Genetic Counseling Processes and Analogue Client Outcome

遗传咨询过程和模拟客户结果

• 批准号: 6801840
• 负责人: Debra L Roter
• 金额: $ 63.56万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-09-19 至 2006-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6801840
• 关键词: Genetic; Counseling; Processes; Analogue; Client

DESCRIPTION (provided by applicant): Genetic counseling provides the translational link between the new technologies of testing and the ability of individuals to engage in a process of informed decision making. The dense and abstract nature of this information, coupled with the heightened anxiety of uncertainty and disease vulnerability that it suggests, can be overwhelming to counseling clients - both cognitively and emotionally. Outcome studies over the past 20 years have found that a significant proportion of information is misunderstood or poorly recalled; indeed, some investigators have warned that the genetic counseling experience may be a significant psychological stressor increasing rather than diminishing disease anxiety. Despite the critical role of the counseling process to client outcomes, few outcome studies have addressed the interactive verbal and emotional processes that comprise the communication of counseling sessions. Furthermore, ethnic minorities and low literate populations are largely underrepresented among users of genetic counseling services and little is known about how to best serve these populations. The current proposal is a two-phase study designed to address these critical issues. In Phase 1, 200 genetic counselors will be recruited from meetings of the National Society of Genetic Counseling (NSGC), or through regional centers, to be videotaped while interviewing trained simulated clients seeking services related to either a) prenatal test counseling for advanced maternal age and a positive family history for cystic fibrosis, or b) susceptibility testing for BRCA1 and BRCA2 gene mutations. Simulated clients who are African American or Caucasian females will be used in interviews singly or accompanied by a male simulator acting as the client's spouse during the session. Phase 2 of the study recruits 800 subjects from ethnically, geographically, and educationally diverse populations to view the videotaped counseling sessions while imagining they are the client or the spouse being counseled. In this way, the subjects will act as analogue clients (AC) to provide a proxy for client satisfaction with the interpersonal and informational aspects of the counselor's communication, comprehension and recall and measures of anxiety.

描述（由申请人提供）：遗传咨询提供了新的测试技术与个人参与明智决策过程的能力之间的翻译联系。 这些信息的密集和抽象的性质，再加上它所暗示的不确定性和疾病脆弱性的焦虑，对客户的咨询 - 在认知和情感上都可能是压倒性的。 在过去的20年中，结果研究发现，很大一部分信息被误解或召回不足。确实，一些调查人员警告说，遗传咨询经验可能是一种重要的心理压力，而不是减轻疾病焦虑。 尽管咨询过程对客户结果的重要作用至关重要，但很少有结果研究解决了构成咨询会议的交流的互动言语和情感过程。 此外，在遗传咨询服务的使用者中，少数民族和识字率低的人数在很大程度上不足，而如何最能为这些人群提供服务。 当前的建议是一项两阶段的研究，旨在解决这些关键问题。 在第1阶段中，将从国家遗传咨询学会（NSGC）的会议上或通过区域中心招募200名遗传辅导员，同时访问培训的培训的模拟客户，以寻求与a的a）高级母亲年龄相关的服务咨询服务，以实现高级母亲年龄的辅助辅导，并为casstic纤维化的积极历史记录或b）对BRCA和BRCA的积极家族史和Brca cene cut进行brca 2 gene cut。非裔美国人或高加索女性的模拟客户将单独使用或伴随着男性模拟器在会议期间充当客户配偶的男性模拟器。 该研究的第2阶段在种族，地理和教育程度多样的人群中招募了800名受试者，以查看录像带咨询会议，同时想象他们是客户或配偶被咨询。 这样，受试者将充当模拟客户（AC），以提供对客户对辅导员沟通，理解和回忆和焦虑措施的人际交往和信息方面的满意的代表。