Friday, September 28, 2007

Genetic counseling, uninsured population & birth order: 3 cases from the Patient and Family Resource Centre (PFRC)

Case #1


A pregnant woman in her late twenties comes into the library. To my untrained eye she looks like she is in her 3rd trimester. She speaks halting French and asks if we have any information on genetic counselling. I conduct a reference interview, asking a few questions in order to narrow down her information needs. She wishes to know whether there is someone she can speak to confidentially at the hospital about the results of a DNA test done recently on her baby.


I phone one of the GPs I provide research assistance to at the Herzl. He suggests that I contact the hospital's genetic counsellor, which I do. I am advised to inform the patient that she will be able to speak with the genetic counsellor but that she will need a referral from her GP in order to do so. I relay this infomration to the woman.

Total time: 20 mins

Case #2


A woman phones and asks for information about admission and regarding the costs of delivery at the hospital (both vaginal and C-section). The woman's sister is 8 months pregnant, has recently immigrated and does not have Quebec insurance.


I contact one of the nurses in Maternal-child health who I have recently assisted with the creation of patient handouts. She advises that the woman contact JGH Admissions for this information. She suspects that the sister is without status and likely has not yet seen a GP in this country, and gives me several names of GPs who are accustomed to accepting uninsured patients. I call the woman back with contact information for JGH Admissions. I also provide the names and tel. nos. of the aforementioned GPs and tell her she can contact them if her sister needs to see a GP before her due date, regardless of insurance status.

Total time: 40 mins


Had the woman contacted JGH Admission directly it is unlikely that they would have detected her sister's underlying and more important need to see a GP.

Case #3


A older female Herzl patient contacts me at the library. Her husband has recently passed away and her three children, who are in their late teens and early twenties, have been arguing over their inheritances. She would like to read 1 or 2 journal articles on the subject of social dominance and sibling rivalry. She believes that reading about these dynamics might help her to cope with her situation.


I contact my colleague at the Institute of Community and Family Psychiatry (ICFP) Library as our collection does not include psychiatry or psychology and this is not my area of expertise. She suggests I do a search in PsychInfo, and provides a couple of key words I might find useful. (PsychInfo does not index using the MeSH vocabulary). I do a quick search in the database and find several articles that may be of interest.

I get back to the woman and conduct a more extensive reference interview, wanting to confirm that I have correctly understood her information needs. She speaks to me at length about her family history and this present situation. She tells me that she wants something that will be simple to read, and I suggest that perhaps she should consider going to Chapters or Amazon instead. She then admits that several weeks ago she found some very interesting articles in our library's Journal of Psychosocial Nursing at which point I am confident that she will be able to read the articles I have found.

Total time: 1 hour


This is an example of an information need that requires access to a library and the assistance of a librarian in order to be filled.

No comments: