Ayoub Sophie, De Clercq Eva, Cytrynbaum Cheryl, Steiner Luzius A, Elger Bernice S
Institute for Biomedical Ethics, University of Basel, Basel, Switzerland.
Division of Clinical & Metabolic Genetics and the Department of Genetic Counselling, The Hospital for Sick Children, Toronto, Canada.
PLoS One. 2025 Jan 9;20(1):e0313845. doi: 10.1371/journal.pone.0313845. eCollection 2025.
22q11 deletion syndrome (22q11DS) results from a microdeletion on chromosome 22 and is the most common microdeletion disorder in humans, affecting 1 in 2148 live births. Clinical manifestations vary widely among individuals and across different life stages. Effective management requires the involvement of a specialized multidisciplinary team. This study aims to explore the experiences of healthcare professionals in caring for the families of children with 22q11DS, focusing on their challenges, rewards, and coping strategies.
Data for this interview study were collected as part of a broader mixed methods research project aimed at enhancing the psychosocial well-being of children aged 3-15 years with 22q11DS and their families. The qualitative aspect of this study focused on capturing the experiences of healthcare professionals involved in their care, recruited purposively through collaborators and snowball sampling methods. Reflexive thematic analysis of semi-structured interviews was performed after verbatim transcription.
Twenty healthcare providers from different specialties were interviewed. The majority had a working experience of more than 10 years and were part of a 22q11DS clinic. After data analysis, four themes (and many sub-themes) were identified that were all related to the topic of uncertainty: acknowledging uncertainty, sharing uncertainty, acting on uncertainty and coping with uncertainty. Many experts showed a sense of humbleness when caring for the families and most of the participants emphasized the role of peer support and multidisciplinary teams.
Our study reveals how healthcare professionals manage the uncertainty associated with 22q11DS, highlighting the importance of peer support and multidisciplinary team collaboration. Providers recognize the limits of their medical expertise and value the perspectives of families living with the condition. Their coping strategies play a critical role in handling uncertainty and suggest a need for further emphasis in the literature on the experiences of healthcare professionals dealing with rare diseases.
22q11 缺失综合征(22q11DS)由 22 号染色体上的微缺失引起,是人类最常见的微缺失疾病,在每 2148 例活产儿中就有 1 例受影响。个体之间以及在不同生命阶段的临床表现差异很大。有效的管理需要一个专门的多学科团队的参与。本研究旨在探讨医疗保健专业人员在照顾 22q11DS 患儿家庭方面的经历,重点关注他们面临的挑战、收获以及应对策略。
本次访谈研究的数据是作为一个更广泛的混合方法研究项目的一部分收集的,该项目旨在提高 3 至 15 岁 22q11DS 患儿及其家庭的心理社会幸福感。本研究的定性方面侧重于捕捉参与患儿护理的医疗保健专业人员的经历,通过合作者和滚雪球抽样方法有目的地招募。在逐字转录后,对半结构化访谈进行了反思性主题分析。
采访了来自不同专业的 20 名医疗保健提供者。大多数人有超过 10 年的工作经验,并且是 22q11DS 诊所的成员。数据分析后,确定了四个主题(以及许多子主题),所有这些主题都与不确定性这一主题相关:承认不确定性、分享不确定性、应对不确定性以及处理不确定性。许多专家在照顾家庭时表现出谦逊的态度,大多数参与者强调了同伴支持和多学科团队的作用。
我们的研究揭示了医疗保健专业人员如何管理与 22q11DS 相关的不确定性,强调了同伴支持和多学科团队合作的重要性。提供者认识到他们医学专业知识的局限性,并重视患有这种疾病的家庭的观点。他们的应对策略在处理不确定性方面起着关键作用,并表明在文献中需要进一步强调医疗保健专业人员处理罕见疾病的经历。