Department of Health Promotion and Education, University of Ibadan, Nigeria.
College of Nursing, Medical University of South Carolina, South Carolina, USA.
J Stroke Cerebrovasc Dis. 2023 Mar;32(3):106978. doi: 10.1016/j.jstrokecerebrovasdis.2023.106978. Epub 2023 Jan 10.
This study explored perceptions, preferences and attitudes towards disclosure of genetic testing results for stroke among stroke-free controls (and their family members) in the SIREN-SIBS Genomics Study, healthcare providers and policymakers.
We conducted a qualitative thematic analysis of key informant interviews with 61 participants recruited from community advisory boards (30) and health care providers (31) across seven sites in Nigeria and Ghana.
Major findings illustrate differences in the knowledge of genetic testing with superior knowledge among health care professionals. Relatives and religious leaders were opined as the best to receive the disclosure as they would be able to break the news to the patient in a culturally sensitive manner to reduce the likely resultant emotional outburst. Poor level of awareness of national guidelines for disclosing genetic results exist. Key facilitating factors for disclosure are education, enabling environment, involvement of religious and community leaders, campaigns, and possible treatment options. Disclosure inhibitors include inadequate information, fear of marital break-up or family displacement, fear of stigmatization, fear of isolation, religious beliefs, health worker attitude, and lack of preparedness to accept results.
These necessitate culturally sensitive interventions for continuing education, increased awareness and sustained engagement to equip all stakeholders in genetic testing disclosure process.
本研究旨在探讨 SIREN-SIBS 基因组学研究中无中风对照组(及其家庭成员)、医疗保健提供者和政策制定者对中风基因检测结果披露的看法、偏好和态度。
我们对来自尼日利亚和加纳 7 个地点的社区咨询委员会(30 人)和医疗保健提供者(31 人)的 61 名关键信息参与者进行了定性主题分析。
主要发现表明,遗传检测知识存在差异,医疗保健专业人员的知识更优。亲属和宗教领袖被认为是接收披露的最佳人选,因为他们能够以文化敏感的方式将消息告知患者,从而减少可能产生的情绪爆发。国家披露遗传结果的指南意识水平较低。披露的主要促进因素包括教育、有利的环境、宗教和社区领袖的参与、宣传活动以及可能的治疗选择。披露抑制剂包括信息不足、担心婚姻破裂或家庭流离失所、担心被污名化、担心被孤立、宗教信仰、卫生工作者的态度以及缺乏接受结果的准备。
这些都需要进行文化敏感的干预措施,以进行继续教育、提高认识并持续参与,使遗传检测披露过程中的所有利益相关者都能做好准备。