Wilson disease: the look of medical staff, patients and family members

e201904014

Authors

  • Lucía Páramo Rodríguez Unidad Mixta de Investigación en Enfermedades Raras. FISABIO-UVEG. Valencia. España.
  • Óscar Zurriaga Llorens Unidad Mixta de Investigación en Enfermedades Raras. FISABIO-UVEG. Valencia. España. / Dirección General de Salud Pública. Generalitat Valenciana. Valencia. España. / CIBER de Epidemiología y Salud Pública. España.
  • Mª Eugenia González Sanjuán Universidad de Valencia. Departamento Sociología y Antropología Social. Valencia. España.
  • Clara Cavero Carbonell Unidad Mixta de Investigación en Enfermedades Raras. FISABIO-UVEG. Valencia. España.

Keywords:

Wilson disease, Rare disease, Research qualitative, Early diagnosis, Focus group, Interview

Abstract

Background: Wilson disease (WD) is a rare congenital disease that causes hepatic, neurological or lenticular degeneration due to the accumulation of copper. Sometimes it is incapacitating with implications in the quality of life of those affected and their families. The objective of this work was to identify the needs of medical staff and the social and emotional needs of patients with WD and their families.

Methods: A qualitative research was developed in the Valencian Region during 2015-2016, five interviews with medical staff and two focus groups were made, one with family members and another with patients using a script divided into: diagnosis, treatment, health care and quality of life. The information was collected in audio/video and transcribed. An analysis of discourse (professional vs family/affected) determining needs was made.

Results: Medical staff felt away from the emotional needs of families and patients and need more information in order to facilitate an early diagnosis. Families expressed difficulties regarding the treatment’s adherence, especially when those patients are teenagers who have doubts about the cooper-free diet. Patients had problems with the treatment’s instructions. Also, those with neurological problems felt stigmatised by the physical consequences.

Conclusions: Medical staff need more knowledge about this pathology. Better educational training for them would facilitate the diagnosis. Families and patients need more information about the guidelines for the treatment’s administration and foods that should be excluded from the diet. The correct administration of the treatment will allow those affected to improve their quality of life with a total or partial recovery of their symptoms.

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References

Unión Europea. Definición Enfermedad Rara. Disponible en: http://eur-lex.europa.eu/legal-content/ES/TXT/?uri=uriserv%3Asp0012.

Ala A, Walker A, Ashkan K, et al. M. Wilson’s disease. Lancet 2007; 369: 397-408.

European Association for the Study of the Liver. EASL Clinical Practice Guidelines: Wilson’s disease. J Hepatol 2012; 56: 671-85.

Solís Muñoz P, Solís Herruzo J.A. Enfermedad de Wilson. Una enfermedad rara pero presente. Revista Española de Enfermedades Digestivas. 2008; 100 (8): 447-55.

Gow P, Smallwood RA, Smith AL, et al. Diagnóstico de la enfermedad de Wilson hepática. Salud i Ciencia. 2002; 11: 3-4.

Hernández Villén MD, López Martínez S. Enfermedad de Wilson. Revista del Laboratorio Clínico. 2011; 4: 102-11.

Bruguera M, Abraldes JG. Problemas frecuentes en el diagnóstico y tratamiento de la enfermedad de Wilson. Gastroenterología y Hepatología 2013; 36: 316-25.

European Association for Study of Liver. EASL Clinical Practice Guidelines: Wilson’s disease. Journal of Hepatology. 2012; 56: 671-85.

Jara P, Hierro L. La enfermedad de Wilson: formas de presentación en la infancia. Gastroenterología y Hepatología. 2006; 29: 560-7.

Nicastro E, Ranucci G, Vajro P, et al. Re-evaluation of the diagnostic criteria for Wilson disease in children with mild liver disease. Hepatology 2010; 52 (6): 1948-56.

Jordán T, Casado M. Revisión Técnica Diagnóstica. Indicaciones de la biopsia hepática percutánea en el siglo XXI. Gastroenterología y Hepatología Continuada. 2003; 2: 29-40.

Schilsky M L. Wilson disease: Treatment and prognosis. Disponible en: http://www.uptodate.com/contents/wilson-disease-treatment-and-prognosis?source=search_result&search=wilson&selectedTitle=3~142#H25).

Gimeno Martos S, Cavero-Carbonell C, Gras Colomer E, et al. La Enfermedad de Wilson en el Sistema de Información de Enfermedades Raras de la Comunitat Valenciana. II Congreso Iberoamericano de Epidemiología y Salud Pública y XXXIII Reunión Científica de la SEE y X Congresso da APE. 2 al 4 de septiembre de 2015. Santiago de Compostela.

Millán Jiménez A, Ruiz Moreno M. Enfermedad de Wilson. Protocolos diagnóstico-terapéuticos de Gastroenterología, Hepatología y Nutrición Pediátrica. SEGHNP-AEP. Madrid. 2010; 189-96.

Fernández Nuñez L. Fichas para investigadores: ¿Cómo analizar datos cualitativos? Butlletí LaRecerca: Universitat de Barcelona. 2006; 1-13.

Muñoz-Justicia J, Sahagún-Padilla M. Análisis cualitativo asistido por ordenador con ATLAS.ti. In: Izquierdo C, Perinat A, editors. Investigar en Psicología de la Educación. Nuevas Perspectivas Conceptuales y Metodológicas. Barcelona: Amentia; 2011; 299-363.

Vergara M, Jara P, Bruguera M. El proyecto Euro-Wilson: un proyecto europeo para el estudio de la enfermedad de Wilson. Gastroenterología y Hepatología. 2008; 31: 17-9.

Murillo O, et al. Long-term metabolic correction of Wilson’s disease in a murine model by gene therapy. Journal of Hepatology. 2016; 64(2):419-26.

Margarit E, Bach V, Gómez D, et al . Mutation analysis of Wilson disease in the Spanish population - identification of a prevalent substitution and eight novel mutations in the ATP7B gene. Clinical Genetics. 2005; 68: 61-8.

Huarte-Muniesa MP, Lacalle-Fabo E, Uriz-Otano J, et al. Complexity of the diagnosis of Wilson disease in clinical practice: our experience in 15 patients. Gastroenterología y Hepatología. 2014; 37: 389-96.

Enfermedad de Wilson. Consejos alimentarios. Disponible en: http://enfermedaddewilson.org/wp-content/uploads/2015/07/dietawilson.pdf.

Benedito MC. Intervención psicológica en la adhesión al tratamiento de enfermedades crónicas pediátricas. Anales Pediatría. 2001; 55: 329-34.

Araneda M. Adherencia al tratamiento de la diabetes mellitus tipo 1, durante la adolescencia. Una perspectiva psicológica. Revista Chilena de Pediatría 2009; 80: 560-569.

Fotokian Z, Mohammadi Shahboulaghi F, Fallahi-Khoshknab M, et al. The empowerment of elderly patients with chronic obstructive pulmonary disease: Managing life with the disease. PLoS ONE. 2017; 3; 12 (4): e0174028.doi: 10.1371/journal.pone.0174028. eCollection.

March J.C. Empowered patients for greater confidence in the health system. Revista de Calidad Asistencial. 2015; 30: 1-3.

Geense WW,Van Gaal BGI, Knoll JL, et al. The support needs of parents having a child with a chronic kidney disease: a focus group study. Child Care Health and Development. 2017 ;43 (6):831-38.

Published

2019-04-01

How to Cite

1.
Páramo Rodríguez L, Zurriaga Llorens Óscar, González Sanjuán ME, Cavero Carbonell C. Wilson disease: the look of medical staff, patients and family members: e201904014. Rev Esp Salud Pública [Internet]. 2019 Apr. 1 [cited 2025 May 18];93:11 páginas. Available from: https://ojs.sanidad.gob.es/index.php/resp/article/view/1261

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