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 55 records · Page 3Linked to original sources

PubMed1999

Psychosocial problem disclosure by primary care patients.

The vast majority of psychologically distressed primary care patients present exclusively somatic concerns at the outsets of their visits. However, it is not known how often such patients subsequently disclose psychosocial problems to their primary care physicians (PCPs) and what variables predict such disclosures. Our objectives were to measure, among psychologically distressed primary care patients, the frequency of disclosure of psychosocial problems (disclosure), the effects of prior psychosocial inquiry (prior inquiry) by PCPs and various patient variables on disclosure, and the effect of disclosure on mental health problem recognition (recognition) by PCPs. The study was based in the practices of 69 community-based PCPs and involved 308 adult patients with 28-item General Health Questionnaire scores of 5 or greater, indicating significant psychological distress. Disclosure occurred during 51% of visits overall and 67% of visits with prior inquiry. The odds of disclosure were increased by prior inquiry (p < 0.001), greater physician-patient familiarity (p < 0.001) and greater severity of patient psychological distress (p < 0.001). Prior inquiry and physician-patient familiarity had a negative interaction (p < 0.05) of smaller size than either variable's main effect, so that their combined effect on disclosure exceeded the effect of either variable alone but was less than multiplicative. The estimated odds ratio for recognition given disclosure was 24.13 (95% confidence interval, 11.28-51.63) after adjustment for the effects of significant covariates. We conclude that if PCPs inquire, most psychologically distressed, somatically presenting patients will disclose psychosocial problems. Inquiry is particularly productive with unfamiliar patients. PCPs can engender a substantial increase in psychosocial disclosure simply by adding one or two questions about mood or interpersonal problems to their clinical interviews.

Adolescent↗

PubMed2003

Does full disclosure of medical errors affect malpractice liability? The jury is still out.

BACKGROUND: Mandatory disclosure of medical errors has been advocated to improve patient safety. Many resist mandatory disclosure policies because of concerns about increasing malpractice exposure. It has been countered that malpractice liability actually decreases when there is full disclosure of medical errors. A comprehensive literature search was conducted to determine what is known about the impact of full disclosure on malpractice liability. METHODS: Electronic searches of multiple databases were supplemented with hand searches of bibliographies and communication with recognized experts in the field. RESULTS: Screening the titles, abstracts, and, in many cases, the full articles from more than an estimated 5,200 citations resulted in identification of one published study directly examining malpractice liability when a policy of full disclosure was implemented. DISCUSSION: Despite extensive literature on the impact of disclosure on malpractice liability, few well-designed studies have focused on the real-world impact on the volume and cost of suits following implementation of a full disclosure policy. Many articles examine why patients sue their doctors, suggesting that some lawsuits may be averted by disclosure, but the articles do not allow us to estimate the additional suits that would be created by disclosure. Additional studies addressing the effect of disclosure on malpractice liability are needed.

Compensation and Redress↗

PubMed2004

Disclosure of HIV-positive status to Latino gay men's social networks.

This study explored disclosure of serostatus in a sample of 155 HIV-positive Latino gay men from New York City and Washington, DC. We examined rates of disclosure to different members of the social network: mothers, fathers, close friends, and primary sexual partners. There were high rates of disclosure of HIV-positive serostatus to main partners and closest friends and lower rates to fathers and mothers. We examined the role of 3 contextual target-dependent factors (emotional closeness to target, anticipated reactions from target, and target's knowledge of sexual orientation), as well as acculturation and time since diagnosis. Three separate logistic regression models were performed to predict disclosure of HIV-positive status to 3 targets: mothers, fathers, and closest friends. We found that disclosure was not a generalized tendency, but rather different factors were influential depending on the target. Whether the target was aware of participant's sexual orientation was associated with disclosure in all 3 models. Greater emotional closeness also predicted disclosure to mother and father; greater U.S. acculturation was associated with disclosure to father and marginally to mother. A longer time since diagnosis was associated with disclosure to the closest friend. These findings highlight the importance of taking into account roles and relationships, and their effect on disclosure.

Adolescent↗

PubMed2005

Consistent, inconsistent, and non-disclosure to casual sexual partners among HIV-seropositive gay and bisexual men.

OBJECTIVE: This study examined the disclosure of HIV status to casual sex partners, factors related to disclosure, and the relationship between disclosure and HIV sexual risk behaviors among a sample of HIV-positive gay and bisexual men in New York City and San Francisco. Comparisons were made particularly among men who reported consistent disclosure, inconsistent disclosure, and non-disclosure. METHOD: The data from a baseline assessment of 1168 HIV-positive gay and bisexual men in the two cities were utilized. Men were recruited from a variety of community-based venues, through advertising, and other techniques. RESULTS: Consistent disclosers reported greater self-efficacy for disclosing and more intentions to disclose than other men. They also reported less drug use, lower incomes, and more perceived viral consequences resulting from unsafe sex than did inconsistent disclosers. Overall, sexual risk behaviors were greater among inconsistent disclosers, followed by non-disclosers, with consistent disclosers reporting the fewest HIV sexual risk behaviors. CONCLUSION: Disclosure is not an all-or-nothing process, as evidenced by the 38% of men in the sample who reported disclosing to some, but not all, of their casual sexual partners. These inconsistent disclosers, who reported the most sexual risk practices, seem to lack strategies to deal with disclosure and risky sex. Some men who never disclose appear to have been able to adopt strategies by which they do not engage in sexual risk with casual partners. Interventions to improve self-efficacy for disclosure and help HIV-positive gay and bisexual men to identify and adopt specific strategies to address disclosure and safe sex are needed.

Adult↗

PubMed2001

Reexamination of therapist self-disclosure.

In mental health practice, a commonly held view is that therapist self-disclosure should be discouraged and its dangers closely monitored. Changes in medicine, mental health care, and society demand reexamination of these beliefs. In some clinical situations, considerable benefit may stem from therapist self-disclosure. Although the dangers of boundary violations are genuine, self-disclosure may be underused or misused because it lacks a framework. It is useful to consider the benefits of self-disclosure in the context of treatment type, treatment setting, and patient characteristics. Self-disclosure can contribute to the effectiveness of peer models. Self-disclosure is often used in cognitive-behavioral therapy and social skills training and might be useful in psychopharmacologic and supportive treatments. The unavoidable self-disclosure that occurs in non-office-based settings provides opportunities for therapeutic deliberate self-disclosure. Children and individuals who have a diminished capacity for abstract thought may benefit from more direct answers to questions related to self-disclosure. The role of self-disclosure in mental health care should be reexamined.

Humans↗

PubMed2005

Therapist self-disclosure to child patients.

The primary aim of this study was to investigate therapists' use of self-disclosure with their child patients. A sample of 126 mental health professionals with an average of 20 years of clinical experience completed the Therapist-to-Child Disclosure Inventory (TCDI), a 42-item Likert-type measure created for this study. Therapist self-disclosure was examined using three principle dimensions: the mean frequency of specific disclosures, the degree to which child patients solicit these disclosures, and the extent to which specific self-disclosures are seen as advancing treatment aims for child patients. Results indicate that therapists reveal personal information to their child patients infrequently, that children almost never solicit personal disclosures from their therapists, and that therapists perceive self-disclosure as seldom advancing treatment aims for child therapy. Future studies, the authors suggest, should examine the differences between therapists' use of self-involving disclosures to children and their use of factual self-disclosures.

Adult↗

PubMed2005

The relationship of non-disclosure in therapy to shame and depression.

OBJECTIVE: This study aimed to explore the relationship between shame-proneness, depression, and non-disclosure in therapy in 85 men and women who had received treatment for depression. METHOD: Data were collected by means of a questionnaire, which assessed depressive symptoms, shame-proneness, non-disclosure in therapy, and reasons for non-disclosure. RESULTS: In total, 54% of the respondents reported concealing depression-related symptoms and behaviours or other distressing experiences from their therapist. Shame was the most frequently reported reason for non-disclosure overall, but was a more frequent reason for non-disclosure of symptoms than experiences. Similarly, shame-proneness was significantly related to non-disclosure of symptoms but not to non-disclosure of experiences. For participants no longer in therapy, non-disclosure of symptoms made a significant independent contribution to current level of depressive symptoms after controlling for demographic variables, worst depression, and shame-proneness. CONCLUSIONS: The hypothetical model put forward in this study predicting a significant relationship between shame, non-disclosure in therapy, and current depressive symptomatology was supported. The findings suggest that encouraging and facilitating the disclosure of shameful symptoms and related behaviours has positive implications for the effectiveness of treatment.

Adult↗

PubMed2005

Parental preferences for error disclosure, reporting, and legal action after medical error in the care of their children.

OBJECTIVE: No data exist on parental preferences for disclosure, reporting, and seeking legal action after errors in the care of their children are disclosed. This study examined parental preferences for error disclosure and reporting; responses to error disclosure; and preferences and responses by race/ethnicity, gender, age, and insurance. METHODS: A 4-scenario survey instrument portraying a range of medical error was provided to a convenience sample of parents who presented with children to an emergency department. Parents were asked to categorize the error, express preferences for disclosure and reporting, and then report how they expected to respond with and without disclosure. Basic demographics were collected also. Bivariate analyses of demographics were performed with Fisher's exact tests, analysis of scenario responses was performed with Somers' D, and the independent effects of the study variables were assessed with a generalized estimating equation. RESULTS: Research assistants approached 661 parents; 499 participated (75% response rate). Of all scenarios presented to the parents, they judged 54% of the scenarios as severe, 99% wanted disclosure, 39% wanted the error reported to a disciplinary body, and 36% were less likely to seek legal action if the error was disclosed by the physician. In multivariate modeling, severity was associated with desire for disclosure, reporting, and change in likelihood of legal action with disclosure. CONCLUSIONS: Regardless of severity, parents want to be informed of error. Educational interventions to improve error disclosure should emphasize the uniformity of parental preferences for disclosure, reporting, and the decreased likelihood of legal action when errors are disclosed than if discovered through other means.

Adult↗

PubMed1976

Self-disclosure in friendship.

An experimental investigation of the influence of self-disclosure on friendship was conducted by manipulating the level of self-disclosure. 65 same-sex pairs were randomly assigned to one of three treatment conditions, intimate self-disclosure, nonintimate self-disclosure and control (no disclosure); the treatment conditions were independently verified by judges' ratings. One member of each pair was randomly selected as the confederate or first speaker and was provided with a list of 7 conversation topics. There were no lists provided in the control condition. The dependent variable, level of friendship as measured by the Acquaintance Description Form (Wright, 1969), was rated before and after Ss engaged in self-disclosure, and the influence of the experimental conditions on friendship scores was assessed by analyses of covariance. The results showed that the general level of friendship increased as a function of intimate and nonintimate self-disclosure; however, intimate disclosure produced greater increases in friendship than nonintimate disclosure. The unique influence of self-disclosure on male friendship patterns is discussed.

Female↗

PubMed2000

[Does disclosure of medical records to patients influence medical care?].

UNLABELLED: Disclosure of medical records to patients has been assessed, but the influence of disclosure on medical care has not been well researched. To address this situation, this study was conducted to test three hypotheses: 1) doctors think that the disclosure can influence medical care, 2) whether doctors think disclosure can influence medical care depends on how they rank medical records (for example, as evidence for diagnosis and treatment, a process to reach a diagnosis, a tool to communicate with other medical staff, etc), and on whether they think medical record disclosure could change the content of the record. Questionnaires were sent to 881 doctors who work at two hospitals affiliated with N Medical School and K Medical University. RESULTS: Four hundred eighty-eight doctors responded. The findings related to the hypotheses were as follows: 1) Those who answered that the disclosure could have an influence on medical care were 49.1% of the total. 2) There was no relation between how doctors ranked medical records and whether they thought disclosure could influence medical care. 3) Doctors who answered that there were things that they would not be able to write if medical records were disclosed accounted for 73.5% of the total. These doctors answered "yes" significantly higher to the question that the disclosure could influence medical care than others (Odds 3.6, P < 0.01). Doctors who thought they would not be able to enter the diagnosis, the name of the disease for insurance, self-evaluation, information that could be judged and subjective information answered that disclosure could influence on medical care (P < 0.05). It was assumed that disclosure of medical records to patients could change the content of the medical records and that could influence medical care. How to deal with information will become an important issue if records are disclosed.

Attitude of Health Personnel↗

PubMed1990

[Is self disclosure by a physically handicapped proband reciprocated by the interaction partner? An experimental study of the effect of physical handicap on interaction behavior with non-handicapped interaction partners].

An experimental study tested whether an able-bodied person's positive disposition toward a disabled interaction partner was effective in the amount of reciprocation given to the disabled partner's self-disclosure. Sixty female subjects were confronted with either a disabled or nondisabled conversation partner who showed either a high or a low amount of self-disclosure. We anticipated that a "sympathy" effect of disablement in the amount of the subjects' self-disclosure would result from the nondisabled partner's overcompensation. This arises from an effort to compensate the negative, stereotyped attitudes to the disabled in actual behavior toward a single, disabled person by more strongly reciprocating the self-disclosure of a disabled interaction partner compared to a nondisabled one. Results showed that, contrary to expectations, self-disclosure was equally reciprocated with both a disabled and a nondisabled partner. However, a "sympathy" effect was found in the impression judgments on the disabled partner who had shown a high amount of self-disclosure in the previous conversation. The lack of a "sympathy" effect in the amount of self-disclosure was possibly the result of (1) the reciprocation of self-disclosure not being exclusively determined by intentional control processes; and/or (2) the evaluative significance of the amount of self-disclosure not being clear to the subjects in the interaction studied. It is concluded that the efforts of the nondisabled to show an unprejudiced attitude toward a disabled interaction partner are mostly effective in other aspects of behavior than the amount of self-disclosure.

Adult↗

PubMed2005

Relationship between accreditation scores and the public disclosure of accreditation reports: a cross sectional study.

OBJECTIVE: To examine the association between accreditation scores and the disclosure of accreditation reports. DESIGN: A cross sectional study. SETTING: Hospitals participating in an accreditation programme in Japan. PARTICIPANTS: 547 of the 817 hospitals accredited by the Japan Council for Quality Health Care (JCQHC) by January 2003. MAIN OUTCOME MEASURES: Data on participation in public disclosure of accreditation reports through the JCQHC website were obtained from the JCQHC database. Comments on the disclosure were obtained using a questionnaire based survey. RESULTS: A total of 508 (93%) of the participating hospitals disclosed their accreditation reports on the JCQHC website. Public hospitals were significantly more committed to public disclosure than private hospitals, and larger hospitals were significantly more likely to participate in public disclosure than smaller hospitals. Accreditation scores were positively related to the public disclosure of hospital accreditation reports. Scores for patient focused care and efforts to meet community needs were significantly higher in actively disclosing hospitals than in non-disclosing hospitals. Among the large hospitals, scores for safety management were significantly higher in hospitals advocating disclosure than in non-disclosing hospitals. CONCLUSIONS: There was a positive correlation between accreditation scores and public disclosure. Our results suggest that the public disclosure of accreditation reports should be encouraged to improve public accountability and the quality of care. Future studies should investigate the interaction between public disclosure, processes and outcomes.

Accreditation↗

PubMed2004

Self-disclosure in eating disorders.

OBJECTIVE: Secrecy and concealment are typical behaviours in individuals with eating problems. This study explored the relationship between eating-related problems and self-disclosure. It examined whether women with greater eating related problems were less willing to disclose. Different types of self-disclosure were calculated, considering disclosure related to body appearance and to restrained eating. The role of risk factors which concur to the development and maintenance of eating symptomatology was also explored. METHOD: The Eating Symptoms Inventory was used to investigate the existence of an eventual eating symptomatology, self-disclosure was calculated through the Self-Disclosure Index, while a new scale was validated to assess a self-disclosure related to body image and eating attitudes. Other scales measured the influence of different risk factors, as body dissatisfaction, social pressure to be thin, and restrained eating. RESULTS: A significant inverse relationship was found between general self-disclosure and psychological aspects related to the practice of wrong weight control behaviours and risk factors as dieting, body dissatisfaction, and social pressure to be thin. The significant role of risk factors was confirmed in the development and maintenance of eating disturbances. Interesting results were found using the different self-disclosure indexes as mediators and moderators. Relevant differences were found between Dutch and Italians concerning to their eating attitudes and to the role of different risk factors. CONCLUSION: Some limits are the impossibility to generalize these findings and the use of a non clinical sample. Some new longitudinal studies should be done in this direction to deepen the relationship between self-disclosure and eating disorders.

Adolescent↗

PubMed2006

Reducing HIV transmission risk by increasing serostatus disclosure: a mathematical modeling analysis.

Persons living with HIV infection are encouraged to disclose their HIV-positive serostatus to prospective sex partners to decrease the likelihood of unsafe sex and HIV transmission. However, the effectiveness of serostatus disclosure as a preventive measure is not known. We developed a mathematical framework for assessing the HIV transmission risk reduction effectiveness of serostatus disclosure, examined how increasing the disclosure rate affects the transmission risk reduction effectiveness of disclosure, and explored the interaction between condom use and disclosure effectiveness. Under base-case assumptions, serostatus disclosure reduced the risk of HIV transmission by between 17.9% and 40.6% relative to no disclosure. Increasing the disclosure rate from the base-case value of 51.9-75.7% produced a 26.2-59.2% reduction in risk. The findings of this modeling study strongly support intervention efforts to increase both serostatus disclosure and condom use by persons living with HIV.

Condoms↗

PubMed2001

Utilizing disclosure in the treatment of the sequelae of childhood sexual abuse: a theoretical and empirical review.

Although disclosure is a component of many therapeutic approaches to treating the long-term symptoms associated with child sexual abuse (CSA), the ameliorative mechanisms of this approach are still unclear. This review investigates the expected benefits of disclosure in therapy by looking at the theoretical and empirical support for its effectiveness in treating the specific psychopathological sequelae associated with a history of CSA. In order to accomplish this task, a core group of sequelae associated with sexual abuse are presented. The components of disclosure as a therapeutic process are divided into three processes: disclosure-through-description, disclosure-through-rethinking, and disclosure-in-relationship. The review describes the ways in which these elements of disclosure are used within different therapeutic approaches. The treatment outcome literature is then reviewed in terms of the elements of disclosure included in the treatment approaches and the symptoms improved by treatment. In conclusion, implications are presented concerning the appropriate uses of disclosure in psychotherapy directed at alleviating the long-term sequelae associated with a history of CSA.

Adult↗

PubMed2003

Stress, social support, and HIV-status disclosure to family and friends among HIV-positive men and women.

Patterns of HIV-status disclosure and social support were examined among 331 HIV-positive men and women. Structured interviews assessed HIV-status disclosure to family and friends, perceived stress of disclosure, social support, and depression. Results showed patterns of selective disclosure, where most participants disclosed to some relationship members and not to others. Rates of disclosure were associated with social support. Friends were disclosed to most often and perceived as more supportive than family members, and mothers and sisters were disclosed to more often than fathers and brothers and perceived as more supportive than other family members. Path analyses tested a model of HIV-status disclosure showing that perceived stress of disclosing HIV was associated with disclosure, and disclosures were related to social support. Disclosure and its association to social support and depression varied for different relationships and these differences have implications for mental health and coping interventions.

Adaptation, Psychological↗

PubMed2000

Disclosure of developmental disability: a study of paediatricians' practices.

OBJECTIVE: To investigate paediatricians' practices in disclosure of disability and the influences on their practices, including attitude to people with disabilities. METHODOLOGY: Interviews were conducted with 26 paediatricians regarding their disclosure practices and their experience, training, contact with children with significant disabilities and influences on practices. Anonymous self-report questionnaires to the same group of practitioners relating to attitude to disability were also employed. RESULTS: Paediatricians' practices in the disclosure process scored relatively low on an index based upon recommended practices. No significant relationships were found between index scores and the experience or training of the paediatrician or the amount of contact of the paediatrician with children with disabilities. However, more experienced paediatricians were found to be more likely to mention the practice of informing both parents together and the presence of a support person at the time of disclosure. Paediatricians having more contact with children with disabilities were more likely to mention that they would disclose disability in a child as soon as possible. The major modifying influences on disclosure practices were reported to be the intelligence of the parents and their emotional state of at the time of disclosure. Time was the most frequently reported constraint upon disclosure practices. CONCLUSIONS: The low 'disclosure practice index' scores in this study are not necessarily an indication that practices are poor, as there are challenges to the validity of the advocated practices. There were few significant associations found between the practices of paediatricians in disclosure and their experience, training, contact with children with disabilities and attitude to people with disabilities.

Australia↗

PubMed1992

Development of the reciprocity of self-disclosure.

This study was designed to assess whether children demonstrate covariant and equivalent forms of the reciprocity of self-disclosure, and if so, at what age. Twenty-one kindergarten, 23 second-grade, 24 fourth-grade, and 24 sixth-grade children were shown videotapes of three children (partners) who provided pre-established low-, medium-, and high-intimate disclosures. The subjects were required to send a message to the partners on topics varying in personal content. Fourth-grade children showed evidence of covariant reciprocity of self-disclosure by disclosing higher intimacy to high-intimate partners than to low-intimate partners. Sixth-grade children showed equivalent reciprocity of self-disclosure by providing a greater number of high- and medium-intimate disclosures to high- and medium-intimate partners, respectively, than to low-intimate partners. By contrast, neither form of reciprocity of self-disclosure was shown by kindergarten and second-grade children. Consistent with our expectations, girls provided a greater number of high-intimate disclosures than did boys in three of the four grades. The findings are discussed in terms of interplay between the development of the reciprocity of self-disclosure and the norm of the reciprocity of self-disclosure.

Child↗