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PubMed2003

The validity of self-reports in a follow-up study with drug addicts.

Self-reports continue to be the most commonly used method in studies on the effectiveness of treatments for drug addiction. Nevertheless, the validity of this procedure has been called into question, so that subjects' reports are often compared with data from other sources. This study compares the data collected from the self-reports of 207 subjects that had participated in a drug-free treatment program with information from the family and with official records from the main assistance units for drug addicts in the region (Asturias, Spain). As regards misuse of illegal drugs and alcohol, the results show a high level of agreement (91.3% and 90.35%, respectively) between self-reports and information from the family. The data are similar for the other variables studied (work and educational activity, leisure activities, and family relationships). Agreement between self-reports and data collected from the assistance units is very high, reaching 91.19%. These results support the hypothesis that self-reports may constitute a valid instrument for assessing the results of drug-addiction treatment programs.

Adolescent↗
PubMed2006

[Validity of patient self report data in rehabilitation research: identifying circumstances of the patients' completion of questionnaires].

BACKGROUND: Self-report questionnaires have become wide-spread and are an integral part in different fields of rehabilitation. However, it is still unclear to what extent the validity of the patients' reports is affected by motivational factors. How difficult is it for the patient to fill out questionnaires? What are the situational characteristics in which the patients fill them out? The present study aims to identify the situational, motivational and cognitive requisites of the respondents and to analyse possible impacts on the validity of self-reports. METHOD: A total of n = 105 patients scheduled for inpatient rehabilitation were interviewed by means of a guided open-ended interview in the admission phase. It is a consecutive sample of all admissions in two rehabilitation clinics in Schleswig-Holstein, which provide each patient with a questionnaire to fill out prior to their stay. The analysis involved a description of statements (categories) that have been derived by content analysis based on the patient interviews. In addition, physicians rated various patients' characteristics at the end of their hospital stay. RESULTS: The participation rate of the patients was 95.5 %. Of all patients, 95 % filled out the questionnaires at home, 69 % without a break. 57 % of the patients interviewed had filled out the questionnaires by themselves without any help, another 22 % worked it through together with their partner or spouse. The extent of influence on the responses appeared to be dependent on the amount of help necessary. In a substantial number of patients the questionnaires were regarded as an "official" document that had to be worked through meticulously. Physicians attested 96 % of the patients to have provided honest reports with regard to personal characteristics, and 95 % to have shown a sufficient degree of willingness of self-disclosure. By and large the patients' perceptions of themselves fit with the perceptions the physician in 76 % of the patients from the physicians' point of view. All patients except one were attested a positive motivation to take part in rehabilitation activities in the clinic by the physician. In individual cases there were substantial deficits of cognitive capacities necessary to work through a questionnaire, as well as limitations in literacy. Four patients had insufficient mastery of the German language. DISCUSSION AND CONCLUSION: The vast majority of the patients possessed sufficient motivational and cognitive prerequisites to provide valid self-reports. Patients with problems in responding asked partners or others for help, its impact on the self-reports being as yet not clear-cut. In individual cases it can not be ruled out that patients who think about early retirement provide distorted statements.

Adult↗
PubMed1987

Failure to warn.

Explore the source record for details and available documents.

Clinical Competence↗
PubMed1997

Donor insemination: attitudes of parents towards disclosure.

OBJECTIVE: To determine attitudes of parents of children conceived by donor insemination to telling the children of their origin. DESIGN: Questionnaire survey, in 1992-1993, of parents who had had a child by donor insemination at four New South Wales clinics from 1979 to 1990. SETTING: Three hospital-based clinics (two public, one private) and a private clinic service. PARTICIPANTS: 276 families who altogether had had 420 children by donor insemination. MAIN OUTCOME MEASURES: Number of children told that they had been conceived by donor insemination; parents' intentions, before conceiving and after the birth, of informing the child; and whether other people were informed of the child's origin. RESULTS: Of 393 families who could be contacted, 353 agreed to participate and 276 (70%) replied to the questionnaire. Only 22 of the 420 children (5.2%) had been informed of their origin. Before conceiving, 18% of parents (49/273) planned to tell the child. Seventy-one per cent of families (182/257) had told others of the origin of the child, but 94% (241/257) had not told the child. Of the 29% of families (75/257) who had not told others of the child's origins, none had told the child. As the children grow older, more parents decide not to tell them of their origin. CONCLUSIONS: Most parents of children conceived by donor insemination do not plan to tell their child, but most of these parents have told others, creating the potential for accidental disclosure. Because of the small number of children who are told of their origin, there may not be a need for government-regulated donor registers, provided donor insemination units maintain a high standard of record-keeping.

Adult↗
PubMed1985

Informed consent. An update.

A review of recent case law demonstrates that there is little agreement regarding either the amount of disclosure required for informed consent or the person who must present the information for informed consent. Examples of objective standards, subjective standards, and statutory standards are presented, as well as the impact of these recent developments on nursing practice.

Disclosure↗
PubMed1996

Managing HIV. Part 7: Professional issues. 7.6 Legal issues in HIV medicine.

The mortality, stigma and publicity surrounding HIV/AIDS have brought into focus many legal and ethical issues arising in the practice of medicine. Three important aspects of the practice of HIV medicine are the obligation to notify health authorities of HIV diagnoses, special obligations to inform and counsel patients who have or may have HIV and the duty of confidentiality.

Acquired Immunodeficiency Syndrome↗
PubMed1997

Influence of physician confidentiality assurances on adolescents' willingness to disclose information and seek future health care. A randomized controlled trial.

CONTEXT: Adolescents' concerns about privacy in clinical settings decrease their willingness to seek health care for sensitive problems and may inhibit their communication with physicians. OBJECTIVE: To investigate the influence of physicians' assurances of confidentiality on adolescents' willingness to disclose information and seek future health care. DESIGN: Randomized controlled trial. SETTING: Three suburban public high schools in California. PARTICIPANTS: The 562 participating adolescents represented 92% of students in mandatory classes. INTERVENTION: After random assignment to 1 of 3 groups, the adolescents listened to a standardized audiotape depiction of an office visit during which they heard a physician who assured unconditional confidentiality, a physician who assured conditional confidentiality, or a physician who did not mention confidentiality. MAIN OUTCOME MEASURES: Adolescents' willingness to disclose general information, willingness to disclose information about sensitive topics, intended honesty, and likelihood of return visits to the physician depicted in the scenario were assessed by anonymous written questionnaire. RESULTS: Assurances of confidentiality increased the number of adolescents willing to disclose sensitive information about sexuality, substance use, and mental health from 39% (68/175) to 46.5% (178/383) (beta=.10, P=.02) and increased the number willing to seek future health care from 53% (93/175) to 67% (259/386) (beta=.17, P<.001). When comparing the unconditional with the conditional groups, assurances of unconditional confidentiality increased the number of adolescents willing to return for a future visit by 10 percentage points, from 62% (122/196) to 72% (137/190) (beta=.14, P=.001). CONCLUSIONS: Adolescents are more willing to communicate with and seek health care from physicians who assure confidentiality. Further investigation is needed to identify a confidentiality assurance statement that explains the legal and ethical limitations of confidentiality without decreasing adolescents' likelihood of seeking future health care for routine and nonreportable sensitive health concerns.

Adolescent↗