Genetic Counseling Processes and Analogue Client Outcome

超出所提供的空间。遗传咨询提供了新的测试技术和个人参与知情决策过程的能力之间的翻译联系。这些信息的密集和抽象，再加上它所暗示的对不确定性和疾病脆弱性的高度焦虑，可能会让咨询客户在认知和情感上都不堪重负。过去20年的结果研究发现，相当大比例的信息被误解或记忆不良；事实上，一些研究人员警告说，遗传咨询的经历可能是一个重要的心理压力源，增加而不是减少疾病焦虑。尽管咨询过程对客户结果起着关键作用，但很少有结果研究解决了包括咨询会议沟通的交互式口头和情感过程。此外，在遗传咨询服务的使用者中，少数民族和文化程度低的人口的比例很大程度上不足，人们对如何最好地为这些人口服务知之甚少。目前的建议是一个两阶段的研究，旨在解决这些关键问题。在阶段中，1200名遗传咨询师将从国家遗传咨询协会（NSGC）的会议中招募，或通过区域中心招募，在采访经过培训的模拟客户时进行录像，这些客户寻求以下服务：a)高龄产妇产前检查咨询和囊性纤维化阳性家族史，或b) BRCA1和BRCA2基因突变的易感性测试。非裔美国人或白人女性的模拟客户将被单独使用或在会话期间由男性模拟器作为客户的配偶陪同。研究的第二阶段招募了800名来自不同种族、地域和教育背景的受试者，让他们观看咨询过程的录像，同时想象自己是客户或被咨询的配偶。通过这种方式，被试将充当模拟来访者（AC），为来访者对咨询师的沟通、理解和回忆以及焦虑测量的人际和信息方面的满意度提供代理。网站性能 ======================================== 节结束 ===========================================

EXCEED THE SPACE PROVIDED. 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, Icoupled with the heightened anxiety of uncertainty and disease vulnerability that it suggests, can be overwhelming to counseling clients-- both eognitively and emotionally. Outcome studies over the past 20 years have found that a si_ificant 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. PERFORMANCE SITE ========================================Section End===========================================