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 415 records · Page 23Linked to original sources

PubMed2003

A preliminary study of self-esteem, stigma, and disclosure in adolescents who stutter.

UNLABELLED: This study examined the self-esteem, perceived stigma, and disclosure practices of 48 adolescents who stutter divided into two age cohorts: younger (13, 14, and 15 years) and older (16, 17, and 18 years) adolescents. Results revealed that 41 (85%) of the participants scored within 1 S.D. from the mean on a standardized measure of self-esteem, indicative of positive self-esteem. Results also showed that stuttering did not present a stigmatizing condition for the majority (65%) of adolescents who stutter. However, 60% of participants indicated that they "rarely" or "never" discussed their stuttering. The younger adolescents perceived stuttering as a more negative and stigmatizing condition than older adolescents. Implications for understanding stuttering in adolescents are discussed. EDUCATIONAL OBJECTIVES: Readers will learn about and understand (a) the role of stigma, disclosure, and self-esteem in stuttering; (b) the methods used to evaluate stigma, disclosure, and self-esteem in adolescents; and (c) the similarities between adolescents who stutter and normative data on self-esteem and stigma scales.

Adolescent↗

PubMed1998

Disclosure of disability: exploring the perspective of parents.

OBJECTIVE: To explore the perspective of parents with regard to disclosure of disability and early follow-up care. DESIGN: The research approach was hermeneutic phenomenology. Data were collected using focused interviews that were audio-taped, transcribed and interpreted. SETTING: Scotland. PARTICIPANTS: The parents of 63 children born with a congenital limb deficiency. FINDINGS: The findings demonstrate the complexity and variability in parental response. Additionally, what is shown is that disclosure was often handled poorly and that the support offered during the stay in the maternity unit was frequently inadequate. CONCLUSION: In order to handle disclosure effectively, health professionals require appropriate education and training and it is recommended that innovative ways of encouraging discussion and debate are sought.

Adaptation, Psychological↗

PubMed2003

Disclosure of cancer diagnosis and prognosis in Northern Tanzania.

Whether to tell patients with cancer about their diagnoses and prognoses is a matter of great debate. While many argue the importance of giving this information to facilitate informed decision-making, others argue that this same information can extinguish hope. Although there is some evidence that disclosure of this information is now commonplace in many Northern and Western settings, there are very few data about this issue from resource-poor nations describing physicians' decision-making regarding whether to disclose this information. Using a combination of ethnographic and other qualitative methods including participant observation, semi-structured interviews, informal interviews, and a review of key documents in Northern Tanzania, we map some of the salient issues in this setting. Like their colleagues in many other parts of the world, Tanzanian physicians often withhold diagnostic and prognostic information from patients. In addition, however, to the cultural arguments often used to justify this practice, issues of treatment availability and patient poverty also influenced the physicians' disclosure practices. Expatriate and Tanzanian physicians practicing in Northern Tanzania often had different approaches to informing patients of their diagnoses and prognoses. Some Tanzanian physicians advocated the use of a "roundabout" approach to disclosure, arguing that it was more reflective of the normal mode of discourse in Tanzania than the more direct approach advocated by many of their expatriate colleagues. Expatriate physicians and some of their Tanzanian colleagues felt that such an indirect approach often left patients confused, or indeed, uninformed.

Cost of Illness↗

PubMedDate not supplied

Self-disclosure and the treatment of substance abuse.

Identification and treatment of the substance-abusing physician has led to outcome studies focusing on years of abstinence and resultant work performance, but little has been written addressing the therapeutic changes recovery brings in the personal lives of these physicians or in their approach to similarly addicted patients. The unique position of recovering psychiatrists engaged in the treatment of substance-abusing patients has not been addressed. Self-disclosure is a major issue and becomes unavoidable if the psychiatrists meet their patients at Twelve-Step meetings. This paper begins a discussion of the issues of self-disclosure and anonymity for recovering psychiatrists. The informal method used to gather information highlights the sensitivity of these issues for both patients and psychiatrists. The clinical examples show the importance of evaluating the psychodynamic impact of self-disclosure on the patient, the psychiatrist, and their treatment relationship.

Adult↗

PubMed1992

Diagnostic disclosure: a tale in two cultures.

Diagnostic communication between doctors and patients is thought to differ radically between Japan and Western countries. To understand diagnostic disclosure to psychiatric patients, a questionnaire with six case vignettes was sent to practising psychiatrists in Japan (N = 166) and North America (N = 112). While over 90% of both groups would inform patients with affective and anxiety disorders of their diagnoses, only 70% of North Americans and less than 30% of Japanese would similarly inform patients with schizophrenia or schizophreniform disorders. The Japanese preferred alternative was to give a vague alternative diagnosis such as neurasthenia. North Americans would discuss differential diagnoses with the patient instead. Nearly all in both groups would inform the family, but North Americans would do so only with patient consent. For disorders for which there are effective treatments, diagnostic disclosure is common to both cultures; when prognosis is uncertain or the diagnosis is feared, as in schizophrenia, culturally constructed views of patienthood govern disclosure practice.

Adult↗

PubMed1998

Mexican geneticists' opinions on disclosure issues.

Here we discuss the opinion on disclosure issues (respect for confidentiality) of Mexican professionals working in clinical genetics. The information was obtained from a comprehensive survey on genetics, ethics and society organized by Wertz and Fletcher in 1993, in which geneticists from 37 nations participated. The responses to 18 questions from 64 of 89 (72%) geneticists invited to participate were analyzed for this paper. The questions were directed to investigate: a) disclosure of clinically relevant information in several situations such as testicular feminization syndrome, mosaic de novo balanced translocation in a fetus, or accidental discovery of non-paternity; b) the protection of patient's privacy from the spouse or blood relatives; and c) confidentiality in cases with high genetic risk to relatives. The results reveal significant disparity between general responses related to disclosure of all clinically relevant information and specific responses in particular cases. In addition, professionals appear to give higher priority to protecting the spouse, blood relatives or public safety, rather than the patient's confidentiality.

Attitude of Health Personnel↗

PubMed1995

Women's self-disclosure of HIV infection: rates, reasons, and reactions.

A survey of 65 ethnically diverse women at 2 outpatient HIV clinics revealed relatively low rates of disclosure of HIV-positive serostatus to extended family members, somewhat higher rates for immediate family members, and highest rates for lovers and friends. Spanish-speaking Latinas were less likely to disclose their serostatus or to discuss HIV-related worries with others than English-speaking Latinas, African Americans, and Anglo Americans. Reasons for disclosure and nondisclosure varied by target. In general, targets reacted positively to disclosure. Implications for clinicians treating women with HIV infection are discussed.

Adolescent↗

PubMed1985

Adolescent self-disclosure and loneliness: private self-consciousness and parental influences.

Using structural equation techniques, we tested a theoretical model designed to describe the causal relations existing among loneliness, self-disclosure to peers and parents, and specific antecedent variables. Participants were 350 high-school students who answered questions concerning themselves and their interpersonal relationships. Results generally indicated a good fit between the theoretical model and the observed relations. In addition to replicating the findings of previous studies concerning the relation between self-disclosure and loneliness, results also indicated an indirect relation between private self-consciousness and loneliness via peer self-disclosure; that is, high private self-conscious adolescents' greater willingness to self-disclose to peers resulted in their feeling less lonely. Results are discussed in terms of current theory in related fields.

Adolescent↗

PubMed1999

Self-efficacy and disclosure of HIV-positive serostatus to sex partners.

HIV-positive persons face significant challenges to disclosing their HIV serostatus, and failure to disclose can place their sex partners at risk. The current study examined HIV serostatus disclosure in 266 sexually active HIV-positive persons recruited from the community. Results showed that 41% had not disclosed their HIV serostatus to sex partners. Men who had not disclosed to partners indicated lower rates of condom use during anal intercourse and scored significantly lower on a measure of self-efficacy for condom use compared to individuals who had disclosed. Emotional distress was also greatest among persons who had not recently disclosed. Having not disclosed to sex partners was closely associated with lower self-efficacy for disclosing, with women who had not disclosed reporting the lowest disclosure self-efficacy. As people living with HIV-AIDS are encouraged to disclose their HIV status, interventions are needed to facilitate disclosure decision making.

Adult↗

PubMed2005

Further examination of the exposure model underlying the efficacy of written emotional disclosure.

In the current study, the authors examined the effects of systematically varying the writing instructions for the written emotional disclosure procedure. College undergraduates with a trauma history and at least moderate posttraumatic stress symptoms were asked to write about (a) the same traumatic experience, (b) different traumatic experiences, or (c) nontraumatic everyday events across 3 written disclosure sessions. Results show that participants who wrote about the same traumatic experience reported significant reductions in psychological and physical symptoms at follow-up assessments compared with other participants. These findings suggest that written emotional disclosure may be most effective when individuals are instructed to write about the same traumatic or stressful event at each writing session, a finding consistent with exposure-based treatments.

Adult↗

PubMed1993

Disclosure of terminal prognoses in a general hospital: the nurse's view.

Some of the issues which nurses confront when they deal with the disclosure of terminal diagnoses and prognoses to patients are explored. In such circumstances, the nurse must respond to the competing demands of patients, relatives and medical staff. The paper examines the way in which a group of experienced staff nurses in a general hospital accounted for their activities during and after the disclosure of a lethal diagnosis. In particular, it explores the ways in which nurses are included or excluded from decision making about disclosure by medical staff.

Attitude of Health Personnel↗

PubMed1999

Japanese nurses' perceptions about disclosure of information at the patients' end of life.

Information disclosure at the end of life is one of the most debated ethical issues in Japan. This paper, using data from a larger questionnaire survey in which 147 Japanese nurses participated, describes nurses' perceptions about this issue. The nurses perceived that non-disclosure of impending death information to patients was the norm in Japan due to its traditional values. This non-disclosure of information has various impacts on clinical nurses. Tension was evident between the Japanese traditional concepts supported by some nurses and the shift toward Western cultural and ethical values supported by other nurses. The nurses confronted uninformed patients who became suspicious, isolated, angry, or died unprepared for their life's ending. The nurses were placed in the middle between the patient and the family, as nurses became keepers of family secrets, or between nurses' ethical obligations to the patient and those of the institution. The nurses had the belief that at the patient's end of life, it is important to change health professionals' attitude from curing to caring.

Adult↗

PubMed2002

Priorities for disclosure of the elements of informed consent for research: a comparison between parents and investigators.

BACKGROUND: Disclosure is a key element of the informed consent process. This study examines and compares the priorities for disclosure of the elements of informed consent between parents of paediatric research subjects and investigators. METHODS: The study sample comprised 184 parents who had been approached for permission to allow their child to participate in a clinical anaesthesia or surgery study. Parents were asked to rank 11 elements of informed consent that they believed were most important for them to know before allowing their child to participate in a research study. In addition, 38 investigators were asked to rank, in order of importance, the same elements that they felt were most important for parents to know. RESULTS: The results showed that risk was the most important element considered by both parents and investigators. However, parents placed significantly greater importance on knowledge of the potential benefits to their child (direct) and to other children (indirect) compared with investigators, and less importance on the details of the protocol and the element of voluntariness. CONCLUSIONS: These results demonstrated differences in the priorities for disclosure of the elements of consent between parents and investigators. As such, they may be important in directing the investigator to focus on the elements that are most important to parents and thus maximize their ability to provide truly informed consent.

Adult↗

PubMed2002

Evaluating a written emotional disclosure homework intervention for lower-limb amputees.

OBJECTIVE: To evaluate the Pennebaker Emotional Disclosure paradigm with lower-limb amputee patients in terms of compliance and efficacy. DESIGN: Repeated measures. SETTING: Home based. PARTICIPANTS: Low compliance, both with the initial mailed request (28%) and the subsequent writing task (48%), resulted in 23 lower-limb amputees who had been fitted with a prosthesis participating. INTERVENTIONS: Patients completed a 15-minute writing task, 6 times, over 2 weeks, with initial baseline and 2-month follow-up assessments. MAIN OUTCOME MEASURES: Cognitive processing, well-being, adjustment to an artificial limb, pain, and prosthetic use. RESULTS: Stronger emotional disclosure was associated with significant reductions in psychologic and physical aspects of amputees' satisfaction with their prosthesis, some of which were mediated by positive changes in affect immediately after the writing tasks. CONCLUSIONS: Our results failed to support previous findings with nonclinical samples; in fact, our results contradicted previous findings. We therefore caution that written emotional disclosure may be contraindicated with lower-limb amputee patients.

Amputees↗

PubMedDate not supplied

Perceptions of children with HIV infection when not told for so long: implications for diagnosis disclosure.

INTRODUCTION: The perceptions of school-aged children with HIV infection about their illness were evaluated in light of parental/guardians communication about the child's diagnosis to clarify guidelines for disclosure. METHOD: An innovative, qualitative research design using methods of grounded theory and projective drawings involved 12 children and 13 parents/guardians from a West Coast Pediatric AIDS Clinical Trial treatment center. RESULTS: A specific process of interaction between parents/guardians and children, when not told for so long, emerged as the central phenomenon of the study. Parents/guardians kept the children's HIV infection secret for 2 to 8 years after diagnosis. Regardless of disclosure status, the children's drawings and conversations suggested severe emotional distress, disturbed self-image, and social isolation. Parents and guardians were unaware of their children's concerns. DISCUSSION: Although other circumstances of the children's lives contributed to their poor psychosocial adjustment, the long interval of silence about the illness also played a part in their poor adjustment. Parents/guardians did not recognize when their children needed more supportive information. Pediatric clinicians should therefore continually assess children's psychosocial adjustment to guide families through the disclosure process. The use of projective drawing techniques can facilitate this process.

Adaptation, Psychological↗

PubMed1975

The effects of self-concept, trust, and imagined positive or negative self-disclosures on psychological space.

This study focused on some of the determinants of schematic interactional distance based on an analysis of social learning processes. It was hypothesized that closer interpersonal constructions would be associated with a more positive rather than negative self-concept, a greater rather than lesser degree of trust, and a covert positive rather than negative self-disclosure to a significant other. One hundred fifty-nine male and female undergraduate students were administered the Tennessee Self Concept Scale and Jourard's Self-Disclosure Questionnaire. Of these Ss, 82 were also given either positive or negative covert self-disclosure conditions. Interactional distances consisted of "Self" placements in relation to several key social target representations. The results supported the hypothesis regarding the relationship between self-concept and psychological distance, but only for females. There was also a tendency for more trusting females to produce closer distances than less trusting females. These results, as well as the obtained significant sex differences in distancing responses and in renditions of vertical displacements, were discussed within the context of culturally determined sex role differences.

Hierarchy, Social↗

PubMed1979

Preferences and self-disclosure in relation to psychotherapist professional and ethnic identification.

This study examined the effects of psychotherapist ethnicity and expertise on preferences and self-disclosure. Thirty-four white Anglo American college students, 20 male and 14 female, listened to one of two matched psychotherapy tapes. The therapist was identified by background introductions as being either professional or nonprofessional and as either of Anglo American or Mexican American ethnicity. After hearing the tape, the Ss' perceptions and willingness to talk to the therapist were measured on a self-disclosure scale and an attitude-toward-therapist scale. Ss showed significantly higher self-disclosure to the therapist introduced as an Anglo American professional. The Mexican American nonprofessional also received significantly higher negative attitude-toward-therapist scores compared to the other therapist conditions.

Clinical Competence↗

PubMedDate not supplied

Congruence of knowledge, experiences, and preferences for disclosure of diagnosis and prognosis between terminally-ill cancer patients and their family caregivers in Taiwan.

BACKGROUND: Over the last 40 years, studies have shown cultural differences in attitudes toward truth telling at the end-of-life. Nevertheless, the argument that cancer patients from an Asian culture have different preferences about information disclosure that necessitate significantly modifying information disclosure practices has not been validated by direct investigation from patients' points of view. METHODS: Six hundred seventeen dyads of patient-designated family caregivers across 21 hospitals throughout Taiwan were surveyed and interviewed by a semistructured interview guide. Percentage of agreement, kappa coefficients, McNemar tests, and paired t-tests were conducted to examine the extent of congruence of knowledge, experiences, and preferences for disclosure of diagnosis and prognosis between the dyads. RESULTS: There were substantial discrepancies in the knowledge and experiences of being informed about the diagnosis and prognosis between Taiwanese terminally-ill cancer patients and their family caregivers (kappa values ranged from 0.08 to 0.44). Cancer patients strongly proclaimed their superior rights to be informed about their disease over their family and preferred their physicians to inform themselves before releasing any information to their family caregivers. CONCLUSION: The arguments that cancer patients from an Asian culture (i.e., Chinese/Taiwanese culture) have different preferences regarding being informed of their diagnosis and prognosis and that family members have legitimate superior power in decision making could not be supported by data from this group of terminally-ill cancer patients. Physicians need to respect patients' preferences rather than routinely taking the family's opinions into consideration first in the event of disagreement. Equipped with adequate information, terminally-ill cancer patients from Asia may have better opportunities to make end-of-life care decisions that are in accord with their wishes.

Adult↗