Wells David M, McCarthy Veach Patricia, Martyr Meredith A, LeRoy Bonnie S
Hazelden Betty Ford Foundation, Plymouth, MN, USA.
Department of Educational Psychology, University of Minnesota, Minneapolis, MN, USA.
J Genet Couns. 2016 Aug;25(4):799-817. doi: 10.1007/s10897-015-9901-1. Epub 2015 Oct 24.
Genetic counselors routinely engage with patients and families who grapple with questions of meaning while making decisions about genetic risk. Research and theory demonstrate genetic counselors gain important personal insights through their work and develop professionally from self-reflective practice regarding their beliefs and values. Data are lacking, however, about the nature of the meaning genetic counselors bring to their profession and how they directly experience and/or navigate issues of meaning within clinical practice over time. Accordingly, a national sample (N = 298) of practicing genetic counselors completed a brief survey assessing their demographic characteristics and willingness to participate in a semi-structured telephone interview exploring their views on meaning as they relate to their clinical work and professional development. Sixty-eight individuals of varied experience levels were interviewed about: 1) how they define a meaningful life for themselves; 2) lifetime sources of influence on their sense of meaning; 3) how they experience meaning within both personal and professional contexts; 4) work-related contexts that reaffirm and challenge their sense of meaning; and 5) how their sense of meaning has changed over time. Twenty-five interviews were analyzed using Consensual Qualitative Research methods, at which point, data saturation was reached. Five themes, 32 domains, and 29 categories were extracted. Common findings include: importance of satisfying relationships; helping others; personal fulfillment; personal and patient experiences of illness and loss; religious and/or spiritual foundations; value conflicts; competing obligations; challenges to meaning; development of empathy; resiliency; and increased humility. Results suggest the importance of professional venues for discussions of meaning (e.g., genetic counseling program curricula, continuing education, and peer supervision/consultation). Additional findings, practice implications, and research recommendations are presented.
遗传咨询师经常与那些在做出有关遗传风险的决策时纠结于意义问题的患者及其家属打交道。研究和理论表明,遗传咨询师通过工作获得了重要的个人见解,并通过对自身信念和价值观的反思性实践实现了职业发展。然而,关于遗传咨询师赋予其职业的意义的本质,以及随着时间推移他们如何在临床实践中直接体验和/或应对意义问题的数据却很缺乏。因此,一个全国性的执业遗传咨询师样本(N = 298)完成了一项简短调查,评估他们的人口统计学特征以及参与半结构化电话访谈的意愿,该访谈旨在探讨他们对与临床工作和职业发展相关的意义的看法。68名经验水平各异的个体接受了访谈,内容包括:1)他们如何为自己定义有意义的生活;2)对其意义感产生终身影响的因素;3)他们在个人和职业背景中如何体验意义;4)重申和挑战其意义感的与工作相关背景;5)他们的意义感如何随时间变化。使用共识定性研究方法对25次访谈进行了分析,此时达到了数据饱和。提取了五个主题、32个领域和29个类别。常见的发现包括:满意关系的重要性;帮助他人;个人成就感;疾病和损失的个人及患者经历;宗教和/或精神基础;价值冲突;相互竞争的义务;对意义的挑战;同理心的发展;复原力;以及增强的谦逊。结果表明了专业场所对于意义讨论(如遗传咨询项目课程、继续教育以及同行监督/咨询)的重要性。还呈现了其他发现、实践意义和研究建议。