1275.3 Cultural Considerations
Adapting your questioning to your patient’s needs and cultural background is criti-
cal. Questions may seem rude and intrusive to patients from some cultures
(Oosterwal 2009 ). Explain at the beginning of the session that you will need to
obtain certain information and why you need to do so. Fisher ( 1996 ) offers these
examples of cultural views of questions:
- Some Southwest Native American tribes believe that “speaking about a defor-
mity may give it the power to manifest itself in human form” (p. 78). - Some members of the Navajo tribe and others may not answer questions imme-
diately (p. 83). - Some Southeast Asian patients will more readily answer questions such as the
date of the last menstrual period when you are the same gender as they are
(p. 118).
Glessner et al. ( 2012 ) surveyed GLBT patients about their experiences in genetic
counseling and genetic counselors about their attitudes and practices when counsel-
ing GLBT patients. Some counselors reported treating GLBT patients differently
during sessions. Pertinent to using questioning skills to gather information, one par-
ticipant commented “I may ask how they would prefer that I refer to their partner or
may ask more detailed questions about their reproductive plans” (p. 331). Based on
responses from both samples, Glessner et al. ( 2012 ) recommended “As in any coun-
seling situation, [genetic counselors] should talk directly to patients and their part-
ners about their experiences in a non-judgmental way in order to build rapport.
During verbal communication, they could use open-ended questions containing
gender neutral terms, especially when inquiring about family...attend to their
patients’ use of language and self-identification, and use similar terms; when in
doubt, they could ask patients what terms they prefer...” (p. 335). They further rec-
ommended that when patients openly disclose their sexual orientation, counselors
ask follow-up questions such as “‘Do you have a partner?’...[and] It is also impor-
tant for providers to ask patients how they would like them to refer to their partner
and how that relationship should be documented in their medical file. It may be
helpful to explain to patients why such personal questions are being asked...”
(p. 335).
In a follow-up study VandenLangenberg et al. ( 2012 ) interviewed lesbian and
gay individuals about their experiences as genetic counseling patients. Their par-
ticipants recommended that genetic counseling service providers ask about a
patient’s orientation if medically relevant and, during the remaining discussion,
take orientation into consideration and ask further about orientation in safe and
appropriate ways. The researchers suggested that providers “should proceed cau-
tiously...[for example] prior to asking questions about sexuality, it is important
5.3 Cultural Considerations