Abstract
The present study was undertaken to characterize the variables that influence parental perception of metabolic disorders and their genetic origin before and after genetic counselling, the effect of counselling on parental attitudes towards prenatal diagnosis and pregnancy termination, and the factors affecting parental coping with burden.
Parents of children with metabolic diseases from 32 Arab-Muslim families were interviewed, answering a pre-structured questionnaire. These interviews indicate the following. (1) Traditional belief and religious commitment are more important determinants than education in parental perception of inherited metabolic diseases. (2) The number of affected children has a greater impact on parental evaluation of the burden than the number of healthy children. The social component, i.e. the way families are viewed by society, is the most significant factor of the burden. (3) Parents use different techniques to divide responsibility regarding reproduction. Having a healthy child and the availability of prenatal diagnosis and pregnancy termination were the two most important factors in parental reproductive decision making. In the absence of a healthy child and when the burden was perceived as too heavy, parents tended ‘not to decide’. (4) Parental attitude to pregnancy termination was dependent on two factors: religious commitment (leading to objection) and severity of disease (leading to flexibility and approval). (5) In almost all families, genetic counselling altered parental perception of the disease and its hereditary origin.
We conclude that genetic counselling and population education may be helpful in the prevention of consanguineous marriages and in family planning, even in a society that values traditional beliefs very highly.
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REFERENCES
Beeson D, Golbus MS (1985) Decision making: whether or not to have prenatal diagnosis and abortion for X-linked conditions. Am J Med Genet 20: 107–114.
Ekwo EE, Kim JO, Gosselink CA (1987) Parental perceptions of the burden of genetic disease. Am J Med Genet 28: 955–963.
Frets PG, Duivenvoorden HJ, Verhage F, Miermeijer MF, Van de Berge SMM, Galjaard H (1990) Factors influencing the reproductive decision after genetic counseling. Am J Med Genet 35: 496–502.
Good BJ, Good MD (1981) The meaning of symptoms: a cultural hermeneutic model for clinical practice. In Eisenberg L, Kleinman A, eds. The Relevance of Social Science for Medicine. Boston: D. Riedel, 165–196.
Handelman L, Menahem S, Eisenbruch IM (1989). Transcultural understanding of a hereditary disorder. Mucopolysaccharidosis VI in a Vietnamese family. Clin Pediatr 28: 470–473.
Jaber L, Bailey-Wilson J, Haj-Yehia M, Hernandez J, Shohat M (1994) Consanguineous matings in Israeli-Arab community. Arch Pediatr Adolesc. Med 148: 412–415.
Janis IL, Mann L (1977) Decision Making: A Psychological Analysis of Conflict, Choice and Commitment. New York: The Free Press, 10–12.
Kirscht JP (1988) The health belief model and predictions of health actions. In Gochman DS, ed. Health Behavior: Emerging Research Perspectives. New York: Plenum Press, 27–42.
Kleinman A (1978) Concepts and a model for the comparison of medical systems as cultural systems. Soc Sci Med 12: 85–93.
Lippman-Hand A, Fraser FC (1979a): Genetic counseling: provision and reception of information. Am J Med Genet 3: 113–127.
Lippman-Hand A, Fraser FC (1979b) Genetic counseling - the postcounseling period: I. ParentÏ s perceptions of uncertainty. Am J Med Genet 4: 51–71.
Lippman-Hand A, Fraser FC (1979c) Genetic counseling - the postcounseling period: II. Making reproductive choices. Am J Med Genet 4: 73–87.
Rosenstock IM (1974) The Health Belief Model and preventive health behavior. Health Educ Monogr 2: 354–386.
Sagi M, Shiloh Sh, Cohen T (1992) Application of the Health Belief Model in a study on parents' intentions to utilize prenatal diagnosis of cleft lip and/or palate. Am J Med Genet 44: 326–333.
Shiloh S, Sagi M (1989) Effect of framing on the perception of genetic recurrence risks. Am J Med Genet 33: 130–135.
Shilo S, Saxe L (1989) Perception of risk in genetic counseling. Psychol Health 3: 45–61.
Tversky A, Kahneman D (1974) Judgment under uncertainty: Heuristics and biases. Science 185: 1124–1131.
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Saleem, R., Gofin, R., Ben-Neriah, Z. et al. Variables influencing parental perception of inherited metabolic diseases before and after genetic counselling. J Inherit Metab Dis 21, 769–780 (1998). https://doi.org/10.1023/A:1005453301377
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DOI: https://doi.org/10.1023/A:1005453301377