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Self-reported religious concerns of university underclassmen.
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The 800-COCAINE helpline: survey of 500 callers.
Five hundred cocaine users who called the 800-COCAINE helpline received an extensive telephone interview to assess the nature, extent and consequences of their self-reported cocaine use. The data revealed a high incidence of dysfunctional cocaine use associated with numerous physical, psychological, and social problems. The typical caller was a white, middle-income male between 25 and 40 years old with no history of drug dependency or serious psychiatric problems. The findings are discussed with regard to the high abuse potential of cocaine and other factors that lead to problematic use and adverse effects.
Do we operate too many cataracts? The referred cataract patients' own appraisal of their need for surgery.
A questionnaire was sent to 379 patients referred for cataract extraction, asking them to assess their visual disability and their need for surgery. Two hundred and seventy-nine patients (73.6%) answered the questionnaire, this group being representative for the 379 patients regarding all relevant variables. The patient's answers were analyzed in relation to data extracted from their referral notes (visual acuity, monocular pseudophakia, age, sex, place of residence, referring ophthalmologist). The overall level of self-reported visual problems and need for cataract surgery were significantly correlated to a reduced best-eye visual acuity, although the correlation factor was low. A similar correlation between the subjective need for surgery and a worst-eye visual acuity < or = 6/24 was also found. Forty-seven patients (16.9%) answered that cataract surgery was not needed for the time being, and this attitude was not significantly correlated to the visual acuity, provided the acuity was > or = 6/24 in the best eye and > or = 6/36 in the worst eye. One hundred and twenty patients (43.0%) felt that their visual disability was so severe that they had to be operated within 1 month and 67 patients (24.0%) within 3 months, while 45 patients (16.1%) felt that surgery could be postponed for at least 6 months. Age, sex, place of residence and the presence of monocular pseudophakia were not found to significantly influence the level of self-reported visual problems. Only 18.3% preferred to be treated as out-patients.
Asking adolescents to explain discrepancies in self-reported suicidality.
We present a typology of adolescents' most common explanations for discrepant reporting of suicidal behavior. Forty-eight adolescents provided attempt histories by completing a self-report measure of suicidality. A select number of items were subsequently readministered (average interval = 5 days) using a semistructured interview format. Discrepancies in reporting were found among 50% of the sample. Adolescents were also asked to clarify, using an open-ended format, what might have accounted for a particular discrepancy. Based on these responses, seven mutually exclusive and exhaustive categories were derived. High rates of interrater agreement indicated that these categories were reliable.
Disclosure of tardive dyskinesia: effect of written policy on risk disclosure.
Over half of the states in the country have written statutory and/or regulatory policies that require psychiatrists treating inpatients within the state mental health system to disclose risks associated with treatment to voluntarily admitted patients. A severe side effect associated with the long-term use of neuroleptic medication is tardive dyskinesia (TD). A nationwide study was conducted to investigate the effect of written risk disclosure policy on psychiatrists' self-reported disclosure of the risks associated with neuroleptics to individuals diagnosed as having schizophrenia of a chronic nature. Participating in the study were 520 psychiatrists from 94 state/county mental hospitals located in 35 states. Fifty-four percent of those psychiatrists reported that they typically disclosed TD to the target patient population. The study results did not support the hypothesis that the presence of statutory and regulatory policy on disclosure of risk results in psychiatrists typically disclosing TD to patients.
Emotional and physical intimacy in coping with lupus: women's dilemmas of disclosure and approach.
This study examined whether self-rated physical and emotional intimacy of 74 women with their heterosexual partner, during an illness episode of lupus, was related to their affect and relationship satisfaction. It was predicted that greater intimacy would be related to better psychosocial adjustment. Women who engaged in physically intimate behavior with their partner more often reported greater relationship satisfaction. Women who frequently avoided or who were often the initiators of physical intimacy, however, reported greater negative affect. Concerning emotional intimacy, women who disclosed more information about illness symptoms and women who concealed more information about their symptoms and feelings experienced the highest levels of negative affect. Results identify dilemmas that women with recurrent illness may face when trying to maintain intimacy during illness periods.
Self-treatment and its discussion in medical consultations: how is medical pluralism managed in practice?
Recent policy changes in the UK such as deregulation of prescribed medicines and the introduction of telephone helpline services are intended to promote self-treatment. Drawing on interviews with, and consultations between, 35 patients and 20 general practitioners, we use Kleinman's (Patients and Healers in the context of culture: an exploration of the Borderland between Anthropology, Medicine and Psychiatry, University of California Press Ltd., London) model of the three sectors of health care in order to examine the range of self-treatments people use and the discussion of these treatments in medical consultations. We argue that despite the availability of a range of treatment options and policy changes advocating greater use of self-treatment, patients are inhibited from disclosing prior self-treatment, and disclosure is affected by patients' perceptions of the legitimacy of self-treatment. The findings are in keeping with Cant and Sharma's (A New Medical Pluralism, Alternative Medicines, Doctors, Patients and the State, UCL Press, London) contention that although there has been a pluralisation of "legitimate" providers of health care and a restructuring of expertise, biomedicine itself remains dominant.
A questionnaire on requests for disclosure of diagnosis, self-choice of treatment, and second opinion of patients with oral cancer in Japan.
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A survey-based exploration of the impact of dyslexia on career progression of UK registered nurses.
AIM: To explore the effects of dyslexia on the practice and career progression of UK registered nurses (RN). BACKGROUND: Literature suggests dyslexia can have a negative impact in the workplace and may pose particular difficulties for nurses, where accuracy in information processing activities is essential for practice. METHODS: A questionnaire was used to survey RNs with dyslexia (n = 116) and results analysed using content analysis. FINDINGS: Dyslexia provided a challenge to the everyday work of RNs, which was often met successfully using a range of individualized strategies. Career progression was achievable but compared with peers, was perceived to take longer. Disclosure of dyslexia to work-colleagues was selective and dependent on the perceived benefits. Informal support mechanisms were commonly utilized with formal management support less well defined. CONCLUSION: Dyslexia appears to have a negative impact on working practices and career progression, but remains a poorly understood and often hidden disability.
Response phases in methadone treatment for chronic nonmalignant pain.
Although studies on the beliefs of persons with chronic nonmalignant pain (CNMP) are still scarce, methadone is increasingly prescribed for the treatment of CNMP. This qualitative case study uses semistructured interviews to explore the beliefs of 11 patients with CNMP and the challenges they faced coming to terms with and integrating methadone treatment into their lives. The study identifies a two-phase process of acceptance and integration. In the first phase, during acceptance of the prescribed methadone treatment, initial beliefs were mostly determined by the societal stigma that "methadone is for junkies." Different influencing factors such as knowledge about methadone for pain management, family support, and trust in physicians changed behavior in a positive way. In the second phase, patients dealt with the degree of disclosure about their treatment. Full disclosers have no problem in telling others that they were being treated with methadone, whereas partial disclosers were more selective. They were confronted with various barriers: negative encounters with family, friends, and the public; past addict experiences; safety issues; and obstacles within the health care system. As a result of these challenges, their beliefs were summarized as: "others think I'm an addict," and "methadone can harm me and/or my family."This study highlights the important role nurses have in the education of patients on the use of methadone in pain management, and in assisting patients with CNMP to gain confidence and a greater sense of control to cope with the challenging issues related to disclosing information.
Impact of diabetes disclosure on perceptions of eating and self-care behaviors.
PURPOSE: This study investigated whether disclosure of diabetes and gender influenced perceptions of eating and self-care behaviors. METHODS: A vignette was developed in which a hypothetical friend engaged in diabetes self-care behaviors during a meal. Respondents (231 young adults) read vignettes that varied according to a 2 x 2 design (male vs female, preventative disclosure vs nondisclosure of diabetes). Participants answered 12 questions, which resulted in 2 factors: concern for friend and encourage professional help. RESULTS: Significantly higher scores resulted on the concern for friend and encourage professional help factors when diabetes was not disclosed. Female characters also received significantly higher scores on the concern for friend factor. CONCLUSIONS: Individuals with diabetes who choose to disclose their illness may prevent negative or incorrect perceptions related to self-care and eating behaviors, and may have a decreased likelihood that a true eating disorder would be identified by others.
Responding to children's disclosure of familial abuse: what survivors tell us.
This study is based on the reports of 384 adults who were abused physically, sexually, and/or emotionally in childhood by family members. It describes the survivors' attempts, as children, to get help by disclosing the abuse to someone who might intervene; those who did not disclose explain their reasons. The results indicate that disclosure usually did not bring an end to the abuse, and that little action was taken to control the perpetrator, even after disclosure took place. The responses received by the children to their disclosure are linked to their levels of self-esteem and family functioning as adults.
"By the way, I'm poz". One man's experience with dating and disclosure.
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Aversive exchanges with peers and adjustment during early adolescence: is disclosure helpful?
We examined the relationship between the frequency of four types of aversive exchanges with peers (teased, threatened, hit, excluded), disclosure, and psychological distress in a sample of 130 early adolescents (65 boys, 65 girls). Most (73%) reported at least one aversive exchange with a peer during the 3-month target period. Many reported that they did not talk to anyone about these exchanges. When disclosure occurred, other adolescents were more likely than adults to be chosen as confidants. More frequent aversive exchanges and non-disclosure of these events were related to higher self-reported loneliness for boys and girls. A similar pattern was found for girls only using mothers' ratings of the adolescents' internalizing and externalizing symptoms.
Too many still fail to tell sex partners of serostatus.
An analysis of disclosure of HIV status shows that a large number of HIV-infected people failed to tell sexual partners about their HIV status. The study of HIV-positive people showed that 42% of men who have sex with men, 19% of heterosexual men, and 17% of women reported having had sex without disclosure.