Parents’ experiences of decision making for rapid genomic sequencing in intensive care
Autor: | Zornitza Stark, Fiona Lynch, Amy Nisselle, Clara Gaff, Belinda J McClaren |
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Rok vydání: | 2021 |
Předmět: |
Adult
Male Parents Critical Care Service delivery framework media_common.quotation_subject Genetic Counseling Coercion Article Nursing Informed consent Surveys and Questionnaires Intensive care Genetics Humans Genetic Testing Child Genetics (clinical) media_common Genomic sequencing fungi Sequence Analysis DNA Framing (social sciences) Attitude Feeling Female sense organs Patient Participation Thematic analysis Psychology |
Zdroj: | Eur J Hum Genet |
ISSN: | 1476-5438 1018-4813 |
DOI: | 10.1038/s41431-021-00950-6 |
Popis: | The clinical utility of rapid genomic sequencing (rGS) for critically unwell infants and children has been well demonstrated. Parental capacity for informed consent has been questioned, yet limited empirical data exists to guide clinical service delivery. In an Australian nationwide clinical implementation project offering rGS for critically unwell infants and children, parents made a decision about testing in under a day on average. This study reports parents’ experiences of decision making for rGS within this rapid timeframe to inform pre-test counselling procedures for future practice. A nationwide sample of 30 parents, whose children were amongst the first to receive rGS, were interviewed. We found that framing and delivery of rGS require careful consideration to support autonomous decision making and avoid implicit coercion in a stressful intensive care setting. Many parents described feeling ‘special’ and ‘lucky’ that they were receiving access to expensive and typically time-consuming genomic sequencing. Thematic analysis revealed a spectrum of complexity for decision making about rGS. Some parents consented quickly and were resistant to pre-test counselling. Others had a range of concerns and described deliberating about their decision, which they felt rushed to make. This research identifies tensions between the medical imperative of rGS and parents’ decision making, which need to be addressed as rGS becomes routine clinical care. |
Databáze: | OpenAIRE |
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