Department of Political Science, University of Vienna, Universitätsstraße 1, 1010, Vienna, Austria.
Ludwig Boltzmann Institute for Rare and Undiagnosed Diseases, Vienna, Austria.
Orphanet J Rare Dis. 2024 Feb 14;19(1):68. doi: 10.1186/s13023-024-03058-4.
Genetic diagnosis is often understood as a single event within the care pathway of rare disease patients. Legal, policy and ethical scholarship focusing on rare diseases and genetic information discusses questions of how to best deal with the process of genetic diagnosis and the communication of genetic information within a given health system. We co-created a research design with rare disease patients and their families in Austria to explore in-depth the experiences of genetic diagnosis for people affected by rare diseases. Our objective was to trace the whole pathway of genetic testing and understand how rare disease patients experience genetic diagnosis as part of their care pathway in the healthcare system.
Data was collected through in-depth semi-structured qualitative interviews with 14 patients with a suspected or diagnosed rare disease or their parents, focusing on their perception of the pathway of genetic diagnosis in Austria. This pathway included the initial triggering of genetic diagnosis, the process of testing and its immediate (communication of results, counselling) and long-term, wider aftermath. Patients missed a clear link to already established forms of care such as their primary care/treating physicians. They also advocate for an integrated and interdisciplinary care pathway.
Our study underscores the importance of a continuous care and communication pathway spanning from the initial genetic diagnosis process to post-test phases. It further shows the importance of exploring patients' perspectives through qualitative research methods to understand the intricate workings of public health policies and tools. Integrating genetic diagnosis into a broader care trajectory is crucial for a holistic approach to care for rare disease patients who often rely on regular interactions with the healthcare system. Achieving this holistic approach requires collaboration between experts in specific rare disease areas, primary care physicians, and support networks.
遗传诊断通常被理解为罕见病患者护理路径中的一个单一事件。法律、政策和伦理学术研究聚焦于罕见病和遗传信息,探讨如何在特定的卫生系统中最好地处理遗传诊断过程和遗传信息的传播问题。我们与奥地利的罕见病患者及其家属共同设计了一项研究,深入探讨了受罕见病影响的人群进行遗传诊断的体验。我们的目标是追踪遗传检测的整个路径,了解罕见病患者如何将遗传诊断作为其医疗保健系统中护理路径的一部分来体验。
通过对 14 名疑似或确诊罕见病患者或其父母进行深入的半结构化定性访谈,收集了数据,重点关注他们对奥地利遗传诊断路径的看法。该路径包括遗传诊断的初始触发、检测过程及其直接(结果沟通、咨询)和长期、更广泛的后续影响。患者错过了与已建立的护理形式(如初级保健/治疗医生)的明确联系。他们还倡导综合和跨学科的护理路径。
我们的研究强调了从初始遗传诊断过程到后续检测阶段的连续护理和沟通路径的重要性。它进一步表明,通过定性研究方法探索患者观点对于理解公共卫生政策和工具的复杂运作至关重要。将遗传诊断纳入更广泛的护理轨迹对于为罕见病患者提供整体护理方法至关重要,因为他们通常依赖于与医疗保健系统的定期互动。实现这种整体方法需要特定罕见病领域的专家、初级保健医生和支持网络之间的协作。