The main aspects of proper family history and its use in medicine
Family history is a collection of information about all diseases of the patient's closest relatives. The importance of collecting such information is to determine hereditary diseases and predispositions to various diseases.
Events in a person's life correspond with the past illnesses, their history is deduced on special schemes, which are called life cards.
It is especially necessary to compile such maps if the ratio of somatic pathology and deviations of the psychic plan is seen.
What does the
life map look like? Typically, a schematic map is a table with four columns. The first one indicates the age of the patient, in which the event occurred, in the second - the event itself, the third tells about the somatic disease, and in the fourth, the psychological one for the same period.
Each item of the first column can correspond to the year of a person's life, but sometimes it makes sense not to specify less important events, the time when something important happened. This results in a more informative and easy-to-analyze life map.
How detailed this analysis will be, depends on the characteristics of a person, according to this scheme, it is easy to track the frequency of pathology detection.
For convenience, some family data are depicted schematically, using certain symbolic images. So, for example, the female relatives can be marked with circles, and the male ones with squares. Brother or sister also stand out icons. If a relative has died, then his character is crossed out, and next it is necessary to indicate for what reason this occurred, and the age at the time of its onset. In the event that there was an alliance that ended in divorce, the line that unites the married couple is crossed out diagonally.
At first, such a map is drawn with the help of the patient himself, all the diseases transferred by his immediate relatives are applied to her. This scheme is very informative way of collecting data on genetic burden. If, during its compilation and study, a certain sequence is observed for this or that disease, one can speak of the patient's propensity to develop it.
What should be taken into account when collecting an anamnesis
This information can be collected only by a doctor, since it requires a professional approach and careful compilation, especially when deciding on the hereditary predisposition to certain types of pathological conditions( a burdened family anamnesis).
Initially, information about the patient, his closest relatives - the father, mother, brother, sister, children, is recorded. The doctor necessarily writes down in this scheme all the necessary data - the surname of the relative, including the maiden's age, all the diseases transferred and the peculiarities of their course. It is necessary to enter data indicating the deceased close patients, including the cause and date of death. If there is a need, information is also provided on the availability and number of sexual partners.
During the consultation on medical genetic issues, the physician must record all data on the methods and methods of contraception or the sterilization operation performed. Obligatory to clarification are information on the presence of stillborn in the family,
. An obligatory point of compiling an anamnesis is a note on the kinship of the parents. This may explain the presence of many autosomal recessive pathologies. For couples who plan to have children, such information is also very important, in addition, it is necessary to clarify the ethnic and geographical features where future parents grew up, as in some sufficiently isolated areas, marriages between relatives can often occur.
An example of a family history should take into account the variability of a number of signs of certain diseases that are inherited. Based on this, you need a thorough survey of all the nuances and features of the disease. In addition to collecting maximum information about primary relatives, it is necessary to clarify the presence of hereditary or rare diseases in other family members, including those associated with intellectual disabilities, birth abnormalities, mortality at delivery or at an early age.
The prevalence of various genetic abnormalities depends on the geographic and ethnic characteristics of the patient's residence. Therefore, such data must be taken into account when collecting a family history.
Why Social Data Are Required?
An important aspect in drawing up a map of a person's life is the establishment of such an aspect as a social anamnesis of the family. For this, the following data are specified:
- Age of parents. If they were less than 25 years old at the time of the birth of the child, then most likely, his upbringing was spontaneous, more attention was paid to their own problems and work. After 25 years, parents give their child much more time and attention. His upbringing and needs are brought to the fore and become priorities.
- Education and work. This will allow you to determine the social status of this family, the level of prosperity in it.
- Family composition. It is important to note a complete family or not. In the absence of a mother or father in it, the possibility of participation in the upbringing of the child of other members of her - grandmothers, grandfathers, stepfathers or stepmothers. It is also necessary to find out if there are other children in the family.