Challenges Faced by Genetics Service Providers’ Practicing in a Culturally and Linguistically Diverse Population: An Australian Experience

Abstract

This paper explores the perceived challenges facing clinical genetics practitioners in multicultural Australia. Focus groups conducted with 53 practitioners explored: 1) participants' experiences and definitions of cultural diversity; 2) their use of educational resources with clients; 3) their experiences with culturally diverse groups/individuals in practice; 4) their experiences working with interpreters; and 5) the impact culturally specific educational training and/or experiential learning had on their confidence or practice when dealing with culturally diverse clients. Participants viewed culture as extending beyond traditional definitions such as ethnicity, language and religion. Most respondents had experienced positive results working with health care interpreters, although at times, this was a challenge for the family as they preferred privacy and the use of family members as interpreters. Another commonly reported challenge was the limited availability of reliable, culturally appropriate translated resources. Some participants expressed concern that learning theories about specific cultures may lead to stereotypes and that opportunities for formal cultural competence training were limited. Recommendations for practice include the targeting of educational resources to meet the needs of a diverse community and placing cultural competence on the agenda for ongoing training and maintenance of professional standards for clinical genetics practitioners to avoid the current ad hoc approach.

Health service use and costs for infant behaviour problems and maternal stress

“…Single mothers more frequently experience financial hardship, physical and mental health problems and difficulties in caring for their children, which may explain this finding . Our finding that mothers with English as a second language reported lower costs of HS for their depressive symptoms supports evidence of language‐based and culture‐based barriers to access in Australian community health care . Finally, maternal completion of high school was associated with higher HS costs for infant's behaviour problems and to some extent maternal depressive symptoms, in line with Steele et al .…”

“…31,34 Our finding that mothers with English as a second language reported lower costs of HS for their depressive symptoms supports evidence of language-based and culture-based barriers to access in Australian community health care. 35,36 Finally, maternal completion of high school was associated with higher HS costs for infant's behaviour problems and to some extent maternal depressive symptoms, in line with Steele et al 37 who found that depressed individuals who have completed high school have a higher rate of mental HS use than those who did not complete high school.…”

Identifying and Addressing Genetic Counseling Challenges among Indigenous People of Oaxaca—One Center's Experience with Two Immigrant Farmworker Families in the Central Valley of California

“…Lessons learned : (1) If it is suspected that there is a low level of health literacy as it relates to Western medicine, attempts should be made to incorporate the family’s traditional medicine beliefs, such as curses and bad blood, into a simplified Western medicine-oriented genetic counseling approach regarding genes, patterns of inheritance, and recurrence risks (Parker et al 2003; Saleh et al 2009). (2) There may be different expectations for how much clinical information the medical and genetic staff want to provide, compared to how much the family wants to hear and understand.…”

What hinders minority ethnic access to cancer genetics services and what may help?

“…Cultural variations in perceptions of which relatives constitute close family members have been identified, for example among Chinese Australians, 41 underlining how patterns of inheritance for disease may be variably understood, and consistent with the confusion about this noted here. 23 Other evidence also suggests differing kinship systems may affect the way people view inheritance, and thus genetic counselling, because of family privacy, 36, 42 or highlights cultural differences in people's advice seeking about cancer. 43 …”