Skip to main content
Top
Published in: Journal of Genetic Counseling 6/2016

Open Access 01-12-2016 | Original Research

Understanding the Psychosocial Effects of WES Test Results on Parents of Children with Rare Diseases

Authors: Lotte Krabbenborg, L. E. L. M. Vissers, J. Schieving, T. Kleefstra, E. J. Kamsteeg, J. A. Veltman, M. A. Willemsen, S. Van der Burg

Published in: Journal of Genetic Counseling | Issue 6/2016

Login to get access

Abstract

The use of whole exome sequencing (WES) for diagnostics of children with rare genetic diseases raises questions about best practices in genetic counselling. While a lot of attention is now given to pre-test counselling procedures for WES, little is known about how parents experience the (positive, negative, or inconclusive) WES results in daily life. To fill this knowledge gap, data were gathered through in-depth interviews with parents of 15 children who underwent WES analysis. WES test results, like results from other genetic tests, evoked relief as well as worries, irrespective of the type of result. Advantages of obtaining a conclusive diagnosis included becoming more accepting towards the situation, being enabled to attune care to the needs of the child, and better coping with feelings of guilt. Disadvantages experienced included a loss of hope for recovery, and a loss by parents of their social network of peers and the effort necessary to re-establish that social network. While parents with conclusive diagnoses were able to re-establish a peer community with the help of social media, parents receiving a possible diagnosis experienced hurdles in seeking peer support, as peers still needed to be identified. These types of psychosocial effects of WES test results for parents are important to take into account for the development of successful genetic counselling strategies.
Footnotes
1
One interview was carried out by author SvdB
 
Literature
go back to reference Appelbaum, P. S., Waldman, C. R., Fyer, A., Klitzman, R., Parens, E., Martinez, J., Price W. N., 2nd., & Chung, W. K. (2014). Informed consent for return of incidental findings in genomic research. Genetics in Medicine, 16(5), 367–373. Appelbaum, P. S., Waldman, C. R., Fyer, A., Klitzman, R., Parens, E., Martinez, J., Price W. N., 2nd., & Chung, W. K. (2014). Informed consent for return of incidental findings in genomic research. Genetics in Medicine, 16(5), 367–373.
go back to reference Boeije, H. (2012). Analyseren in Kwalitatief Onderzoek. Denken en Doen. The Hague: Boom Lemma. Boeije, H. (2012). Analyseren in Kwalitatief Onderzoek. Denken en Doen. The Hague: Boom Lemma.
go back to reference Bosma, A. R., Rigter, T., Weinreich, S. S., Cornel, M. C., & Henneman, L. (2015). A genetic diagnosis of maturity-onset diabetes of the young (MODY): experiences of patients and family members. Diabetic Medicine. doi:10.111/dme.12742.PubMed Bosma, A. R., Rigter, T., Weinreich, S. S., Cornel, M. C., & Henneman, L. (2015). A genetic diagnosis of maturity-onset diabetes of the young (MODY): experiences of patients and family members. Diabetic Medicine. doi:10.​111/​dme.​12742.PubMed
go back to reference Brooks-Howell, L. C. (2006). Living without labels: the interactional management of diagnostic uncertainty in the genetic counselling clinic. Social Science & Medicine, 63, 3080–3091.CrossRef Brooks-Howell, L. C. (2006). Living without labels: the interactional management of diagnostic uncertainty in the genetic counselling clinic. Social Science & Medicine, 63, 3080–3091.CrossRef
go back to reference Carmichael, N., Tsipis, J., Windmueller, G., Mandel, L., & Estrella, E. (2015). “Is it going to hurt?”: the impact of the diagnostic odyssey on children and their families. Journal of Genetic Counseling, 24, 325–335.CrossRefPubMed Carmichael, N., Tsipis, J., Windmueller, G., Mandel, L., & Estrella, E. (2015). “Is it going to hurt?”: the impact of the diagnostic odyssey on children and their families. Journal of Genetic Counseling, 24, 325–335.CrossRefPubMed
go back to reference De Ligt, J., Willemsen, M. H., van Bon, B. W., Kleefstra, T., Yntema, H. G., Kroes, T., Vulto-van Silfhout, A. T., Koolen, D. A., de Vries, P., Gillisen, C., del Rosario, M., Hoischen, A., Scheffer, H., de Vries, B. B., Brunner, H. G., Veltman, J. A., & Vissers, L. E. (2012). Diagnostic exome sequencing in persons with severe intellectual disability. The New England Journal of Medicine, 367, 1921–1929.CrossRefPubMed De Ligt, J., Willemsen, M. H., van Bon, B. W., Kleefstra, T., Yntema, H. G., Kroes, T., Vulto-van Silfhout, A. T., Koolen, D. A., de Vries, P., Gillisen, C., del Rosario, M., Hoischen, A., Scheffer, H., de Vries, B. B., Brunner, H. G., Veltman, J. A., & Vissers, L. E. (2012). Diagnostic exome sequencing in persons with severe intellectual disability. The New England Journal of Medicine, 367, 1921–1929.CrossRefPubMed
go back to reference Eisenberg, L. (1977). Disesase and illness: distinctions between professional and popular ideas of sickness. Culture, Medicine and Psychiatry, 1, 9–23.CrossRefPubMed Eisenberg, L. (1977). Disesase and illness: distinctions between professional and popular ideas of sickness. Culture, Medicine and Psychiatry, 1, 9–23.CrossRefPubMed
go back to reference Evers, J. (red) (2007). Qualitative interviewing: art and skill (in Dutch). The Hague: Boom Lemma. Evers, J. (red) (2007). Qualitative interviewing: art and skill (in Dutch). The Hague: Boom Lemma.
go back to reference Fanos, J. H. (2012). New “first families”: the psychosocial impact of new genetic technologies. Genetics in Medicine, 14(2), 189–190.CrossRefPubMed Fanos, J. H. (2012). New “first families”: the psychosocial impact of new genetic technologies. Genetics in Medicine, 14(2), 189–190.CrossRefPubMed
go back to reference Graungaard, A. H., & Skov, L. (2006). Why do we need a diagnosis? A qualitative study of parents’ experiences, coping and needs, when the newborn child is severely disabled. Child: Care, Health and Development, 33(3), 296–307. Graungaard, A. H., & Skov, L. (2006). Why do we need a diagnosis? A qualitative study of parents’ experiences, coping and needs, when the newborn child is severely disabled. Child: Care, Health and Development, 33(3), 296–307.
go back to reference Hallberg, U., Óskarsdóttir, S., & Klingberg, G. (2010). 22q11 deletion syndrome – the meaning of a diagnosis. A qualitative study on parental perspectives. Child: Care, Health and Development, 36(5), 719–725. Hallberg, U., Óskarsdóttir, S., & Klingberg, G. (2010). 22q11 deletion syndrome – the meaning of a diagnosis. A qualitative study on parental perspectives. Child: Care, Health and Development, 36(5), 719–725.
go back to reference Hitch, K., Galen, J., Guiltinan, J., Kianmahd, J., Youngblom, J., & Blanco, A. (2014). Lynch syndrome patients’ views of and preferences for return of results following whole exome sequencing. Journal of Genetic Counseling, 23(4), 539–551.CrossRefPubMedPubMedCentral Hitch, K., Galen, J., Guiltinan, J., Kianmahd, J., Youngblom, J., & Blanco, A. (2014). Lynch syndrome patients’ views of and preferences for return of results following whole exome sequencing. Journal of Genetic Counseling, 23(4), 539–551.CrossRefPubMedPubMedCentral
go back to reference Hofmann, B. (2002). On the triad disease, illness and sickness. Journal of Medicine and Philosophy, 27(6), 651–673.CrossRefPubMed Hofmann, B. (2002). On the triad disease, illness and sickness. Journal of Medicine and Philosophy, 27(6), 651–673.CrossRefPubMed
go back to reference Iglesias, A. J., Anyane-Yeboa, K., Wynn, J., Wilson, A., Truitt Cho, M., Guzman, E., Sisson, R., Egan, C., & Chung, W. K. (2014). The usefulness of whole-exome sequencing in routine clinical practice. Genetics in Medicine, 16, 922–933.CrossRefPubMed Iglesias, A. J., Anyane-Yeboa, K., Wynn, J., Wilson, A., Truitt Cho, M., Guzman, E., Sisson, R., Egan, C., & Chung, W. K. (2014). The usefulness of whole-exome sequencing in routine clinical practice. Genetics in Medicine, 16, 922–933.CrossRefPubMed
go back to reference Krabbenborg, L., Schieving, J., Kleefstra, T., Vissers, L. E. L. M., Willemsen, M. A., Veltman, J. A., & van der Burg, S. (2015). Evaluating a counselling strategy for diagnostic WES in paediatric neurology: an exploration of parents’ information and communication needs. Clinical Genetics, 89(2), 244–250.CrossRefPubMed Krabbenborg, L., Schieving, J., Kleefstra, T., Vissers, L. E. L. M., Willemsen, M. A., Veltman, J. A., & van der Burg, S. (2015). Evaluating a counselling strategy for diagnostic WES in paediatric neurology: an exploration of parents’ information and communication needs. Clinical Genetics, 89(2), 244–250.CrossRefPubMed
go back to reference Levenseller, B. L., Soucier, D. J., Miller, V. A., Harris, D., Conway, L., & Bernhardt, B. A. (2013). Stakeholders’ opinions on the implementation of pediatric whole exome sequencing: implications for informed consent. Journal of Genetic Counseling, 23(4), 552–565.CrossRefPubMedPubMedCentral Levenseller, B. L., Soucier, D. J., Miller, V. A., Harris, D., Conway, L., & Bernhardt, B. A. (2013). Stakeholders’ opinions on the implementation of pediatric whole exome sequencing: implications for informed consent. Journal of Genetic Counseling, 23(4), 552–565.CrossRefPubMedPubMedCentral
go back to reference Navon, D. (2012). Genetic counseling, activism, and ‘genotype –first’ diagnosis of developmental disorders. Journal of Genetic Counseling, 21, 770–776.CrossRefPubMed Navon, D. (2012). Genetic counseling, activism, and ‘genotype –first’ diagnosis of developmental disorders. Journal of Genetic Counseling, 21, 770–776.CrossRefPubMed
go back to reference Reiff, M., Bernhardt, B. A., Mulchandani, S., Soucier, D., Cornell, D., Pyeritz, R. E., & Spinner, N. B. (2012). “What does it mean?” uncertainties in understanding results of chromosomal microarray testing. Genetics in Medicine, 14(2), 250–258.CrossRefPubMedPubMedCentral Reiff, M., Bernhardt, B. A., Mulchandani, S., Soucier, D., Cornell, D., Pyeritz, R. E., & Spinner, N. B. (2012). “What does it mean?” uncertainties in understanding results of chromosomal microarray testing. Genetics in Medicine, 14(2), 250–258.CrossRefPubMedPubMedCentral
go back to reference Rigter, T., Van Aart, C. J. A., Elting, M. W., Waisfisz, Q., Cornel, M. C., & Henneman, L. (2013). Informed consent for exome sequencing in diagnostics. Clinical Genetics, 85, 417–422.CrossRefPubMedPubMedCentral Rigter, T., Van Aart, C. J. A., Elting, M. W., Waisfisz, Q., Cornel, M. C., & Henneman, L. (2013). Informed consent for exome sequencing in diagnostics. Clinical Genetics, 85, 417–422.CrossRefPubMedPubMedCentral
go back to reference Roche, M. I., & Palmer, C. G. S. (2014). Next generation genetic counselling: introduction to the special issue. Journal of Genetic Counseling, 23(4), 439–444.CrossRefPubMedPubMedCentral Roche, M. I., & Palmer, C. G. S. (2014). Next generation genetic counselling: introduction to the special issue. Journal of Genetic Counseling, 23(4), 439–444.CrossRefPubMedPubMedCentral
go back to reference Sapp, J. C., Dong, D., Stark, C., Ivey, L. E., Hooker, G., Biesecker, L. G., & Biesecker, B. B. (2013). Parental attitudes, values and beliefs toward the return of results from exome sequencing in children. Clinical Genetics, 85, 120–126.CrossRefPubMedPubMedCentral Sapp, J. C., Dong, D., Stark, C., Ivey, L. E., Hooker, G., Biesecker, L. G., & Biesecker, B. B. (2013). Parental attitudes, values and beliefs toward the return of results from exome sequencing in children. Clinical Genetics, 85, 120–126.CrossRefPubMedPubMedCentral
go back to reference Skirton, H. (2001). The client’s perspective of genetic counselling: a grounded theory study. Journal of Genetic Counseling, 10(4), 311–329.CrossRefPubMed Skirton, H. (2001). The client’s perspective of genetic counselling: a grounded theory study. Journal of Genetic Counseling, 10(4), 311–329.CrossRefPubMed
go back to reference Tabor, H. K., Stock, J., Brazg, T., McMillin, J., Dent, K. M., Yu, J. H., Shendure, J., & Bamshad, M. J. (2012). Informed consent for whole genome sequencing: a qualitative analysis of participant expectations and perceptions of risks, benefits, and harms. American Journal of Medical Genetics. Part A, 158A, 1310–1319.CrossRefPubMedPubMedCentral Tabor, H. K., Stock, J., Brazg, T., McMillin, J., Dent, K. M., Yu, J. H., Shendure, J., & Bamshad, M. J. (2012). Informed consent for whole genome sequencing: a qualitative analysis of participant expectations and perceptions of risks, benefits, and harms. American Journal of Medical Genetics. Part A, 158A, 1310–1319.CrossRefPubMedPubMedCentral
go back to reference Vaismoradi, M., Turunen, H., & Bondas, T. (2013). Content analysis and thematic analysis: implications for conducting a qualitative descriptive study. Nursing and Health Sciences, 15, 398–405.CrossRefPubMed Vaismoradi, M., Turunen, H., & Bondas, T. (2013). Content analysis and thematic analysis: implications for conducting a qualitative descriptive study. Nursing and Health Sciences, 15, 398–405.CrossRefPubMed
go back to reference Vissers, L. E., de Ligt, J., Gillissen, C., Janssen, I., Steehouwer, M., de Vries, P., van Lier, B., Arts, P., Wieskamp, N., del Rosario, M., van Bon, B. W., Hoischen, A., de Vries, B. B., Brunner, H. G., & Veltman, J. A. (2010). A de novo paradigm for mental retardation. Nature Genetics, 42(12), 1109–1112.CrossRefPubMed Vissers, L. E., de Ligt, J., Gillissen, C., Janssen, I., Steehouwer, M., de Vries, P., van Lier, B., Arts, P., Wieskamp, N., del Rosario, M., van Bon, B. W., Hoischen, A., de Vries, B. B., Brunner, H. G., & Veltman, J. A. (2010). A de novo paradigm for mental retardation. Nature Genetics, 42(12), 1109–1112.CrossRefPubMed
go back to reference Webb, C. L. (2005). Parents’ perspectives on coping with Duchenne muscular dystrophy. Child: Care, Health and Development, 31(4), 385–396. Webb, C. L. (2005). Parents’ perspectives on coping with Duchenne muscular dystrophy. Child: Care, Health and Development, 31(4), 385–396.
go back to reference Whitmarsh, I., Davis, A. M., Skinner, D., & Bailey, D. B. (2007). A place for genetic uncertainty: parents valuing an unknown in the meaning of disease. Social Science & Medicine, 65, 1082–1093.CrossRef Whitmarsh, I., Davis, A. M., Skinner, D., & Bailey, D. B. (2007). A place for genetic uncertainty: parents valuing an unknown in the meaning of disease. Social Science & Medicine, 65, 1082–1093.CrossRef
Metadata
Title
Understanding the Psychosocial Effects of WES Test Results on Parents of Children with Rare Diseases
Authors
Lotte Krabbenborg
L. E. L. M. Vissers
J. Schieving
T. Kleefstra
E. J. Kamsteeg
J. A. Veltman
M. A. Willemsen
S. Van der Burg
Publication date
01-12-2016
Publisher
Springer US
Published in
Journal of Genetic Counseling / Issue 6/2016
Print ISSN: 1059-7700
Electronic ISSN: 1573-3599
DOI
https://doi.org/10.1007/s10897-016-9958-5

Other articles of this Issue 6/2016

Journal of Genetic Counseling 6/2016 Go to the issue