Titel: Non-directiveness and shared decision-making in genetic counselling in the context of prenatal diagnostics – A systematic review from 1990 to 2021
ID: P-ClinG-064
Art: Postertalk
Redezeit: 2 min
Session: Poster Session
ClinG 2

Referent: Wera Hofmann (Stuttgart/DE)

Abstract - Text


Objective: The research objective was to systematically review published empirical studies on how the counselling concept of non-directiveness and the communication model of shared decision-making in a genetic counseling setting in the context of prenatal diagnosis affect patient decision-making and satisfaction.

Methods: A systematic electronic search of three databases, a hand-search of reference lists as well as a search in the journal medizinischegenetik was conducted, followed by a selection of studies which fullfiled the inclusion criteria. Data relevant to the research study were extracted and a narrative synthesis was carried out. A PRISMA flow chart was used for the graphical representation of the citation flow.

Results: In total, more than 1060 references were retrieved and a set of 38 studies were selected as eligible. Although strong heterogeneity was observed in the individual studies, a trend in using communication strategy of shared decision-making can been seen mainly driven by offer prenatal screening tests, such as noninvasive prenatal testing (NIPT) provided by gynecologists and midwives too. While some studies found that both non-directiveness and shared decision-making have no influence or no negative influence on evaluated patient outcomes, other research groups highlighted following counsellor behaviors as important:  empathy, responsiveness to patient values and beliefs, unbiased conversation, choice of words, and dealing with conveying probabilities. Other factors to consider such as lack of time, high workload, and insufficient training programs can negatively affect the behavior of counsellors, who in turn are very aware of their behavior on counsellees.

Conclusion: Further research is needed to investigate how individualized and oral genetic counselling desired by the vast majority of counsellees can succeed with the knowledge of constant technological advances in genetics and genomics.

Practice implications: Interested genetic clinicians with a focus on prenatal diagnostics, obstetricians and gynecologists offering prenatal screening and students of the new master's program Genetic and Genomic Counseling in German-speaking countries can use the present work as a basis for an in-depth discussion of succeeded genetic counselling.