Lehtinen Esa
Department of Modern Finnish and Translation, University of Vaasa, Finland.
Sociol Health Illn. 2005 Jul;27(5):575-601. doi: 10.1111/j.1467-9566.2005.00457.x.
Genetic counselling as a medical encounter is characterised by the centrality of the provision of information. Much of the counselling session is filled by information delivery about the symptoms, the prognosis and the transmission of the disease, the risks involved and the possibilities for genetic testing. The present paper is a study of how information is delivered in actual genetic counselling sessions. The data consist of 10 video-recorded sessions from a genetics clinic in Finland, and the methodology is based on conversation analysis. The paper focuses on the doctor's talk in a specific interactional context, the slot after a candidate understanding by a client. The analysis shows that the doctors have two basic orientations: they work towards securing correct understanding and they display being attuned to what the information means to the clients, particularly to whether it is positive or negative to them. The latter orientation is related to what has been called 'the benign order of everyday life' (Maynard 2003). The findings in the paper offer a possibility for a discussion about the principles and practices of genetic counselling.
作为一种医疗问诊形式的遗传咨询,其特点是以提供信息为核心。咨询过程的大部分时间都用于传递有关症状、疾病预后和遗传方式、所涉及的风险以及基因检测可能性等信息。本文是一项关于在实际遗传咨询过程中信息如何传递的研究。数据包括来自芬兰一家遗传学诊所的10次视频记录问诊,其方法基于会话分析。本文聚焦于特定互动情境下医生的谈话,即患者表示理解之后的时段。分析表明,医生有两个基本取向:他们致力于确保患者正确理解,并且表现出关注信息对患者意味着什么,尤其是对他们是积极还是消极的影响。后一种取向与所谓的“日常生活的良性秩序”(梅纳德,2003年)相关。本文的研究结果为讨论遗传咨询的原则和实践提供了可能。