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Results for “Disclosure”

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PubMed1977

Self-disclosure as a function of self-concept and sex.

It was hypothesized that the amount of self-disclosure occurring in a dyadic interaction would be a function of the level of self-concept and the sex of the subjects, with high self-concept subjects and females disclosing more than low self-concept subjects and males. Two hundred and ten subject (105 females and 105 males) were measured for level of self-concept and then paired so that every possible combination of high, medium, and low self-concept subject paired with a partner of high, medium, or low self-concept, and a partner of the same or opposite sex, occurred. The amount of self-disclosure that occurred in the dyadic interaction was measured. It was found that self-concept was significantly related to the amount of self-disclosure. High self-concept subjects were more responsive to the level of self-concept of their partners than were other subjects. There was no relationship between the sex of the subject and the amount of self-disclosure.

Female↗

PubMed2006

Why disclosure of genetic tests for health insurance should be voluntary.

Whether the disclosure of genetic (and non-genetic) information should be mandatory or voluntary is of concern. At present there are two opposing camps--the insurance industry argues for mandatory disclosure to avoid problems of adverse selection, and genetic interest groups argue for voluntary disclosure, fearing discrimination and public reluctance to have tests, thus missing out on any benefits from subsequent interventions. Policy has to balance these sides of the debate, as reducing adverse selection and encouraging maximum take-up of tests are both important for public health. We outline why voluntary disclosure is the optimal policy as it creates an incentive for people both to undergo testing and to disclose their result thus reducing the potential for adverse section.

Genetic Testing↗

PubMedDate not supplied

Self-disclosure in adult and mental health nursing students.

Self-disclosure, the process whereby people verbally reveal themselves to others, is an important interpersonal skill in initiating, developing, maintaining, and terminating therapeutic relationships. Studies of this interpersonal skill in nursing have, primarily, focused on adult nurses. They are dated, make no comparisons between this and other nursing specialisms, and have not considered the patient as a focus for nurses' self-disclosure. This study attempts to address these issues in relation to student nurses by: replicating a previous study of self-disclosure in adult nursing students (ANS) and offering a comparison of two nursing specialisms, reporting on the use of this skill in relation to the patient. A matched sample of 25 ANS and 25 mental health nursing students (MHNS) were asked to complete a modified version of Jourard's 25-item self-disclosure questionnaire. The findings suggest that: ANS were more self-disclosing than students sampled in an earlier study (Burnard and Morrison, 1992); both sets of students disclosed significantly less items to the patient as target-person than to other categories; and MHNS disclosed significantly more items than the ANS to the patient category.

Adolescent↗

PubMedDate not supplied

Mental health nursing students' rationales for self-disclosure: 1.

This study explored mental health nursing students' rationales for choosing whether or not to self-disclose in therapeutic encounters with patients. Using a two-item questionnaire, data were collected from a convenience sample of 162 preregistered students recruited from two universities in the UK. Content analysis of the data produced three categories for using self-disclosure: "building a therapeutic relationship", "similar experiences" and "appropriate information". Reasons for not self-disclosing fell into four categories: "crossing the line", "unhelpful", "name, rank and serial number" and "students' vulnerability". The research findings suggest that both therapeutic and personal reasons are involved in the decision to use self-disclosure. This article, the first of a two-part series, outlines the background, research methods and nurses' reasons for using self-disclosure. The second article will present students' reasons for not using self-disclosure and a discussion of the findings and their implications.

Adolescent↗

PubMed2004

Deconstructing stigma: perceptions of HIV-seropositive mothers and their disclosure to children.

This study addressed the perceptions of stigma and disclosure behavior of HIV-seropositive mothers. Eighty-eight HIV-seropositive women in New York City completed two independent measures of stigma, the Perceived Stigma Scale and the Devaluation-Discrimination Measure. Disclosers (67%) and nondisclosers (33%) were similar in most sociodemographic characteristics-marital status, race, religion and employment, with the exception of age and education. Significant differences were found between disclosure groups in the use of secrecy as a stigmamanagement tool and in perceived devaluation-discrimination associated with an HIV diagnosis. Nondisclosers to children were significantly more likely than disclosers to use secrecy as a stigma management tool (t =-2.76; p =.01), and to feel devalued and discriminated against as a result of HIV serostatus (t = 3.11; p =.01). Disclosure of parental HIV serostatus to children is an important aspect of continuous care and custody planning. Secrecy and perceptions of devaluation and discrimination related to HIV diagnosis should be seen as barriers to disclosure of serostatus to children.

Child↗

PubMed2003

Stigma, disclosure, and psychological functioning among HIV-infected and non-infected African-American women.

HIV is on the rise among African-American women. AIDS-related stigma plays an important role in the lives of HIV-infected and non-infected African-American women. Among HIV-infected women, the decision to disclose HIV seropositive status is likely affected by perceived stigma. The first purpose of the study is to examine perceived AIDS-related stigma over a six year period and across two groups of African-American women: HIV-infected and non-infected. The second purpose of the study examines whether disclosure of HIV seropositive status moderates the relationship between stigma and psychological functioning. Participants were 98 HIV-infected and 146 non-infected African-American women, between the ages of 18 and 50. Data were collected at four points across six years. Results indicated that HIV-infected women perceived a significantly higher level of AIDS-related stigma than non-infected women at all four assessments. Perceptions of stigma did not significantly change over time for the entire sample or within either HIV group. Among HIV-infected women, as the level of perceived stigma increased, the level of disclosure and psychological functioning decreased. Regarding the hypothesized moderating relationship, at high, but not low, levels of disclosure, the relationship between stigma and distress was significant. Implications for health professionals' work with HIV-infected African-American women around the issue of disclosure and stigma are discussed.

Adolescent↗

PubMed1996

Chemically dependent physicians and informed consent disclosure.

Developments in law, professional guidelines, and public attitudes support informed consent disclosure by physicians who have been treated for chemical dependency. This view is built on the apparent materiality of the risk of relapse to informed treatment decisions by patients. Several considerations undercut this position. The probability is remote that a patient will be injured by a recovering physician who suffers an undetected relapse while being properly monitored. Monitoring by impaired physicians programs provides a more sensitive and specific mechanism for detecting relapsed physicians. Moreover, compromise of the privacy and employment rights of recovering physicians by consent disclosure is not justified if programs provide rigorous monitoring that protects the welfare of patients. Finally, required consent disclosure will reduce referrals of chemically dependent physicians to impaired physicians programs, thereby increasing the danger to patients. Limiting demands for required consent disclosure necessitates effective operation of impaired physicians programs.

Confidentiality↗

PubMed2003

The relationship between shame, eating disorders and disclosure in treatment.

BACKGROUND: This study considered shame in 68 women who had received treatment for eating disorders (EDs) compared to 72 non-clinical controls, and shame in relation to disclosure in treatment. METHOD: All participants completed questionnaires on ED and depressive symptoms, and bodily, behavioural and characterological shame and shame around eating. ED women also answered questions on disclosure in treatment. RESULTS: The ED group scored significantly higher than controls on all shame areas when depression was controlled. ED women who were currently symptomatic and those who had recovered scored higher than controls on bodily and characterological shame and shame around eating. Non-disclosure in treatment was reported by 42% of the ED group and was associated with higher shame in all areas except bodily shame. CONCLUSIONS: The study is the first to show a relationship between shame and ED in a clinical sample. It supports existing evidence regarding the importance of bodily shame in women with EDs, and extends the literature in terms of the importance of other shame aspects for ED symptomatology and disclosure. Implications for treatment are discussed.

Adult↗

PubMed2005

Self-disclosure as a situated interactional practice.

Self-disclosure has long been a site of research in clinical and social psychology, where it suffers the fate of many interactional phenomena. It is operationalized (typically, into a set of bald statements of varying intimacy), and measured as a dependent variable (subject to the operation of factors like the age or gender of the discloser, the degree of acquaintance with the disclosed-to recipient, the expectation of reciprocity and so on), or manipulated as a causative independent variable (which affects such things as the perception of the discloser, the effectiveness of therapy, and so on). This treatment of self-disclosure, embedded in a research culture of a-contextual, experimenter-defined phenomena, risks missing the point that in ordinary life, self-disclosure is a social performance which must be brought off in interaction, and has its interactional context and its interactional consequences. When we examine examples of such brought-off disclosures, we start to see patterns in their design as voluntary revelations of personal data, and patterns in their social function, which are invisible to the standard factors and measures paradigm of experimental social psychology.

Humans↗

PubMedDate not supplied

Disclosure of physician incentives: do practices satisfy purposes?

Under legal pressure, discussion has quickly shifted from whether health plans should disclose how they pay their physicians to how, when, and what should be disclosed and by whom. This paper describes health plans' disclosure practices and evaluates their adequacy and likely impact. It begins by explaining how different reasons for disclosure alter the form and content of disclosure, illustrating these approaches with actual examples. The paper concludes with a recommended approach that attempts to layer and stage disclosures so that people have as much information as they want, when they need it.

Attitude to Health↗

PubMed2007

Reliability of disclosure forms of authors' contributions.

BACKGROUND: The contribution disclosure forms used by medical journals to assess and confirm authorship are surveys of self-reported behaviour that follow the cognitive rules of psychometric instruments. We sought to analyze how autobiographical memory, defined as memory for events and issues related to oneself, affected the reliability of contribution forms for the judging of authorship of research articles. METHODS: We conducted a prospective study, which ultimately included 919 authors of 201 articles submitted to a general medical journal from July 2001 through December 2002. A authorship disclosure form with a checklist of 11 possible contribution choices for all authors was sent first to each article's corresponding author, who was asked to fill it out for all authors. A blank form was then sent to each author individually to disclose his or her own contribution to that article. The main outcome measure was test- retest differences between the corresponding authors' self-declarations, expressed in percent as the gross difference rate (GDR) for each article. RESULTS: More than two-thirds of the corresponding authors (69.7%) differed in at least 1 contribution choice between the 2 disclosure statements made about their own contributions. The reliability of their answers was low to moderate (GDRs > 10%), especially for contributions on the provision of study materials or patients or final approval of the article (GDR 22.9%), guarantor of the study (GDR 20.9%) and drafting of the manuscript (GDR 20.4%). As a proxy for their coauthors' contributions, corresponding authors also differed from them in the perception of noncorresponding authors' contributions, disagreeing in 69.4% of cases. Of the 718 noncorresponding authors, 204 (28.4%) met all the criteria for authorship set out by the International Committee of Medical Journal Editors according to the statement given by the corresponding author. When they described their own contributions, this prevalence increased to 40.5%. INTERPRETATION: Psychological factors such as autobiographical memory may confound contribution disclosures as an evaluation tool for authorship on scientific articles and affect responsible authorship and publication practices.

Authorship↗

PubMed2004

Communicating with parents with full disclosure: a case of cloacal extrophy with genital ambiguity.

UNLABELLED: Full disclosure and complete involvement of parents in decisions concerning assignment of sex and genital surgery must be part of medical care for children presenting with findings consistent with disorders of intersex. Intersex most commonly involves disorders of steroidogenesis or gonadal function, but may include multiple cloacal anomalies, such as presented here. OBJECTIVE: To describe full disclosure of medical findings, by a multi-disciplinary medical team, as they became available over a period of weeks, in an infant originally assigned male, but eventually assigned female. PATIENT: An infant born at 24 weeks of gestation, after prenatal ultrasound showing distended bladder, ascites, and bilateral hydroureters, found to have an imperforate anus and a tubular structure appearing as a thin penis, without palpable corpora. DISCUSSION: Events concerning this case are discussed in relation to full disclosure of medical information to parents, guidelines for management of intersex, and the diagnosis (cloacal anomaly, cloacal extrophy, ano-rectal anomalies or uro-rectal septum malformation sequence). CONCLUSIONS: Full disclosure with involvement of parents with medical decisions is not only mandated currently, but also can be an effective approach in intersex care.

Cloaca↗

PubMed2001

A test of two HIV disclosure theories.

The purpose of this study was to examine two theories of HIV disclosure. The first is a disease progression theory and the second is the theory of competing consequences. Participants were 138 HIV-positive gay men involved in a larger study of HIV disclosure. Structural equation modeling was used to analyze each model, with the root mean square error of approximation (RMSEA) and the nonnormed fit index (NNFI) used to evaluate goodness of fit. The RMSEA for the disease progression model was .031 and the NNFI was .932. The RMSEA for the consequences model was .018 and NNFI was .978. Both indices are considered to be a close fit; however, the parameter estimates for disease progression to disclosure in the disease model and disease progression to consequences in the consequences model were nonsignificant, suggesting that disease progression may not play a role in the decision to disclose an HIV diagnosis. Researchers may want to focus on the intentions and possible outcomes from disclosure as predictive factors.

Acquired Immunodeficiency Syndrome↗

PubMed2001

Disclosure of adverse events and errors in healthcare: an ethical perspective.

Adverse events and medical errors affecting patient care are recognised internationally as major problems in medicine. The failure of health care professionals and health institutes to address this problem has threatened to undermine public confidence in the health care system as a whole. Less focus has been directed at the ethical issues raised by negative outcomes of care, specifically the issue of disclosure. Efforts to prevent negative outcomes of care must be supplemented by policies of increased honesty and openness with patients and their families about adverse incidents. Disclosure should be made easier, not riskier, for healthcare practitioners so clinicians can learn from mistakes and improve patient care. Ethical guidelines for error disclosure must distinguish between disciplinary action and reporting of adverse incidents. Disclosure of negative outcomes requires tact and good communication skills. Healthcare institutions should provide training for the clinicians in this area, if necessary. As a general rule, patients should be informed of unexpected adverse incidents as soon as possible. Medical staff should be rewarded for adverse event reporting and protected from institutional retaliation on account of errors made in health care.

Attitude of Health Personnel↗

PubMed1997

Environmental factors and clients' self-disclosure in counseling.

Self-disclosure by clients is regarded as a fundamental component of counseling, with increased self-disclosure being related to positive outcome of treatment; however, scant attention has focused on environmental characteristics that may facilitate self-disclosure among clients. An evaluation of prior research in this area leads to suggestions for studies on environmental factors and self-disclosure.

Counseling↗

PubMedDate not supplied

Relationships of nurses' critical thinking ability and perceived patient self-disclosure to accuracy in assessment of depression.

This descriptive study examined the relationships of nurses' critical thinking ability and perceived patient self-disclosure to accuracy in nursing assessment of depression in older medical patients. The sample consisted of 120 female nurse-patient dyads. Critical thinking ability was measured by the Watson-Glaser Critical Thinking Appraisal. Accuracy in nursing assessment was measured by deviations between the patient's SDS observed score and the patient's SDS predicted score. The patient's predicted score was based on the relationship between the Depression Status Inventory and Self-Rating Depression Scale. Perceived patient self-disclosure was measured by a 3-point system on patients' disclosure of information on symptoms of depression. A Pearson product-moment correlation and multiple regression analysis were used to analyze the data. The result showed that nurses' education was not significantly related to accuracy in assessment but related to critical thinking ability (r = .26; p = .004). Nurses' critical thinking ability was significantly related to accuracy in nursing assessment depression (r = -.24; p = .008). Perceived patients self-disclosure was not significantly related to accuracy in nursing assessment of depression.

Adult↗

PubMed1997

Disclosure issues and decisions of couples who conceived via donor insemination.

Disclosing the use of donor insemination (DI) to family, friends, and offspring poses a quandary for many DI patients. A cross-sectional survey was conducted to determine whether couples opted to share information about conception via donor sperm with their children, as well as the issues and concerns that arose for parents once infertility treatment was completed. Twenty-seven married heterosexual infertile husbands and wives who had used DI to conceive completed a follow-up questionnaire asking them about disclosure decisions as well as thoughts about DI as a reproductive option. Results revealed that nearly three-quarters of the sample had not disclosed to their child and did not plan to, although 85% had told at least one other person about conception via DI. With few exceptions, husbands and wives agreed about how to handle disclosure. Notably, 32% of the mothers reported not knowing when or how to disclose. However, the majority of couples were not offered psychological counseling prior or subsequent to DI. It is suggested that mental health professionals should be aware of the divergence of opinion between what they believe about the benefits of disclosure/counseling, the beliefs of infertile couples about disclosure and what is actually known about the benefits of full disclosure among all involved parties.

Adolescent↗

PubMed1992

[Self-disclosure and loneliness].

This study examined the relationship between self-disclosure and loneliness. The self-disclosure questionnaire (ESDQ) and the loneliness scale (LSO, consists of two subscales, U-scale and E-scale) were administered to 114 female subjects (junior college students). Results show that self-disclosure scores were negatively related to the U-scale of loneliness (whether or not they believe in mutual sympathy among human beings), but not to the E-scale of loneliness (whether or not they are conscious of individuality of each individual). The results suggest that we have to specify the quality of loneliness in question, when we examine the relationship between self-disclosure and loneliness.

Adult↗