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PubMed2005

[Main reasons for non-use of illicit drugs by young population exposed to risk situations].

OBJECTIVE: Although there are many studies on risk factors for drug use, little has been known about the reasons that prevent people away from drug use. The aim of this study was to identify the reasons that would prevent low-income youngsters against psychotropic drug experimentation and use, even when living in a drug dealing environment. METHODS: A qualitative study was carried out in an intentional sample selected according to a set of criteria. Sixty-two youngsters, aged between 16 and 24 years, from low-income families who have never used psychotropic drugs (32 subjects) or who were heavy drug users (30 subjects) were interviewed. Each interview lasted on average 110 minutes. RESULTS: Among non-users, access to information and a protective family structure were identified as major reasons from preventing youngster from drug use. Comprehensive information on the outcomes of drug use and affective bonds between parents and their children, assured by feelings of support and respect, seems to be important in helping them avoid drug use. The importance of these two factors as reasons to keep youngsters away from drugs is emphasized when their lack is mentioned and censured by drug users. CONCLUSIONS: The outlook of those who have never used drugs in their lifetime and their reasons should be considered in the development of drug prevention programs targeting low-income youngsters.

Adolescent↗
PubMed2006

Moral reasoning and personality traits.

Moral reasoning should not be clearly associated with measures of personality traits. Although this assumption pervades the moral reasoning literature, it may not always be true. This paper provides evidence that moral reasoning, as assessed with P scores of the Defining Issues Test, is indeed positively associated with five traits from the California Psychological Inventory: Achievement via Independence, Intellectual Efficiency, Tolerance, Responsibility, and Capacity for Status. Such relationships make conceptual sense, shed light on the meaning and implications of moral reasoning, call into question prevailing assumptions in the literature, and may encourage investigators to broaden the types of research questions asked in the context of moral reasoning.

Achievement↗
PubMed1985

Why do our patients see us? A study of reasons for encounter in general practice.

The patients' reasons for encounter were recorded in 10 278 personal doctor-patient contacts in nine Norwegian municipalities over a two-month period, and were classified according to a simplified version of the WHO "Reason for Encounter Classification". A two-dimensional classification system was used where each reason was classified according to the location and type of problem. Symptoms and complaints made up 64.9% of all encounters. Most of the encounters were related to the musculo-skeletal, circulatory and female genital systems. The most frequent single reason for encounter was pain in the musculo-skeletal system (15.5% of all encounters). Psychological and social reasons were rather infrequent 3.1% and 0.3%. Compared with the frequencies of psychiatric and social diagnoses recorded in general practice, this indicates a discrepancy between the patient's own opinion of problems and the doctor's interpretations. Females had a significantly higher contact rate than males, mainly due to problems related to the genital system, inclusive of the breast.

Adult↗
PubMed2006

The effect of emotion on interpretation and logic in a conditional reasoning task.

The effect of emotional content on logical reasoning is explored in three experiments. Theparticipants completed a conditional reasoning task (If p, then q) with emotional and neutral contents. In Experiment 1, existing emotional and neutral words were used. The emotional value of initially neutral words was experimentally manipulated in Experiments 1B and 2, using classical conditioning. In all experiments, participants were less likely to provide normatively correct answers when reasoning about emotional stimuli, compared with neutral stimuli. This was true for both negative (Experiments 1B and 2) and positive contents (Experiment 2). The participants' interpretations of the conditional statements were also measured (perceived sufficiency, necessity, causality, and plausibility). The results showed the expected relationship between interpretation and reasoning. However, emotion did not affect interpretation. Emotional and neutral conditional statements were interpreted similarly. The results are discussed in light of current models of emotion and reasoning.

Adolescent↗
PubMed2005

Associative and causal reasoning accounts of causal induction: symmetries and asymmetries in predictive and diagnostic inferences.

Associative and causal reasoning accounts are probably the two most influential types of accounts of causal reasoning processes. Only causal reasoning accounts predict certain asymmetries between predictive (i.e., reasoning from causes to effects) and diagnostic (i.e., reasoning from effects to causes) inferences regarding cue-interaction phenomena (e.g., the overshadowing effect). In the experiments reported here, we attempted to delimit the conditions under which these asymmetries occur. The results show that unless participants perceived the relevance of causal information to solving the task, predictive and diagnostic inferences were symmetrical. Specifically, Experiments 1A and 1B showed that implicitly stressing the relevance of causal information by having participants review the instructions favored the presence of asymmetries between predictive and diagnostic situations. In addition, Experiment 2 showed that explicitly stressing the relevance of causal information by stating the importance of the causal role of events after the instructions were given also favored the asymmetry.

Adult↗
PubMed2004

Information processing and reasoning with premises that are empirically false: interference, working memory, and processing speed.

In this study, we looked at the contributions of individual differences in susceptibility to interference and working memory to logical reasoning with premises that were empirically false (i.e., not necessarily true). A total of 97 university students were given a sentence completion task for which a subset of stimuli was designed to generate inappropriate semantic activation that interfered with the correct response, a measure of working memory capacity, and a series of logical reasoning tasks with premises that were not always true. The results indicate that susceptibility to interference, as measured by the error rate on the relevant subset of the sentence completion task, and working memory independently account for variation in reasoning performance. The participants who made more errors in the relevant portion of the sentence completion task also showed more empirical intrusions in the deductive reasoning task, even when the effects of working memory were partialed out. Working memory capacity was more clearly related to processes involved in generating uncertainty responses to inferences for which there was no certain conclusion. A comparison of the results of this study with studies of children's reasoning suggests that adults are capable of more selective executive processes than are children. An analysis of latency measures on the sentence completion task indicated that high working memory participants who made no errors on the sentence completion task used a strategy that involved slower processing speed, as compared with participants with similar levels of working memory who did make errors. In contrast, low working memory participants who made no errors on the sentence completion task had relatively shorter reaction times than did comparable participants who did make errors.

Adult↗
PubMed2004

An evaluation of dual-process theories of reasoning.

Current theories propose that reasoning comprises two underlying systems (Evans & Over, 1996; Sloman, 1996; Stanovich & West, 2000). The systems are identified as having functionally distinct roles, differ according to the type of information encoded, vary according to the level of expressible knowledge, and result in different responses. This article evaluates the arguments and the evidence from a select number of key tasks that have been supportive of dual-reasoning theorists' proposals. The review contrasts the dualist approach with a single-system framework that conjectures that different types of reasoning arise through the graded properties of the representations that are utilized while reasoning, and the different functional roles that consciousness has in cognition. The article concludes by arguing in favor of the alternative framework, which attempts to unify thedifferent forms of reasoning identified by dual-process theorists under a single system.

Humans↗
PubMed2002

Antidepressant medication management and Health Plan Employer Data Information Set (HEDIS) criteria: reasons for nonadherence.

BACKGROUND: While nationwide data have found that many patients do not meet the National Committee for Quality Assurance uniform standards for successful antidepressant treatment, reasons for this failure are not well understood. We examined the reasons for this failure through a systematic chart review. METHOD: A chart review was conducted on a random sample of 249 health maintenance organization patients who failed 1 or more of the 3 Health Plan Employer Data Information Set criteria (i.e., 3 follow-up visits or adequate duration of acute or continuation phase treatment). RESULTS: The most common reason for visits failure (N = 192) was that the patient restarted a previously prescribed successful antidepressant (N = 30, 16%). In 23 patients (12%), the patient had a visit with the prescribing provider, but mental health was not coded or documented in the case notes. Twenty-one percent (N = 40) were misclassified as not having 3 visits. The most common reasons for misclassification were mental health was discussed but not coded (N = 16, 8%) and wrong start dates due to use of medication samples (N = 10, 5%). Patient nonadherence was the most common reason for failure to meet adequate acute (N = 109) and continuation (N = 99) phase duration of treatment (13% and 24%, respectively); only 9% stopped taking medication in the acute phase due to side effects. Twenty-five percent of patients had told their doctor they were taking their medication while the pharmacy database found they were not. CONCLUSION: A large discrepancy between patients' actual and reported compliance was found and may in part account for physicians' inability to detect and thus address this issue. Patients' restarting a previous medication is common and warrants discussion regarding differential need for visit frequency.

Adolescent↗
PubMed2003

Prevalence rate and reasons for refusals of influenza vaccine in elderly.

More knowledge on the reasons for refusal of the influenza vaccine in elderly patients is essential to target groups for additional information, and hence improve coverage rate. The objective of the present study was to describe precisely the true motives for refusal. All patients aged over 64 who attended the Medical Outpatient Clinic, University of Lausanne, or their private practitioner's office during the 1999 and 2000 vaccination periods were included. Each patient was informed on influenza and its complications, as well as on the need for vaccination, its efficacy and adverse events. The vaccination was then proposed. In case of refusal, the reasons were investigated with an open question. Out of 1398 patients, 148 (12%) refused the vaccination. The main reasons for refusal were the perception of being in good health (16%), of not being susceptible to influenza (15%), of not having had the influenza vaccine in the past (15%), of having had a bad experience either personally or a relative (15%), and the uselessness of the vaccine (10%). Seventeen percent gave miscellaneous reasons and 12% no reason at all for refusal. Little epidemiological knowledge and resistance to change appear to be the major obstacles for wide acceptance of the vaccine by the elderly.

Age Factors↗
PubMed1991

The narrative nature of clinical reasoning.

Narrative reasoning is a central mode of clinical reasoning in occupational therapy. Therapists reason narratively when they are concerned with disability as an illness experience, that is, with how a physiological condition is affecting a person's life. In this paper, narrative reasoning is contrasted with propositional reasoning, and two kinds of narrative thinking are examined. The first is the use of narrative as a mode of speech that can be contrasted with biomedical discourse, in which disability is framed as physical pathology. The second involves the creation rather than the telling of stories. Therapists try to "emplot" therapeutic encounters with patients, that is, to help create a therapeutic story that becomes a meaningful short story in the larger life story of the patient.

Clinical Competence↗
PubMed1995

Using the case method to develop clinical reasoning skills in problem-based learning.

Clinical reasoning is increasingly recognized as a crucial component of the occupational therapy process. Different types of clinical reasoning used by occupational therapists have been identified, including scientific, procedural, interactive, narrative, conditional, and pragmatic reasoning. This article describes the use of the case method in the University of New Mexico undergraduate occupational therapy curriculum to facilitate development of occupational therapy students' problem-solving and reasoning abilities. The case method is a component of problem-based learning that emphasizes small group work to solve clinical problems that are presented as case studies. Students are presented with a variety of case formulas including paper or written cases, videotape cases, simulated client cases, and real client cases to promote the development of specific types of clinical reasoning. Problem-based learning may also hold promise as an educational strategy for fieldwork students and clinicians.

Curriculum↗
PubMedDate not supplied

The nature of clinical reasoning with groups: a phenomenological study of an occupational therapist in community mental health.

OBJECTIVE: The purpose of this paper is to examine the clinical reasoning of an occupational therapist in group practice in mental health. It emerged from a larger phenomenological study of expert occupational therapy practitioners in community mental health. METHOD: Data were gathered through intensive, semi-structured interviews with 1 day of participant observation. Analysis was an iterative process in which emerging themes were identified for reflection and interpretation. Previously established categories of clinical reasoning were used as a structure for describing the results. RESULTS: A rich description of clinical reasoning in psychosocial task groups is presented using interactive, narrative, conditional, and pragmatic reasoning. The gestalt of community practice is illustrated, as the therapist describes the multiple levels of consciousness used in her consideration of, and response to, clients within the context of the larger environment. CONCLUSION: This study suggests that an examination of occupational therapy with psychosocial groups is a rich area for research to extend our understanding of clinical reasoning in occupational therapy.

Community Mental Health Services↗
PubMedDate not supplied

Motivation and reasons to quit: predictive validity among adolescent smokers.

OBJECTIVES: To examine reasons to quit among adolescents in a smoking cessation program, and whether reasons were associated with subsequent cessation. METHODS: Participants were 351 adolescents. At baseline, adolescents reported motivation, reasons to quit, and stage of change for cessation. Quit status was assessed at end of treatment. RESULTS: Girls were more likely to endorse image and appearance reasons to quit. Cessation was more likely among adolescents with higher motivation and those wanting to quit because of friends. CONCLUSIONS: Different reasons to quit were associated with motivation and cessation. Baseline motivation strongly predicted cessation, suggesting the relative value of assessing global motivation.

Adolescent↗
PubMed1993

Mercy: an insufficient motive for euthanasia. Catholic ethical tradition requires that we temper our motives with reason and care before acting.

Some experts argue that acts of assisted suicide and euthanasia are ethically appropriate because they are merciful. Compelling though it is, this argument is not sufficient for determining the morality of these acts. The ethical tradition that calls for mercy has never suggested that mercy is, by itself, a sufficient criterion for determining an act's moral appropriateness. Human motives are rarely, if ever, pure and objective. For that reason, our ethical tradition has insisted on tempering motives with reason and care. The criteria for determining when it is merciful to assist in another's suicide or engage in an act of euthanasia are, for all practical purposes, impossible to define. Commonly writers refer to a person's hopeless condition to justify the merciful response of assisted suicide or euthanasia. But unless we can agree on whether hopelessness is an objective or subjective reality, and until the criteria to define this reality are evident, it is difficult to see how assisted suicide or euthanasia can be a careful and reasoned expression of mercy. Only by examining one's intention can one judge whether an act that may appear to be merciful in a hopeless situation is appropriate. "Intention" refers to the reasoned decision or judgment one makes about a goal and the means used to achieve that goal. Even if we cannot control our emotional response (our motives) in a particular situation, we can control our judgment (our intentions). Within our moral tradition, we can be sure we are being merciful in a careful and reasoned way when we intend to protect and promote the good of life.(ABSTRACT TRUNCATED AT 250 WORDS)

Altruism↗
PubMed1998

"Why don't they just call the cops?": Reasons for differential police contact among women with abusive partners.

Incidents of domestic violence are frequently not reported to police (e.g., Johnson, 1990; Langan & Innes, 1986; Roy, 1977), and people commonly assume that women's reasons for not calling about violence by a current or former partner are intrapersonal (e.g., shame, embarrassment, love). However, few researchers have asked battered women themselves about the frequency of their police contacts and their reasons for not calling the police. In this study, participants were recruited from a battered women's shelter and asked about their experiences with the police over the prior 6 months. Two thirds of the sample had had contact with the police during that time, but most did not have as much contact with the police as they had needed. Women gave multiple reasons for not calling the police; these reasons frequently included situational barriers, such as being physically prevented from using the telephone and/or being threatened with more violence. Only 3% of the sample reported that shame, embarrassment, or love were their sole reasons for not calling the police. Underreporting was related to previous (negative) experience with the police, as well as to the level of violence experienced. The practical implications of these findings are discussed.

Adult↗
PubMed1999

Restoration longevity and analysis of reasons for the placement and replacement of restorations provided by vocational dental practitioners and their trainers in the United Kingdom.

OBJECTIVE: This study examined the reasons given by vocational dental practitioners and their trainers for placement and replacement of restorations. METHOD AND MATERIALS: Each participant was asked to record the reason for placement or replacement of restorations. The age and class of the restoration being replaced were also recorded, as was the material being used and the material being replaced (if known). RESULTS: Details of the reason for placement or replacement was received on 9,031 restorations. Of the restorations placed, 53.9% were amalgam, 29.8% were resin composite, and 16.3% were glass-ionomer cement. The reasons for placement or replacement of the restorations were principally primary caries (41.3%), secondary caries (21.9%), tooth fracture (6.4%), marginal fracture or degradation (6.1%), and noncarious defects (5.8%). Of the amalgam restorations, most were placed to restore Class II and Class I preparations (65.8% and 29.9%, respectively). Of the composite restorations, most were placed in Class III and Class V cavities (35.5% and 26.3%, respectively). Glass-ionomer cement was used predominantly to restore Class V cavities (63.5%). CONCLUSION: Secondary caries was the most prevalent reason for replacement of restorations, regardless of material. Statistical analysis indicated that amalgam provided significantly greater longevity than composite or glass-ionomer materials.

Clinical Clerkship↗
PubMed1999

Patients' reasons for not presenting emotional problems in general practice consultations.

BACKGROUND: Patients commonly do not mention emotional problems in consultations, and this is a factor in general practitioners' (GPs') difficulty in identifying psychological morbidity. AIM: To investigate patients' self-reported reasons for not disclosing psychological problems in consultations with GPs. METHOD: From nine general practices, a sample of patients with high General Health Questionnaire scores, who planned to present only somatic symptoms to the GP, were interviewed after their consultation with the GP. The interview covered their reasons for not mentioning emotional problems. A patient satisfaction questionnaire was administered. RESULTS: A total of 83 patients were interviewed. Sixty-four patients confirmed that they had not mentioned emotional problems in the consultation; 23 (36%) of these gave primarily realistic reasons for not presenting emotional problems (e.g. able to cope with distress), 29 (45%) gave reasons related to psychological embarrassment or hesitation to trouble the GP, and 12 (19%) were mainly deterred by the doctors' interview behaviours. The latter group had significantly lower satisfaction scores than patients in the other two groups. In addition, patients in all groups commonly reported perceptions of lack of time (48%) and that there is nothing doctors can do to help (39%) as barriers to mentioning emotional problems. CONCLUSION: An understanding of patients' reasons for not disclosing emotional problems can assist in identifying subgroups of patients with different management needs.

Adolescent↗
PubMedDate not supplied

Registered nurses' clinical reasoning abilities: a study of self perception.

Effective clinical reasoning by nurses is an essential component of nursing practice. The purpose of this study was to gain increased awareness and insight into registered nurses' perception of their clinical reasoning ability. A convenience sample of post-registration nursing students (n = 520) who enrolled in a Bachelor of Nursing program from 1993 to 1996 participated in the study. Perceptions of clinical reasoning abilities were assessed using the Jenkins' Clinical Decision Making in Nursing Scale (CDMNS). Analysis of CDMNS total scores indicated these students entered the program with positive perceptions of how they go about making clinical decisions. Measurement of aspects of these perceptions in relation to searching for alternatives (Subscale A), canvassing objectives (Subscale B) and evaluating consequences (Subscale C) indicated moderately positive perceptions of clinical reasoning abilities. However, highly positive perceptions were evident for assimilating new information (Subscale D). These results indicate some dissonance between the perceived abilities and the actual abilities reported in clinical reasoning literature and frequently observed in practice.

Clinical Competence↗