Hudson Paul, Zajo Kristin, Gerhardt Cynthia A, Stanek Joseph, Varga Elizabeth
Genetic Counseling Program, The Ohio State University College of Medicine, Columbus, OH, USA.
Division of Hematology, Oncology and BMT, Nationwide Children's Hospital, Columbus, OH, USA.
J Genet Couns. 2019 Dec;28(6):1139-1147. doi: 10.1002/jgc4.1164. Epub 2019 Sep 3.
As genetic testing is increasingly integrated into medical care, the genetic counselor (GC) has emerged as a key member of multidisciplinary (MD) teams. Prior research has demonstrated the importance of role clarification when subspecialties are introduced to these teams given the potential differences in team member expectations regarding the division of responsibilities in clinic. To assess perceptions of a GC's role in four pediatric hematology/oncology clinics, Accreditation Council for Genetic Counseling (ACGC) competencies were used to develop two separate surveys for providers and patients and their caregivers. Providers (n = 25) perceived roles related to genetic expertise and coordination of care to be primarily the role of a GC significantly more often than psychosocial roles (p < .0001). Several potential GC roles were perceived as a shared role or the role of another provider, such as eliciting psychosocial history. Patients/caregivers (n = 70) perceived genetic-centric roles as significantly more important than roles related to coordination of care (p = .03) and psychosocial skills (p < .0001). Our findings from a pediatric specialty department suggest that GCs may maximize their potential in MD clinics by functioning as genetic subject matter experts with care coordination responsibilities related to genetic testing. Further communication between team members may be indicated to clarify the division of responsibilities.
随着基因检测越来越多地融入医疗保健中,遗传咨询师(GC)已成为多学科(MD)团队的关键成员。先前的研究表明,当将亚专业引入这些团队时,角色明确非常重要,因为团队成员对临床责任分工的期望可能存在差异。为了评估GC在四家儿科血液学/肿瘤学诊所中的角色认知,利用遗传咨询认证委员会(ACGC)的能力标准为医护人员以及患者及其护理人员分别开发了两份调查问卷。医护人员(n = 25)认为,与基因专业知识和护理协调相关的角色主要是GC的职责,这一认知的频率显著高于心理社会角色(p <.0001)。一些潜在的GC角色被视为共同职责或其他医护人员的职责,比如获取心理社会病史。患者/护理人员(n = 70)认为,以基因为中心的角色比与护理协调相关的角色(p = 0.03)和心理社会技能相关的角色(p <.0001)更为重要。我们在儿科专科部门的研究结果表明,GC可以通过担任基因主题专家并承担与基因检测相关的护理协调责任,在多学科诊所中充分发挥其潜力。可能需要团队成员之间进一步沟通,以明确责任分工。