Nondirectiveness in genetic counseling: an empirical study.
Nondirectiveness in genetic counseling: an empirical study.
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遗传咨询的非指导性：一项实证研究。
DOI：
10.1097/00006254-199706000-00010
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发表时间：
1997
影响因子：
9.8
通讯作者：
T. Marteau
中科院分区：
文献类型：
--
作者：
S. Michie;Faye Bron;M. Bobrow;T. Marteau
非指导性被认为是遗传咨询的重要组成部分，但没有普遍接受的定义，也没有数据记录其对咨询者的影响。本研究是一个实证调查的指示性，使用的成绩单的咨询和比较这些与辅导员报告和辅导员报告的指示性。评级指导性被定义为建议，表达意见或选择性强化咨询者的行为，思想或情绪（建议，评估和强化）。对131份成绩单的分析显示，每次咨询平均有5.8份咨询声明，5.8份评价声明和1.7份强化声明。当被要求描述他们的咨询风格时，11名咨询师中没有一人将其评为“根本没有”指示。一半面临决定的咨询者感到受到咨询师的指导。评定的指导性项目显示出令人满意的评定者间可靠性（kappa = .63）。因子分析表明，它们形成一个因素（特征值1.72）。辅导员报告，辅导员报告，和额定的指导性或这些措施和辅导员的焦虑和关注，满意度的信息，或会议的辅导员的期望之间没有关联。额定的指导性是唯一的措施，与其他协商过程中的措施，与更长的磋商，更多的块的话，更多的社会和情感问题被提出，更少的关注被跟进。建议更有可能被给予辅导员的社会经济地位较低，并辅导员判断为高度关注。接受过心理咨询培训的咨询师更有可能做出评价性陈述。这些结果表明，遗传咨询的特点是没有-由辅导员，辅导员，或一个标准化的评级量表-作为统一的非指令性。
Nondirectiveness is considered an essential part of genetic counseling, yet there is no generally accepted definition nor data documenting its impact on counselees. This study is an empirical investigation of directiveness, using ratings from transcripts of consultations and comparing these with counselor-reported and counselee-reported directiveness. Rated directiveness was defined as advice, expressed views about or selective reinforcement of counselees' behavior, thoughts, or emotions (advice, evaluation, and reinforcement). Analysis of 131 transcripts revealed a mean of 5.8 advice statements per consultation, 5.8 evaluative statements, and 1.7 reinforcing statements. When asked to describe their counseling style, none of the 11 counselors rated it as "not at all" directive. Half the counselees who faced a decision felt steered by the counselor. Items of rated directiveness showed satisfactory interrater reliability (kappa = .63). Factor analysis revealed that they formed one factor (eigenvalue 1.72). There were no associations either between counselor-reported, counselee-reported, and rated directiveness or between these measures and counselee anxiety and concern, satisfaction with information, or the meeting of counselees' expectations. Rated directiveness was the only measure to be associated with other process measures of the consultation, being associated with longer consultations, more blocks of speech, more social and emotional issues being raised, and fewer concerns being followed up. Advice was more likely to be given to counselees of lower socioeconomic status and to counselees judged by counselors to be highly concerned. Evaluative statements were more likely to be made by counselors who had received counseling training. These results show that genetic counseling was not characterized--by counselors, counselees, or a standardized rating scale--as uniformly nondirective.