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Biomedical subjects

M R DiMatteo

Publications and source records attributed to M R DiMatteo.

At least 37 records · Page 2Linked to original sources
PubMed1992

Antecedents of adherence to medical recommendations: results from the Medical Outcomes Study.

A longitudinal study of patients with chronic medical diseases (hypertension, diabetes, heart disease) was conducted to identify antecedents of adherence to medical recommendations. Data are from 1198 patients in three health-care provision systems in Los Angeles, Chicago, and Boston. Nonadherence at the beginning of the study was the strongest predictor of nonadherence 2 years later. Other significant predictors varied by type of adherence outcome. Patients who were younger and who relied upon avoidant coping strategies tended to be less likely to follow their doctor's specific recommendations. Patients who were distressed about their health, used avoidant coping strategies, or who reported worse physical and role functioning were less likely to adhere in general. Patient satisfaction with two features of care (interpersonal quality and financial aspects) was positively related to adherence in some models, but satisfaction with the technical quality of care was negatively associated with adherence to specific recommendations among heart disease patients. Social support contributed to specific adherence among diabetic patients. Implications of the study for medical care providers are discussed.

Adaptation, Psychological↗
PubMed1992

Adherence to cancer regimens: implications for treating the older patient.

Cancer presents unique challenges to the clinician who hopes to achieve patient adherence to medical recommendations. Preventive and treatment regimens, particularly those that involve lifestyle change, are often extremely difficult to carry out (eg, smoking cessation; following a low fat diet). Although research suggests that there is no clearcut relationship between a patient's age and his or her degree of adherence to medical treatment, older patients may have more difficulties than younger persons in understanding precisely the medical recommendations made to them and tend to be more passive recipients of care. The authors describe six factors that significantly affect adherence and clinical changes that are likely to be effective in enhancing the adherence behavior of older patients with cancer. Measurement of patient adherence in the Medical Outcomes Study is described. This paper also examines the difficulties and pressures faced by medical professionals in enhancing the adherence of their patients.

Adolescent↗
PubMed1991

Development of an instrument to measure job satisfaction among dentists.

Because of the rapid changes that have occurred in the dental profession, the Dentist Satisfaction Survey (DSS) was developed to assess both facet and overall job satisfaction among dentists. The DSS was administered to a sample of 558 California general dentists. The results suggest that the DSS is a practical, reliable, and valid measure of dentists' job satisfaction. Internal consistency reliability coefficients for all facet subscales and the overall job satisfaction scale ranged from 0.60-0.92. The DSS discriminated between groups of dentists known to have different levels of job satisfaction; dentists identified by dental society presidents as being very dissatisfied scored significantly differently in the hypothesized direction on the DSS. A high correlation (r = 0.68) was found between judges' independent ratings of dentists' satisfaction based on their open-ended comments and DSS scores. While the majority of respondents were satisfied with most facets of their jobs, substantial variation was found among dentists in their levels of satisfaction.

Adult↗
PubMed1990

Professional satisfaction among California general dentists.

Dentists' assessments of their jobs provide insights about issues in the dental profession needing attention. This study assessed professional satisfaction among 558 California general dentists using the 54-item, multi-faceted Dentist Satisfaction Survey (DSS). Although dentists tended to be satisfied with various facets of their jobs and careers, substantial variation in the levels of satisfaction was noted. The most satisfied dentists were older, reported higher incomes, attended more continuing education, and employed more dental auxiliaries than dentists who were the most dissatisfied. Fifty-eight percent of the variation in overall job satisfaction was explained by quality of nonwork life and satisfaction with five facets of the profession: respect received from being a dentist, the actual process of delivering care, income derived from dentistry, relationships with patients, and reduced levels of job-related stress. Dentists were most dissatisfied with the threat of malpractice, level of income, demands of managing the practice, and amount of personal time. Professional organizations should direct programs to address these issues. Dental educators should use these findings to counsel predoctoral students about the realities of dental practice and as an outcome measure of their programs. Moreover, these findings document the perceptions of the practicing profession and support several components of the SELECT recruitment strategy.

Adult↗
PubMed1989

Methodological issues in adherence to cancer control regimens.

A six-factor model provides a heuristic framework for understanding adherence behavior: (1) effective provider communication; (2) rapport with provider; (3) client's beliefs and attitudes; (4) client's social climate and norms; (5) behavioral intentions; and (6) supports for and barriers to adherence. Four classes of methodological issues are discussed. Recruitment may be affected by the sociodemographics of the target population, biomedical variables, population size and location, and patient sources utilized. Interventions can be structured to maximize enrollment, participation and long-term retention, and adherence to the regimen promoted with behavioral methodology. Measurement of adherence optimally includes multiple measures at multiple time points, a well-defined focus and unit of adherence, well-constructed response options, and multiple sources of information. Sample size calculations and interpretation of clinical trial results are affected by adherence rates. Multivariate analytic techniques, such as structural equation modeling, make it possible to specify models depicting hypothesized structural relationships between different theoretical constructs and to evaluate the plausibility of these models.

Adaptation, Psychological↗
PubMed1987

Problem behavior theory and adolescent alcohol use.

The prevalence of adolescent alcohol use has prompted interest in identifying the factors associated with its use. A comprehensive theory that provides a framework for understanding alcohol use is Jessor and Jessor's Problem Behavior Theory (PBT). We adopted PBT in a study of alcohol use among 226 Catholic high school students. PBT explained 38% of the variation in quantity-frequency of alcohol use and 31% of the variation in problem drinking. The three major systems (personality, perceived environment, behavioral) of the theory were about equally predictive of alcohol use.

Adolescent↗
PubMed1987

Structural-equation models of current drug use: are appropriate models so simple(x)?

The simplex and common-factor models of drug use were compared using maximum-likelihood estimation of latent variable structural models in two samples: a sample of 226 high school students, using ratio-scale measures of current drug use, and a sample of 310 industrial workers and 811 college students, using ordinal-scale measures of current drug use. Latent variables of alcohol, marijuana, enhancer hard drugs, and dampener hard drugs were specified in a series of structural models. Contrary to previous findings with cumulative drug-use data, the common-factor model provided a more acceptable representation of the observed current-use data than did the simplex model in both samples. In addition, the similarity of results across both of these samples supports recent contentions by Huba and Bentler (1982) that quantitatively measured variables are not necessarily superior to qualitative, ordinal indicators in latent variable models of drug use.

Adolescent↗
PubMed1987

Measuring physicians' humanistic attitudes, values, and behaviors.

This paper describes the reliability and validity of 10 easily administered and scored self-report measures of physicians' humanistic attitudes, values, and behaviors. This research also provides evidence that evaluations of physicians' humanistic behavior made by their outpatients, and non-physician staff with whom they worked, and the faculty physicians supervising them on inpatient ward rotations were positively and significantly correlated with one another. The potential usefulness of a multi-modal approach in evaluating humanistic physician attributes in which self-report measures are combined with direct feedback from all of those who interact with physicians is discussed.

Attitude of Health Personnel↗
PubMed1987

A short-form measure of loneliness.

The revised UCLA Loneliness Scale (ULS-20) and a four-item short form (ULS-4) are widely used in personality research (Russell, Peplau, & Cutrona, 1980). In an exploratory factor analysis of the ULS-20, we identified eight items that loaded substantially on the first factor. These items were combined to form an alternative short-form measure, the ULS-8. The results of this study indicate that the ULS-8 is reliable, valid, and a better substitute for the ULS-20 than is the ULS-4. Consistent with the previous research, the loneliness measures (ULS-20, ULS-8, ULS-4) were strongly related to socially undesirable personality characteristics, but loneliness was uncorrelated with the six different health-related behaviors (exercise, meal regularity, alcohol use, hard drug use, smoking, and hours of sleep) assessed in this study.

Adolescent↗
PubMed1986

Relationship of physicians' nonverbal communication skill to patient satisfaction, appointment noncompliance, and physician workload.

A field study of 28 residents in family practice was conducted. Physicians' self-reports of empathy, self-monitoring ability, and affective communication skill as well as their objectively measured nonverbal communication skills were examined as predictors of patient satisfaction, appointment noncompliance, and physician workload (schedule density). Physicians completed the Hogan Empathy Scale, Snyder Self-Monitoring Scale, Affective Communication Test, short form of the Profile of Nonverbal Sensitivity, and a nonverbal encoding task. Patient satisfaction with communication, affective care, and technical care was assessed using a 25-item, visit-specific satisfaction scale. Appointment records were used to determine the number of patients seen by each physician and the compliance of patients with scheduled appointments. Results indicated that the three self-report measures were unrelated to the measures of patient noncompliance and patient satisfaction, but self-reported affective communication ability was significantly correlated with physician workload. Objectively measured physician sensitivity to audio communication predicted patient compliance: More sensitive physicians experienced fewer unrescheduled appointment cancellations. Nonverbal encoding skill was significantly related to patient satisfaction with affective care and to physician workload.

Adult↗
PubMed1985

Affect and neutrality in physician behavior: a study of patients' values and satisfaction.

Physicians' emotional expressivity was contrasted with emotional neutrality in a study of consumers' preferences regarding physician behavior in the medical encounter. Two hundred twenty-seven health-science students completed instruments designed to measure the values they held regarding physicians' emotional expressions as well as their perceptions of and satisfaction with the emotional behavior of a physician presented in a videotape simulation. Overall, consumers attached a low value to neutrality and preferred affective behavior to it, although their previously held values did significantly influence their degree of satisfaction with neutral behavior by the physician. Values did not influence recognition of or satisfaction with the nonneutral emotions. This research also shed light on consumer reactions to other emotions including reassurance and humor.

Affect↗
PubMed1985

Validity of self-reports of alcohol and other drug use: a multitrait-multimethod assessment.

Four methods (self-reported rating, self-reported intake, peer-reported rating, peer-reported intake) and multiple analytical criteria were employed to assess the construct validity of reports of three types of substance use (alcohol, marijuana, and cigarettes) in a study of 194 college students who were members of friendship pairs. The resulting multitrait-multimethod matrix was analyzed in the traditional fashion as well as with confirmatory factor analysis. Convergent and discriminant validity for the three substance use traits were quite adequate, although the validity of one measure (the peer-reported intake measure of alcohol use) may be considered inadequate according to some criteria. This study demonstrates the usefulness of multimethod assessment and confirmatory factor analysis for research on construct validity and for derivation of more accurate measures of drug use.

Adolescent↗
PubMed1984

Covariation among health-related behaviors.

There is substantial covariation in the use of alcohol, cigarettes, and hard drugs and it has been suggested that different types of drug use are part of a "syndrome" of behavior that may include other health-related and "problem" behaviors. A critical challenge is the determination of the behaviors included within this syndrome and the mapping of the perimeter. In this study, six health-related behaviors (meal regularity, hard drug use, alcohol use, cigarette use, exercise, hours of sleep) were intercorrelated and factor analyzed in both a high school and a college sample. Consistent with previous research, alcohol use, cigarette use, and hard drug use were significantly associated in each of four subsamples (sex by sample) and formed a cohesive drug use factor. The measures of meal regularity, exercise, and hours of sleep were found to lie outside the perimeter of the drug use behaviors, with meal regularity consistently residing closest to the perimeter.

Adolescent↗
PubMed1984

Consumer values and subsequent satisfaction ratings of physician behavior.

The role of respondents' values in their evaluation of and satisfaction with medical care was explored in four health education settings. Two hundred and twenty-seven nursing, medical, and health psychology students completed a forced-choice instrument designed to measure their value preferences for technical quality of care, psychosocial concern, courtesy, and mutual participation style of interacting in a medical visit. They subsequently watched a standardized 14-minute videotape of a simulated physician-patient interaction and evaluated the physician's behavior from the patient point of view on the four dimensions using two popular methods for assessing patient satisfaction. Respondents' ratings of the medical encounter were more often significantly influenced by their values when the more subjective satisfaction measure was considered. In addition, respondents who valued technical quality more highly were more satisfied with the other three dimensions of physician behavior, while respondents who more highly valued psychosocial concerns were less satisfied with these three dimensions. Ratings of satisfaction with technical quality were not affected by respondents' values. The importance of these findings in assessing patient satisfaction is discussed.

Adult↗
PubMed1983

Humor and other communication preferences in physician-patient encounters.

In light of recent evidence suggesting the importance of communication in the health care setting, an instrument to measure communication style preferences was developed. This reliable and content-valid paper-and-pencil measure consisted of six scenarios depicting physician-patient interactions, each followed by four potential verbal responses from the physician. The four responses, representing four communications styles--humor, hostility, reassurance, and neutrality--were ranked by respondents according to their preferences. Among both physicians and consumers, reassuring responses were the most preferred, followed by neutral, humorous, and hostile responses. The intercorrelations of the four preferences and their relationships to standardized tests of both facilitating verbal response preferences and nonverbal expressiveness are presented. Potential uses of the instrument are discussed.

Adult↗
PubMed1981

Sources of assessment of physician performance: a study of comparative reliability and patterns of intercorrelation.

The technical and the interpersonal skills of resident physicians in four separate samples were examined with subjective performance evaluations from four different sources: attending physicians, peers, patients and the residents themselves. Residents were from programs in internal medicine, family practice and general surgery. The reliabilities of measures from all four sources were found to be substantial, suggesting the potential usefulness of these sources of physician evaluation. Ratings or technical and interpersonal skill were found to be highly intercorrelated within each source. Reasons for this high degree of overlap are discussed. Finally, the ratings from the four sources were found to be fairly independent, indicating that they provide relatively separate measures of physician performance. The implications of these findings for medical care, education and research are considered.

Clinical Competence↗