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生殖遗传携带者筛查中对患者重要的结局:一项用于确定核心结局集的定性研究

Outcomes of Importance to Patients in Reproductive Genetic Carrier Screening: A Qualitative Study to Inform a Core Outcome Set.

作者信息

Richardson Ebony, McEwen Alison, Newton-John Toby, Crook Ashley, Jacobs Chris

机构信息

Graduate School of Health, University of Technology Sydney, Chippendale, NSW 2008, Australia.

出版信息

J Pers Med. 2022 Aug 12;12(8):1310. doi: 10.3390/jpm12081310.

Abstract

There is significant heterogeneity in the outcomes assessed across studies of reproductive genetic carrier screening (RGCS). Only a small number of studies have measured patient-reported outcomes or included patients in the selection of outcomes that are meaningful to them. This study was a cross-sectional, qualitative study of 15 patient participants conducted to inform a core outcome set. A core outcome set is an approach to facilitate standardisation in outcome reporting, allowing direct comparison of outcomes across studies to enhance understanding of impacts and potential harms. The aim of this study was to incorporate the patient perspective in the development of a core outcome set by eliciting a detailed understanding of outcomes of importance to patients. Data were collected via online, semi-structured interviews using a novel method informed by co-design and the nominal group technique. Data were analysed using reflexive thematic analysis. Outcomes elicited from patient stakeholder interviews highlighted several under-explored areas for future research. This includes the role of grief and loss in increased risk couples, the role of empowerment in conceptualising the utility of RGCS, the impact of societal context and barriers that contribute to negative experiences, and the role of genetic counselling in ensuring that information needs are met and informed choice facilitated as RGCS becomes increasingly routine. Future research should focus on incorporating outcomes that accurately reflect patient needs and experience.

摘要

在生殖遗传携带者筛查(RGCS)的各项研究中,所评估的结果存在显著的异质性。只有少数研究测量了患者报告的结果,或者在选择对患者有意义的结果时纳入了患者。本研究是一项对15名患者参与者进行的横断面定性研究,旨在确定一个核心结局集。核心结局集是一种促进结局报告标准化的方法,可使不同研究的结果直接进行比较,以加深对影响和潜在危害的理解。本研究的目的是通过详细了解对患者重要的结局,将患者的观点纳入核心结局集的制定过程。数据通过在线半结构化访谈收集,采用了一种基于协同设计和名义群体技术的新方法。数据使用反思性主题分析法进行分析。患者利益相关者访谈得出的结果突出了几个未来研究中尚未充分探索的领域。这包括悲伤和失落感在风险增加夫妇中的作用、赋权在理解RGCS效用方面的作用、社会背景的影响以及导致负面体验的障碍,以及随着RGCS日益常规化,遗传咨询在确保满足信息需求和促进知情选择方面的作用。未来的研究应侧重于纳入准确反映患者需求和体验的结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d20/9409855/ce8144ab721a/jpm-12-01310-g001.jpg

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