Table 3 Comparison of responses from individual interviews and focus groups
Genetic counselors | Nurses | Counselees | ||
|---|---|---|---|---|
Lack of knowledge regarding genetic counseling | Lack of pre-counseling knowledge | Aware of counselee lack of knowledge | Aware of counselee lack of knowledge | Pervasive lack of knowledge |
Desire for action - need for some type of community education | Did not mention | Suggested “marketing” campaign in the community | Desire for community outreach | |
Negative personal and cultural preconceptions about genetic testing and counseling | Lack of trust | Mention lack of trust from counselees | Mention lack of trust and negative narrative | Some negative narrative |
Referral interpreted with stigma | Aware of stigma | Aware of stigma | Fear of stigmatization | |
Misconception - expectation for negative event | Did not mention | Aware of counselee’s negative pre-conceptions | Negative pre-conceptions | |
Lack of effective communication regarding the counseling service | Risk perception | Objective based- Provide technical definitions statistics | Counselees interpret as dichotomous | Counselees interpret as dichotomous |
Culturally-influenced differences in decision making regarding pregnancies between Arab subsets | Family involvement | Feel all families can interfere | Aware of Muslims family interference | - Muslims: family interference - Christians: family support - Druze: Did not mention |
Termination of pregnancy | No distinction between Arab subgroups | Aware of Muslim and Druze objection due cultural reasons | Most Muslim and Druze object for reasons of conscience and culture | |
Other differences between counselor and counselee perceptions | Major expectation for genetic counseling outcome | facilitator of informed consent | Teach genetic information | Desire for empathy and reassurance from counselors |
Language | Major barrier to effective counseling | Mild mention of language barriers | No mention of language as barrier |