The impact of Marfan syndrome on an Aboriginal Australian family: ‘I don’t like it as much as I don’t like cancer’

Aideen M. McInerney-Leo, Jennifer West, Bettina Meiser, Malcolm West, Maree R. Toombs, Matthew A. Brown, Emma L. Duncan

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Marfan syndrome (MFS) is an autosomal dominantly inherited connective tissue disorder. Aortic dilatation/dissection and ectopia lentis are the most severe features, which affect physical functioning and psychological well-being. In Aboriginal Australians, there is little psychosocial research on genetic conditions. This study explored the physical, psychological, and practical impacts of MFS on Aboriginal Australians. Eighteen (8 affected and 10 unaffected) members of a large Aboriginal Australian family with MFS participated in an ethically approved study. Semi-structured qualitative interviews were conducted, transcribed verbatim, and analyzed thematically. All individuals reported challenges from MFS, negatively affecting day-to-day living. Severe vision impairment was perceived as the greatest challenge, contributing to feelings of stigma and exclusion. With aging, concerns shifted toward cardiac complications. The unpredictability of lens dislocation and aortic dissection was reported to be psychologically challenging. Participants described MFS-related barriers to obtaining and retaining employment, especially following cardiac surgery; with consequential psychological and financial hardships. Participants articulated that their cultural drive to support the ill and respectfully mourn the deceased, regardless of distance, resulted in a significant financial burden. Additionally, when hospitalization and/or funerals occurred, financially solvent individuals were expected to share resources, without any expectation of repayment or reciprocity (i.e., ‘demand sharing’, common in Aboriginal Australian culture). This study documents the nature and pervasiveness of uncertainty for both affected and unaffected members of an MFS family. Many reported challenges are consistent with other MFS cohorts (including stigma, social exclusion, and unemployment). However, our findings suggest that cultural values may exacerbate the financial costs of MFS for Aboriginal Australians.

Original languageEnglish
Pages (from-to)620-630
Number of pages11
JournalJournal of Genetic Counseling
Volume31
Issue number3
Early online dateOct 2021
DOIs
Publication statusPublished - Jun 2022
Externally publishedYes

Bibliographical note

Funding Information:
We are very grateful to the individuals who participated in this study. This study was funded by a project grant from the Prince Charles Hospital Foundation (MS 2012‐39). Aideen McInerney‐Leo is funded by a National Health and Medical Research Council (NHMRC) Early Career Fellowship (ID 1158111), while Bettina Meiser is funded by an NHMRC Senior Research Fellowship Level B (ID 1078523). Matthew Brown was funded by an NHMRC Senior Principal Research Fellowship (ID 1024879). The University of Queensland Diamantina Institute is located in the Translational Research Institute, which is supported by a grant from the Australian Government. We especially acknowledge Professor Malcolm West, an invaluable member of the research team, who passed away before manuscript submission. May his gentle soul Rest In Peace. The author confirmed that this work was not completed as part of a degree requirement and is not eligible for the student paper award.

Publisher Copyright:
© 2021 National Society of Genetic Counselors

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