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Experiences of Families Caring for Children with Newborn Screening-Related Conditions: Implications for the Expansion
Lynn Bush1, Hannah Davidson2, Shani Gelles2
1Division of Genetics and Genomics, Boston Children's Hospital and Center for Bioethics, Harvard Medical School, Boston, MA 02115, USA.
Insights
Family caregivers shared experiences with newborn screening (NBS) conditions, highlighting needs for better medical and psychological support. Their insights can shape policies for genomic newborn screening programs.
Area of Science:
- Genetics
- Public Health
- Bioethics
Background:
- Global expansion of newborn screening (NBS) conditions.
- Increasing use of genomic technologies for early detection.
- Need for ethically informed policies for integrating genomics into NBS.
Purpose of the Study:
- To explore lived experiences of family caregivers of children with NBS-related conditions.
- To identify lessons learned from these experiences.
- To inform policy and practice for genomic NBS programs.
Main Methods:
- In-depth interviews with 169 family caregivers.
- Analysis of narratives from caregivers of 77 children with NBS-related conditions.
- Identification of themes within medical and psychological domains.
Main Results:
- Caregivers identified needs for educational resources for healthcare professionals and families.
- Caregivers highlighted the necessity of empowerment programs and patient-centered communication training.
- Caregivers emphasized the need for access to multi-disciplinary specialists, long-term counseling, patient navigators, and peer support.
Conclusions:
- Caregiver experiences reveal critical areas for improving medical and psychological support systems.
- Policy recommendations should focus on enhancing resources and support for families navigating NBS-related conditions.
- Integrating these lessons learned can benefit children, families, healthcare systems, and society.
Abstract:
With the expansion of newborn screening conditions globally and the increased use of genomic technologies for early detection, there is a need for ethically nuanced policies to guide the future integration of ever-more comprehensive genomics into population-based newborn screening programs. In the current paper, we consider the lived experiences of 169 family caregivers caring for 77 children with NBS-related conditions to identify lessons learned that can inform policy and practice related to population-based newborn screening using genomic technologies. Based on caregiver narratives obtained through in-depth interviews, we identify themes characterizing these families' diagnostic odyssey continuum, which fall within two domains: (1) medical management implications of a child diagnosed with an NBS-related condition and (2) psychological implications of a child diagnosed with an NBS-related condition. For Domain 1, family caregivers' experiences point to the need for educational resources for both health care professionals that serve children with NBS-related conditions and their families; empowerment programs for family caregivers; training for providers in patient-centered communication; and access to multi-disciplinary specialists. For Domain 2, caregivers' experiences suggest a need for access to continuous, long-term counseling resources; patient navigator resources; and peer support programs. These lessons learned can inform policy recommendations for the benefit of the child, the family, the healthcare system, and society.
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