Mittman Ilana Suez, Bowie Janice V, Maman Suzanne
Department of Epidemiology and Preventive Medicine, University of Maryland at Baltimore, School of Medicine, 807 S Clinton Street, Baltimore, MD 21224-4030, USA.
Patient Educ Couns. 2007 Feb;65(2):230-6. doi: 10.1016/j.pec.2006.08.002. Epub 2006 Sep 20.
Genetic technology is complex, relatively new and involves sensitive issues pertaining to personhood and reproduction. While ethno cultural barriers to genetic care are well documented, little attention has been devoted to understanding religious beliefs pertaining to genetic services. This study evaluated the discourse between genetic counselors and Orthodox Jewish community members' perceptions of reproductive genetic technology.
A cross section of the Orthodox Jewish community was sampled through purposeful and snowball recruitment for in-depth interviews with key informants.
Genetic counselors felt apprehensive about serving the Orthodox Jewish population and were unaware of social norms, religious and cultural practices unique to this population. Similarly, Orthodox Jewish consumers exhibited major misgivings about genetic testing. Importantly, stereotypic expectations by both counselors and consumers exacerbated existing communication difficulties.
Cultural differences and poor communication between genetic counselors and Orthodox Jewish community members impeded the ability of the Orthodox Jewish community to utilize genetic services.
This work illuminates complex issues pertaining to medical encounters between providers and patients with ideological, social and cultural differences. In particular, issues of access to care and transcultural competence in serving religious minority groups, such as Orthodox Jews are presented. On the whole, this group is largely unrecognized in the minority health literature in spite of barriers and challenges that they face. Findings of this study may have application to other cloistered and highly observant religious groups when dealing with reproductive technology and other populations with diverse values, beliefs and behaviors pertaining to reproductive health.
基因技术复杂且相对新颖，涉及与人格和生殖相关的敏感问题。虽然基因护理方面的种族文化障碍已有充分记录，但对于与基因服务相关的宗教信仰却鲜有研究。本研究评估了基因咨询师与东正教犹太社区成员对生殖基因技术的看法之间的对话。
通过有目的的抽样和滚雪球式招募，选取东正教犹太社区的一部分人进行关键信息提供者的深入访谈。
基因咨询师对为东正教犹太人群体提供服务感到担忧，并且不了解该群体特有的社会规范、宗教和文化习俗。同样，东正教犹太消费者对基因检测也表现出重大疑虑。重要的是，咨询师和消费者的刻板期望加剧了现有的沟通困难。
基因咨询师与东正教犹太社区成员之间的文化差异和沟通不畅阻碍了东正教犹太社区利用基因服务的能力。
这项工作揭示了提供者与具有意识形态、社会和文化差异的患者之间医疗接触中涉及的复杂问题。特别是，提出了为宗教少数群体（如东正教犹太人）提供护理的可及性和跨文化能力问题。总体而言，尽管该群体面临诸多障碍和挑战，但在少数群体健康文献中基本上未得到认可。本研究的结果可能适用于其他与世隔绝且严格遵守教规的宗教群体在处理生殖技术以及与生殖健康相关的具有不同价值观、信仰和行为的其他人群时的情况。
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