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A nonverbal signal in voices of interview partners effectively predicts communication accommodation and social status perceptions.

Derivations from nonverbal communications accommodation theory are tested, and this knowledge is extended both theoretically and methodologically. Fast fourier transform and statistical analysis of a low-frequency nonverbal signal-in voices from 25 dyadic interviews between a talk show host and his guests revealed voice convergence between partners. Correlation coefficients from comparisons of partners' voice spectra and factor analysis of the correlation matrix showed that lower status partners accommodated their voices to higher status partners via the nonverbal signal. Student ratings of the social status of the same talk show host and guests were correlated with factor loadings, thereby providing convergent validity of the nonverbal signal as a predictor of social status perceptions and accommodation.

Dominance-Subordination

The partner relationship in psychological response to breast cancer.

The social support literature has demonstrated that interpersonal relationships play an important role in adaptation to serious illness. However, researchers have recently emphasized the limitations of the social support construct and have urged a focus of attention away from global measures of perceived support and towards specific processes that occur in close relationships. The present study examined the role of one such process--informal helping from the partner--in women's psychological response to breast cancer. Structured interviews were conducted with 113 women who had received a diagnosis of breast cancer within the previous year. We found that satisfaction with the partner helping relationship was associated with psychological well-being. Even though most women had a good helping relationship with another person, this did not compensate for a problematic helping relationship with the partner. Good communication with the partner was characterized by high empathy and low withdrawal. The findings suggest that the partner plays an important role in breast cancer patients' adaptation, and that interventions aimed at couples may be an effective way of reducing psychological distress.

Adaptation, Psychological

Emotional communication in close relationships.

Emotional communication patterns characterizing interactions between partners in close relationships were investigated by asking 29 couples who were married or living together to engage in a videotaped discussion of a problem they were having in their relationship. In a later experimental session, partners identified specific communications that they believed had an important influence on the discussion and then rated the communications in terms of the feelings the communicator intended to convey and the recipient's reactions. Partners attempted to reciprocate both the positive and negative feelings that they perceived their partner to express toward them. However, only negative feelings were actually reciprocated. This was because subjects were sensitive to differences in the negative feelings their partners reported expressing and interpreted those feelings correctly, but they were inaccurate in perceiving their partners' expressions of positive feelings. Men (but not women) interpreted their partners' failures to express love as an indication of hostility, whereas women (but not men) interpreted their partners' lack of hostility as an indication of love. These and other results were conceptualized in terms of a general model of emotional communication. Parameters of the model pertaining to the hostility of partners' communications were often related to women's satisfaction with their relationship and their beliefs about relationships in general. However, they were unrelated to men's satisfaction and general beliefs. This suggested that women are generally more adversely affected by overt expression of hostility than are men.

Adolescent

Factors associated with Hispanic women's HIV-related communication and condom use with male partners.

To determine factors influencing Hispanic women's HIV-related communication and condom use with their primary male partner, 189 Dominican, Puerto Rican, and Mexican women were interviewed regarding sexual behaviour and condom use, relationship characteristics, perceived risk for HIV, and HIV-related communication with the primary male partner. Level of HIV-related communication with the primary male partner was associated with the woman's perceived risk for HIV and her rating of the openness with which she could communicate with her primary partner. Mexican women were less likely than Puerto Rican or Dominican women and women with multiple partners were less likely than those with one partner to communicate about HIV-related issues with their primary partner. Women reporting more condom use with their primary partner were younger, had discussed HIV-related issues more with the primary partner, and were less likely to expect negative reactions to requests for condom use than those reporting less condom use. These results suggest that prevention programmes that increase both general and HIV-specific communication between members of a couple may facilitate safer sex practices by the couple. Prevention programmes that encourage women to insist on condom use should consider the woman's expectations about her partner's reaction as a potential barrier to the initiation of safer sex practices.

Acculturation

Does choice make a difference to contraceptive use? Evidence from east Java.

This study investigates sustained use of contraceptives among women in East Java, Indonesia. Interest is focused on the effect of whether the client's choice of contraceptive method was granted or denied, and the interaction between whether choice was granted or denied and husband-wife concurrence concerning method choice. Data were collected twice in a panel survey. The first round was conducted in family planning clinics among women initiating contraceptive use; the second was a follow-up household survey carried out 12 months later. Whether the user was granted her choice of method was found to be a very important determinant of sustained use of contraceptives. The interaction between whether choice was granted and whether there was husband-wife concurrence on method choice was also important. The highest rate of discontinuation occurred when method choice was denied in the presence of husband-wife agreement on method choice, and the lowest rate occurred when method choice was granted in the presence of such concurrence. The results imply that contraceptive continuation can be enhanced either when family planning workers pay more attention to the stated desires of their clients, or when policy is instituted allowing clients to use their method of choice.

Choice Behavior

Training profoundly retarded adults to communicate using handguiding.

Four multiply disabled, profoundly retarded young adults received two series of instructional activities designed to teach them to use handguiding to communicate basic needs and intents. All had failed in previous attempts to learn to communicate using augmentative devices and strategies. Caregivers and staff served as partners in communication. Three of the four subjects were successful in learning some basic communication skills using the strategy of having a partner and handguiding as a technique.

Adult

Sex therapy for erectile dysfunction: characteristics of couples, treatment outcome, and prognostic factors.

Outcome and prognostic factors were studied in 36 couples who entered sex therapy because of the male partners' erectile dysfunction. Treatment was completed by two thirds. Noncompletion was associated with lower socioeconomic status, the female partner having a history of psychiatric treatment, pretreatment poorer motivation of the male partner, poor communication in the general relationship, and less sexual pleasure experienced by the female. A positive treatment outcome occurred in 69.4%, and was associated with better pretreatment communication and general sexual adjustment, especially the female partner's interest and enjoyment of sex, absence of a positive psychiatric history in the female partner, and a couple's early engagement in homework assignments. Results highlight important aspects of the initial assessment, indicate couples for whom the initial phase of treatment should be prolonged and modified or an alternative approach considered, and have implications for assignment of couples to treatment groups in evaluative studies of therapy.

Adult

Contraceptive decision making in a sample of Jordanian Muslim women: delineating salient beliefs.

In this article, the authors identify attitudes, normative beliefs, and behavioral control beliefs of Muslim Jordanian women with regard to avoiding unplanned pregnancy and using specific contraceptive methods. Based on Ajzen and Fishbein's theory of planned behavior, open-ended questions were used in audio-taped face-to-face interviews with 25 married 19-44-year-old Jordanian Muslim women. A majority of respondents interviewed were currently using an intrauterine device (IUD) for contraception. Few women were using oral contraceptives, condoms, or the rhythm method and none of them reported using foam or a diaphragm. Content analyses of narrative transcriptions suggest the individual's concerns for family and individual well-being, as well as husbands' and families' opinions, may influence women's contraceptive behavior in this population.

Adult

The effect of husband counseling on NORPLANT contraceptive acceptability in Bangladesh.

A pilot study of the effect of husband counseling on NORPLANT contraceptive acceptability was conducted at four family planning clinics in Bangladesh. The study objectives were to compare discontinuation rates and user satisfaction among acceptors whose husbands received counseling about the method versus those who did not. Of a total 617 subjects enrolled in the study which began in 1988, about two-thirds (408) of the husbands were counseled at admission or at the one-month follow-up visit while the remainder of the husbands (209) were not counseled. Follow-up visits were scheduled at one and six months after NORPLANT implants insertion, and every six months thereafter until the close of the study in 1991. Some evidence was found that counseling husbands of NORPLANT implants acceptors may reduce discontinuation rates. At the end of 36 months, a difference of 10 percentage points in total discontinuation rates was observed between the husband-counseled group (32 per 100 women) and the husband-not-counseled group (42 per 100 women). The husband counseling had the most impact at clinics with higher discontinuation rates. Based on Cox's proportional hazards regression model results, the hazard for discontinuation among the acceptors in the husband-not-counseled group. Satisfaction with NORPLANT implants did not differ between the two groups. Although these results are not striking, they do suggest a potential positive effect of husband counseling on NORPLANT contraceptive accept-ability. In future studies, the counseling of husbands should be more intensive and standardized.

Adolescent

Effects of female sterilization: one year follow-up in a prospective controlled study of psychological and psychiatric outcome.

A prospective controlled study of the psychological effects of elective interval and postpartum tubal sterilization was carried out on a selected sample of women. Subjects were interviewed pre-operatively (n = 138) and one year post-operatively (n = 116; 83%), using standardized instruments and procedures, including the Present State Examination. No differences within or between sterilization and control groups were found over the follow-up year in the prevalence of psychiatric morbidity, which was no higher than would be expected in a general population sample. Beneficial effects of sterilization were reported on a number of psychosexual variables. Adverse effects such as regret or deterioration in marital relationship were rare, but were more likely to occur in postpartum subjects, among whom abdominal pain was also reported more commonly at one year follow-up than pre-operatively. The relevance of "normal" postnatal events and of the role of pre-operative counselling are considered in relation to these findings. Less favourable outcome at one year follow-up was commonly associated with higher PSE scores pre-operatively.

Abdomen

Risk of HIV transmission in sexual behaviors of college students.

The purpose of this study was to investigate the sexual behaviors of college students and assess the extent to which they were engaging in behaviors that have a risk for contracting AIDS. A total of 132 single sexually active students and 58 married students responded to a survey on their sexual behaviors and attitudes. Risk behaviors such as engaging in unprotected sex, having multiple sex partners, practicing anal sex, alcohol use, and infidelity and deceptive communication with partner were examined. Compared with earlier surveys on the same population, there was an increase in concern about contracting AIDS and a significant increase in the percentage of students who took the AIDS antibody test. Although none indicated they would lie to partners about a seropositive AIDS test, a few would not tell their partner unless specifically asked. A small percentage of subjects would have extradyadic relations without informing their steady partners and a small number of respondents indicated they might continue to engage in sexual relations with a seropositive partner or a new partner who recently had a seronegative AIDS test. The risks most predominant in this sample were the practice of unprotected sex, having multiple sex partners, and the consumption of alcohol in conjunction with sexual activity. With the exception of unprotected intercourse, the majority of respondents were engaging in behaviors that pose a minimal risk for contracting AIDS.

Adolescent

The causes of unmet need for contraception and the social content of services.

Since the 1960s, survey data have indicated that substantial proportions of women who have wanted to stop or delay childbearing have not practiced contraception. This discrepancy is referred to as the "unmet need" for contraception. The traditional interpretation, that these women lack access to contraceptive supplies and services, has led in turn to an emphasis on expanding family planning programs. This study analyzes survey data and related anthropological studies on the causes of unmet need and concludes that the conventional explanation is inadequate. Although for many environments geographic access to services remains a problem, the principal reasons for nonuse are lack of knowledge, fear of side effects, and social and familial disapproval. This finding underscores the need for expanded investment in services that not only provide contraceptives, but also attend to closely related health and social needs of prospective clients. Programs are likely to be most successful when they reach beyond the conventional boundaries of service provision to influence and alter the cultural and familial factors that limit voluntary contraceptive use.

Contraception Behavior

An investigation of the role of fathers in immunization uptake.

BACKGROUND: Mothers, but not fathers, are the usual focus of strategies to maximize immunization coverage in low income countries. METHODS: A study of the immunization determinants of children aged 12-18 months was conducted in 1991 in the Eastern Region of Ghana using structured interviews of a population sample of 294 mothers and 170 (67%) of the children's fathers. RESULTS: Fathers were more likely than mothers to perceive that the fathers had participated in the decision to send children for immunizations. Where both parents reported that the father had participated in the decision, and he could speak English, the child was more likely to have completed the immunization schedule by 12 months (OR = 5.7, 95% confidence interval [CI]: 1.5-21.7), independently of other factors. Neither the father's participation, nor his ability to speak English, was independently associated with the child's immunization status. CONCLUSIONS: The results of the study suggest that, where fathers have a higher level of education, programmes which are designed to involve them in decisions about their children's use of preventive health services have the potential to increase timely immunization coverage levels.

Child, Preschool

Women's position and family planning in Egypt.

In this report, data from the 1988 Egypt Demographic and Health Survey are used to address some of the most frequently raised questions about the relationship between gender inequality and reproductive behavior. The findings from binomial and multinomial logit models show that while the relationship between women's position and fertility control in Egypt is complex, some clear, broad patterns exist that have important theoretical and policy implications. First, although women's status in Egypt is clearly multidimensional, the reproductive aspect of women's position has a strong connection with the nonreproductive dimensions. Second, the case of the continued use of education and employment as proxies of women's position, especially in relationship to fertility control, is considerably discredited by the results. Finally, the findings indicate that Egyptian culture supports gender equality in the form of interaction and negotiation rather than women's autonomy.

Adolescent

Initiation of prenatal care by adolescents. Associations with social support, stress, and Hispanic ethnicity.

The purpose of this study was to determine the social factors associated with initiation of prenatal care by adolescents. Eighty-one postpartum adolescents aged 17 years and under were interviewed within 24 hours of delivery about background factors, living situation, experiences, and behaviors during pregnancy. Of the adolescents, 58 were of Hispanic (Mexican) origin; the remainder were non-Hispanic whites. The first prenatal visit occurred at a mean of 4.04 months' gestation for Hispanics and 4.39 months' gestation for the non-Hispanics, one month after the pregnancy test. Differences between the ethnic groups were not significant. Controlling for ethnicity, both age and social support from the partner and his family were associated with initiation of care (P less than .01). In a separate analysis, age and partner-family support were unaffected by the introduction of stress and parental support (P less than .01). These findings highlight the importance of the partner and his family as a source of support to pregnant adolescents. To whom and when the adolescent communicates about the pregnancy may be the key linking social support to initiation of prenatal care. Providers who work with sexually active adolescents should emphasize the importance of early communication with partners and with family members if a pregnancy is suspected.

Adolescent