Menon Kriti, Agarwal Vani
Apollo Genomics institutes Indraprastha Apollo Hospitals, New Delhi, India.
Grade XII, Heritage International Xperiential School, Gurugram, India.
J Community Genet. 2025 Feb;16(1):57-71. doi: 10.1007/s12687-024-00756-1. Epub 2024 Nov 30.
This study investigates the factors contributing to the recurrence of severe genetic conditions in multiple children of the same couple, focusing on a cohort of 26 families who had more than one child affected by the same genetic disorder. Conducted at a genetic clinic in India, the study employed a qualitative methodology guided by COREQ guidelines, using semi-structured interviews to explore the interplay of individual beliefs, healthcare provider practices, and systemic healthcare inefficiencies. The interviews were transcribed and analyzed using a combination of content analysis and grounded theory, which allowed for the identification of recurrent themes and emerging ideas. The study found that strong religious and cultural beliefs often led families to disregard medical advice, contributing to the recurrence of genetic conditions. Additionally, significant gaps in healthcare provider knowledge and inadequate reproductive counseling were identified as critical barriers to timely diagnosis and prevention of recurrence. Another major theme was the inherent complexities of genetic diseases and genetic testing, where variable expression of conditions, delayed symptom onset, and limitations of genetic tests themselves often prevented early diagnosis and intervention. This research highlights the need for improved genetic literacy among healthcare providers, culturally sensitive counseling, and better integration of genetic services into the broader healthcare system. By addressing these barriers, the risk of recurrence can be significantly reduced, improving patient outcomes and family well-being. This study is one of the few in India to analyze such factors and underscore the critical need for targeted interventions at multiple levels.
本研究调查了同一对夫妇的多个孩子中严重遗传疾病复发的影响因素,重点关注26个家庭组成的队列,这些家庭中有不止一个孩子受同一遗传疾病影响。该研究在印度的一家基因诊所开展,采用了以COREQ指南为指导的定性研究方法,通过半结构化访谈来探究个人信念、医疗服务提供者的做法以及医疗系统效率低下之间的相互作用。访谈内容经转录后,采用内容分析和扎根理论相结合的方法进行分析,从而确定反复出现的主题和新出现的观点。研究发现,强烈的宗教和文化信仰常常导致家庭无视医学建议,从而促使遗传疾病复发。此外,医疗服务提供者知识方面的重大差距以及生殖咨询不足被确定为及时诊断和预防复发的关键障碍。另一个主要主题是遗传疾病和基因检测本身固有的复杂性,疾病的可变表达、症状出现延迟以及基因检测本身的局限性常常阻碍早期诊断和干预。这项研究强调了提高医疗服务提供者的基因素养、提供具有文化敏感性的咨询以及更好地将基因服务纳入更广泛的医疗系统的必要性。通过消除这些障碍,可以显著降低复发风险,改善患者预后和家庭福祉。这项研究是印度为数不多的分析此类因素的研究之一,强调了在多个层面进行有针对性干预的迫切需求。