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PubMed1977

A personal construct approach to perception of disclosure targets.

Investigating the perception of targets for self-disclosure from the perspective of the psychology of personal constructs, it was predicted that respondents from a mixed-nationality group would (a) characterize friends more than acquaintances in terms of 'superordinate' personality-descriptive dimensions, (b) 'differentiate' friends more than acquaintances by extensive application of constructs to them, and (c) 'polarize' targets for high disclosure by construing them sharply and meaningfully in terms of personally significant dimensions of meaning. All predictions received significant support for 34 college students (Mdnage 22 yr.) who responded in writing to a questionnaire. The results suggest the fruitfulness of further examining self-disclosure and friendship formation from a vantage point which emphasizes the perceptual and interpretive framework of an adult person.

Adolescent↗
PubMed1988

Effects of intimacy of therapist's self-disclosure and formality on perceptions of credibility in an initial interview.

A therapist's expertness, trustworthiness, empathy, and attractiveness were evaluated by 300 subjects after viewing a 5-min. videotape of a therapist-client interaction. Therapist's level of self-disclosure and formality were the independent variables. Ratings of trustworthiness were highest when the therapist was informal. Therapist's high disclosure of depression yielded decreased ratings of attractiveness, empathy, and expertness in comparison with no disclosure by the therapist.

Adult↗
PubMed1992

A controlled study of sensation awareness and verbal disclosure for regulation of arousal and anxiety.

Interactions of attention and verbalization were investigated for effects of self-reported arousal and state-anxiety. Levels of verbalization from silence through talking-without-a-listener to disclosure were compared while self-directed attention was manipulated for sensation versus general thoughts and feelings. Following a stimulus, disclosure of sensations was expected to reduce state anxiety and increase energetic arousal significantly more than disclosure of thoughts. Based on a randomly assigned sample of 120 men, a 3 x 2 x 2 multivariate analysis of variance indicated a significant interaction in the predicted directions. A significant interaction was also found for the 3 x 2 interaction for energetic arousal. For state anxiety means were in the predicted direction. Results indicate that verbalization of sensations is more energizing and calming than silence, while for general thought, silence is more energizing and calming than verbalization. The results suggest efficacy in reframing self-talk to quiet awareness and in communicating sensed distinctions as they emerge.

Adult↗
PubMed2001

Differences in self-disclosure in psychotherapy between American and Israeli patients.

This study investigated differences in extent and patterns of disclosure in psychotherapy between American (n = 164) and Israeli (n = 45) patients. Participants completed the Disclosure to Therapist Inventory-R, an 80-item measure that uses a rating scale to assess the extent to which psychotherapy patients have discussed each of 80 moderately to highly intimate topics with their most recent therapist. Analysis yielded no significant difference between groups in overall disclosure and high overlap in the topics most and least discussed. Both groups frequently discussed aspects of their personalities they disliked, feelings of desperation or depression, and feelings of rage or anger towards parents. Findings suggest universal concerns may outweigh the cultural context in which therapy occurs.

Adolescent↗
PubMed2005

Evaluation of HIV counselling and testing, self-disclosure, social support and sexual behaviour change among a rural sample of HIV reactive patients in South Africa.

The aim of this study was to evaluate HIV counselling and testing, self-disclosure, social support and sexual behaviour change among HIV reactive patients among a rural sample of HIV reactive patients in South Africa. The sample consisted at the post-test counselling exit interview of 55 participants (41 women and 14 men) who tested HIV-positive conveniently selected from a rural hospital and at five months follow-up at their homes 47. Results indicated that most patients had an HIV test because of medical reasons. At follow-up only 36% had disclosed their HIV status and half of the participants had had sex without condoms in the past three weeks. Major reason for not disclosing of their HIV status were being afraid of negative reactions, fear of discrimination, fear of violence, concerns about confidentiality and not yet ready. Social support was found to be significantly related to disclosure of HIV status, while counselling context and content and counselling satisfaction were not related with HIV disclosure.

Adolescent↗
PubMed2001

Symptom management in older primary care patients: feasibility of an experimental, written self-disclosure protocol.

BACKGROUND: Distress-driven symptoms are prevalent among older primary care patients and account for a large percentage of office visits and increased medical costs. An experimental written self-disclosure protocol has been shown to reduce symptoms and use of health care services in healthy adults. Written self-disclosure as a method for reducing symptoms has not been evaluated in the primary care setting. OBJECTIVE: To evaluate the feasibility of adapting an experimental written self-disclosure protocol for the primary care setting. DESIGN: Randomized, single-blind feasibility study. SETTING: University-based geriatric and internal medicine primary care clinics. PATIENTS: 45 patients 66 years of age or older without a psychiatric diagnosis. INTERVENTION: Three 20-minute writing sessions focusing on distressing experiences (in the intervention group) or health behaviors (in the control group). MEASUREMENTS: The feasibility outcomes were patient recruitment, protocol logistics, and patient and provider satisfaction. The clinical outcomes were somatic and distress symptoms, health care utilization, and associated costs. RESULTS: One third of patients screened were recruited; 96% of patients recruited completed the protocol. Clinic contact time was an average of 55 minutes per patient. Patients and providers reported high levels of satisfaction with the protocol. Reductions in symptoms were minimal for both groups. Use of outpatient services and associated costs decreased in both groups, but the reduction was twice as great in the treatment group as in the control group. CONCLUSIONS: Findings support the feasibility of implementing the protocol as a primary care intervention.

Aged↗
PubMed1993

American Health Information Management Association. Position Statement. Issue: disclosure of health information.

Health information is used for a variety of legitimate purposes, including patient care, quality review, education, research, public health, and legal and financial interests. Regardless of the use or users, patients must be assured that the information they share with healthcare professionals will remain confidential. To protect patients' privacy rights, each healthcare facility must develop policies and procedures for disclosure of health information in accordance with federal and state laws. Careful consideration must be given to any disclosure of health information. Confidential information should be disclosed only as needed for continuing care or upon written authorization by the patient or his legal representative or where such disclosure is authorized by federal or state law, subpoena, or court order.

Confidentiality↗
PubMedDate not supplied

Responding to children's disclosure of familial abuse: what survivors tell us.

This study is based on the reports of 384 adults who were abused physically, sexually, and/or emotionally in childhood by family members. It describes the survivors' attempts, as children, to get help by disclosing the abuse to someone who might intervene; those who did not disclose explain their reasons. The results indicate that disclosure usually did not bring an end to the abuse, and that little action was taken to control the perpetrator, even after disclosure took place. The responses received by the children to their disclosure are linked to their levels of self-esteem and family functioning as adults.

Adult↗
PubMed2001

[Results of questionnaire on open disclosure to patients with malignant lung tumors comparison of responses before and after chemotherapy].

To investigate patient attitudes towards open disclosure of malignant disease, we conducted a questionnaire survey of 17 patients with malignant lung tumors, to whom the nature of their disease was revealed. The questionnaire used a 100 mm analog scale. Ten of the patients were treated by chemotherapy and their questionnaire results before and after treatment were compared. It was found that they were mostly satisfied about being truthfully informed and that, indeed, they were anxious to know their true diagnoses. They were also keen to have their true prognosis revealed, but not as much as the diagnosis. They also wished to be informed about treatment and its effects. These attitudes showed no marked changes resulting from the administration of chemotherapy, and we therefore concluded that chemotherapy itself had no influence on patients' feelings about disclosure. The questionnaire was well accepted and was useful in judging attitudes to open disclosure.

Female↗
PubMed2002

Does disclosure of emotions facilitate recovery from bereavement? Evidence from two prospective studies.

Two longitudinal studies assessed whether disclosure of emotions facilitates recovery from bereavement. Study 1 tested prospectively over a 2-year period whether the extent to which bereaved persons talked about their loss to others and disclosed their emotions was associated with better adjustment to the loss of a marital partner. There was no evidence that disclosure facilitated adjustment. Study 2 randomly assigned recently bereaved individuals either to the Pennebaker writing task (J. W. Pennebaker & S. K. Beall, 1986) or to no-essay control conditions. The writing task did not result in a reduction of distress or of doctors visits either immediately after the bereavement or at a 6-month follow-up. Beneficial effects were not demonstrated for bereaved persons who had suffered an unexpected loss or who at the time of the study still expressed a high need for emotional disclosure.

Aged↗
PubMed2002

Disclosure of cancer diagnosis and prognosis by physicians in Kuwait.

To analyse preferences for disclosure of cancer diagnosis and prognosis among physicians practising in Kuwait, a cross-sectional survey was conducted in public hospitals in both urban and suburban parts of the country, which included physicians likely to encounter adult cancer patients in their practice. A total of 217 physicians participated, 67% indicating they preferred full and complete disclosure of cancer diagnosis to patients. However, 79% of those would withhold the truth if the patient s family requested them to do so. Preference for concealment was more common among physicians who had experienced cancer directly with a friend or a family member, or who were in medical as opposed to surgical specialties. The belief that patients in Kuwait did not want to hear the truth about cancer diagnosis or prognosis was also significantly associated with concealment preference. Changes in public norms and expectations should be monitored, because they seem to play a major role in physicians preference for disclosure of cancer diagnosis and prognosis.

Adult↗
PubMed2002

Unanticipated consequences of unanticipated outcomes disclosures.

This article discusses the complex legal and operational issues related to the Joint Commission on Accreditation of Healthcare Organizations' (JCAHO) unanticipated outcomes disclosure standard. The author examines case law on the discoverability of hospital quality improvement efforts and information submitted to the JCAHO, and considers whether submitting this information to JCAHO amounts to a waiver of privilege. The author concludes disclosure of an unanticipated outcome should not give rise to a waiver if the hospital and physician are careful in making the disclosure.

Accreditation↗
PubMed1976

Supervisors' perceptions of the relationship between therapist self-disclosure and clinical effectiveness.

The findings suggest that the clinical supervisors surveyed associate therapist effectiveness (i.e., competence and sophistication) with capacity for self-revelation in the presence of clients. Trainee maturity as therapist was not correlated highly with self-disclosure, a finding that may indicate that self-disclosure is (a) more independent of the training process than competence and sophistication, and (b) that self-disclosure, as manifested in the clinical context, may be more of a trait than a state-like personality characteristic.

Achievement↗
PubMed2003

The cultural differences in perceived value of disclosure and cognition: Spain and Canada.

A previous multicentre international study on sedation at the end of life has detected major differences between Canadian and Spanish patients. This was particularly evident in the need to sedate Spanish patients for psychological/existential distress. This study was designed to explore the hypothesis that marked differences in the value patients and families attach to disclosure and cognition were a factor. The study population included patients referred to two palliative care consulting services based in acute care hospitals in Madrid, Spain (M), and in Edmonton, Canada (E). Questions addressed the issue of clear thinking, pain/nausea-medication-induced somnolence/confusion, anxiety/antidepressant-medication-induced somnolence/confusion, details of diagnosis. One hundred patients were evaluated on each site. Patients and families in E placed a higher value on clear thinking, change in medication causing somnolence/confusion, and wanting full disclosure. Patients and families in E agreed almost 100% of the time, while agreement in M varied from 42% to 67%. These results suggest major differences in the perceived value of clear cognition and disclosure of information between patients and families in E and M. The lack of agreement between patients and families in M is a further significant factor that may complicate communication with patients and families, as well as medical management.

Aged↗
PubMed2004

Self-disclosure of HIV serostatus in recently diagnosed patients with HIV in South Africa.

Failure of people living with HIV/AIDS to disclose their HIV serostatus can place their sexual partners at risk. The current study examined HIV serostatus disclosure and its relationship to risky sexual behaviours in 69 sexually active, heterosexual, married (62%) or cohabiting (38%) patients recently diagnosed as HIV positive. Results show that 78% had not disclosed their HIV serostatus to their sexual partners and 46% had no knowledge of their sexual partner's serostatus. Compared to those who disclosed their serostatus, those who did not disclose were more likely to be male (chi2 = 7.02, p = 0.00), to have not used a condom during their last sexual encounter (chi2 = 29.64, p = 0.000), to have used alcohol heavily before sex (chi2 = 6.79, p = 0.00), to have multiple sexual partners (t = 3.01, p = 0.05), and to have engaged more frequently in sexual intercourse in the six months preceding the study (t = 8.21, p = 0.00). Logistic regression analysis show that being in a married relationship (OR = 0.86, 95% CI = 0.65, 1.15), being male (OR = 1.48, 95% CI = 0.24, 1.99), having more than two multiple partners (OR = 2.03, 95% CI = 1.11, 3.68) and non-use of condom at last sex (OR = 1.53, 95% CI = 0.83, 1.88) were significantly associated with non-disclosure of HIV serostatus. Preventive strategies among HIV-positive patients should place emphasis on the management of self-disclosure and its importance in safe sexual behaviour.

AIDS Serodiagnosis↗
PubMed2005

Competition and disclosure incentives: an empirical study of HMOs.

I examine Health Maintenance Organizations' (HMOs) voluntary disclosure of product quality, which is not as complete as unraveling theories predict. After controlling for cost and demand factors, I find that HMOs use voluntary disclosure to differentiate from competitors, with lower disclosure rates in highly competitive markets. These findings are consistent with product differentiation, but challenge the intuition that competition should lead to more provision of quality information.

Consumer Behavior↗
PubMed2005

Bondholder disclosure and Sarbanes-Oxley: how one medical center aligned best practices.

More than a year ago, Chicago's Rush University Medical Center embarked on an ambitious project to implement enhanced investor disclosure practices. Among its keys to success are the following: Board and senior management buy-in is essential. Tailor the bondholder disclosure to comparable SEC practice. Increase the assurance of accuracy of disclosure by adopting selective Sarbanes-Oxley provisions.

Academic Medical Centers↗