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Biomedical subjects

B N Dowds

Publications and source records attributed to B N Dowds.

15 recordsLinked to original sources
PubMed1998

Students' philosophical assumptions and psychology in the classroom.

The current study investigated the underlying philosophical assumptions, or world views, that undergraduate nursing students bring to the psychology classroom. It was hypothesized that students would most prefer mechanistic explanations of behavior, explanations derived from an analytical, linear, cause-and-effect model. It was also hypothesized that they would least prefer contextualistic explanations of behavior, i.e., explanations derived from a synthetic, subjective, and relational model. Forty female hospital-based RN students completed a modified version of the World Hypothesis Scale. As predicted, they were significantly more likely to endorse mechanistic explanations and less likely to endorse contextualistic explanations. Because teaching psychology lends itself to a contextualistic approach in which a variety of models for understanding behavior are explored, the study of psychology can be one way to increase nursing students' critical thinking skills.

Adolescent↗
PubMed1996

Entry into the health care system: the family's decision-making process.

BACKGROUND AND OBJECTIVES: Prior work has demonstrated the importance of family members in deciding whether or not to consult a physician. This study investigated how such decisions are made and what dimensions are important in the decision-making process. METHODS: Thirty middle-class couples each role-played four hypothetical illness situations. Verbatim transcripts were analyzed according to a negotiation paradigm. RESULTS: If the decision was to wait rather than to consult a physician, the decision was more likely to have been initiated by the person designated as experiencing the signs and symptoms. Conversely, if the decision was to consult a physician, the decision was more likely to have been initiated by the spouse. Subjective views of the meaning, duration, and effect of the signs and symptoms were important dimensions in deciding whether or not to call the physician. CONCLUSION: We suggest that family practice residents be taught to inquire about family members' roles in the patient's decision to seek health care. This would demonstrate in a concrete way, beginning with the initial steps in the doctor-patient interview, the family physician's commitment to the context of the family.

Adult↗
PubMed1980

Social class and suitability for psychodynamic psychotherapy A causal Model.

A causal model is postulated to mediate the connection between patients' social class and therapists' evaluations of patients' suitability for psychodynamic psychotherapy. The model postulates that patients' social class gives rise to the learning of intellectual skills cognitive styles, which lead to ways of interacting verbally with others, which in turn result in therapists' evaluations of patients suitability. Thirty psychiatric outpatients were assessed therapists during the first therapy session. One mediational pathway was discovered as postulated by the model. This pathway was found to mediate the connection between patients' social class and their subsequent attendance in psychotherapy as well. Two unexpected pathways were found to mediate therapists' judgments of suitability, one of which also mediated patients' attendance in psychotherapy. These unexpected pathways are of particular interest for the clues they offer to the ways in which psychodynamic psychotherapy may be possible and rewarding with lower-class patients.

Adult↗
PubMed1980

Psychological impairment and psychological health in the psychological well-being of the physically ill.

There has been a growing acceptance of the view that psychological health is not merely the absence of psychological impairment, but rather is a separate state making its own contribution to a person's overall psychological well-being. Research on the separation of positive and negative affect represents a major empirical development of this view. The present study supports the model as it has been developed from people's self-reports. However, the postulation of complete separation of positive and negative affect is too extreme for others' reports about people. For others' reports, the model should be modified to state that positive and negative affect are partially separate and have differentially strong associations with harmonious and disruptive/distressing behaviors. These findings have implications for the measurement of psychological well-being in investigations of the physically ill. Both psychological impairment and psychological health should be represented, particularly when they are assessed from people's self-reports. Finally, there are promising indications that this view of psychological well-being is applicable to mentally ill persons as well.

Affect↗
PubMed1980

Ward polity and therapeutic outcome: II. Ratings of patient behavior.

In a study to determine the therapeutic value of ward policies of restriction and coercion, as in a step system of privileges, investigators compared the adjustments of patients in three ward settings: one with a formal step system, one in which the formal system had been abolished but a significant degree of restriction-coercion maintained, and one in which almost all activities and medications were optional. Patients' behaviors in seven areas were rated at admission, at discharge, and at one and six months after discharge. The patients on the ward with the formal step system showed better adjustment on 23 out of 35 ratings, although only one of the ratings was statistically significant. The slight therapeutic value of restriction-coercion suggested by these data contrasts with the results of an earlier, retrospective study. Cost-benefits involving economic, political, and therapeutic issues are raised.

Behavior↗
PubMed1977

Cognitive mediators between patients' social class and therapists' evaluations.

Previous research has shown that therapists are more likely to accept middle-class than lower-class persons for psychotherapy and to rate middle-class patients more favorably than lower-class patients. One explanation that has been offered is that lower-class patients may not conceptualize their experiences in a manner compatible with traditional kinds of therapy. This study investigated several cognitive variables that could theoretically serve as mediators between patients' social class and therapists' differential evaluations--specifically, verbal intelligence, psychological differentiation, and locus of control. Therapists evaluated patients after the initial therapy session. Results indicated that psychological differentiation was a mediator for therapists' judgments of both patients' desire for structure and their suitability for psychotherapy. Similarly, a locus of control orientation emphasizing the role of chance functioned as a mediator of therapists' judgments of suitability.

Attitude of Health Personnel↗
PubMed1977

The world hypotheses scale: rationale, reliability and validity.

Theoretical descriptions are presented for four different sets cognitive assumptions concerning the fundamental meaning of events. These cognitive assumptions or world hypotheses are called formism, mechanism, organicism, and contextualism. The development of a 12-item scale to measure individual preferences for these world hypotheses is described. Finally, several empirical studies are reported in which diverse behavioral correlates have been found for individuals preferences among world hypotheses. Specifically, significant results have been obtained for choice of careers, stability of friendships, and success in both group and individual therapies.

Journal Article↗
PubMed1976

Psychological differentiation and psychotherapy.

Patient's level of psychological differentiation was studied in relation to patients' and therapists' evaluations of the initial psychotherapy session. The evaluations assessed two broad dimensions of the interaction which generally have been considered important for psychotherapeutic success and which have been found to be related to patients' psychological differentiation: namely, patients' and therapists' satisfaction with the amount of structure, and therapists' impressions of patients' appropriateness for therapy. Significant correlations were obtained between patients' psychological differentiation and both of these dimensions. However, two control variables, socioeconomic status and alcohol use, were also found to be related to these dimensions. When the effects of these variables were partialed out, the relationships with therapists' impressions of appropriateness disappeared, but the relationships with patients' and therapists' satisfaction with the amount of structure remained significant. The relationship of these findings to other studies of psychological differentiation and psychotherapy is discussed. Finally, the contribution of the present results to the choice of the most appropriate measure of psychological differentiation is noted.

Adult↗
PubMed1976

Coping with interpersonal conflicts through life events and hospitalization.

Previous studies have helped to explicate the coping process prior to hospitalization by investigating the frequency and pattern of life events during this period. The present study extends the empirical applicability of the model to the period following hospitalization. Predictive validity for the model is provided by an investigation of posthospital community adjustment and rehospitalization. It was found that the resolutions of interpersonal conflicts during the period of hospitalization enhanced the ability to predict these outcome measures substantially when the conflict resolutions were added as predictors to patients' demographic and background characteristics, their hospital behavior, and their therapists' evaluations. Two case histories are presented to illustrate the applicability of the model for furthering the understanding of individual patient's lives.

Conflict, Psychological↗
PubMed1975

Assessing treatment outcome. I. Adjustment in the community.

In recent years, the re-examination of treatment outcome has substantially advanced the sophistication with which the issues involved have been conceptualized. This study is directed toward the empirical elaboration of four of these issues as they relate to adjustment in the community. They may be stated briefly as the extent to which a) a common outcome pattern exists across different dimensions of adjustment; b) the vantage point of the observer influences adjustment ratings; c) judgments of overall improvement encompass the major dimensions of adjustment; and d) judgments of overall improvement represent changes in adjustment levels. With regard to the first issue, the data indicate that each major dimension of adjustment has a somewhat different pattern over time. Secondly, a substantial consensus exists between patients and their significant others concerning patients' adjustment relative to the adjustment of other patients as described by them and their significant others, although not in terms of the actual magnitude of their adjustment. Third, global improvement ratings are related to two dimensions of adjustment primarily (symptomatology and social involvement), and they are virtually unrelated to other major dimensions. Finally, global improvement ratings are highly reflective of the current level of adjustment. The relevance of these findings to outcome assessment is discussed and some suggestions are offered.

Adult↗
PubMed1975

Assessing treatment outcome. II. The prediction of rehospitalization.

Many of the previous studies of rehospitalization are surveyed and those findings are abstracted that are relevant to three basic methodological issues: the selection of predictor content, the source of predictor information, and the length of the follow-up interval. An empirical examination is made of several questions surrounding each issue, including the relative predictive power of a) patients' background characteristics vs. their behavior; b) symptomatic behavior vs. instrumental role behavior; c) patients' own reports vs. others' reports; d) hospital behavior vs. community behavior; and e) each domain of predictor content at a 6-month vs. a 1-year follow-up interval. Finally, individual predictors are selected from each domain to produce a composite picture of the person who is at high risk for rehospitalization.

Adult↗