Knowledge and Acceptance of Premarital Genetic Screening Among Youths of Amauzam Obeagu Community in Enugu South Local Government Area, Enugu State
Chapter One
Purpose of the Study
The purpose of this study was to investigate the perception of premarital genetic screening among youths at Amauzam Obeagu Community.
Objectives of the Study
The specific objectives were:
- To investigate the youths’ knowledge level of premarital genetic screening at the Amauzam Obeagu Community.
- To assess the importance attached to premarital genetic screening by youths at Amauzam Obeagu Community.
- To establish the perception of premarital genetic screening among youths at Amauzam Obeagu Community.
CHAPTER TWO
LITERATURE REVIEW
Introduction
This chapter reviews literature related to the study based on the following research objectives: knowledge of premarital genetic screening, importance attached to premarital genetic screening and the perception of premarital genetic screening.
Counselling by Genetic Counsellor
Genetic counseling is the process by which an individual or a family obtains information about a genetic condition that may affect them, so that they can make appropriate decisions about marriage, reproduction and health management. Genetic counseling protects the autonomy of the couple, fulfilling their right to be fully informed about the disorder and all valuable options (Albar, 2019; Kuliev & Modell, 2010).
Although premarital tests for haemoglobinopathies are reliable and useful, not everyone with these genes responds to counseling. Neal-Cooper and Scoot 10 reported that young couples concerned about producing a child with sickle cell disease are often offset by their strong desire to have children regardless of risk. The researchers suggested that at-risk couples should be contacted directly by counselors and encouraged to undertake education and counseling. Prevention and treatment of genetic diseases are virtually impossible (Al-Arrayed SS et al, 2017).
One successful approach is ‘solution-focused’ premarital counseling. Murray and Murray discuss how this focuses on a couple’s resources, helping them to develop a shared vision for the marriage. Background information about premarital counseling and solution-focused therapy provide a framework in which intervention strategies in those confined with positive status for a disease can
be developed. These solution- oriented interventions include solution–oriented questions and feedback, as well as a Couple’s Resource Map (CRM) which depicts the support available to the couple from various personal relationships and contextual resources (Murray and Murray, 2004).
The available choices include avoidance of marriage, reproductive options for those who proceed with the marriage following prenatal diagnosis, adoption of the affected child, donation of sperm, ova or a pre-embryo from an unaffected individual and pre-implantation diagnosis. Choosing the best option depends on availability, cost and local regulations and religious rules. For example, in Saudi Arabia and most other Muslim countries abortion is prohibited on religious grounds and prenatal diagnosis is useless because abortion is forbidden unless the fetus is malformed. However, pre-implantation diagnosis is permitted and affordable. Thus, the success of genetic counseling depends on the approach adopted by the counselor as well as the education and attitude of the couple. Screening programmes must be equitable, accessible and understood by the target population, but most importantly they must comply with the prevailing cultural, ethnic, economic and social values (Monaghan, 2008).
In Nigeria, there is still no recognized genetic centre where appropriate genetic counseling facility is available. Genetic counseling is or should be a part of premarital screening. Genetic Counsellor can help to decide the type of test the couple should consider. A detail of the family history, medical records and conditions of family members from both the sides need to be provided to the counsellors to have a proper advice from him (Eastern Biotech, 2016).
If the couple are informed of the possibility that they are at an increased risk of having a genetically abnormal child, they can choose to plan conceptions according to medical advice and can make use of the genetic counselling services available, such as:
- Couples may decide not to get married
- If couples decide to get married, they may not wish to have children
- If couples wish to have children, they must do the Prenatal Screening of the fetus at an early stage of pregnancy
- Couples must understand the option of termination of the pregnancy
- Couples must understand the social, economic perspectives of having children with genetic disorders (Eastern Biotech, 2016).
Role of Culture and Education in the Success of premarital genetic screening
Marriages between same tribes or extended family groups are favoured in some cultures, including those between first cousins. Consanguineous marriages are uncommon in Western countries. Marriage between first cousins is forbidden by the Orthodox Church and Roman Catholic Church, and may be seen as incestuous in the United States. Personal characteristics including socioeconomic status have implications for the outcome of premarital screening programmes. Education of the couples who are to be screened is extremely important and it is important to educate all members of the screening team consisting of laboratory technologists, nurse practitioners, physicians, counselors, outreach workers and social workers (Tosun et al, 2006).
According to Schmidt (1974), sufficient planning in the educational area before the first blood sample is drawn can avoid failures of the programme. The meaning of the term ‘carrier status’ should be made known to members of the public long before they get married. For successful public education, government and government organizations must cooperate, as well as community and religious leaders, school parent organizations and health personnel.
CHAPTER THREE
RESEARCH DESIGN AND METHODOLOGY
Introduction
This chapter covers the research design that was used in the study, which serves as a guide to obtain answers to the research questions and objectives. It also contains the study area, the target population, the sample size, sampling techniques, data collection instruments and procedure, pilot, reliability and validity of the research instrument, data analysis and ethical consideration.
Research Design
Schindler (2003) defines a research design as a blueprint for fulfilling objectives and answers to research questions. The author emphasizes that a research design is a plan and a structure of investigations so conceived as to obtain answers to research questions. The research design expresses both the structure of the research problem and the plan for investigation used to obtain empirical evidence on relations of the research problem. The current study employed a case study research design. A case study is an empirical research method used to investigate a contemporary phenomenon, focusing on the dynamics of the case, within its real-life context (Yin, 2003).
A case study recommends triangulation of data by giving the observant an opportunity of collecting data using interview schedule all under a single study (Eisenhardt, 2019). It involves incorporation of multiple sources of collecting information like observation and interviews schedules. In this case study, an in-depth understanding of the cases through collecting multiple forms of data was developed situating the case within its setting which may be physical, social, historical or economic in nature (Miller et al., 2009). Qualitative study is appropriate when human beings are the population of the study or when they are being studied (Denzin & Lincoln, 2008). This research design was selected as it gave the researcher an opportunity to be more interactive with participants during collection of data. A qualitative approach gives the researcher an opportunity to investigate a phenomenon within the part offer a great understanding of how real life is (Kombo and Tromp as cited by Moeti, 2019). By using qualitative approach enabled the researcher to interact with the participants. It is through this interaction that the researcher was able to probe for further information.
Interpretivist paradigm was chosen as it aims to acquire new interpretations which are dependent on perspective and time. Interpretivist paradigm is of the view that in research, information can only be acquired if there is a dialogue between the participant and researcher and it is through this dialogue where an in-depth understanding of the phenomenon under study was achieved (Ponterotto, 2005). Researchers using the interpretivist paradigm mostly use qualitative methods during their study in order to make meaningful responses of a phenomenon (Tuli, 2010).
Target Population
The population of a study refers to a large group of people who take part in the study (Neuman, 2007). 12A target population was the subject on which the measurement is being taken in Amauzam Obeagu Community. Youths from 1st, 2nd, 3rd and 4th year from all the faculties were chosen to be the target population for this study. The total targeted population was composed of 10,600 youths.
CHAPTER FOUR
DATA ANALYSIS, INTERPRETATION AND DISCUSSION
Introduction
This chapter presents the study findings; data analysis, interpretation and discussion. The general objective of this study was to investigate the perception of youths on premarital genetic screening.
The chapter comprises of the following sections: knowledge on premarital genetic screening, importance attached to premarital genetic screening among youths and perception of premarital genetic screening among youths. The above sections correspond with the research objectives and questions in chapter one.
CHAPTER FIVE
SUMMARY, CONCLUSION AND RECOMMENDATION
Introduction
This chapter provides a concise summary of the study findings, conclusions and areas suggested for further research. The study sort to achieve the following objective: to investigate youths’ knowledge on premarital genetic screening, assess the importance attached to premarital genetic screening by youths and to assess youths’ perception on premarital genetic screening.
Summary of the Findings
The results of the study indicated that Amauzam Obeagu Community youths were aware of premarital genetic screening. The researcher also sought to find out the main source of knowledge about premarital genetic screening. Results shows that majority of the respondents’ main source of knowledge about premarital counselling was information from media, school, church, health workers, followed by magazines, and then friends. About one third of the participants reported that they were aware of the existence of premarital genetic screening. Religious bodies, hospitals and schools are some of the organizations helping to raise the level of awareness about premarital genetic screening. The religious bodies through their counseling sections or seminars inform the public and most of them mandate premarital genetic screening before couples could be joined together.
The second objective sought to find out the importance attached to premarital genetic screening. Findings indicated that most of the respondents agreed that premarital counselling has values to the participants and others youths who are preparing to get married. The areas usually given importance to premarital counselling are the couples interest and activities, self-expectations from the marriage, communication with each other, religion, family issues, children, finance and sexuality. Results showed that most of the respondents agreed that premarital counselling has value to the youths who are preparing to get married. This shows that premarital counselling is of great importance because the counselor helps identify what the problem areas or differences are between the couples which may later cause, conflict, and help them resolve them earlier.
Findings showed that premarital genetic screening can provide guidance so that each person can mature to their fullest potential within the boundaries of a vital, fulfilling relationship. This finding indicates that 80 percent of youths feel that premarital counselling helps the youths to know the couple better in terms of their fear, dreams and what they like and they are able to understand one another in a better way.
Findings indicated that premarital counselling helps youths to have skills on how to tackle their life experience, premarital counselling is a good idea and should be introduced to the university since youths are in a good position to be mentor especially college and youths who are in the bracket of courtship while others said it is important and should be brought to light for the youth to know its advantages to facilitate their general growth and development. Results indicate that it has assisted them to create awareness, it has partly changed because most of the youths got married before they completed their studies while a few complete before getting married.
Conclusions
This study concludes that Amauzam Obeagu Community youths have enough knowledge about premarital genetic screening program as a beneficial tool. The programs offered helps the couples to identify loopholes in the relationships: those that are likely to negatively affect their relationship and address them appropriately before the knot is tied. Premarital counselling reduces anxiety about marriage and its challenges, because during the premarital genetic screening programs the couples are allowed to discuss their fears and insecurities together. From the findings the results indicated that most of the Amauzam Obeagu Community youths are not aware of premarital genetic screening because most of them believe they are right and r premarital genetic screening programs.
The study also concluded that most of the youths have different perceptions on premarital genetic screening because of several reasons as it brings values, opinions which are important in a relationship/marriage and can be seen as a solution to relationship which are prone to divorce and break ups.
Recommendations
Based on the findings of the study, the following three recommendations were suggested.
Policy
The study made the following recommendation for policy:
- A curriculum should be designed by every University in consultation with the church to guide those who offer premarital counselling. This ensures that counseling becomes interesting and attractive to youths thus encouraging them to participate in the
- Premarital genetic screening should be maintained and encouraged in all the This means that universities should increase their intake of youths in guidance and counseling so that more youths can be help in their preparation for marriage.
Practice
The following practice recommendation was made:
- Conducting psychological training services about premarital genetic screening in every university should be Youths
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