'Do language and culture really matter?': A trans-disciplinary investigation of cultural diversity in genetic counseling in Hong Kong.

Abstract

In this paper, we present evidence that in counseling culturally diverse patients, differences in spoken language and cultural beliefs of the patients and genetic counseling professionals do not necessarily impede successful counseling. We also highlight sociocultural factors, including socioeconomic background and genetic literacy, that may impact communication in multicultural/ multilingual contexts or when languages other than English are used. While genetic counseling is not short of insights and practical guidelines on sociocultural and language issues, and increasingly, research that employs interviews and surveys, empirical research that draws on authentic interactional data (in the form of video- and audio-recorded interactions and their transcripts) is limited. Our goal here is to assess how needs are communicated among a diverse population using an innovative empirical approach that builds on the analysis of transcribed interactions as the primary data and optimizes trans-disciplinary expertise in linguistics, genetics and genetic counseling. We present data from 42 genetic counseling encounters addressing Sudden Arrhythmic Death Syndrome (SADS) in Hong Kong. We demonstrate the value of the situated analysis of genetic counseling, which focuses on those junctures in the interaction where participants orient to their different linguistic and/or cultural backgrounds as relevant to the ongoing interaction. We further show that participants draw on various interactional resources to negotiate and resolve possible differences or misunderstandings. We highlight the advantages of incorporating authentic (i.e., non-simulated) data into the training of genetic counselors to increase cultural awareness and to provide communication tools (i.e., interactional strategies) they can draw on in their counseling practice.