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成为并身为一名具有弥漫性胃癌遗传易感性的父母:一项针对携带致病变异的年轻人的定性研究。

Becoming and being a parent with an inherited predisposition to diffuse gastric cancer: A qualitative study of young adults with a pathogenic variant.

作者信息

Tutty Erin, Forbes Shepherd Rowan, Hoskins Cass, Purvis Rebecca, Shanahan Mary, Boussioutas Alex, Forrest Laura E

机构信息

Parkville Familial Cancer Centre, Peter MacCallum Cancer Centre and The Royal Melbourne Hospital, Melbourne, Australia.

Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Australia.

出版信息

J Psychosoc Oncol. 2023;41(3):286-302. doi: 10.1080/07347332.2022.2104676. Epub 2022 Aug 12.

Abstract

PURPOSE

This study explored the experiences of young people with hereditary diffuse gastric cancer (HDGC), an inherited cancer predisposition syndrome, as they navigate becoming and being a parent.

DESIGN

We used interpretive description and conducted semi-structured interviews with 13 young Australians (18-39 years) with a pathogenic variant (PV). Data were analyzed using team-based, reflexive thematic analysis.

FINDINGS

Participants' reproductive decisions centered on the perceived manageability of HDGC, namely via gastrectomy, and timing of their genetic testing. Participants yet to have children and those with challenging gastrectomy experiences favored using reproductive technologies to prevent passing on their PV. Parents who had children before genetic testing described complicated decisions about having more children. Gastrectomy was considered a parental responsibility but recovery diminished parenting abilities.

CONCLUSION

Young people with HDGC face unique challenges navigating reproductive decision-making and parenting with gastrectomy. Findings lend credence to calls for longitudinal, developmentally sensitive genetic counseling services.

摘要

目的

本研究探讨了患有遗传性弥漫性胃癌(HDGC,一种遗传性癌症易感性综合征)的年轻人在为人父母过程中的经历。

设计

我们采用解释性描述方法,对13名携带致病变异(PV)的澳大利亚年轻人(18 - 39岁)进行了半结构化访谈。使用基于团队的反思性主题分析法对数据进行了分析。

结果

参与者的生育决策集中在HDGC的可感知可管理性上,即通过胃切除术以及基因检测的时机。尚未生育的参与者以及经历了具有挑战性的胃切除术的参与者倾向于使用生殖技术来防止传递他们的PV。在基因检测之前就已生育的父母描述了关于生育更多孩子的复杂决策。胃切除术被视为一项父母的责任,但恢复过程会削弱养育能力。

结论

患有HDGC的年轻人在进行生殖决策和通过胃切除术为人父母方面面临独特的挑战。研究结果支持了对纵向的、对发育敏感的遗传咨询服务的呼吁。

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