'Your test result is sort of, cut off ...higher than average': delivery of positive screening result for fetal down syndrome in prenatal genetic screening in Hong Kong

Abstract

In this paper we employ a discourse analytic perspective and examine how a positive screening result for fetal Down Syndrome is presented to clients. These clients are identified as high-risk group therefore they are recommended follow-up diagnostic testing. Currently our data comprise 6 clients and the follow-up interviews with healthcare providers and clients. The delivery of a positive screening result is an interactionally complex activity with several intertwined discourses at play. First, the healthcare providers need to find a balance between the predictive nature of the test results and presenting them in a credible or expert manner (Sarangi and Clarke, 2000). Secondly, as the results are likely to find an affective response from the clients, the healthcare providers also engage in offering re-assurance to clients. In addition, in this paper we argue that in the sociocultural context of Hong Kong, the diverse sociocultural and linguistic backgrounds of the participants further exacerbate these interactional challenges. Cultural beliefs and perceptions have a critical influence on what would be considered as appropriate or acceptable course of actions in the circumstances of the positive screening result. Linguistic proficiency may interfere with the understanding of the information provided to clients about the test results. In this paper we examine the discursive practices of the healthcare providers and how in delivering the positive screening results they balance the predictability of these results and their medical expertise while at the same time offering reassurance to the patients and taking into consideration the client‘s sociocultural and linguistic background.