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对 BRCA1/2 基因突变相关身份认同体验的定性反思性主题分析:“本可以避免这么多小创伤”。

A qualitative reflexive thematic analysis into the experiences of being identified with a BRCA1/2 gene alteration: "So many little, little traumas could have been avoided".

机构信息

School of Psychology, National University of Ireland, Galway, Ireland.

出版信息

BMC Health Serv Res. 2022 Aug 6;22(1):1007. doi: 10.1186/s12913-022-08372-w.

Abstract

BACKGROUND

BRCA1/2 alterations increase females' lifetime breast cancer risk to 40 - 90%, ovarian cancer to 10 - 60%, and males' lifetime prostate cancer risk to ~ 10 - 25%. Psychosocial issues such as heightened distress can, therefore, occur in this population. This study aimed to explore the subjective experiences and needs of the BRCA1/2 alteration population in navigating cancer risk reduction measures.

METHOD

This study aimed to explore the experiences and identify the needs of 18 BRCA1/2 alteration carriers, recruited through strategic sampling. A public and patient panel (N = 6) collaborated on study development. Data were analysed using reflexive thematic analysis.

RESULTS

Two themes were identified: (i) Healthcare Services as a Burden to Navigate, and (ii) Burden Experienced Through Interactions with Healthcare Professionals. Results indicated uncertainty regarding care pathways, alongside a lack of relevant information. Participants felt unsupported by healthcare professionals, and as though healthcare professionals often perceive them as a burden.

CONCLUSIONS

These findings suggest that the quality of interactions in healthcare systems are of relevance to the BRCA1/2 alteration population, and that uncertainty surrounding access to services and information is prevalent. The establishment of specialist hereditary cancer clinics could reduce such burden.

摘要

背景

BRCA1/2 改变会使女性终生患乳腺癌的风险增加到 40%-90%,患卵巢癌的风险增加到 10%-60%,使男性终生患前列腺癌的风险增加到~10%-25%。因此,该人群可能会出现心理困扰等问题。本研究旨在探讨 BRCA1/2 改变人群在应对癌症风险降低措施时的主观体验和需求。

方法

本研究旨在通过战略抽样,招募 18 名 BRCA1/2 改变携带者,以探索他们的经验并确定他们的需求。公共和患者小组(N=6)共同参与了研究的开发。使用反思性主题分析对数据进行分析。

结果

确定了两个主题:(i)医疗保健服务作为导航的负担,以及(ii)与医疗保健专业人员互动带来的负担。结果表明,对护理途径存在不确定性,同时缺乏相关信息。参与者感到不被医疗保健专业人员支持,并且他们觉得医疗保健专业人员常常把他们视为负担。

结论

这些发现表明,医疗保健系统中互动的质量与 BRCA1/2 改变人群有关,并且对服务和信息的获取存在不确定性。建立专门的遗传性癌症诊所可以减轻这种负担。

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Which Genes for Hereditary Breast Cancer?哪些基因与遗传性乳腺癌有关?
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