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马来西亚父母对原发性免疫缺陷病基因检测的知识、意识和看法:一项定性研究。

Knowledge, awareness, and perception on genetic testing for primary immunodeficiency disease among parents in Malaysia: a qualitative study.

机构信息

Department of Paediatrics, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.

Clinical Immunology Unit, Department of Paediatrics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia.

出版信息

Front Immunol. 2024 Jan 12;14:1308305. doi: 10.3389/fimmu.2023.1308305. eCollection 2023.

Abstract

BACKGROUND

Primary Immunodeficiency Disease (PID), also known as Inborn Errors of Immunity (IEI), comprises a group of rare genetic disorders that impair the body's immune responses. These conditions result from monogenic germline mutations that affect the function of genes governing the innate and adaptive immune system. Therefore, individuals with PID are more susceptible to infectious diseases, allergies, and autoimmune and autoinflammatory conditions. The prevalence of PID has been on the rise, with the number of classified diseases reaching 404, and 430 genetic defects reported to cause these conditions. However, in Malaysia, genetic testing for PID is currently limited and needs to be outsourced to overseas laboratories, posing financial challenges for families. Moreover, limited research has focused on the knowledge and awareness of genetic testing among parents of children with PID in Malaysia. This study aims to address this gap and provide valuable insights into the knowledge, awareness, and perception of genetic testing among this specific population.

METHOD

This qualitative cross-sectional study utilised online open-ended, semi-structured focus group interviews to explore the perceptions and experiences of parents of children with Primary Immunodeficiency (PID). Participants were recruited through convenience sampling from the Malaysian Patient Organisation for Primary Immunodeficiencies (MyPOPI), a non-governmental organisation dedicated to providing support and raising awareness about PID. The study spanned from May 2023 to July 2023 and included participants from diverse regions of Malaysia who had undergone different diagnostic journeys in various hospitals.

RESULT

The focus group discussions yielded 11 sub-themes that highlighted the experiences, understanding and challenges of the participants regarding genetic testing based on the semi-structured questions. These sub-themes were then grouped into four main themes that are awareness and understanding of genetic testing, the journey towards diagnosis and treatment, emotional impact and psychological factors, and the importance of medical experts in diagnosing and managing PID, as well as public perception and awareness.

CONCLUSION

In conclusion, this study highlights the diverse knowledge, awareness, and perception surrounding genetic testing for PID. Factors such as access to services, family history, and personal circumstances shape individuals' understanding of genetic testing. The importance of healthcare professionals, along with the need for improved accessibility and targeted communication strategies, is underscored to enhance understanding and reduce stigma surrounding genetic testing for rare diseases like PID.

摘要

背景

原发性免疫缺陷病(PID),又称先天性免疫缺陷(IEI),是一组罕见的遗传性疾病,会损害人体的免疫反应。这些疾病是由影响先天和适应性免疫系统的基因种系突变引起的。因此,PID 患者更容易感染传染病、过敏和自身免疫及自身炎症性疾病。PID 的患病率一直在上升,已分类的疾病达到 404 种,报告有 430 种遗传缺陷可导致这些疾病。然而,在马来西亚,PID 的基因检测目前受到限制,需要外包给海外实验室,这给家庭带来了经济挑战。此外,针对马来西亚 PID 患儿父母对基因检测的知识和意识的研究有限。本研究旨在填补这一空白,并为这一特定人群对基因检测的知识、意识和看法提供有价值的见解。

方法

本研究采用在线开放式、半结构式焦点小组访谈,对马来西亚原发性免疫缺陷(PID)患儿的父母进行了调查,以探讨他们对基因检测的看法和经验。采用便利抽样法从马来西亚原发性免疫缺陷患者组织(MyPOPI)招募参与者,该组织是一个致力于为 PID 患者提供支持和提高公众意识的非政府组织。研究于 2023 年 5 月至 7 月进行,参与者来自马来西亚各地,他们在不同的医院经历了不同的诊断过程。

结果

焦点小组讨论产生了 11 个子主题,这些子主题突出了参与者基于半结构式问题在基因检测方面的经验、理解和挑战。这些子主题随后被分为四个主要主题:对基因检测的意识和理解、诊断和治疗的过程、情感影响和心理因素,以及医学专家在诊断和管理 PID 以及公众对 PID 的看法和意识方面的重要性。

结论

综上所述,本研究强调了 PID 基因检测相关知识、意识和看法的多样性。服务的可及性、家族史和个人情况等因素影响了个体对基因检测的理解。强调了医疗保健专业人员的重要性,以及需要改善可及性和实施有针对性的沟通策略,以提高对基因检测的理解,减少对 PID 等罕见疾病基因检测的污名化。

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