Psychological aspects of genetic counseling: VI. A critical review of the literature dealing with education and reproduction

Abstract

The post-1979 literature dealing with the educational and reproductive outcome and process of genetic counseling is reviewed. Despite methodological difficulties, recent publications strongly suggest that genetic counseling is successful in educating counselees about diagnostic and risk information. In general, investigators suggest that there is room for improvement and the factors leading to imperfect recall of information need to be elucidated. Process studies suggest that the educational priorities of counselors and counselees may not always be consistent. The contribution of these inconsistencies to outcome measures needs further study. Also, it appears that differing counseling approaches may be equally effective in achieving educational goals. Studies on the reproductive outcome of genetic counseling show no strong impact of counseling; there appears to be a net increase of desire for more children following counseling. Precounseling reproductive intentions, rather than counseling, were found to be a major factor in determining postcounseling outcome. Process studies suggest that although many counselees say that they were influenced by genetic counseling, it is uncertain what they mean, since for many counselees, reproductive decisions seem to have been made prior to counseling.

Avaliação psicológica dos cuidadores de mulheres com câncer pelo General Comfort Questionnaire

“…Uma possível razão é que quando a mulher assume cuidar de uma paciente com câncer de mama ou genital, confronta-se a todo instante com a possibilidade de também adoecer, o que é muito desgastante emocionalmente (Cella & Bonomi, 1995;Kessler, 1989). Os cuidadores vivenciam temores e fantasias relacionadas à herança genética do câncer, imaginam que também poderão desenvolver a doença, adicionando ansiedade a esta população (Erblich, Bovbjerg, & Valdimarsdottir, 2000;Silva, 2003).…”

Reproductive choices of haemophilia carriers

“…Genetic counselling can also in¯uence the carrier's choices, although it has no strong impact on reproduction according to some studies (Lubs, 1979;Kessler, 1989). However, before PD was available, genetic counselling and recommendations to abstain from having children probably accounted for the lower birth rate among childless women with a haemophiliac brother, that was noted in the U.S.A. after 1965 (Francis & Kasper, 1983).…”

Depressão e ansiedade nos cuidadores de mulheres em fase terminal de câncer de mama e ginecológico

“…Somado a isto, a convivência da filha com uma doença que acomete a mulher de forma indiscriminada e com alta prevalência pode intensificar os temores e sentimentos de ameaça a si. Na relação mãe-filha aparecem as fantasias relacionadas à herança genética, cada vez mais discutida socialmente, trazendo carga de ansiedade adicional a esta população 27 . Nos estudos que abordam as conseqüências de cuidar do paciente nesta fase, a experiência é descrita como muito pesada e negativa para os cuidadores informais 1,3,5 .…”