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PubMed2002

Participants' ratings of male physicians who vary in race and communication style.

Research has shown minorities receive lower quality health care than White persons even with socioeconomic conditions controlled. This difference may partially be related to racially biased attitudes and impaired communication in interracial relationships between physicians and patients. This study investigated the effect of physicians' race and nonverbal communication style on participants' evaluations. Patients at a local health clinic were participants (N = 116: 84% Black, 16% White). Each participant viewed one of four videotapes showing varied race of a physician (Black or White) and the physician's nonverbal behavior (expressing concern or distance), and then completed a questionnaire evaluating the depicted physician. Overall, participants did not give significantly different preferences for physicians of the same race. However, participants' evaluations were significantly associated with physicians' nonverbal style. Nonverbal concern was associated with highest satisfaction, trust, self-disclosure, recall of information, likelihood of recommending the physician, and intent to comply with the physician's recommendations. When male and female participants were compared, preference for a physician of the same race was found only among male participants who viewed verbally distant physicians. Results suggest that social skills are more important than race in shaping patients' perceptions of physicians.

Black or African American↗
PubMed1978

Patterns of aspirin use among American youth.

The use of aspirin was ascertained in several population cohorts. In the college age samples, aspirin had been used in the previous 48-hour period by one of every 4 students. Females reported a higher rate (33.2%) than males (16.9%). In the 4th to 12th grade samples, aspirin use was higher than other drugs with 39.6% of the 3,306 students sampled indicating that they had ingested aspirin during the previous week. In a 9--11 year-old category, 25% of these 4th to 6th graders used aspirin without parental knowledge. The relationship of aspirin use and drug education is discussed.

Adolescent↗
PubMed1999

Web-based administration of a personality questionnaire: comparison with traditional methods.

The World-Wide Web holds great promise as a mechanism for questionnaire-based research. But are data from Web-based questionnaires comparable to data from standard paper-and-pencil questionnaires? This study assessed the equivalence of the Ruminative Responses Scale in a Web-based format and in a paper-and-pencil format among introductory psychology, upper-level psychology, and non-psychology students. Internal consistency coefficients were comparable across the groups. The participants in the Web sample reported higher levels of self-focused rumination than did the other groups. Women in the Web sample reported more self-focused rumination than did women in the other groups. In the Web sample, results did not covary with access location. These results suggest that findings from Web-based questionnaire research are comparable with results obtained using standard procedures. The computerized Web interface may also facilitate self-disclosure among research participants.

Adult↗
PubMed2003

Eye movement desensitization and reprocessing. A brief and effective treatment for stress.

1. Eye movement desensitization and reprocessing (EMDR) is an integrative therapy that "unlocks" disturbing memories or beliefs and reprocessess them, in some way, so they are no longer as disabling. 2. EMDR can be used for any experientially based psychological problems and has proven especially effective for traumatic imagery associated with posttraumatic stress disorder. 3. A primary benefit of EMDR is its time efficiency, requiring as few as 3 to 5 hours of treatment. 4. Many potential mechanisms (i.e., cognitive, hypnotic, self-disclosure, biological) may account for the effectiveness of EMDR.

Abreaction↗
PubMedDate not supplied

Enhancing theoretical fidelity: an e-mail-based walking program demonstration.

PURPOSE: To examine the extent to which theoretical fidelity, or precision in replicating theory-based recommendations, influenced the effectiveness of two walking programs based on social cognitive theory (SCT). DESIGN: Two-group randomized controlled trial. SETTING: College town in Virginia. SUBJECTS: Sixty-one sedentary adult women. INTERVENTION: Two 12-week e-mail-based walking programs were compared. The high fidelity program was designed to more precisely follow SCT recommendations for operationalizing mastery procedures than the low fidelity program, which was designed to simulate how mastery procedures were operationalized in most existing SCT-based physical activity programs. Treatment contact and walking prescription were controlled across groups. MEASURES: The 1-mile walk test of physical fitness and SCT measures were completed at baseline and posttest. Self-reported walking quantity was assessed at baseline, posttest, and 1-year follow-up. Walking logs were completed during the program. Process evaluation measures were completed at posttest. RESULTS: Fifty women completed the study. The high fidelity group improved more than twice as much as the low fidelity group on 1-mile walk test time (86 vs. 32 seconds, p < .05), goal setting (p < .05), and positive outcome expectations (p < .05) and reported greater program satisfaction (p < .01). CONCLUSION: Theoretical fidelity could advance the quality of physical activity interventions, which have often shown small effects.

Adult↗
PubMed2001

[Effects of gender and physical distance with an old friend on same-sex friendship].

This study examined the differences between interpersonal relationship of same-sex old friends (OF) and that of new friends (NF). It also investigated the effects of physical distance with an old friend and gender on the friendship. Respondents were 208 undergraduates, 86 men and 122 women, who chose one of most intimate person each from same-sex friends they had made before and after they entered a university, and answered questions to describe their relationship. Results showed that relationship satisfaction and tired feeling were higher for OF than NF. Spending time together and talking over telephone were more frequent for NF than OF, but for each occasion together or over telephone, OF spent longer time than NF. OF expected more self-disclosure between them than NF. Gender differences in friendship expectation were similar to previous findings (Wada, 1993, 1996). Furthermore, gender and physical distance both influenced the frequencies of OF spending time together and over telephone. These findings are discussed in terms of gender differences in friendship.

Adult↗
PubMed1999

What's funny about nursing?

The authors examine the topic of humour and argue that humour is needed as one of many skills within the nurse patient relationship. We advance the view that humour has been well researched as an agent of therapeutic value and as a communication tool which helps to relieve stress, but, to date is not used to its fullest potential and tends therefore to be underestimated in both general and psychiatric nursing areas. Humour has benefits for both the nurse and the patient having psychological benefits and a vast array of physiological advantages and is regarded by those who use it as a social lubricant acting as a positive in nurse patient relationships. We also argue that it is essential that nurses know when to use humour as timing and appropriateness is imperative in order for it to be most effective. Humour can be used in all areas of clinical nursing practice and may prove useful in being a reliable predictor over the course of a patient's illness. The use of humour can help improve the nurse-patient relationship by initially breaking the ice between nurse and patient. This alternative mode of delivery can then be foundational to other areas of the nurse patient relationship such as self-disclosure, the enhancement of learning and relieving stress. Furthermore, it helps to facilitate and promote mutual health and well being for both the patient and the nurse. The usage of humour in psychiatric nurse settings is discussed and the benefits to both the patients and their staff are outlined as being of immense therapeutic value. The literature perhaps tends to skirt around these benefits somewhat, as psychiatry and laughter in partnership are not really considered important discursive topics.

Humans↗
PubMed2005

Developing interpersonal relationships with adolescents with anorexia nervosa.

Anorexia nervosa is a complex eating disorder that usually develops during adolescence. This paper reports how paediatric nurses develop professional interpersonal relationships with adolescent patients with anorexia nervosa. The study used a grounded theory approach to data collection and analysis. Data were collected using in-depth interviews from ten registered nurses who worked on a paediatric ward. The findings revealed two foci of care: 'interacting with nurses', and 'interacting with patients', with interrelated categories and strategies. A core category highlighted the importance of instigating an individual focus when developing professional interpersonal relationships with patients with anorexia. Contextual factors emphasise the broader influences that modified the way nurses developed relationships with these patients. The findings have implications for clinical practice, education, unit administration, and further research, and these are examined. Nurses who use this approach are better positioned to gain understanding of individuals experiencing the disorder and to develop professional interpersonal relationships.

Adaptation, Psychological↗
PubMed2002

Responding effectively to patient anger directed at the physician.

BACKGROUND AND OBJECTIVES: Patient anger because of a long wait is a common occurrence, but few studies have looked at how the anger should be addressed. This study determined patient levels of satisfaction, rating of importance, and preference for a variety of approaches for addressing anger being directed toward a physician. METHODS: A video trigger tape of an angry patient and 12 physician responses to the angry patient were shown to 130 participants who then rated the physician responses based on four approaches, alone or in combination (apology, explanation, self disclosure, and acknowledgment) for satisfaction and importance of the response. Participants also evaluated four physician follow-up questions. RESULTS: An apology combined with an explanation was rated highest in satisfaction and importance and individually ranked as the best approaches for physicians to use. "I apologize for your long wait" was rated significantly higher than "I am sorry you have been kept waiting." Although gender and prior high anger with clinicians affected the ratings of some responses, participants consistently preferred an apology and/or an apology combined with explanation as the best response. Participants also preferred physician follow-up questions that facilitated segue to the medical interview rather than questions that explored patient feelings. CONCLUSIONS: Participants clearly indicated that they would like a physician to apologize, explain the reason for the delay, and then quickly move along with the interview.

Adolescent↗
PubMed2001

Eo na Mahu o Hawai'i: the extraordinary health needs of Hawai'i's Mahu.

An overview of health and social issues is presented here regarding Native Hawaiian transgenders. Perhaps due to relatively greater tolerance of gender diversity among Polynesian cultures, approximately 70% of all male-to-female transgenders in Hawai'i are Native Hawaiian. However, the overall climate is one of discrimination and harassment such that transgenders--who tend to be under-educated, under-employed, and medically underserved--may be the most severely impacted of all Native Hawaiians. Lei Anuenue, human immunodeficiency virus (HIV) prevention program for Native Hawaiians, has provided a variety of services for transgenders, including outreach, educational workshops, support groups, HIV testing, and case management. All services are provided by peer leaders who are employed by the program. Data for this article are based on case management, including client self-disclosures and reports of peer staff who knew details of clients' lives having shared with them both generic experiences and specific activities. Information from 100 transgender clients and their case managers indicated that the transgender health profile is far more serious than that of mainstream Native Hawaiians. For example, 74% smoke, 31% use illegal drugs (excluding marijuana), more than 50% have been involved in street or domestic violence, and few individuals over age 50 have been found during three years of outreach. To some extent, employment options limit transgenders to prostitution, drug dealing, and minimum-wage jobs. In addition, a lifestyle of multiple sex partners and lack of opportunities for stable relationships place transgenders at much greater risk for HIV, sexually transmitted diseases (STD), and other infectious and non-infectious diseases as compared to the mainstream Native Hawaiian community. Clients in this study were from O'ahu, primarily from downtown Honolulu, Chinatown, and Wai'anae. Future studies should compare the results of this sample to transgenders from the neighbor islands (especially in rural Hawaiian areas), as well as utilize a structured prospective longitudinal approach.

Adolescent↗
PubMed2002

PTSD, depression and help-seeking patterns following the Miyake Island volcanic eruption.

Assessing help-seeking patterns following disaster provides useful information about who needs professional help the most, who is willing to seek help, and who is reluctant to seek help. 231 Japanese evacuees from the Miyake Island volcanic eruption (2000) participated in this study (ages 20-93, average age 59.52). Ten months after the evacuation, participants were mailed questionnaires which elicited demographic data, disaster experiences, help-seeking patterns, and psychological symptoms (Post-traumatic stress disorder and depression). Help-seeking patterns were categorized as: professionals (physicians, nurses, psychotherapists/counselors, telephone consultation, social workers, priests and monks, and others); or informal (family, relatives, friends, neighbors, and others) and, (information, advice, tangible, and emotional). The findings indicate that younger and/or female victims frequently sought help from informal sources while male and/or older victims frequently sought help from professionals. Severity of PTSD and depression symptoms were positively correlated with help-seeking from physicians, but not psychologists or mental health professionals. Very high rates of utilizing medical assistance rather than mental health treatment were also identified among these disaster victims, and appeared related to cultural norms regarding shame and self disclosure of emotional distress.

Adult↗
PubMed2003

Determinants of HIV and AIDS among young African-American men who have sex with men: a public health perspective.

This study was an examination of community, age, race and ethnicity. Individual behavior and health promotion was critically examined within the context of (HIV) Human Immunodeficiency Virus and AIDS (Acquired Immuno Deficiency Syndrome) among young African-American men who have sex with men. Examples from the literature provided empirical illustrations of how these concepts have been defined conceptually and measured with respect to HIV/AIDS; particularly among this population from a public health perspective. Additionally, a conceptual model depicting the interplay of these concepts was reviewed and is provided and discussed to shed further light on the conceptual link between these concepts and healthy behaviors among sexually active African-American young men who have sex with men. The concepts are discussed in an integrative format throughout the paper within the backdrop of the proposed model for understanding the wave of HIV/AIDS within this subculture from a public health nursing perspective.

Black or African American↗
PubMed2005

Middle East aircrew use of alcohol, tobacco, coffee, and medicaments.

OBJECTIVE: The purpose of this study was to assess the prevalence of the use of alcohol, tobacco, coffee, and various medications among flying crew and clerks working in a ministry in Kuwait. METHODS: In a cross-sectional study, a self-administered questionnaire was filled in by 277 flying crew and 302 clerks of a comparable age and gender ratio. RESULTS: Frequencies of using alcohol, tobacco, coffee, and various medications were much higher among flying crew as compared to clerks. Flying crew were a very homogenous group in terms of exposure to the substances studied with only two exceptions: younger people were more likely to drink alcohol abroad (but not in Kuwait), and cabin crew relied on herbal medicine more than pilots. CONCLUSIONS: Flying crew differ very much from a socially comparable segment of the local population, but it is not possible to discern the impact of occupational risks (jet leg and night shifts) from exposure to foreign influences and, as for alcohol and sedatives, from easier availability.

Adult↗
PubMed2005

Shaping effective communication skills and therapeutic relationships at work: the foundation of collaboration.

Effective communication is essential to practice and can result in improved interpersonal relationships at the workplace. Effective communication is shaped by basic techniques such as open-ended questions, listening, empathy, and assertiveness. However, the relationship between effective communication and successful interpersonal relationships is affected by intervening variables. The variables of gender, generation, context, collegiality, cooperation, self-disclosure, and reciprocity can impede or enhance the outcome of quality communication. It is essential for occupational health nurses to qualitatively assess the degree to which each of these concepts affects communication and, in turn, relationships at work.

Communication↗
PubMed1977

[Psychic help for aged people of day-care-centers by attending person-centered encounter groups (author's transl)].

UNLABELLED: 45 old people (Average age 72 years) took part in 9 person-centered encounter groups together with younger people (Average age 32 years). Psychological changes of the old people were collected by questionaires and compared to a control group of 38 old people who subsequently took part in 4 encounter groups without younger people. Excerpts from the encounter talks were rated in certain variables. MAIN RESULTS: delta The old people of the mixed aged encounter groups showed constructive psychological changes after participation, for example reduced feelings of loneliness, reduced stress with emotional problems, and they see ageing less resignative. The mixed aged encounter groups were more helpful for the old people than the groups without younger people. The old people of the mixed group were more emotionally occupied by their own person, they showed more self-exploration and self-acceptance, they talked with more emotional engagement about their experiences and were more genuine; 3 months later their self-disclosure in an interview with a stranger was higher.

Aged↗
PubMed1989

Simultaneous patient/family education regarding schizophrenia: the Nebraska model.

A course entitled "How to Enter the World of Schizophrenia ... a Family Educational Perspective" was developed to simultaneously educate individuals with schizophrenia and their families regarding the psychiatric diagnosis, treatment, and management of schizophrenia. The course was developed and implemented by psychiatric-mental health nursing clinical specialists utilizing an eclectic approach. The complexity of this endeavor required the incorporation of five theoretical models to effect the delivery of health education in a multigeneration family situation complicated with a serious mental illness. It was essential that the leaders possess working knowledge of the aforementioned theories as well as advanced knowledge of the medical diagnosis and treatment of schizophrenia to include neuroanatomy, physiology, and biochemistry; therapeutic nutrition; and psychopharmacology. Equally important were the leaders' abilities to conduct groups using the style of coleadership, as each class averaged 30 to 50 people, including individuals with schizophrenia, siblings, parents, and grandparents, which represented segments of families or the entire family. The leaders must display open, honest communication techniques while developing self-esteem and self-worth among the family members. Use of here-and-now material facilitates self-disclosure of emotionally painful material and leaders role-model problem-solving techniques, which aid families in coping with problems occurring with serious mental illness. The class has been taught 12 times since 1985 to over 500 persons.

Curriculum↗
PubMed1980

Depression: the tip of the iceberg.

A number of potential obstacles to objective diagnosis have been described, somatic presentations of 'masked depression' being only one of these. The morbidity associated with untreated depressive illness, availability of effective treatment resources, and gradually increasing community expectations, have all contributed to an increased responsibility on the medical practitioner for accurate diagnosis. It is evident that not only intellectual diagnostic acumen but an attitude of tolerance and acceptance of pathological emotional states is fundamental in facilitating self-disclosure leading to accurate diagnosis, and is a foundation for effective treatment. A model of depressive illness which includes biological, psychological and social aspects is appropriate, and can greatly augment mastery of these problems in practice.

Adult↗