored resources to address parents' genetics and health service needs may lead to more satisfactory experiences of genetic testing.

摘要

基因组学正迅速融入患有肾脏疾病的儿童及其家庭的常规护理中,主要作为一种诊断工具,同时也用于指导治疗、识别有患病风险的亲属以及促进计划生育。然而,尽管在理解遗传性肾脏疾病的遗传异质性方面取得了重大进展,但基因检测对患病儿童的父母及其家庭的影响仍未得到充分了解。本研究旨在调查接受基因检测的家庭的经历、收到基因检测结果后的心理社会影响以及父母的信息需求和支持需求。在两家三级儿科肾脏病服务机构,对26名儿科患者(<18岁)的父母进行了深入的半结构化访谈,这些患者因疑似遗传性肾脏疾病接受了基因组调查。访谈内容逐字转录,使用NVivo软件进行编码,并进行了主题分析。关键主题包括对基因诊断的情绪调整、医患关系的重要性、通过社会联系获得 empowerment、以及以家庭为中心的护理的价值。结果强调了基因检测对父母广泛的心理社会影响,以及患者支持网络在帮助父母/家庭应对和适应方面的重要性。加强基因信息沟通的针对性方法以及开发量身定制的资源以满足父母的遗传学和健康服务需求,可能会带来更令人满意的基因检测体验。 (注:empowerment此处结合语境推测可能是“增强权能感”之类意思,但未找到完全合适的对应准确中文,保留英文供参考)

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