Modes of risk explanation in telephone consultations between nurses and parents for a genetic condition

Risk explanations are a crucial part of clinical encounters that concern clients’ genetic risk status. The ways in which risk explanations are delivered may impact on clients’ decision-making and outcomes of these clinical encounters. In this article, we examine risk explanations in telephone consultations in Hong Kong between genetic nurses and parents whose infants have been diagnosed with a mild hereditary disorder, G6PD deficiency, commonly known as favism. Using discourse analytic methods, we focus on 50 audio-recorded telephone consultations. First, we show the distribution of different types of risk explanation in terms of their volume and sequential positioning in the study corpus. The two predominant explanation types – physiological explanations and hereditary explanations – are then discussed in relation to their respective functions in these telephone consultations, namely serving as warrants for advice-giving and providing reassurance. We then examine how the genetic nurses interactionally orient themselves to the parents’ existing knowledge regarding G6PD deficiency while delivering these risk explanations. The differences in explanation trajectories are linked to the presence or absence of prior knowledge of the condition on the part of the parents; and these differences are displayed at the interactional rather than at the substantive level, that is parents with prior knowledge of the condition occupy a different participant status in eliciting and responding to the risk explanations.