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Peering into a Chilean Black Box: Parental Storytelling in Pediatric Genetic Counseling
Authors:Jessica Ordonez  Sonia Margarit  Katy Downs  Beverly M. Yashar
Affiliation:1. John T. Macdonald Foundation Department of Genetics, John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, 1501 NW 10th Ave; BRB 334 (M-860), Miami, FL, 33136, USA
2. Medical School, Clinical Alemana- Universidad del Desarrollo, Av. Las Condes 12.438 Lo Barnechea, Santiago, Chile
3. Undergraduate Research Opportunity Program, University of Michigan, 1190 Undergraduate Science Building, Ann Arbor, MI, 48109-2215, USA
4. Department of Human Genetics, University of Michigan, 4909 Buhl, 1241 E. Catherine Street, Ann Arbor, MI, 48109-5618, USA
Abstract:While genetic counseling has expanded to multiple international settings, research about providing culturally sensitive services to non-U.S. patients is limited. To gain insights, we utilized a process study to explore parental communication in pediatric genetics clinics in Chile. We utilized a phenomenological hermeneutic approach to assess storytelling in six pediatric sessions that were conducted in Spanish, and translated into English. The majority of the sessions focused on information gathering (35 %), and providing medical (20 %) and genetics education (18 %). The 14 instances of storytelling we identified usually emerged during information gathering, genetics education, and the closing of the session. Stories illustrated parental efforts to create a cognitive and emotional context for their child’s genetic diagnosis. Parents emerged as competent caregivers who discussed the role of the child as a social being in the family and the larger community. Our analysis found that genetic counseling sessions in the U.S. and Chile are structured similarly and although communication is not a balanced process, parents use storytelling to participate as active agents in the session. Via storytelling, we learned that parents are working to understand and gain control over their child’s genetic diagnosis by relying on mechanisms that extend beyond the genetics appointment.
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