Genetic counselors' response types to prenatal patient deferring or attributing religious/spiritual statements: An exploratory study of US genetic counselors

Abstract

Research shows religiosity and spirituality (R/S) influence genetic counseling patients' and families' risk perception, decision-making, and coping. No published studies have examined how genetic counselors respond to patient-initiated R/S statements. This exploratory study examined genetic counselors' response types and reasons for their responses to two prenatal patient's R/S statements. Genetic counselors (n = 225) recruited through a National Society of Genetic Counselors eblast completed a survey containing two hypothetical scenarios regarding a prenatal patient's receipt of a trisomy 18 diagnosis. Scenarios were identical except for the last patient statement: "God makes everything possible…we leave things in his hands" (a deferring statement)or "I feel like God is punishing me for something I did" (an attributing statement).Imagining they were the counselor, participants wrote a response to each scenario and provided reasons for their response. Responses were analyzed using the Helping Skills Verbal Response System. MANOVA and chi-square tests, examining differences in response type based on patient statement (deferring or attributing), participant comfort with R/S, and years of experience, yielded a significant multivariate effect for scenario (p < 0.001). Responses to the deferring statement scenario contained a greater proportion of content statements (p < 0.001), closed questions (p < 0.001), and information-giving (p < 0.001). Responses to the attributing statement scenario contained a greater proportion of open questions (p = 0.05), influencing statements (p < 0.001), and affective statements (p = 0.006). Neither comfort with R/S nor genetic counseling experience significantly affected response type. Thematic analysis of reasons for responses yielded nine themes. Most prevalent were exploration (of the patient's statement), validation, correction (of patient's beliefs), and reassurance.The findings reflect stylistic differences in how and why genetic counselors respond to patients.

Exploring spirituality, religion and life philosophy among parents of children receiving palliative care: a qualitative study

“…Parental statements included in the "theory of origin" code illustrate how parents' RSLP is interrelated with Fisher's analysis of scientific explanations and with Sitaula's analysis of genetic counselors' roles, where religious and scientific explanations coexist in a background of high vulnerability and uncertainty [13,35]. Our findings also contribute to improve the understanding of how spirituality is related to decision making, to prenatal genetic counseling, to future medical decisions, and directly or indirectly to parents' trust in clinical teams [6,13,[35][36][37].…”

“…We found that variations within each code did not match necessarily with parental self-concept of believers (spiritual or religious) or nonbelievers. The codes image of God and role of faith have been identified as key aspects that support parents' coping in children with rare diseases [33,35].…”

Exploring spirituality, religion and life philosophy among parents of children receiving palliative care: a qualitative study

“…Parental statements included in the "theory of origin" code illustrate how parents' RSLP is interrelated with Fisher's analysis of scienti c explanations as well as Sitaula's genetic counselors' roles, as well as how religious and scienti c explanations coexist in a background of high vulnerability and uncertainty [13,35]. Our ndings also contribute to improve the understanding of how spirituality is related to decision making, to prenatal genetic counseling, and to future medical decisions, and directly or indirectly to parents' trust in clinical teams [6,13,[35][36][37].…”

“…We found that variations within each code did not match necessarily with parental self-concept of believers (spiritual or religious) or non-believers. The codes image of God and role of faith have been identi ed as key aspects that support parents' coping in children with rare diseases [33,35].…”