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探索向健康儿童的父母披露囊性纤维化病情的情况。

Exploring parental cystic fibrosis disclosure to well children.

作者信息

Boyer Amanda, Raraigh Karen, Riley Stephanie, Frank Julie

机构信息

University of Maryland School of Medicine, Baltimore, Maryland, USA.

McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University, Baltimore, Maryland, USA.

出版信息

J Genet Couns. 2023 Apr;32(2):486-494. doi: 10.1002/jgc4.1658. Epub 2022 Dec 2.

Abstract

Cystic fibrosis (CF), a genetic disease and chronic illness, affects multiple organ systems and requires exceptional medical care and treatment. Few studies have assessed the diagnosis disclosure process to well children when their sibling(s) have CF, and none have evaluated the association between parental knowledge of CF and the disclosure of CF. The objectives of this study were to assess parental understanding of CF, demonstrate the most commonly shared topics and their frequencies of discussion with well children, and identify associations between parental understanding of CF and aspects of the disclosure process to well children. Parents were recruited from CF support organizations and asked to complete an online, anonymous survey. Individuals were eligible to participate in the study if they had at least one living child with CF and at least one living child without CF. Completed surveys from 48 individuals revealed that most parents began discussing a sibling's diagnosis of CF with the first-born well child at 5.4 years old. Topics related to CF were discussed openly and as needed with their well children (n = 44). The most frequently discussed topic, and the topic ranked most important (1.93 of 5, SD: 1.17) by 40 participants (90.9%), was medical concerns and treatment for CF. Fewer parents (n = 18, 40.9%) reported discussing the financial impact of CF, and many ranked this as least important to share (4.64 of 5, SD: 0.75). The CF knowledge assessment revealed that participants were well-informed about CF, with a mean total score of 8.9/10 (SD: 0.91). There were no associations between CF knowledge assessment scores, education level, income, and the topics discussed with well children. These results can be utilized by genetic counselors and other healthcare specialists in discussion with parents about the disclosure process of a diagnosis of CF to well children.

摘要

囊性纤维化(CF)是一种遗传性疾病和慢性病,会影响多个器官系统,需要特殊的医疗护理和治疗。很少有研究评估当健康儿童的兄弟姐妹患有CF时的诊断告知过程,也没有研究评估父母对CF的了解与向健康儿童告知CF之间的关联。本研究的目的是评估父母对CF的理解,展示最常讨论的话题及其与健康儿童讨论的频率,并确定父母对CF的理解与向健康儿童告知过程的各个方面之间的关联。从CF支持组织招募父母,并要求他们完成一项在线匿名调查。如果个人至少有一个患有CF的在世子女和至少一个没有CF的在世子女,则有资格参与该研究。48人的完整调查显示,大多数父母在第一个健康孩子5.4岁时开始与他们讨论兄弟姐妹的CF诊断。与CF相关的话题会根据需要与他们的健康孩子公开讨论(n = 44)。最常讨论的话题,也是40名参与者(90.9%)认为最重要的话题(5分制中得1.93分,标准差:1.17),是CF的医疗问题和治疗。较少的父母(n = 18,40.9%)报告讨论了CF的经济影响,许多人将其列为最不重要的分享内容(5分制中得4.64分,标准差:0.75)。CF知识评估显示,参与者对CF了解充分,平均总分8.9/10(标准差:0.91)。CF知识评估得分、教育水平、收入与与健康儿童讨论的话题之间没有关联。这些结果可供遗传咨询师和其他医疗保健专家在与父母讨论向健康儿童披露CF诊断的过程时使用。

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