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青少年和年轻人在选择了解基因组研究结果时的决策稳定性。

Decision stability among adolescents and young adults making choices about learning genomic research results.

作者信息

Blumling Amy A, Elder Holly, Sinclair Jessica A, Mulukutla Srimayi, Mahoney Madeline, Prows Cynthia A, Myers Melanie F, McGowan Michelle L

机构信息

Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.

Biomedical Ethics Research Program, Mayo Clinic, Rochester, Minnesota, USA.

出版信息

J Genet Couns. 2025 Apr;34(2):e2010. doi: 10.1002/jgc4.2010.

Abstract

With increasing opportunities for minors to undergo genomic testing, factors influencing young people's decision stability and instability regarding genomic testing are unclear. This interpretive description study examines decision stability when adolescents (13-17) and young adults (18-21) decide whether to learn genetic testing results. Adolescents and young adults enrolled in a clinical trial chose whether they wanted to learn genetic testing results and could modify their decisions during a study visit or 2 weeks later. A purposive sample of clinical trial participants was invited to participate in an interview exploring their decision preferences, confidence level, and factors impacting decision stability. Twenty-two participants chose to learn all (n = 7), some (n = 7), or no genetic test results (n = 8). Perceptions of the impact of personal genetic information on one's quality of life and sense of reproductive goals and responsibilities were driving factors for people who chose to learn no or some genetic results, while curiosity influenced those who chose to learn all. Prior health and healthcare experiences and others' influence also factored into decision-making about receiving results. Decision stability varied among individuals but increased over time and was positively influenced by parents, baseline decision confidence, and fear of missing out on the opportunity to learn genetic information. Participants felt favorably about the opportunity to change their decision 2 weeks after the study visit. Among study participants, decision stability was high, as was satisfaction with decisions regarding how much personal genetic information to learn. The results suggest that adolescent and young adult genetic research participants may experience high decision stability and confidence in making choices regarding personal genetic testing, especially when a window of opportunity for change is available. Researchers and clinicians should consider the benefits and challenges of offering multiple checkpoints to bolster decision stability.

摘要

随着未成年人接受基因检测的机会越来越多,影响年轻人对基因检测做出决定稳定与否的因素尚不清楚。这项解释性描述研究考察了青少年(13 - 17岁)和青年(18 - 21岁)决定是否了解基因检测结果时的决定稳定性。参与一项临床试验的青少年和青年选择是否想要了解基因检测结果,并且可以在研究访视期间或两周后修改他们的决定。一项针对临床试验参与者的目的抽样邀请他们参加一次访谈,探讨他们的决定偏好、信心水平以及影响决定稳定性的因素。22名参与者选择了解全部(n = 7)、部分(n = 7)或不了解(n = 8)基因检测结果。对于个人基因信息对生活质量以及生殖目标和责任意识影响的认知,是那些选择不了解或部分了解基因检测结果的人的驱动因素,而好奇心则影响了那些选择了解全部结果的人。先前的健康和医疗经历以及他人的影响也在关于是否接受检测结果的决策中起到了作用。决定稳定性因人而异,但会随着时间增加,并且受到父母、基线决定信心以及害怕错过了解基因信息机会的积极影响。参与者对在研究访视两周后有机会改变他们的决定持积极态度。在研究参与者中,决定稳定性很高,对于决定了解多少个人基因信息的满意度也很高。结果表明,青少年和青年基因研究参与者在对个人基因检测做出选择时可能会有较高的决定稳定性和信心,尤其是当有改变的机会窗口时。研究人员和临床医生应考虑设置多个检查点以增强决定稳定性的益处和挑战。

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