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Results for “Disclosure”

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PubMed1987

[Self-disclosure patterns of college students and their gender-differences in the patterns].

Self-disclosure patterns of adolescents were examined. Subjects (105 male and 159 female college students) were requested to complete the questionnaire on self-disclosure of 11 different aspects of self to four target-persons (father, mother, the best friend of same sex, the best friend of opposite sex). The following results were found. Both male and female showed the highest self-disclosure to the best friend of same sex, while the lowest to father. But sex differences were found in regard to both overall extent and pattern of self-disclosure. Female disclosed significantly more than male, especially to mother. Although male put the focus of self-disclosure on only the best friend of same sex, female put it on both the best friend of same sex and mother. Moreover, the subjects tend to vary the extent of self-disclosure with respect to the category to which each item about the self belonged. There was the interaction among sex, target-persons, and aspects of self.

Adolescent↗

PubMed1996

Factors associated with disclosure of diagnosis to children with HIV/AIDS.

Disclosure of the diagnosis of human immunodeficiency virus (HIV) infection or acquired immunodeficiency syndrome (AIDS) to a child is a controversial and emotionally laden issue. To understand the factors that affect the process of disclosure and its consequences, we studied 99 parent-child dyads recruited from patients being treated at the National Cancer Institute (NCI). Parents and HIV-infected children were interviewed and administered several standardized measures. Parental depression, family environment, social support satisfaction, socioeconomic status, child and parent gender, child's age, parental HIV serostatus, and disease severity were used to predict disclosure status. Results indicate that the majority of caregivers do disclose the diagnosis to the child, usually with no ill effects, and that age is the most significant predictor of whether or not a child has been told. The Centers for Disease Control and Prevention currently estimate that there are over 6611 children with AIDS (under age 13), and 2184 adolescents with AIDS (ages 13-19) in America. As an increasing number of children who are born infected with HIV live to older ages, the question of when and how to talk with them about their illness becomes more crucial. In addition to the growing number of children infected with HIV, there are many thousands of children profoundly affected by the impact of this disease on a close family member--a mother, father, sibling, or other relative in the kinship network. Yet, the initial reaction most adults have upon learning of their own, or of a family member's, HIV diagnosis is that the diagnosis must be kept a closely guarded secret. One reason frequently cited by parents and family members is their fear that the stigma of AIDS will have a negative impact on their children and their families. Disclosure of an HIV diagnosis to a child is a controversial and emotionally laden issue in the pediatric health-care community as well. However, no systematic research has studied the issues that surround disclosure of an HIV diagnosis to the patient and the factors that predict disclosure.

Adolescent↗

PubMed2001

Overcoming the barriers to disclosure and inquiry of partner abuse for women attending general practice.

OBJECTIVES: To determine the barriers to and rates of disclosure of partner abuse by women attending GPs. METHODS: In a qualitative study, abused Melbourne women were interviewed about their experiences with GPs. Following this, adult women attending a random sample of Brisbane general practices were surveyed. Multivariate analyses were conducted on the data, using levels of disclosure and GP inquiry adjusting for cluster effect to obtain prevalence rate ratios. RESULTS: Thirty-seven per cent of the survey participants (n=1836, response rate 78.5%) admitted to having ever experienced abuse in an adult intimate relationship. One-third (36.7%) of these abused women (n=674) had ever told a GP and 87.8% had never been asked by their GP about partner abuse. Women who disclosed were almost twice as likely than women who have not: to be middle aged, have experienced combined physical, emotional and sexual abuse and be afraid of their partner. They were more than twice as likely to have been asked about abuse. A GP's good communication skills facilitated disclosure. The main barriers to disclosure were that women saw the problem as their own i.e. internal barriers. The data from the qualitative study (n=20) are used to illustrate these findings. CONCLUSION: Educational interventions that improve GPs' communication skills might result in increased disclosure and early intervention in partner abuse. GPs need sensitive attitudes, greater skills, knowledge and support to manage the consequences of disclosure.

Adult↗

PubMed2006

Adolescents' sexual self-disclosure on the internet: deindividuation and impression management.

This study examined the effect of anonymity on adolescents' sexual self-disclosure on the Internet and the impact of topic intimacy on their reply intent for sexual disclosure by conducting a survey with 1,347 adolescents. It was found that male participants were more likely than females to engage in sexual self-disclosure and to correspondingly respond to cyber partners' sexual disclosure. Results showed that the greater the anonymity, the greater the intent for sexual self-disclosure. Participants exhibited greater reply intent when cyber partners self-disclosed sexual topics with greater intimacy, and the effect of topic intimacy was more pronounced in male participants. The findings suggest that male adolescents tend to adopt a reciprocal strategy in responding to partners' sexual disclosure on the Internet, whereas females tend to employ a conservative strategy. It was concluded that male and female adolescents revealed differential self-presentation and impression management for their sexual self-disclosing and responding on the Internet.

Adolescent↗

PubMed1987

Nursing and medical student attitudes towards nursing disclosure of information to patients: a pilot study.

The American Hospital Association 'Patient's Bill of Rights' encourages greater disclosure of medical information to patients. However, the 'Bill of Rights' and conventional hospital practice centre responsibility for disclosure on physicians. The standing of nurses with regard to disclosure of information remains unclear. Many features of the nursing role indicate nurses could participate more fully in disclosure. A questionnaire exploring issues of disclosure by nurses was circulated to senior nursing students and fourth-year medical students. The 28 nursing respondents and 28 medical respondents differed significantly on 20 of the 87 items. In 15 of these, nursing students clearly showed more support than medical students for an active nursing role in disclosure, informed consent, expressing professional opinions, and patients' decision-making. A more active role by nurses in disclosing information may support increased patient participation in decision-making.

Adult↗

PubMed1995

Harnessing the heightened public awareness of celebrity HIV disclosures: "Magic" and "Cookie" Johnson and HIV testing.

This article investigates the impact NBA basketball star Earvin ("Magic") Johnson's HIV disclosure had on changes in demand for HIV counseling and testing services in New York State's 61 Anonymous HIV Counseling and Testing sites. Interrupted time-series analyses were conducted on weekly data from over 34,000 clients seeking anonymous HIV counseling and testing services from January 1991 to June 1992, to determine whether demand for these services changed as a result of the disclosure. Results indicated that immediately following the HIV disclosure, there was a substantial increase in service demand, which transcended all sex, race, age, and most HIV risk-related boundaries. Seven months later, demand had not returned to pre-disclosure levels. The strong impact on females, coupled with additional data analyses in obstetrical settings, suggests that previous research has been too narrow in focus, and that the effect of Johnson's HIV disclosure has been enhanced, in part, by the publicity surrounding his wife and baby. The importance of harnessing the heightened public awareness of celebrity HIV disclosures is discussed.

AIDS Serodiagnosis↗

PubMed1997

Depression, developmental level and disclosure in sexually abused children.

OBJECTIVE: To investigate the relationship between sexual abuse disclosure, developmental level and psychopathology in children. DESIGN: A retrospective analysis of case records, using chi-square and t-tests for statistical significance. SETTING: Child and Adolescent Unit, Midlands Hospital, Pietermaritzburg. SUBJECTS: One hundred children consecutively admitted for all types of mental health problems. OUTCOME MEASURES: Diagnostic evaluations were made using the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (3rd edition, revised). RESULTS: Forty of the 100 children had been sexually abused, but 14 (35%) of the abused children did not disclose their abuse until after admission. The post-admission disclosure group had a significantly higher mean age (13.71 years) than the pre-admission disclosure group (10.96 years). Also, significantly more post-admission disclosure children received a diagnosis of major depressive disorder than their pre-admission disclosure counterparts. CONCLUSION: The study highlights the issue of sexual abuse disclosure and its relationship to depression and developmental level. Internal psychological and developmental mechanisms appear to influence the disclosure/non-disclosure of sexual abuse.

Adolescent↗

PubMed2000

Japanese patients' preferences for receiving cancer test results while in the United States: introducing an advance directive for cancer disclosure.

BACKGROUND: While disclosure of cancer is routine in the United States, it is not in Japan. The primary goals of this investigation were to describe overseas Japanese patients' preferences for participation in decisions about cancer; to delineate patients' beliefs about how physicians should make cancer disclosure decisions; and to assess patients' attitudes about a advance directive for cancer disclosure. METHODS: This ethnography utilized data from participant observations, 30 interviews, and lay materials. Using the analytic technique of immersion and crystallization the data were organized around major themes and subthemes. RESULTS: The mean age of the 30 participants was 38 years and most (n = 20) were female. While most patients expressed preferences to be told the results of cancer testing, the number who did not want to be told increased with more advanced cancer stage. Many participants believed decisions about disclosure should be influenced by a patient's personality, age, or gender, although the relative importance of these factors was variable. Virtually all believed circumstances existed when fully competent patients should not be told the cancer diagnosis. Most participants were supportive of using an advance directive for cancer disclosure. DISCUSSION: These participants' beliefs about many aspects of the management of cancer test results differ from recommended approaches to conveying cancer test results and discussing the cancer diagnosis in the United States. Most encourage the use of an advance directive for cancer disclosure as mechanism for physicians to elicit patients' unique preferences for participation in decision making about cancer.

Journal Article↗

PubMed2001

Predictors of HIV-1 serostatus disclosure: a prospective study among HIV-infected pregnant women in Dar es Salaam, Tanzania.

OBJECTIVES: To examine the socio-demographic and behavioral factors predictive of women's disclosure of an HIV-positive test result in Dar es Salaam, Tanzania. DESIGN: From April 1995 to May 2000, 1078 HIV-positive pregnant women participated in an ongoing randomized trial on micronutrients and HIV-1 vertical transmission and progression. Disclosure to a partner or to a female relative was assessed 2 months after post-test counseling and at 6 monthly follow-up visits. Socio-demographic, health, behavioral and psychological factors were measured at baseline and during follow-up. METHODS: Predictors of time to disclosure of HIV serostatus were determined using Cox proportional hazards regression models. RESULTS: Prevalence of disclosure to a partner ranged from 22% within 2 months to 40% after nearly 4 years. Women were less likely to disclose to their partners if they were cohabiting, had low wage employment, had previously disclosed to a female relative, or reported ever-use of a modern contraceptive method. Women reporting fewer than six lifetime sexual partners or knowing someone with HIV/AIDS were more likely to disclose to their partners. Disclosure to a female relative was predicted by knowing more than two individuals with HIV/AIDS, full economic dependency on their partner, high levels of social support, and prior attendance at a support group meeting. CONCLUSIONS: A substantial proportion of HIV-infected pregnant women never disclosed their result to a partner or a close female relative. Lack of disclosure may have limited their ability to engage in preventive behaviors or to obtain the necessary emotional support for coping with their serostatus or illness.

AIDS Serodiagnosis↗

PubMed2001

Improving understanding of research consent disclosures among persons with mental illness.

OBJECTIVE: The objective of this study was to evaluate alternative procedures for improving the understanding of research consent disclosures by persons who have mental illness. METHODS: Three groups participated in the study: persons with schizophrenia (N=79), persons with depression (N=82), and a healthy control group (N=80). The participants were guided through an informed consent process in which two factors were manipulated. One was the structure of the disclosure form; either a typical disclosure form involving standard dense text was used, or a graphically enhanced form was used. The other was the interpersonal process: the presence or absence of a third-party facilitator, with iterative feedback given to participants for whom a facilitator was not present. Participants' understanding of the disclosure was assessed with the use of recall tests that involved paraphrasing and recognition tests that involved multiple choice. RESULTS: The mean understanding scores did not differ significantly between the depression and control groups, and the mean scores of the schizophrenia group were significantly lower than those of the other two groups. Neither the graphically enhanced consent disclosure form nor the presence of a third-party facilitator was associated with improved understanding. The use of iterative feedback was associated with improvement in comprehension scores in all groups. CONCLUSIONS: The use of a feedback procedure in the consent disclosure process during the recruitment of persons who are mentally ill may be a valuable safeguard for ensuring adequate understanding and appropriate participation in research.

Adult↗

PubMed1977

Disclosure and informed-consent: does it matter how we tell it?

Traditionally, informed consent has been handled by the physician in a one-to-one interchange with the patient. As standards for adequate disclosure become more rigid and demands on physician time increase, however, the physician-patient model may cease to be practical. This study evaluated four alterative disclosure models: a formal discussion, a videotape, a pamphlet, and an informal discussion, each designed and executed by a team of health educators. Study results suggest that the informed consent process is little affected by disclosure medium and that it may be possible to strive for cost-efficiency in disclosure without compromising the quality of the consent obtained. Based on these results, a two-part disclosure process is proposed which allocates certain aspects of the disclosure to the treating physician, others to health education.

Adult↗

PubMed1994

Pediatrician interview style and mothers' disclosure of psychosocial issues.

OBJECTIVE: Primary care pediatricians play an important role in the detection, diagnosis, treatment, and referral of children with mental health problems. Some parents, however, are reluctant to discuss behavioral and emotional symptoms with their child's pediatrician. Studies of patient-physician communication suggest that specific aspects of pediatrician interview style (asking questions about psychosocial issues, making supportive statements, and listening attentively) increase disclosure of sensitive information. We hypothesized that disclosures of parent and child psychosocial problems would be more likely to occur during visits when pediatricians used these techniques. DESIGN: Cross-sectional analysis of a systematic sample of pediatric primary care visits. POPULATION: Two hundred thirty-four children ages 6 months to 14 years and their mothers or female guardians attending an inner-city hospital-based pediatric primary care clinic; 52 physicians in their second or third year of pediatric residency training. METHODS: Visits audiotaped and dialogue coded using the Roter Interactional Analysis System. Independent variables included counts of pediatrician utterances in the following categories: (a) questions about psychosocial issues, (b) statements of support and reassurance, and (c) statements indicating sympathetic and attentive listening. Dependent variables were the disclosure of information about: (a) parental medical or emotional impairment, (b) family disruption, (c) use of physical punishment, and (d) aggressive or overactive child behavior. RESULTS: Use of psychosocially oriented interviewing techniques was associated with a greater likelihood of disclosure for all four of the topic areas studied. Odds ratios for disclosure, adjusted for parental concerns and child age, ranged from 1.09 to 1.22 depending on the interview technique and outcome involved. Positive associations were observed both for topics raised primarily in response to pediatrician questions (family and parent problems) and for topics raised primarily by mothers (behavior and punishment). CONCLUSIONS: Three simple communication skills were associated with disclosure of specific concerns relevant to child mental health. Training pediatricians to use these skills would help to better detect and diagnose children's mental health problems.

Adolescent↗

PubMed1997

Medical disclosure and consent forms: proposal for an international standard.

Disclosure of material risks prior to invasive medical and surgical procedures remains a fiction derived from legal idealism rather than a clinical reality. Where disclosure has been inadequate, legal allocation of individual medical blame fails to address ongoing systems problems in the disclosure process and thereby potentially jeopardizes patient safety. Patient signature of disclosure and consent forms is a standardised international ritual with great potential for ensuring that international ideals and principles of medical ethics (such as those relating to disclosure of risk) become a recognised and consistent part of global medical practice. This article encourages the development of an international standard for disclosure and consent forms.

Ethics↗

PubMed1996

Patients' perceptions on informed consent and the quality of information disclosure in clinical trials.

In a survey on 26 clinical trials we studied how patients experience and evaluate the information disclosure on the clinical trial they are enrolled in and which factors influence patients' perceptions of information disclosure. Our objective was to obtain more insight thereby in how informed consent is applied in the daily practice of clinical trials. Interviews were held with 198 adult patients and 32 trial-clinicians. Instead of focusing on patient comprehension of the information disclosed we analyzed patient perceptions of informed consent. Patients proved to be quite satisfied with the oral and written information disclosure. Patients' perceptions of the manner and content of information disclosure are influenced by more general attitudes towards medical care, research and institutions. Patients' trust in medical experiments, belief in the integrity of physicians and interest in medical affairs have an impact on the way patients perceive information disclosure. To improve the quality of the informed consent procedure, we propose a patient motivation classification (PMC) to enable trial-clinicians to gain more insight into patient motivation. Relevant factors found in our data have been used as criteria for classification. An informed decision making checklist (IDC) is suggested for patients as a general outline for patient education, covering relevant socio-psychological factors of enrollment.

Attitude to Health↗

PubMed2006

Experimental disclosure and its moderators: a meta-analysis.

Disclosing information, thoughts, and feelings about personal and meaningful topics (experimental disclosure) is purported to have various health and psychological consequences (e.g., J. W. Pennebaker, 1993). Although the results of 2 small meta-analyses (P. G. Frisina, J. C. Borod, & S. J. Lepore, 2004; J. M. Smyth, 1998) suggest that experimental disclosure has a positive and significant effect, both used a fixed effects approach, limiting generalizability. Also, a plethora of studies on experimental disclosure have been completed that were not included in the previous analyses. One hundred forty-six randomized studies of experimental disclosure were collected and included in the present meta-analysis. Results of random effects analyses indicate that experimental disclosure is effective, with a positive and significant average r-effect size of .075. In addition, a number of moderators were identified.

Adaptation, Psychological↗

PubMed2005

Methods of HIV disclosure by men who have sex with men to casual sexual partners.

The purpose of this paper is to report results of a qualitative investigation into the methods that HIV-positive men who have sex with men (MSM) use to disclose their serostatus to casual sexual partners. In-depth, qualitative interviews were conducted with 57 HIV-positive adult MSM from a large midwestern city. Using an inductive approach to data analysis, our participants revealed a typology of disclosure consisting of strategies that can be placed into five primary categorizations of disclosure. These include: point-blank disclosure, indirect disclosure, stage setting, buffering, and seeking similars. This information can be especially beneficial to those working with men to develop better disclosure skills.

Adult↗

PubMed2004

Don't ask, don't tell: patterns of HIV disclosure among HIV positive men who have sex with men with recent STI practising high risk behaviour in Los Angeles and Seattle.

OBJECTIVES: A high incidence of HIV continues among men who have sex with men (MSM) in industrialised nations and research indicates many MSM do not disclose their HIV status to sex partners. Themes as to why MSM attending sexually transmitted infection (STI) clinics in Los Angeles and Seattle do and do not disclose their HIV status are identified. METHODS: 55 HIV positive MSM (24 in Seattle, 31 in Los Angeles) reporting recent STI or unprotected anal intercourse with a serostatus negative or unknown partner from STI clinics underwent in-depth interviews about their disclosure practices that were tape recorded, transcribed verbatim, coded, and content analysed. RESULTS: HIV disclosure themes fell into a continuum from unlikely to likely. Themes for "unlikely to disclose" were HIV is "nobody's business," being in denial, having a low viral load, fear of rejection, "it's just sex," using drugs, and sex in public places. Themes for "possible disclosure" were type of sex practised and partners asking/disclosing first. Themes for "likely to disclose" were feelings for partner, feeling responsible for partner's health, and fearing arrest. Many reported non-verbal disclosure methods. Some thought partners should ask for HIV status; many assumed if not asked then their partner must be positive. CONCLUSIONS: HIV positive MSM's decision to disclose their HIV status to sex partners is complex, and is influenced by a sense of responsibility to partners, acceptance of being HIV positive, the perceived transmission risk, and the context and meaning of sex. Efforts to promote disclosure will need to address these complex issues.

Adult↗

PubMed1992

The disclosure of celebrity HIV infection: its effects on public attitudes.

OBJECTIVES: Despite the magnitude of the acquired immunodeficiency syndrome (AIDS) epidemic, studies have shown low levels of public concern about human immunodeficiency virus (HIV)/AIDS. We investigated the effects of celebrity disclosure of HIV infection on the AIDS-related perceptions of urban men. METHODS: Measures of AIDS-related perceptions were collected from 361 men waiting for mass transportation in downtown Chicago; 252 were assessed at three time points prior to and 109 were assessed at two time points after professional basketball star Earvin "Magic" Johnson's disclosure of his HIV infection. RESULTS: Significant increases in concern about AIDS, interest in AIDS information, and talking with friends about AIDS occurred after celebrity disclosure of HIV infection. CONCLUSIONS: Celebrity disclosure of HIV seropositivity demonstrated a marked change in AIDS-related perceptions among the men surveyed. Changes in awareness due to celebrity disclosure may lead to increased readiness to reduce risk and could be viewed as a window of opportunity for HIV prevention efforts.

Adult↗