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page 1 | page 2 | page 3 | page 4 | page 5 | page 6 | page 7 | page 8 | page 9 | page 10 | page 11 | table of contents | references | test Genetic Health Care The potential for genetic analysis has progressed most rapidly with the rarer, single-gene disorders. However, recent discoveries and technological advances make it possible to test for the presence of a genetic component that contributes to the predisposition of many common illnesses such as cancer, heart disease, and mental disorders. Two meetings, Banbury Conferences on Genetics and Primary Care, were held to provide a forum for discussion about the implications of this "new" genetics for health care. The first meeting in 1994 reviewed the current status of genetics in primary health care; and the second held in 1995 addressed how to incorporate genetics and genetic education into medical and nursing practice. These meeting summaries provide a baseline understanding of the strengths and limitations of knowledge among health professionals with recommendations of mechanisms for meeting the anticipated demand for genetic services (Touchette, Holtzman, Davis, & Feetham, 1997). Services Traditionally, genetic services were provided primarily in academic medical settings by specially trained health professionals (Andrews, Fullarton, Holtzman, & Motulsk, 1994). A greater capability for prenatal diagnosis of genetic diseases brought families to pediatric, obstetric, prenatal diagnostic, and community health settings for case finding and counseling (Forsman, 1994). The need for genetic counselors developed in the 1970s when the types of services offered included assessment, education, counseling, testing, and interpreting of complicated genetic test results. Nurses as part of this genetics team also provided care in regional genetics networks, private office settings, and specialty genetics clinics. Much discussion and exploration has occurred about the role that nurses would be able to assume in both current and future provision of genetic services (ISONG & ANA, 1998; Lea, Williams, Jenkins, Jones, & Calzone, 2000). Resources According to McKusick (1992) during the last 25 years (1956-1991) human genetics has become "medicalized, subspecialized, professionalized, molecularized, consumerized, and commercialized" (p. 667). Soon it will become publicized as that common thread of knowledge that all health professionals must include among their skills when offering health care services. A survey identified three barriers that will limit the ability of health professionals to incorporate genetics into primary care: knowledge, financial, and time constraints (Touchette et. al., 1997). As more genetic tests and gene-based therapies become available, there will be too few professionals with advanced training in genetics (i.e. medical geneticists and genetic counselors) to meet the predicted demand for genetic services. This gap will result in the need for other health professionals to identify alternative strategies for integrating genetics into education and practice. Implications The pace of genetic knowledge is progressing expeditiously. The private sector is increasingly interested in building their markets upon the information available from the HGP and offering commercialization of genetic diagnostics and services (Caulfield, 1998). Molecular medicine and information-based targeted health care is attracting entrepreneurial companies to consider the role of proactive prediction and prevention of disease risk based on an individualized genetic profile (Poste, 1998). The capability to offer such targeted services requires that nurses be able to communicate risk information, interpret genetic tests, and explain variations in treatment design based on genetic differences (Prows & Prows, 1998; Rimer & van Nevel. l999).
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