Translating Genetics Leaflets into Languages Other Than English: Lessons from an Assessment of Urdu Materials

Genetic counselors frequently counsel clients whose first language is not English, relying on interpreters and on supplementary translated written material. This paper highlights factors that counselors need to consider before using or commissioning translated leaflets. It is based on an assessment of leaflets translated into Urdu, the national language of Pakistan, which are available through U.K. genetics clinics for use with Pakistani-origin clients. The 2 authors, who know Urdu as their 2nd and 1st languages respectively, independently read each leaflet, checking for accuracy of information, ease of reading and understanding, cultural sensitivity, and contact details for Urdu-speaking professionals. There were factual errors and confusing or very difficult text in all leaflets; some leaflets also contained culturally insensitive messages that could alienate users of genetics services. The paper discusses the reasons for these pitfalls and makes recommendations to guide the future production of translated genetics leaflets.     

Improving specific autobiographical memory in older adults: impacts on mood,social problem solving,and functional limitations

Older adults have difficulty recalling specific autobiographical events. This over-general memory style is a vulnerability factor for depression. Two groups receiving interventions that have previously been successful at reducing over-general memory in depressed populations were compared to a control group. Participants were healthy older adults aged ≥70 years: memory specificity training (MEST; n = 22), life review (n = 22), and control group (n = 22). There were significant improvements in autobiographical memory specificity in the MEST and life review groups at post-training, relative to the control group, suggesting that over-general memory can be reduced in older adults. Change in social problem solving ability and functional limitations were related to change in autobiographical memory specificity, supporting the suggested role of specific retrieval in generating solutions to social problems and maintaining independence. Qualitative analysis of participants’ feedback revealed that life review may be more appropriate for older adults, possibly because it involves integrating specific memories into a positive narrative.     

Providing a Transcultural Genetic Counseling Service in the UK

This paper uses a broad definition of culture to explore the practice of transcultural genetic counseling through three case studies. The first case involves a White genetic counselor seeing an Asian family, the second, an Asian genetic counselor seeing an Asian family and the third, a hearing genetic counselor seeing a culturally Deaf client. Boundaries, transference and countertransference reactions are considered within each transcultural encounter and the author of each case reflects in detail on their role in the client interaction and their impact on the transcultural dynamic. The cases are used to illustrate some cultural beliefs or characteristics that may challenge the genetic counselor’s expectations. The value of identifying and interpreting these differences to facilitate useful clinical work is considered. The paper debates, where possible, whether it is helpful to culturally match genetic counselor and client.     

Perspectives of Indian Traditional and Allopathic Professionals on Religion/Spirituality and its Role in Medicine: Basis for Developing an Integrative Medicine Program

Allopathic medical professionals in developed nations have started to collaborate with traditional, complementary, and alternative medicine (TCAM) to enquire on the role of religion/spirituality (r/s) in patient care. There is scant evidence of such movement in the Indian medical community. We aim to understand the perspectives of Indian TCAM and allopathic professionals on the influence of r/s in health. Using RSMPP (Religion, Spirituality and Medicine, Physician Perspectives) questionnaire, a cross-sectional survey was conducted at seven (five TCAM and two allopathic) pre-selected tertiary care medical institutes in India. Findings of TCAM and allopathic groups were compared. Majority in both groups (75 % of TCAM and 84.6 % of allopathic practitioners) believed that patients’ spiritual focus increases with illness. Up to 58 % of TCAM and allopathic respondents report patients receiving support from their religious communities; 87 % of TCAM and 73 % of allopaths believed spiritual healing to be beneficial and complementary to allopathic medical care. Only 11 % of allopaths, as against 40 % of TCAM, had reportedly received ‘formal’ training in r/s. Both TCAM (81.8 %) and allopathic (63.7 %) professionals agree that spirituality as an academic subject merits inclusion in health education programs (p = 0.0003). Inclusion of spirituality in the health care system is a need for Indian medical professionals as well as their patients, and it could form the basis for integrating TCAM and allopathic medical systems in India.     

Hoping to Live a “Normal” Life Whilst Living with Unpredictable Health and Fear of Death: Impact of Cystic Fibrosis on Young Adults

This study aimed to explore the hopes and fears of young adults with cystic fibrosis (CF). Fifteen young adults with CF, aged 18–29, were interviewed about their hopes and fears using a grounded theory approach. Five themes were identified during the analysis: perceptions of living with unpredictable health and fear of death and dying; hopes for normality; hopes for a normal relationship and/or marriage; hopes for having children; and hopes for a normal work life. Participants feared the unpredictable nature of CF and the suffering that they believed they would have to endure due to ill health before premature death. Despite their fears, participants hoped to live a “normal” life by achieving their hopes of having long-lasting relationships, having children and pursuing a career. The findings highlight the need to help alleviate the fears of young adults with CF and to enable them to plan to achieve their hopes, hence giving them a sense of control over their condition.     

Indian Health Care Professionals’ Attitude Towards Spiritual Healing and Its Role in Alleviating Stigma of Psychiatric Services

Persons with mental illnesses in India and rest of developing world continue to consult religious/spiritual (R/S) healers or traditional, complementary and alternative medicine (TCAM) professionals prior to seeking psychiatric services that are devoid of spiritual components of care. We aim to understand TCAM and allopathic professionals’ perspectives on patients’ R/S needs within mental health services, cross-sectional study was conducted at five TCAM and two allopathic tertiary care hospitals in three different Indian states; 393 participants completed RSMPP, a self-administered, semi-structured survey questionnaire. Perspectives of TCAM and allopathic health professionals on role of spirituality in mental health care were compared. Substantial percentage, 43.7 % TCAM and 41.3 % allopathic, of participants believe that their patients approach R/S or TCAM practitioners for severe mental illness; 91.2 % of TCAM and 69.7 % of allopaths were satisfied with R/S healers (p = 0.0019). Furthermore, 91.1 % TCAM and 73.1 % allopaths (p = 0.000) believe that mental health stigma can be minimized by integrating with spiritual care services. Overall, 87 % of TCAM and 73 % of allopaths agreed to primary criterion variable: ‘spiritual healing is beneficial and complementary to psychiatric care.’ A quarter of allopaths (24.4 %) and 38 % of TCAM physicians reportedly cross-refer their grieving patients to religious/TCAM healer and psychiatrist/psychologist, respectively; on logistic regression, significant (p < 0.05) predictors were clinical interactions/references to r/s healers. Providing spiritual care within the setup of psychiatric institution will not only complement psychiatric care but also alleviate stigma against mental health services. Implications on developing spiritual care services like clinical chaplaincy are discussed.