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Results for “Disclosure”

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PubMed2005

School-aged children of donor insemination: a study of parents' disclosure patterns.

BACKGROUND: A major concern in relation to donor insemination (DI) is whether children should be told about their genetic origins. This study compared the thoughts, feelings and experiences of DI parents who were inclined towards openness with those who were inclined towards non-disclosure. METHODS: Forty-six families with a 4- to 8-year-old DI-conceived child were interviewed about their decision, their reasons and subsequent concerns regarding disclosure. RESULTS: Thirty-nine percent of parents were inclined towards disclosure whilst the remaining 61% were not. The two main reasons for favouring disclosure were to avoid accidental discovery and a desire for openness. Non-disclosing parents felt that there was no reason to tell and wished to protect family members. The children who had been told reacted with either curiosity or disinterest. CONCLUSIONS: In spite of donor anonymity, parents who were intending to tell their child in the future had optimistic expectations of their child's reaction. Parents who had already told their child generally described the telling experience as a positive one.

Adult↗

PubMed1995

Human immunodeficiency virus seropositivity self-disclosure to sexual partners: a qualitative study.

The article examines the process of human immunodeficiency virus seropositivity self-disclosure to sexual partners. The few studies that have been done in regard to this topic are quantitative and epidemiologic in nature and concentrate on urban gay men. In contrast, the findings described here are qualitative, and they are from HIV-positive small-town southwesterners, heterosexuals included. Five basic topics emerged as salient in regard to the self-disclosure process: a disclosee's need to know, nondisclosure conjoined with safer sex practice, disbelief and denial among the seronegative and untested, strategies for evaluating potential disclosees, and rejection or acceptance by the disclosee. According to participants, self-disclosure does not necessarily lead to safer sex because partners often do not want it. Participants see a lack of prophylactic effort in partners as resulting from informed choice, even if self-disclosure, they also experienced rejection. Rejection can be direct or perfidious. Participants compared partners' often problematic reactions with those of children, which they praised. Future research will lead to the creation of formal guidelines for use by health care professionals in promoting secondary prevention practices, such as condom use, and in determining how best to serve HIV-positive clients.

Adult↗

PubMed2007

Factors correlated with disclosure of HIV infection in the French Antilles and French Guiana: results from the ANRS-EN13-VESPA-DFA Study.

OBJECTIVES: To determine the rate, patterns and predictors of HIV disclosure in the French Antilles and French Guiana. METHODS: A cross-sectional survey was carried out among a 15% random sample (n=398) of the hospital caseload in hospitals providing HIV care. Determinants of disclosure to a steady partner and other members of the individual's social network were analysed using logistic regression. RESULTS: From the time of diagnosis, 84.6% of those in a couple (n=173) disclosed their HIV-positive status to their steady partner, 55.6% disclosed to others, and 30.3% did not tell their status to anyone. Disclosure within a steady partnership was less likely among non-French individuals [Haitians: adjusted odds ratio (AOR) 0.11, 95% confidence interval (CI) 0.02-0.72; other nationalities: AOR 0.13, 95% CI 0.02-0.68]; and among those diagnosed with HIV after 1997 (AOR 0.21, 95% CI 0.05-0.86). Determinants of disclosure to others were found to be sex (women: AOR 2.04, 95% CI 1.24-3.36), age at diagnosis (>or=50 versus<30 years: AOR 0.42, 95% CI 0.19-0.90), nationality (Haitians versus French: AOR 0.39, 95% CI 0.19-0.77), transmission route (non-sexual versus sexual: AOR 3.38, 95% CI 1.12-10.23) and hospital inpatients (hospitalized versus non-hospitalized patients: AOR 1.98, 95% CI 1.17-3.37). After disclosing, social and emotional support from confidants was common and discrimination was infrequent. CONCLUSION: One third of PLWHA had kept their HIV status secret. Interventions targeting the general population and social institutions, and support for PLWHA by healthcare staff are needed to improve the situation.

Adult↗

PubMed2005

Stress-reductive effects of information disclosure to medical and psychiatric patients.

Informed consent has become a central part of medical decision-making. It is based on disclosure of medical information to support patients' rights for autonomous decision-making from a legal point of view. However, information disclosure may also benefit patients. Research indicates that information disclosure reduces stress among patients and that the more patients desire relevant information, the more stress-reductive information disclosure may be. In psychiatry, too, studies have shown that educating psychiatric patients may not necessarily reduce compliance or increase relapse rate. These findings are in line with patients' desires and their legal right to know their own medical matters. It has long been believed that patients, be they psychiatric or non-psychiatric, should be protected and not given information that would potentially cause distress or harm to them. However, patient's competency may be a function of the physicians' efforts to make patients understand necessary information. Therefore, a patient's right to give informed consent leads to a physician's duty to disclose individually tailored information understandable to patients.

Disclosure↗

PubMed1992

Effects of self-consciousness and social anxiety on self-disclosure among unacquainted individuals: an application of the social relations model.

Recent research has demonstrated a positive relationship between private self-consciousness and the tendency to self-disclose. These studies have relied exclusively upon self-reports of disclosure. In the present study, Kenny's Social Relations Model (Kenny & La Voie, 1984) was employed to examine the relationship between a subject's self-reports and others' reports of a subject's level of self-disclosure and the relationship of these reports to private self-consciousness, as well as the other traits measured by the self-consciousness scale: public self-consciousness and social anxiety. Unacquainted college women (N = 102) participated in one-on-one interactions in a round-robin design. Subject's self-reports of disclosure and their levels of private self-consciousness correlated positively. The partners' reports of an individual's disclosure, however, were not related to the individual's level of private self-consciousness. The discrepancy between these correlations emphasizes the necessity to ground research in personal relationships on interacting pairs and not only on the self-reports of one member. Future research that would explore this difference is discussed. The examination of the self- and partner reports and subjects' levels of public self-consciousness and social anxiety demonstrated that these two traits significantly influence the acquaintance process. Public self-consciousness related positively to subjects' beliefs that they had created consistent impressions upon their partners. Social anxiety correlated negatively with partners' reports of a subject's dyadic involvement and openness.

Adult↗

PubMed1992

Paediatricians' practice in disclosure and follow-up of severe physical disability in young children.

Twenty-four paediatricians were asked about their policy and practice regarding disclosure and follow-up of the diagnosis of disability, and for suggestions to improve current practice. Doctors with less clinical experience were more likely to mention the presence of the child as an element of the disclosure interview, and scored higher than those with more experience on an index score of the format of the disclosure interview. Paediatricians' reported constraints on their preferred practice and findings from interviews with mothers in the same study confirmed continuing shortcomings in disclosure practice. Changes in medical training, the adoption of a written policy of good practice and the nomination of a 'key worker' for each family are suggested.

Child↗

PubMed1993

Determinants of parental satisfaction with disclosure of disability.

Parental satisfaction with the process of disclosure of disability was investigated in interviews with 103 parents of children with severe physical disability. Only 37 per cent of parents were satisfied with disclosure. Parents were more likely to be satisfied if they felt that the professional carrying out the disclosure had a sympathetic, understanding and approachable manner, and was direct and communicated well; if they had been given sufficient information and opportunities to ask questions; and if they were from a manual social-class background. Factors in the procedure of the disclosure, such as the timing, were not significantly related to satisfaction. These results demonstrate the importance of the parent-professional interaction and point towards an increased emphasis on communication skills in medical training.

Adolescent↗

PubMed2006

Views of potential research participants on financial conflicts of interest: barriers and opportunities for effective disclosure.

BACKGROUND: There is little guidance regarding how to disclose researchers' financial interests to potential research participants. OBJECTIVE: To determine what potential research participants want to know about financial interests, their capacity to understand disclosed information and its implications, and the reactions of potential research participants to a proposed disclosure statement. DESIGN AND PARTICIPANTS: Sixteen focus groups in 3 cities, including 6 groups of healthy adults, 6 groups of adults with mild chronic illness, 1 group of parents of healthy children, 1 group of parents of children with leukemia or brain tumor, 1 group of adults with heart failure, and 1 group of adults with cancer. APPROACH: Focus group discussions covered a range of topics including financial relationships in clinical research, whether people should be told about them, and how they should be told. Audio-recordings of focus groups were transcribed, verified, and coded for analysis. RESULTS: Participants wanted to know about financial interests, whether or not those interests would affect their participation. However, they varied in their desire and ability to understand the nature and implications of financial interests. Whether disclosure was deemed important depended upon the risk of the research. Trust in clinicians was also related to views regarding disclosure. If given the opportunity to ask questions during the consent process, some participants would not have known what to ask; however, after the focus group sessions, participants could identify information they would want to know. CONCLUSIONS: Financial interests are important to potential research participants, but obstacles to effective disclosure exist.

Adolescent↗

PubMed2005

Transparency and self-disclosure in family therapy: dangers and possibilities.

Therapy is a paid intimate relationship that thrusts clients and therapists into navigating personal and professional boundaries. When, where, why, and how is it appropriate and ethical for family therapists to be transparent, and when is it damaging? Theorists take varied stances from Haley's position of tight boundaries around therapist disclosure--whether in treatment or training--to the narrative viewpoint that therapists should be transparent about models of therapy, personal values, and life experiences that inform their practice and beliefs. However, these positions are not research based, and theorists who support disclosure offer few guidelines other than general statements. This article examines the history of ideas about disclosure in six major family therapy models, and the dangers and possibilities of transparency. It looks at the research on self-disclosure in individual therapy and whether and how it could apply to family therapy. Guidelines are proposed that take into account the multiple social identities of therapists and clients, and issues of safety and transparency.

Emotions↗

PubMedDate not supplied

The effect of social and care environments on the disclosure practices of nurse midwives relative to methods of pain management in childbirth.

A multivariable model of characteristics in the nurse-patient relationship that influence the disclosure practices of nurses was developed to investigate the effects that characteristics of the nurse midwife, the patient, and the setting have on the disclosure practices reported by nurse midwives. Data were collected by a mailed questionnaire using multiple-choice questions and patient case studies. The questionnaire was sent to a random sample of 500 certified nurse midwives. No association occurred between variations in patient characteristics and the content disclosed by nurse midwives. Many of the patient demographic characteristics were observed to be significantly related to the method and time of disclosure. Results of the study suggested that the social as well as the immediate health-care environment influenced the disclosure of information.

Female↗

PubMed1995

Twelve month outcome of depression in general practice: does detection or disclosure make a difference?

OBJECTIVES: To assess the extent to which the outcome of depression among primary care attenders may be affected by medical diagnosis or by feedback of questionnaire results in unrecognised cases. DESIGN: Prospective 12 month study including a randomised controlled trial of the effects of disclosure, with data on depression status and clinical management collected by questionnaire and interview. SETTING: Two group practices in north Liverpool. SUBJECTS: 1099/1444 (76%) consecutive adult attenders completed the Beck depression inventory, of whom 179 with scores of at least 14 were followed up. INTERVENTIONS: Disclosure of a random 45% (52/116) of depression scores to general practitioners for subjects whose depression was undetected. MAIN OUTCOME MEASURES: Depression status estimated by depression score at start of study and at six and 12 months, with subsample validation against ICD-10 criteria. RESULTS: Questionnaire response rates were 76% (136/179) at six months and 68% (122/179) at 12 months and were higher for women than men. The median depression score was 19 (interquartile range 15 to 22) initially, decreasing to 16 (11 to 23) at 12 months. The median depression score decreased significantly (two sided test, P = 0.019) in subjects whose depression was unrecognised at the index consultation but increased in those whose depression had been detected by their general practitioners. Disclosure of cases of unrecognised depression to general practitioners had no effect on outcome. Intention to treat was associated with a worse prognosis, although only a minority of subjects received adequate treatment. CONCLUSIONS: Disclosure of undetected depression did not improve prognosis. A diagnosis of depression in general practice should be considered simply as a marker of its severity.

Adolescent↗

PubMed1999

Attitudes of the Lebanese public regarding disclosure of serious illness.

OBJECTIVES: To measure the preference regarding disclosure of a serious diagnosis, and its determinants, of the Lebanese public. DESIGN AND SETTING: Non-random sample survey of 400 persons interviewed in health care facilities in Beirut in 1995. RESULTS: Forty-two per cent of respondents generally preferred truth not to be disclosed directly to patients. Preference for disclosure was associated with younger age, better education and tendency to rapport-building with physicians. There were no meaningful associations between place of residence (urban/rural), level of religious practice, or religious affiliation, and preference for disclosure. CONCLUSIONS: Under one plausible interpretation, this survey suggests that the expectation for concealment will decrease as the advantage of knowledge in better coping with disease is understood by an increasingly better educated public, and that the Lebanese public will increasingly come to expect direct and full disclosure of serious diagnoses.

Adult↗

PubMed2004

Analytic neutrality, anonymity, abstinence, and elective self-disclosure.

Recent contributions to the psychoanalytic literature propose new ways of understanding analytic neutrality, anonymity, abstinence, and self-disclosure. They advocate elective self-disclosure by the analyst as an antidote to the allegedly game-playing quality of transference and resistance analysis. The analytic relationship, they assert, becomes unreal when attempts are made to observe the principles of neutrality and abstinence. Both are seen as ill-conceived because of the irreducible subjectivity and unwarranted authority of the analyst. These relational and interactional views are criticized because (1) they ignore the fact that transference and resistance analysis have from Freud onward been accepted as minimal criteria qualifying a clinical process as psychoanalytic; (2) elective self-disclosure carries metapsychological implications dismissing not only Freud's theory of motivation but motivation as a basic feature of human personality; (3) they do not recognize interpersonal relations as mental events and so do not consider the ego's ability to create intrapsychic representations of object relations; (4) elective self-disclosures within the empathic parameters of the analytic situation are themselves unreal compared to the reality of the patient's experience with other objects. Abstinence and neutrality as ideals facilitate maintenance of an internal holding environment or container for the analyst's countertransference.

Humans↗

PubMed1995

Unwanted sexual experiences in adolescents. Patterns of disclosure.

More than 300 patients who presented consecutively to a sexual abuse clinic, a family planning clinic, and a family practice clinic filled out an anonymous survey regarding unwanted sexual experiences. In the family planning and family practice clinics, 40% of females and 16% of males reported having at least one unwanted sexual experience prior to their 18th birthday. Although 85% had disclosed their unwanted sexual experience, time to disclosure was prolonged (mean 2.3 years, median 5 to 6 months). Fear and embarrassment were the most common reasons for delay or lack of disclosure. The most common reasons for disclosure reflected internal rather than external or environmental influences. Increased awareness of unwanted sexual experiences and pattern of disclosure may enhance detection and treatment in children and adolescents.

Adolescent↗

PubMed1980

The therapist's self-disclosure in individual psychotherapy: research and psychoanalytic therory.

There appears to be a trend, paralleled by the development of object-relations theory, towards an increasing degree of self-disclosure of the therapist in individual psychotherapy. Research on the subject of self-disclosure of the therapist has tended to focus on experimental interviews and on the dyadic effect of self-disclosure. This author suggests that a useful area for future research will be the realtionship between therapist's self-disclosure and the analysis of transference. Research needs to be done on actual individual psychotherapy.

Humans↗

PubMed2004

Is disclosure of childhood rape associated with mental health outcome? Results from the National Women's Study.

Clinicians often assert that disclosure of childhood rape is beneficial to victims because it sets the occasion for protective action and can bring them into contact with professionals trained to address rape-related mental health needs. Consistent with this is the hypothesis that victims of childhood rape who disclose their victimization soon after it occurs are at lower risk for later psychosocial difficulties relative to those who delay disclosure or never disclose. We explored this issue with a nationally representative sample of 3,220 adult women; 288 (8.9%) endorsed at least one instance of forcible sexual penetration prior to age 18. Results revealed a significantly higher past-year prevalence of posttraumatic stress disorder (PTSD) and major depressive episodes among women who waited longer than 1 month to disclose their rape relative to nondisclosers and women who disclosed within 1 month of the rape. Delayed disclosure remained associated with PTSD after controlling for demographic and rape characteristics. Patterns of disclosure were not associated with past-year substance-use problems.

Adolescent↗

PubMed1994

Japanese attitudes towards truth disclosure in cancer.

Despite the increasing concerns of truth disclosure, most cancer patients are not told the truth about their disease in Japan. The author has tried to provide some insight into this issue by evaluating results from questionnaires given to hospital patients, clients in a mass cancer survey, and doctors of a college hospital. Results showed that 72% of patients and 83% of clients wanted to be told the truth, but only 33% and 34% of them thought that the truth should be told to cancer patients. These attitudes of patients and clients regarding truth disclosure were more positive than those of the general public and health care workers in previous studies. At present, 13% of doctors inform cancer patients of their disease. These trends indicate that the Japanese attitude toward avoiding truth disclosure stems primarily from paternalism but is also influenced by social characteristics including insufficient understanding of this issue. Open discussion involving all factions of society is necessary to attain a better understanding of this issue and to promote eventual truth disclosure.

Adolescent↗

PubMed2006

Advertising and disclosure of funding on patient organisation websites: a cross-sectional survey.

BACKGROUND: Patient organisations may be exposed to conflicts of interest and undue influence through pharmaceutical industry (Pharma) donations. We examined advertising and disclosure of financial support by pharmaceutical companies on the websites of major patient organisations. METHOD: Sixty-nine national and international patient organisations covering 10 disease states were identified using a defined Google search strategy. These were assessed for indicators of transparency, advertising, and disclosure of Pharma funding using an abstraction tool and inspection of annual reports. Data were analysed by simple tally, with medians calculated for financial data. RESULTS: Patient organisations websites were clear about their identity, target audience and intention but only a third were clear on how they derived their funds. Only 4/69 websites stated advertising and conflict of interest policies. Advertising was generally absent. 54% of sites included an annual report, but financial reporting and disclosure of donors varied substantially. Corporate donations were itemised in only 7/37 reports and none gave enough information to show the proportion of funding from Pharma. 45% of organisations declared Pharma funding on their website but the annual reports named more Pharma donors than did the websites (median 6 vs. 1). One third of websites showed one or more company logos and/or had links to Pharma websites. Pharma companies' introductions were present on 10% of websites, some of them mentioning specific products. Two patient organisations had obvious close ties to Pharma. CONCLUSION: Patient organisation websites do not provide enough information for visitors to assess whether a conflict of interest with Pharma exists. While advertising of products is generally absent, display of logos and corporate advertisements is relatively common. Display of clear editorial and advertising policies and disclosure of the nature and degree of corporate donations is needed on patient organisations' websites. An ethical code to guide patient organisations and their staff members on how to collaborate with Pharma is also necessary, if patient organisations are to remain independent and truly represent the interests and views of patients. As many organizations rely on Pharma donations, self-regulation may not suffice and independent oversight bodies should take the lead in requiring this.

Advertising↗