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Results for “Truth Disclosure”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

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At least 1,171 records · Page 65Linked to original sources
PubMed1996

Direct disclosure by radiologists of imaging findings to patients: a survey of radiologists and medical staff members.

OBJECTIVE: A previous survey revealed that patients prefer to hear the results of imaging examinations from radiologists at the time of the procedure rather than be informed later by the referring physician. This study was performed to learn, by means of questionnaires, the attitudes of members of medical staff and of radiologists. SUBJECTS AND METHODS: Questionnaires were sent to members of the medical staff at my institution and to private and academic radiologists throughout the country. Respondents were presented with this statement: "If an adult patient who knows why a radiologic examination is being performed and what is being sought asks to know the results from the radiologist, the radiologist should answer truthfully (and immediately contact the referring physician with the results and the fact that the patient has been informed)." Five alternatives were presented: 1 = strongly agree, 2 = agree, 3 = neutral, 4 = disagree, and 5 = strongly disagree. Results were tabulated by department in the first instance and by state and character of practice in the second. The sum of the replies in each area was divided by the number replying to obtain a mean figure. RESULTS: The mean figure for members of medical staff was 2.35, which was on the agree side of neutral, indicating at least neutrality, leaning toward agreement, on the subject. The overall mean figure of 2.18 for radiologists indicates substantial agreement with the stated proposition. CONCLUSION: This study suggests that radiologists and referring physicians alike tend to support the proposition that, if asked, radiologists should disclose the results of imaging studies to patients.

Academic Medical Centers↗
PubMedDate not supplied

Preparing couples for home birth. Practical suggestions.

Parents planning a home birth need specific information beyond that which typically is covered in childbirth preparation classes geared for hospital couples. Topics that specifically need to be included in preparation for home birth include the meaning of shared responsibility for the birth at home, informed disclosure of personal and professional data, motivating factors and barriers to a successful birth, coping strategies, preparation of the home environment, contingency plans for referral or emergency transport, and preparation for self-care following the birth.

Female↗
PubMed1999

Informed consent in the emergency department.

This article reviews the doctrine of informed consent to treatment, with particular attention to its role in the emergency department. The article begins with a brief look at the moral and legal foundations of informed consent. The article then examines the three essential features of informed consent, patient capacity, disclosure of information, and voluntariness. After a review of five exceptions to the duty to obtain informed consent, the article concludes with a brief summary of issues of special significance for emergency physicians.

Adult↗
PubMed2001

The lived experience of college student lesbians' encounters with health care providers. A preliminary investigation.

The purpose of this preliminary study was to explore the lived experience of four self-identified college student lesbians coming out and their encounters with health care providers. This study used a qualitative method of phenomenology for data collection and analysis. Results of the study revealed a phenomenological model that embodied the core theme of navigating self-disclosure. Two major themes stemming from the core theme were also uncovered. Navigating self-disclosure in homophobic waters and navigating self-disclosure encounters with health care providers unveiled a continuum of self-disclosure to nondisclosure experiences encountered by lesbians. Strategies are offered to enhance interactions between lesbians and health care providers in primary and acute care settings.

Adult↗
PubMed1998

Future directions in genetic counseling: practical and ethical considerations.

The accelerated discovery of gene mutations that lead to increased risk of disease has led to the rapid development of predictive genetic tests. These tests improve the accuracy of assigning risk, but at a time when intervention or prevention strategies are largely unproved. In coming years, however, data will become increasingly available to guide treatment of genetic diseases. Eventually genetic testing will be performed for common diseases as well as for rare genetic conditions. This will challenge genetic counseling practice. The ethical principles that now guide this practice take into account the personal nature of test decision making, the need to respect individual self-determination, and the importance of client confidentiality. Certain of these principles may have to be modified as genetic testing becomes more widespread in order to meet the changing needs of clients and society. This paper offers recommendations to ensure that genetic counselors will take a leading role in the future delivery of ethical genetic services.

Communication↗
PubMed1992

Commentary on NASCIS-2.

Release of results of a clinical study to the public press prior to dissemination in a professional journal is a substantive issue which must undergo continued scrutiny. This report analyzes the second National Acute Spinal Cord Injury Study (NASCIS-2) and its subsequent reportage. NASCIS-2 was an elaborate protocol consisting of the randomized blinded use of methylprednisolone (MP), naloxone or placebo in 487 patients within 12 hours of spinal cord injury. Analysis of the entire population failed to show a significant clinical difference among treatments although data stratification revealed a significant change in patients with a complete loss of function who received MP within 8 hours of injury. The administration of MP was associated with a 7.1% incidence of wound infection. While these results suggested clinical benefit, incomplete data and statistical descriptions reduced assertions. Discrepancies in the report included lack of radiological data or descriptions of time-dependent surgical manipulations and extent of rehabilitative therapy. Justification for the broad 8-hour stratum and multiple hypothesis testing was unclear; incomplete design details included level of statistical significance, study power, stopping rules, trial duration and odds ratio data. The hypothesis that press release prior to publication in a professional journal would result in rapid therapy remained unproven. Reasons for pre-release, including limited peer review, physician familiarity with drug and dosage, and lack of alternative treatment or treatment complications were either unjustified or problematic. Early disclosure to the press resulted in da ta misinterpretation and oversimplification, failure to recognize exclusion or appropriate legal ramifications,and lack of communication to appropriate physicians.

Clinical Trials as Topic↗
PubMed2005

The education and employment status of patients with inflammatory bowel diseases.

Inflammatory bowel disease (IBD) has the propensity to affect patients who are in their late teens and early 20s, an age when most people decide on their educational and career directions. This review describes the effects that IBD has on the continuum of education and employment. Patients with Crohn's disease and ulcerative colitis attain a similar level of education as that of the general population. The quality of life of such patients in school, as measured by both patients' and teachers' perceptions, indicates that, despite the difficulties that students face in terms of missed school time and physical inconveniences, teachers are generally perceived by students to have favorable attitudes toward helping them. Even though earlier work in the area of employment has suggested that the occurrence of IBD is clustered among people in white-collar positions, recent data have suggested that certain environmental risks for IBD (i.e., sedentary or indoor jobs) may be associated with jobs classified as being white-collar, and therefore having a white-collar job may in itself not be a risk factor for the development of IBD. Patients with IBD have a higher rate of nonparticipation in the labor force, and the participation rate seems to maintain steady levels over time. A majority of patients with IBD continue in the same employment positions over a period of years. Patients with IBD, especially those who have undergone surgery, took more sick leave than their counterparts without IBD. A majority of patients with IBD favored the disclosure of their diagnosis to their employers and perceived little discrimination in the workplace. Furthermore, most employers were perceived by their employees with IBD as having fair attitudes toward the compensation provided for their employees with IBD.

Education↗
PubMed1981

Gay fathers: evolution of the gay-father identity.

Interview data from an exploratory study of 18 gay fathers indicate that identity congruence evolves over time as these men participate in both the world of fathers and the world of gays. Disclosure of each identity in the opposite world, and the acceptance of both identities by intimate others, are also crucial to the gay father's achievement of self-acceptance.

Adolescent↗
PubMed2003

Sex without disclosure of positive HIV serostatus in a US probability sample of persons receiving medical care for HIV infection.

OBJECTIVES: We estimated the proportion of HIV-positive adults who have any sexual contact without disclosure and the proportion of their sexual partnerships that involve unprotected sex without disclosure. METHODS: We drew participants from the HIV Cost and Services Utilization Study (n = 1421). Interviews assessed disclosure and sexual activities with up to 5 recent partners. RESULTS: Overall, 42% of the gay or bisexual men, 19% of the heterosexual men, and 17% of all the women reported any sex without disclosure, predominately within nonexclusive partnerships (P <.001). Across all groups, 13% of serodiscordant partnerships involved unprotected anal or vaginal sex without disclosure, with no significant difference between groups. CONCLUSIONS: Risky sex without disclosure of serostatus is not uncommon among people with HIV.

Adult↗
PubMedDate not supplied

Privacy and intra-familiy communication of genetic information.

The new knowledge (and predictions) created by DNA tests and the family nature of genetic information has already lead to a new problem: the intra-familiar communication of genetic data. This raises questions such as the following. Is there a duty to inform in cases when treatment is possible and the patient does not permit disclosure of genetic results to relatives? Is there an obligation to warn or merely an authorization (that could be used or not)? Could privacy protection be maintain as an individual interest but with some justified violations? A balance needs to be establishes between the interest of privacy and the need to disclose secret information.

Family Relations↗
PubMed2003

Parental views on disclosure of diagnosis to their HIV-positive children.

Parents of HIV-positive children are known to delay disclosure of diagnosis. This study examines the concerns parents attending a South London family clinic had about disclosure of diagnosis to school-aged children with HIV, to establish the stages they were at in terms of the disclosure process and to find out what plans they had regarding further disclosure. Thirteen families with vertically-infected children who did not know their HIV diagnosis were included in the study. Findings showed that parents generally partially disclose information about the illness without naming it and delay full disclosure. The most frequently given reason for delay in talking to their child about HIV was fear that the child may accidentally reveal their diagnosis, thereby simultaneously revealing maternal HIV status and exposing the family to potential stigmatization, discrimination and prejudice.

Adaptation, Psychological↗
PubMed2006

Understanding interrelationships among HIV-related stigma, concern about HIV infection, and intent to disclose HIV serostatus: a pretest-posttest study in a rural area of eastern China.

The objective of the study was to examine the interrelationships among HIV-related public and felt stigma, worry of HIV infection, HIV/AIDS knowledge and intention to disclose HIV testing results in a rural area of China, where HIV spread among former commercial blood donors. A one-group pretest-posttest study was conducted among 605 marriage license applicants. The following relationships showed statistical significance in path analysis: (1) HIV/AIDS knowledge --> worry [beta (Standardized coefficient) = -0.39]; (2) worry --> public stigma (beta = 0.27); (3) public stigma --> felt stigma (beta = 0.22); and (4) felt stigma --> intention to disclosure (beta = -0.20). Separate path analyses for males and females generated similar association patterns. HIV counseling reduced perceived worry but exerted little impact on HIV-related stigma and the intention. The pathway from a lack of HIV/AIDS knowledge to increased stigma and to decreased intention to disclose one's serostatus is particularly policy relevant as decreased intention to disclosure may be related to continuing practice of HIV risk behaviors. The findings demonstrate interventions aiming at the reduction of stigma should be targeted at both the individual and community levels.

Adult↗
PubMedDate not supplied

Attitudes about patient safety: a survey of physicians-in-training.

Little is known about the attitudes of physicians-in-training on patient safety, although success in error reduction strategies requires their support. We surveyed house staff and fourth-year medical students from 1 academic institution about their perceptions of adverse patient events. Three hundred twenty-one trainees (41%) completed the survey. Most believe adverse events are preventable (61%) and think improved teamwork (88%), better procedural training (74%), and improved sign-out (70%) would reduce medical mishaps. Forty-seven percent of trainees agree computerized order entry and restricted work hours would prevent adverse events. Although 60% feel malpractice fears inhibit discussion, 80% of trainees agreed physicians must disclose adverse events to patients and grow more comfortable with disclosure as training progresses (P for trend<.01). In conclusion, trainees believe adverse events are preventable and are poised to respond to many components of the patient safety movement.

Attitude of Health Personnel↗
PubMed1995

The discovery that an offspring is gay: parents', gay men's, and lesbians' perspectives.

This study explores and integrates parents', gay men's, and lesbians' perceptions of the "coming out" process. The research employed a sample of thirty-two gay and lesbian young adults and twenty-seven parents. It investigated how family dynamics prior to the discovery of homosexuality could be related to post-discovery experiences on parts of both children and parents. In-depth interviews were conducted with all participants. Two bodies of literature enriched the theoretical framework for this study: self-disclosure literature and the literature pertaining to homosexual identity formation. Findings of this study call for educating parents about homosexuality prior to the actual act of disclosure. Ensuring that parents do not learn about homosexuality while finding out that their child is gay potentially eases parents' adjustment to the discovery and thus may also improve the emotional dynamics within the family.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Men's reactions to disclosed and undisclosed opportunistic PSA screening for prostate cancer.

OBJECTIVE: To assess the degree to which men considered it appropriate for general practitioners to order prostate-specific antigen (PSA) testing if the testing was either "disclosed" or "undisclosed" to the patient. DESIGN: Telephone-administered survey conducted in June to October 2000. PARTICIPANTS: 514 men aged 50-70 years, identified by random selection of households from the Sydney Electronic White Pages phone directory. METHODS: We developed two hypothetical scenarios. Each scenario described a GP ordering a PSA test for a male patient at the same time as other pathology tests were ordered. In Scenario 1, the GP's intention to order a PSA test was disclosed to the patient ("disclosed"). In Scenario 2, the GP did not tell the patient a PSA test was being ordered ("undisclosed"). For each scenario, men reported the degree to which they perceived screening to be "appropriate". We also recorded demographic characteristics, health status and health locus of control, and administered a 14-question knowledge test about prostate cancer and PSA screening. RESULTS: Over 90% of men stated that "disclosed" PSA screening was either "appropriate" or "very appropriate". Significantly fewer (44.9%) rated "undisclosed" screening as appropriate/very appropriate (P < 0.001). While the skewed distribution of responses to Scenario 1 precluded multivariate analysis to determine predictors, men rejecting "undisclosed" PSA screening (Scenario 2) were more likely to be younger (adjusted odds ratio [AOR], 0.97; 95% CI, 0.94-1.00; P = 0.03); to have better knowledge of the issues (AOR, 1.01; 95% CI, 1.00-1.03; P = 0.02); and to be single (AOR, 0.62; 95% CI, 0.41-0.94; P = 0.02). CONCLUSIONS: Many men consider that inclusion of PSA screening within a battery of pathology tests without disclosure to the patient is unacceptable. Educating men about the pros and cons of screening may alter their support of opportunistic screening and thus enhance community expectations of "informed participation".

Aged↗
PubMedDate not supplied

Agreement between hospitalized adolescents' self-reports of maltreatment and witnessed home violence and clinician reports and medical records.

Seventy-one consecutive psychiatrically hospitalized adolescents (34 males and 37 females) were systematically asked about their experiences of sexual abuse, physical abuse, and witnessing home violence using a reliable 46-item self-report measure of maltreatment, the Traumatic Events Questionnaire-Adolescent Version (TEQ-A). Subjects' responses were compared with a "best-estimate" source consisting of data from child protective service and police reports, medical records, and clinician interviews. Rates of agreement varied from 88% (kappa value [kappa] = .75) for sexual abuse, to 83% (kappa = .65) for physical abuse, to 75% (kappa = .49) for witnessing home violence. Disclosures of maltreatment were not significantly influenced by the gender, age, educational level, or ethnicity of the adolescent. Disclosures were highest for sexual abuse (86%) and lowest for witnessing home violence (68%). The results show that psychiatrically hospitalized adolescents' self-reports of maltreatment experiences generally concur very well with best-estimate sources.

Adolescent↗