1
|
Strnadová I, Loblinzk J, Scully JL, Danker J, Tso M, Jackaman KM, Dunn M, Willow SA, Sarfaraz S, Fitzgerald V, Boyle J, Palmer EE. "I am not a number!" Opinions and preferences of people with intellectual disability about genetic healthcare. Eur J Hum Genet 2023; 31:1057-1065. [PMID: 36670247 PMCID: PMC10474088 DOI: 10.1038/s41431-023-01282-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 12/13/2022] [Accepted: 12/19/2022] [Indexed: 01/21/2023] Open
Abstract
There is limited research exploring the knowledge and experiences of genetic healthcare from the perspective of people with intellectual disability. This study, conducted in New South Wales (Australia), addresses this gap. Eighteen adults with intellectual disability and eight support people were interviewed in this inclusive research study. The transcribed interviews were analysed using inductive content analysis. The findings were discussed in a focus group with ten adults with intellectual disability and in three multi-stakeholder advisory workshops, contributing to the validity and trustworthiness of the findings. Five main themes emerged: (i) access to genetic healthcare services is inequitable, with several barriers to the informed consent process; (ii) the experiences and opinions of people with intellectual disability are variable, including frustration, exclusion and fear; (iii) genetic counselling and diagnoses can be profoundly impactful, but translating a genetic diagnosis into tailored healthcare, appropriate support, peer connections and reproductive planning faces barriers; (iv) people with intellectual disability have a high incidence of exposure to trauma and some reported that their genetic healthcare experiences were associated with further trauma; (v) recommendations for a more respectful and inclusive model of genetic healthcare. Co-designed point-of-care educational and consent resources, accompanied by tailored professional education for healthcare providers, are required to improve the equity and appropriateness of genetic healthcare for people with intellectual disability.
Collapse
Affiliation(s)
- Iva Strnadová
- School of Education, UNSW Sydney, Sydney, NSW, Australia
- Disability Innovation Institute, UNSW Sydney, Sydney, NSW, Australia
- Self-Advocacy Sydney, Sydney, NSW, Australia
- Gonski Institute for Education, UNSW Sydney, Sydney, Australia
| | - Julie Loblinzk
- School of Education, UNSW Sydney, Sydney, NSW, Australia
- Self-Advocacy Sydney, Sydney, NSW, Australia
| | | | - Joanne Danker
- School of Education, UNSW Sydney, Sydney, NSW, Australia
| | - Michelle Tso
- School of Education, UNSW Sydney, Sydney, NSW, Australia
| | | | - Manjekah Dunn
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Medicine and Health, Sydney, NSW, Australia
| | | | | | | | - Jackie Boyle
- NSW Genetics of Learning Disability Service, NSW Health, Waratah, NSW, Australia
| | - Elizabeth Emma Palmer
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Medicine and Health, Sydney, NSW, Australia.
- Sydney Children's Hospitals Network, NSW Health, St Leonards, NSW, Australia.
| |
Collapse
|