Analysis of Advantages, Limitations, and Barriers of Genetic Counseling Service Delivery Models
Analysis of Advantages, Limitations, and Barriers of Genetic Counseling Service Delivery Models
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DOI：
10.1007/s10897-016-9932-2
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发表时间：
2016-10-01
影响因子：
1.9
通讯作者：
Grubs, Robin E.
中科院分区：
文献类型：
--
作者：
Cohen, Stephanie A.;Huziak, Rachelle C.;Grubs, Robin E.
先前关于遗传咨询服务提供模式（SDMs）的研究表明，遗传咨询师（GCs）正在采用替代模式来满足不断增长的服务需求并改善遗传服务的可及性。本研究旨在确定先前确定的遗传咨询SDMs的障碍、限制和优势。采用质性研究设计，采用电子邮件访谈的形式对20名使用多种SDMs的执业GCs进行访谈。访谈记录使用专题分析来分析，以确定与sdm的实施和利用相关的主题。导致GCs实施SDMs而非面对面遗传咨询的因素包括：1)出行距离，2)等待时间，3)便利性。后勤问题，如账单和报销，设备设置，安排基因检测和无法见到病人是主要的限制替代遗传咨询SDMs在临床实践。然而，接受采访的GCs表示，替代SDMs对患者和遗传咨询师的便利超过了这些限制。需要更多的研究来评估SDMs在实践中的结果，以证明其对确定的旅行距离、等待时间和便利性障碍的影响。
Previous studies on genetic counseling service delivery models (SDMs) have shown that genetic counselors (GCs) are incorporating alternate models to address growing service demand and improve access to genetic services. This study sought to identify barriers, limitations and advantages to previously identified genetic counseling SDMs. A qualitative research design was employed, in which 20 practicing GCs who utilize a variety of SDMs were interviewed using an email interview format. Interview transcripts were analyzed using a thematic analysis to identify themes related to implementation and utilization of SDMs. Factors that led GCs to implement SDMs other than in-person genetic counseling included: 1) travel distance, 2) wait time and 3) convenience. Logistical issues such as billing and reimbursement, equipment set up, making arrangements for genetic testing and the inability to see the patient are major limitations to alternative genetic counseling SDMs in clinical practice. However, GCs interviewed stated that the convenience to the patient and genetic counselor of alternative SDMs outweighed these limitations. More research is needed to assess the outcomes of SDMs in practice to demonstrate an impact on the identified barriers of travel distance, wait time and convenience.