Carter Emma, Joseph Flora
Centre for Medical Education, School of Medicine, Cardiff University, Cardiff, UK.
J Genet Couns. 2025 Jun;34(3):e70063. doi: 10.1002/jgc4.70063.
Parents of a child with a developmental disorder (DD) experience significant challenges, such as prognostic uncertainty, lack of care coordination, stigmatization, and changes to social and financial positions. Limited research exists into whether parents' support needs are being met by the United Kingdom National Health Service (UK NHS) Genetics Service. Therefore, this study aimed to establish whether these parents feel adequately supported by the UK NHS Genetics Service and, if not, what further support could be provided. This study recruited participants through the Unique and SWAN UK support groups. Fourteen parents of children with a DD took part in semi-structured interviews. Four overarching themes were identified: Expectations, the impact of the delivery of the diagnosis, uncertainty about who has medical responsibility, and isolation. While some positive experiences were described, parents also revealed expectations of support from the Genetics Service that were not met. These expectations included support with care coordination, a medical professional to take a holistic approach, and being signposted effectively to support networks. The analysis suggests that patient expectations of the Genetics Service need to be managed prior to the first appointment and that parents would benefit from access to a dedicated care coordinator. Furthermore, signposting to support groups is inconsistent. Future research should focus on identifying families most in need of support so that these families can be prioritized for the limited resources and investigate how best to prepare patients for receiving a diagnosis.
患有发育障碍(DD)儿童的父母面临着重大挑战,如预后不确定性、缺乏护理协调、受污名化以及社会和经济地位的变化。关于英国国家医疗服务体系(UK NHS)遗传学服务是否满足了父母的支持需求,现有研究有限。因此,本研究旨在确定这些父母是否感到得到了UK NHS遗传学服务的充分支持,如果没有,还可以提供哪些进一步的支持。本研究通过Unique和SWAN UK支持小组招募参与者。14位患有DD儿童的父母参与了半结构化访谈。确定了四个总体主题:期望、诊断结果传达的影响、医疗责任归属的不确定性以及孤立感。虽然描述了一些积极的经历,但父母也透露了未得到满足的对遗传学服务支持的期望。这些期望包括在护理协调方面得到支持、有医疗专业人员采取整体方法以及有效地被指引到支持网络。分析表明,在首次预约前需要管理患者对遗传学服务的期望,并且父母若能获得专门的护理协调员将受益。此外,指引到支持小组的情况并不一致。未来的研究应侧重于确定最需要支持的家庭,以便能为这些家庭优先分配有限的资源,并研究如何最好地让患者为接受诊断做好准备。