The Language of Genetic Counselling

Two pregnant women in their late 30s are at a higher risk of having a Down's Syndrome baby. The healthcare professional who counsels them is steering them towards taking a test for Down's Syndrome. But the clients have very different priorities.

One client, a nurse, is interested in the medical evidence and agrees with the healthcare professional. But the other, a Filipina domestic worker, has strong cultural and religious beliefs: she would never take the test because she would never terminate the pregnancy, whatever the test result.

How the options and risks are presented to these clients is a concern not just for healthcare professionals and clients but also linguists. Researchers at HKU have found the socio-economic, cultural and linguistic backgrounds of both clients and professionals may affect the ways in which counselling is done and they are working with healthcare professionals to help them understand this.

Dr Olga Zayts, Assistant Professor in the School of English, has been instrumental in bringing together linguists from Hong Kong, the UK and the US and healthcare professionals from the Hospital Authority and Tsan Yuk and Queen Mary Hospitals over the past six years.

She and her team focus on genetic counselling for prenatal (Down's Syndrome), postnatal (G6PD deficiency) and adolescent and adult (Sudden Arrhythmia Death Syndrome) conditions. They have worked with patients' and caregivers' associations to update information resources using language that is relevant to them and covers their concerns.

Dr Zayts has also organised local and international workshops, and the Winter School on Health Communication to raise the awareness of healthcare professionals, educators and researchers of the role of communication in healthcare. Additionally, HKU has launched the MMedSc specialized module of studies in Genetic Counselling to train counsellors to a high level.

"Genetic counselling is different from genetic testing - you are not telling clients what to do but facilitating their decision-making. We are teaching linguistic strategies to healthcare professionals and making them more aware of their use of language and the impacts on genetic counselling," she said.

The focus on Asia is particularly important because most previous research on communication in genetic counselling has been done in the UK, the US and Australia.

Dr Brian Chung Hon-yin, Clinical Associate Professor at HKU's Department of Paediatrics and Adolescent Medicineand the lead clinical geneticist on the projects, said the work of Dr Zayts and her team has been influential in the development of professional standards and best practices for genetic counselling in Hong Kong and South-East Asia.

"Understanding how healthcare professionals can better communicate with clients is the key to good healthcare practice, particularly in genetic counselling," he said.

Dr Olga Zayts received the Faculty Knowledge Exchange Award 2013 of the Faculty of Arts for the 'Language and Communication in Genetic Counselling Settings in Hong Kong and South Asia' project.