SEARCH · PubMed Health

Results for “Disclosure”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 271 records · Page 15Linked to original sources

PubMed1997

[A study on disclosure by HIV positives by use of simulation using case vignettes].

AIDS patients/HIV positives have been increasing in Japan, but a large proportion of university students, who have high risk sexual behavior, are not aware of the danger of HIV infection. Because of little disclosure by AIDS patients/HIV positives in Japan, the students have a poor chance of knowing of their risk in sexual behavior situations. Discrimination or prejudice toward AIDS patients/HIV positives has suppressed disclosure. However, as the real risk changes of disclosure is unknown, a simulation study, using case vignettes, was carried out to measure risks. A total of 1,128 university students (487 male and 641 female) were asked to read one of six vignettes describing HIV positives, that consisted of three infection routes (one by blood preparation and two by sexual intercourse) with disclosure or without disclosure. After reading a vignette, they answered questions about the images of HIV positives and their attitudes to him or her. As a result of reading these vignettes, friendly images were enhanced and the disagreeable images were decreased, but students' attitudes were unchanged. Significant differences were recognized in attitudes concerning responsibility for the infection and sympathy toward HIV positives, depending on the infection routes (blood preparation or sexual intercourse). Female students had a tendency to be more favorable to HIV positives than the male students. This simulation study showed the difficulty of changing students' attitudes regardless of the image of HIV positives, and demonstrated the need for effective action toward reducing discrimination or prejudice.

Adult↗

PubMed1998

Analyst subjectivity, analyst disclosure, and the aims of psychoanalysis.

It is preferable to think of what we directly disclose to our patients as "analyst disclosure" rather than as the commonly used "self-disclosure." The author suggests this change because, to some extent, we have equated the analyst's subjectivity with the self-concept in ways that fail to distinguish how disclosure both overlaps and is distinct from other forms of interpretation. What distinguishes the analysts's subjectivity in disclosure is her or his deliberate attempt to reveal a construction of the self to the patient so that something new can be explored. This paper elaborates these issues by examining some of the therapeutic aims of analyst disclosure.

Humans↗

PubMed1999

The effects of disclosure on pain during dental hygiene treatment: the moderating role of catastrophizing.

Catastrophizers and non-catastrophizers were asked to disclose about their dental worries prior to undergoing dental hygiene treatment. It was hypothesized that the effects of emotional disclosure would vary as a function of the level of catastrophizing; where catastrophizers would be more likely than non-catastrophizers to show reductions in pain and emotional distress. The study also examined whether emotional disclosure influenced subsequent levels of catastrophizing and dental anxiety. Eighty undergraduate students were randomly assigned to a disclosure condition or a control condition prior to undergoing a scaling and root planing procedure. In the control condition, catastrophizers reported significantly more pain and emotional distress than non-catastrophizers. In the disclosure condition, catastrophizers and non-catastrophizers did not differ significantly in their pain and emotional distress. The interaction between condition and level of catastrophizing remained significant even when controlling for emotional distress and the emotional content of the thought records. While catastrophizers benefited from disclosure in regard to their immediate physical and emotional experience, their levels of catastrophizing and dental anxiety remained essentially unchanged. Theoretical and clinical implications of the findings are discussed.

Adult↗

PubMed2000

A national survey of policies on disclosure of conflicts of interest in biomedical research.

BACKGROUND: Conflicts of interest pose a threat to the integrity of scientific research. The current regulations of the U.S. Public Health Service and the National Science Foundation require that medical schools and other research institutions report the existence of conflicts of interest to the funding agency but allow the institutions to manage conflicts internally. The regulations do not specify how to do so. METHODS: We surveyed all medical schools (127) and other research institutions (170) that received more than $5 million in total grants annually from the National Institutes of Health or the National Science Foundation; 48 journals in basic science and clinical medicine; and 17 federal agencies in order to analyze their policies on conflicts of interest. RESULTS: Of the 297 institutions, 250 (84 percent) responded by March 2000, as did 47 of the 48 journals and 16 of the 17 federal agencies. Fifteen of the 250 institutions (6 percent)--5 medical schools and 10 other research institutions--reported that they had no policy on conflicts of interest. Among the institutions that had policies, there was marked variation in the definition and management of conflicts. Ninety-one percent had policies that adhered to the federal threshold for disclosure ($10,000 in annual income or equity in a relevant company or 5 percent ownership), and 9 percent had policies that exceeded the federal guidelines. Only 8 percent had policies requiring disclosure to funding agencies, only 7 percent had such policies regarding journals, and only 1 percent had policies requiring the disclosure of information to the relevant institutional review boards or to research subjects. Twenty journals (43 percent) reported that they had policies requiring disclosure of conflicts of interest. Only four federal agencies had policies that explicitly addressed conflicts of interest in extramural research, and all but one of the agencies relied primarily on institutional discretion. CONCLUSIONS: There is substantial variation among policies on conflicts of interest at medical schools and other research institutions. This variation, combined with the fact that many scientific journals and funding agencies do not require disclosure of conflicts of interest, suggests that the current standards may not be adequate to maintain a high level of scientific integrity.

Academies and Institutes↗

PubMed2004

Alexithymia, emotional disclosure, and health: a program of research.

This article reviews a program of research on alexithymia, emotional disclosure, and health. The article first describes two lines of research and then outlines current work attempting to integrate these lines. The first research line involves basic correlational studies on alexithymia's link to health problems; these studies suggest that alexithymia is a potential risk factor for symptoms and illness behavior, although not necessarily organic disease. The second research line involves experimental studies of the health effects of emotional disclosure via expressive writing or talking; these studies suggest that disclosure improves health on average, but that the effects are not that robust and that various moderators likely are involved. The next section of the article describes recent attempts to integrate the two research lines by examining how baseline levels of alexithymia influence the effects of emotional disclosure; these analyses suggest that alexithymia interferes with or attenuates the health benefits of disclosure. Finally, the article describes initial forays into research on interventions with the alexithymic patients. This evolving program of research demonstrates the value of integrating emotion, personality, and health, and highlights the bidirectional relationship between clinical problems and basic research.

Affective Symptoms↗

PubMed2004

"If we can just 'stall' new unfriendly legislations, the scoreboard is already in our favour": transnational tobacco companies and ingredients disclosure in Thailand.

OBJECTIVES: To review the strategies employed by overseas cigarette manufacturers operating in Thailand to obstruct the passage and subsequent enforcement of national public health legislation, specifically the ingredients disclosure provision of the 1992 Tobacco Products Control Act. METHODS: Analysis of previously confidential tobacco industry documents relevant to non-compliance with the ingredients disclosure legislation. RESULTS: Requirement for disclosure of ingredients contained in cigarettes contained in the Tobacco Products Control Act was identified by transnational tobacco companies (TTCs) not only as a significant threat to their operations in Thailand, but as a dangerous global precedent. Industry documents reveal a determined campaign to block, stall, or amend the proposed regulation during the legislative process. Industry representatives petitioned the Ministry of Health to revise the requirement from by brand disclosure to a more palatable by company submission. Strategies were adapted in the wake of the passage of the Act. Most significantly, the industry in concert with embassies in Bangkok threatened the Thai government with appeals to international trade bodies on the grounds of violation of international agreements. Industry documents also reveal that as submission of ingredient lists appeared unavoidable, leading companies operating in Thailand endeavoured to confound the disclosure requirement by disguising ingredients and reformulating brand recipes. CONCLUSIONS: The evidence presented highlights the importance of ingredients regulation and demonstrates how health policy can be transformed during its implementation. A greater understanding of trade agreements emerges as a priority for global tobacco control.

Commerce↗

PubMed2006

A trial platform to develop a tailored theory-based intervention to improve professional practice in the disclosure of a diagnosis of dementia: study protocol [ISRCTN15871014].

BACKGROUND: For people with dementia, care should include an explanation of the diagnosis to individuals and their carers, and information about the likely prognosis and possible packages of care. However, this is neither routine nor inevitable, and there is wide variation in the practice of disclosure. The aim of this study is to develop a tailored theory-based intervention to promote appropriate disclosure of diagnosis of dementia. METHODS: There are three objectives. Objective 1 is to define and develop an appropriate model of disclosure; this will be addressed using a multidisciplinary consensus development process. Objective 2 is to identify factors that influence disclosure of diagnosis; a questionnaire based upon theoretical constructs from a range of behavioural theories will be developed and members of old age mental health teams will be surveyed. The analysis will identify those factors that best predict intention to disclose a diagnosis to a person with dementia. Objective 3 is to develop and pilot test a theory-based intervention to promote disclosure of diagnosis that targets attitudes, beliefs and actions most amenable to change. Objective 3 will use the results of Objectives 1&2 to design and pilot test an intervention to improve the process of and increase the proportion of individuals receiving a diagnosis of dementia, for members of old age mental health teams. This work will lead to a proposal for a randomised controlled trial of the intervention.

Journal Article↗

PubMed2002

An exposure-based examination of the effects of written emotional disclosure.

OBJECTIVES: We undertook this study to clarify the operative mechanisms that account for the relationship between emotional disclosure and health. We hypothesized that emotional disclosure via writing was a form of exposure-based therapy and that exposure was the active therapeutic component. Design and method. A group of 129 male and female undergraduates were randomly assigned to three writing groups: (1) a trauma disclosure writing group; (2) a positive emotion writing group to control for affect arousal; and (3) a neutral writing group to control for any affect arousal - either positive or negative. Process measures were taken before and after each 3-day, 20-minute writing session. All participants completed questionnaires that assessed psychological and physical functioning at both the baseline and the end of the semester (approximately 9 weeks later). RESULTS: Groups reported differential affective arousal as well as disclosure themes in accord with our predictions. We did not replicate the findings of Pennebaker and his colleagues (e.g. Pennebaker & Beall, 1986). In our study, physical health outcome measures did not differ between groups by the end of the semester, nor did psychological measures change from baseline to follow-up. CONCLUSIONS: We found only limited support for the hypothesis that exposure best explains the effects of written self-disclosure. Implications for future research in this area are discussed.

Journal Article↗

PubMed1997

Parental disclosure of child psychosocial concerns: relationship to physician identification and management.

BACKGROUND: Physician identification and management of psychosocial problems in children is related to parental disclosure. The purpose of this research was to evaluate a method of prompting parental disclosure of such problems and to determine the impact of parental disclosure on family physicians' identification of and intervention for childhood psychosocial problems. METHODS: Participants were parents and physicians of 60 children between the ages of 3 and 10 years attending an ambulatory care clinic of a community-based, university-affiliated family medicine training program. Parents completed the Child Behavior Checklist and also indicated whether psychosocial problems were discussed or managed. Physicians completed a checklist about the psychosocial status of the child and potential interventions for identified problems. One half of the participating parents formed the experimental group and were also asked to note their concerns on a Psychosocial Checklist for Children and to discuss these concerns with their child's physician; the other half of parents received no such checklist and acted as the control group. All interactions between parents and physicians were videotaped. RESULTS: The number of parental psychosocial disclosures, but not the number of parents who disclosed them, was significantly higher for the experimental group. Physicians were three times as likely to identify a psychosocial problem and 10 times as likely to intervene when parents discussed psychosocial concerns. CONCLUSIONS: Parents' disclosure of psychosocial concerns to their child's physician increases the likelihood of physicians identifying and intervening for these problems. The finding that physicians intervened for psychosocial problems even when they failed to record these problems suggests that research needs to focus on measuring both intervention and identification.

Child↗

PubMed1997

Stigma, disclosure, and family functioning among parents of children conceived through donor insemination.

OBJECTIVE: To examine the influence of gender, male infertility factor, and other demographic variables on stigma and whether parents tell their children that they were conceived by donor insemination (DI) and to ascertain if stigma and the disclosure decision affect parental bonding with the child or the quality of the interparental relationship. DESIGN: One hundred eighty-four San Francisco Bay Area couples who had become parents by DI were asked to complete a self-administered questionnaire. SETTING: A private infertility practice. PATIENT(S): Eighty-two men and 94 women who completed the questionnaire. MAIN OUTCOME MEASURE: A questionnaire assessing disclosure, stigma, parental bonding, and the quality of the interparental relationship. RESULT(S): Factors that increased the couple's likelihood of disclosure included younger age, azoospermia, lower stigma scores, and having more than one DI child. Fathers who scored higher on stigma reported less parental warmth and parental fostering of independence. CONCLUSION(S): Because the decision regarding disclosure of DI treatment was not linked to parental bonding with the child or to the quality of the interparental relationship, we cannot conclude that nondisclosure is harmful to family relationships or is a symptom of family problems. The husband's perceptions of stigma however, may affect the father--child relationship adversely.

Adult↗

PubMed1981

Disclosure of information to patients in medical care.

It is generally agreed that patients have a right to be adequately informed. However, little is known about the extent to which doctors and patients agree about information that should be disclosed. We studied what patients want to know, as contrasted with what physicians report actually disclosing, in a population of physicians who treat seizures and patients or parents of patients who have this disorder. In general, it was found that patients or parents of patients who have this disorder. In general, it was found that patients prefer far more detailed disclosures than physicians routinely offer and that the two groups have widely different beliefs about the consequences of detailed disclosures. Patients and parents preferred extensive disclosures, particularly regarding risks and alternative therapy. Physicians were likely to disclose only risks with a relatively high probability of occurrence and they provided little information about alternative therapies. Patients and parents were also much more likely than physicians to believe that the final decision concerning therapy should rest with the patient. The data suggest that a better empirical understanding of the consequences of detailed disclosures may help resolve differences of opinion regarding how much information should be provided to patients.

Adolescent↗

PubMedDate not supplied

Disclosure of human immunodeficiency virus status in healthcare settings: ethical concerns.

As knowledge of human immunodeficiency virus (HIV) disease increases, society's attitudes toward disclosure of seropositivity are reverting to a traditional public health approach. Both patients and healthcare professionals fear HIV infection (although the risks of transmission in healthcare are small), and broadly support disclosure. In this article, the disclosure issue is examined within a framework of the ethical principles of autonomy, nonmaleficence, beneficence, and justice, which suggests that patients and healthcare professionals should be required to disclose known seropositivity before exposure-prone procedures are performed. Because of the risk of stigmatization, renewed effort to prevent unwarranted disclosure by healthcare professionals also is required.

Attitude to Health↗

PubMed2005

The effect of physician disclosure of financial incentives on trust.

BACKGROUND: Many physicians receive financial incentives to limit their ordering of expensive tests and procedures. While Medicare mandates disclosure of incentives, it is not clear how to inform patients without undermining trust. METHODS: Our objective was to determine public opinion about physician disclosure of financial incentives and how this might be best communicated to patients. The 2002 General Social Survey included 2765 interviews from a probability sample of English-speaking US households. The interview included questions about financial incentives and an audiotaped scenario of a physician discussing the impact of financial incentives on ordering a magnetic resonance image. Respondents heard 1 of 6 randomly selected disclosure strategies. The measurements included ratings of trust, satisfaction, agreement with the physician's decision, and likelihood of remaining with the physician/health plan or seeking a second opinion. RESULTS: Nearly half (48.8%) of respondents had previously heard of financial incentives to limit test ordering. Of the respondents, 94.8% wanted to be told about incentives, at the time of enrollment in a health plan (80.5%), by a health plan representative (44.8%), their physician (17.1%), or both (38.1%). Of the 6 different disclosure strategies, "addressing emotions" and "negotiation" were associated with the best outcomes, while "common enemy" and "denying influences" were most negatively perceived. Black and Hispanic subjects were less likely to express satisfaction or trust and more likely to disenroll or seek a second opinion. CONCLUSIONS: The public wants information about physician financial incentives. Specific communication styles enhance how this information is conveyed to patients, increasing trust and supporting the physician-patient relationship.

Analysis of Variance↗

PubMed1998

Financial interest and its disclosure in scientific publications.

Journal policies and requirements of funding agencies on financial disclosure of authors and grant applicants have divided editors and scientists who disagree on whether such policies can improve the integrity of science or manage conflicts of interest. Those opposed to such disclosure policies argue that financial interest is one of many interests held by scientists, is the least scientifically dangerous, and should not be singled out. Those who favor open reporting of financial interests argue that full disclosure removes the suspicion that something of relevance to objectivity is being hidden and allows readers to form their own opinions on whether a conflict of interest exists and what relevance that has to the study. The authors believe that the scientific community and the public will be best served by open publication of financial disclosures for readers and reviewers to evaluate.

Authorship↗

PubMed2003

Patients' and physicians' attitudes regarding the disclosure of medical errors.

CONTEXT: Despite the best efforts of health care practitioners, medical errors are inevitable. Disclosure of errors to patients is desired by patients and recommended by ethicists and professional organizations, but little is known about how patients and physicians think medical errors should be discussed. OBJECTIVE: To determine patients' and physicians' attitudes about error disclosure. DESIGN, SETTING, AND PARTICIPANTS: Thirteen focus groups were organized, including 6 groups of adult patients, 4 groups of academic and community physicians, and 3 groups of both physicians and patients. A total of 52 patients and 46 physicians participated. MAIN OUTCOME MEASURES: Qualitative analysis of focus group transcripts to determine the attitudes of patients and physicians about medical error disclosure; whether physicians disclose the information patients desire; and patients' and physicians' emotional needs when an error occurs and whether these needs are met. RESULTS: Both patients and physicians had unmet needs following errors. Patients wanted disclosure of all harmful errors and sought information about what happened, why the error happened, how the error's consequences will be mitigated, and how recurrences will be prevented. Physicians agreed that harmful errors should be disclosed but "choose their words carefully" when telling patients about errors. Although physicians disclosed the adverse event, they often avoided stating that an error occurred, why the error happened, or how recurrences would be prevented. Patients also desired emotional support from physicians following errors, including an apology. However, physicians worried that an apology might create legal liability. Physicians were also upset when errors happen but were unsure where to seek emotional support. CONCLUSIONS: Physicians may not be providing the information or emotional support that patients seek following harmful medical errors. Physicians should strive to meet patients' desires for an apology and for information on the nature, cause, and prevention of errors. Institutions should also address the emotional needs of practitioners who are involved in medical errors.

Adult↗

PubMed1982

The interactive effects of counselor gender, physical attractiveness and status on client self-disclosure.

Investigated client self-disclosure and client perception of counselors (as expressed in counselor evaluations) as a function of the sex, attractiveness and status of the counselor, and the sex of the client. Counselor gender and attractiveness were established by means of stimulus photographs; counselor status was defined in terms of education and experience. Ss (160 college students) first rated their counselors on intelligence and empathy; they then completed Jourard's Self-Disclosure Questionnaire while role-playing clients in therapy. A four-factor between-Ss analysis of disclosure scores revealed that clients disclosed more of themselves to male than to female counselors when the counselors were high in either status or attractiveness. Results supported the hypothesis that the effect of counselor gender on client disclosure depends on an interaction of counselor gender with other counselor variables.

Adult↗

PubMed1983

Marital intimacy and self-disclosure.

Examined the relationship between the qualitative aspects of marital intimacy among 20 couples and a quantitative, microanalysis of their self-disclosing behavior. Two interview segments and their combination were scored for the basic parameters of self-disclosure using the Self-Disclosure Coding System (SDCS). These scores served as predictor variables for each of 12 intimacy dimensions derived from the standardized, structured Victoria Hospital Intimacy Interview in stepwise multiple regression analyses. The resulting multiple Rs ranged from .357 for Sexuality in segment I to .853 for Identity in segment II. Analysis of the couples' self-disclosures across segments I and II yielded multiple Rs from .446 to .850, with the intimacy dimensions of Expressiveness, Compatibility, Behavior, and Identity the highest correlates. These results suggest that although self-disclosure and intimacy are not synonymous, self-disclosing behavior is a major determinant of various aspects of marital intimacy and accounts for more than 50% of the variance in at least four dimensions. Explanations for these findings and their clinical relevance are discussed.

Adaptation, Psychological↗

PubMed1983

Effect of therapist expectations and need for approval on self-disclosure.

Previous therapy analogue studies of self-disclosure have treated Ss as a homogeneous group without examining possibly relevant S variables. In the present study, 68 female students identified as high or low in need for approval listened to a tape-recorded interview between a high self-disclosing therapist and a female client under one of two therapist expectation conditions: Clear expectation of high self-disclosure vs. ambiguous expectation. Ss then indicated on the Jourard Self-Disclosure Questionnaire the degrees to which they would be willing to disclose to the therapist. It was predicted that high need for approval Ss would disclose most under the clear expectation condition, while low need for approval Ss would not be affected by the therapist expectation. A significant Need Approval X Therapist expectation interaction supported this prediction. Further analysis indicated that items for the Work, Money, and Personality subsections of the disclosure questionnaire contributed most to the interaction. Implications for differential treatment of high need for approval Ss who were entering therapy were discussed.

Adult↗