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2003-2022 年唐氏综合征患儿家长的产后诊断反思。

Parents of children with Down syndrome reflect on their postnatal diagnoses, 2003-2022.

机构信息

Stanford Law School, Stanford University, Stanford, California, USA.

Down Syndrome Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA.

出版信息

Am J Med Genet A. 2024 Aug;194(8):e63619. doi: 10.1002/ajmg.a.63619. Epub 2024 Apr 15.

Abstract

A 2003 survey revealed the scope of mothers' dissatisfaction with their postnatal support following a diagnosis of Down syndrome (DS). Substantial proportions of mothers reported that providers conveyed diagnoses with pity, emphasized negative aspects of DS, and neglected to provide adequate materials explaining DS. This study follows up on the 2003 survey by assessing whether parents' experiences have improved. Four DS nonprofit organizations, which participated in the original study, distributed a mixed-methods survey to families who have had children with DS between 2003 and 2022. Quantitative analysis assessed correlations among responses and differences between the 2003 and 2022 survey groups. Open-ended responses were qualitatively analyzed. Compared to the 2003 findings, parents' perceptions of their postnatal care have not improved (N = 89). Parents are increasingly likely to report that their providers pitied them, omitted positive aspects of DS, and provided insufficient materials describing DS. Substantial proportions of parents reported fear (77%) and anxiety (79%), only 24% described receiving adequate explanatory materials, and parents were 45% likelier to report that physicians discussed negative aspects of DS than positive aspects. Qualitatively, substantial numbers of parents recounted insensitive conduct by providers. These results suggest that despite interventions, parents' experiences of postnatal diagnoses of DS have not improved over time. Certain provider behaviors-such as describing positive aspects of DS and providing comprehensive explanatory materials-can reduce fear and anxiety, pointing to directions for reform.

摘要

2003 年的一项调查揭示了母亲们在被诊断出唐氏综合征(DS)后对产后支持的不满程度。相当一部分母亲报告说,提供者在传达诊断结果时带有同情,强调 DS 的负面方面,而忽略了提供充分的解释 DS 的材料。本研究通过评估父母的经历是否有所改善,对 2003 年的调查进行了跟进。四个参与原始研究的 DS 非营利组织向 2003 年至 2022 年间有孩子患有 DS 的家庭分发了一份混合方法调查。定量分析评估了回应之间的相关性以及 2003 年和 2022 年调查组之间的差异。对开放式回答进行了定性分析。与 2003 年的发现相比,父母对产后护理的看法并没有改善(N=89)。越来越多的父母报告说,他们的提供者对他们表示同情,省略了 DS 的积极方面,并且提供的描述 DS 的材料不足。相当一部分父母报告说感到恐惧(77%)和焦虑(79%),只有 24%的父母表示收到了足够的解释材料,父母报告医生讨论 DS 的负面方面而不是积极方面的可能性高出 45%。从定性上看,相当数量的父母描述了提供者的不敏感行为。这些结果表明,尽管采取了干预措施,但父母对 DS 产后诊断的体验并没有随着时间的推移而改善。某些提供者的行为——例如描述 DS 的积极方面和提供全面的解释材料——可以减少恐惧和焦虑,为改革指明了方向。

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