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PubMed1999

Effect of age on reasons for initiation and discontinuation of hormone replacement therapy.

OBJECTIVE: The purpose of this study was to examine age-related differences in reasons that postmenopausal women began and stopped hormone replacement therapy (HRT). DESIGN: Two identical telephone surveys were conducted of women members of Kaiser Foundation Health Plan who had begun HRT within the previous 3 years. The first, in 1997, was of 604 older women aged 65 years or older; the second, in 1998, was of 866 younger women aged 50-55 years. Prescription records for both groups provided the means for determining continuation of therapy. RESULTS: Among older women, 35% reported prevention or treatment of osteoporosis as the primary reason for starting HRT. Younger women were less likely (14%) to report this (p < 0.001). Relief of vasomotor menopausal symptoms was the most frequently reported reason that younger women gave for starting HRT; it was the primary reason in 34%. In contrast, only 7% of older women reported relief of vasomotor symptoms as the primary reason for starting HRT (p < 0.001). Older women were more likely than younger women to discontinue HRT; after 12 months, the probabilities of discontinuation were 62% and 48% (relative risk = 1.4; 95% confidence interval = 1.2-1.6). Treatment-related side effects were most often the reason given for stopping HRT; 87% of older women and 64% of younger women who stopped reported that a treatment side effect was their primary reason (p < 0.001). Among treatment side effects, vaginal bleeding was the most frequently reported reason for stopping HRT; it was the primary reason for stopping in 52% of older women and 29% of younger women (p < 0.001). CONCLUSIONS: Older women differ from younger women in their reasons for starting and stopping HRT. Whereas osteoporosis is the predominant reason that older women begin HRT, relief of vasomotor symptoms is the major reason that younger women begin. Early discontinuation of HRT is common and is greater among older women. Intolerance of treatment, particularly vaginal bleeding, is the predominant reason for stopping HRT.

Aged↗

PubMed1993

Reasons for tooth extraction in the western states of Germany.

The purpose of this study was to collect information on the main causes of tooth loss in the western states of Germany as perceived by dentists and their patients. Sixty-eight dentists, out of 80 that were selected with a systematic random method for an epidemiological study in the western states of Germany, recorded their reason for tooth extraction. Included in the study were only extractions of permanent teeth during a period of 2 weeks (March 1990), up to a maximum of 20 patients per dentist. Of 926 returned questionnaires, 882 could be evaluated. In all 1215 teeth in 882 patients were extracted. The extraction of third molars was included as a reason, when caries, periodontal reasons and others were not indicated. Caries was the reason given for 20.7% of all extractions; periodontal diseases for 27.3%; caries and periodontal reasons for 18.7%; third molars for 14.7%; prosthetic reasons for 11.2%; orthodontic reasons for 4.1%; trauma for 0.4% and others for 2.9%. While caries is a major reason in all age groups, periodontal diseases and the combination of caries and periodontal reasons are more frequent than all other reasons for the age groups beyond 40 or 45 yr, respectively. The third molar was the most often extracted tooth. The patients were asked for their main reason for tooth extraction. For the patients, pain was the major reason for extraction (47.2%). According to the participating dentists periodontal disease is the most frequent cause of tooth extraction for people over 40 yr of age, while for those below 40 yr of age, caries and third molar extractions are the most frequent reasons.

Adolescent↗

PubMed1999

Reasons for rheumatology department admission in 125 patients with disk-related sciatica.

OBJECTIVES: To identify medical and nonmedical reasons for admission of disk-related sciatica patients. PATIENTS AND METHODS: 125 patients were evaluated prospectively using a 25-items questionnaire, including seven items on medical reasons, four on psychological reasons, four on work-related reasons, six on social and family reasons, and four on miscellaneous reasons. RESULTS: Severe nerve root pain (34%), motor loss (17%), atypical clinical manifestations (13%), severe low back pain (8%), and/or sphincter dysfunction (4%) were recorded in only 55% of patients, and only 16% had at least two of these reasons. A minority of patients were admitted to avoid premature surgery (13%) or to try one more conservative approach prior to surgery (15%). Seventy-five per cent of patients reported at least one of the psychological reasons listed in the questionnaire (irritability/fatigue, 66%; anxiety, 42%; depression, 26%; panic disorder, 21%), 50% reported at least one work-related reason (workaholism, 21%; job offer, 16%; self-employed, 14%; fear of losing their job, 11%), 66% reported at least one social or family reason (living alone, 34%; one or more dependents younger than seven years of age, 32%; too many demands from household members, 22%; one or more dependents older than seven years of age, 8%; need to care for another person, 9%; important upcoming family or personal event, 6%), and 26% reported at least one miscellaneous reason (firm belief that sciatica can be cured only by inhospital treatment, 10%; desire to put pressure on the employer or on an expert, 7% and 6%, respectively; admission via the emergency room without prior medical advice, 6%). CONCLUSION: In France, the reason for admission of patients with disk-related sciatica is frequently a mixture of physical, psychological, and social problems, with only 55% of patients having a symptom requiring inhospital management.

Adult↗

PubMed1996

Everyday statistical reasoning during adolescence and young adulthood: motivational, general ability, and developmental influences.

Research on adolescent problem solving was extended into the domain of statistical reasoning and potential biases in reasoning. In Experiment 1, adolescents solved everyday reasoning problems dealing with the "law of large numbers" and the "intuitive analysis of covariance." In each problem, evidence was presented that portrayed each participant's dominant career goal favorably or unfavorably. In Experiment 2, adolescents and young adults were presented "law of large numbers" evidence that was goal-threatening, goal-enhancing, or goal-neutral. In both experiments, statistical reasoning could be used to discredit the evidence. Results indicated that (1) adolescents and young adults found goal-enhancing evidence more convincing than goal-neutral evidence which, in turn, was perceived more favorably than goal-threatening evidence; (2) statistical reasoning was more frequent on goal-threatening problems than on goal-neutral and goal-enhancing problems; (3) intellectual ability was unrelated to the biases in adolescents' reasoning; (4) verbal ability was linked to "law of large numbers" reasoning, but no cognitive ability was systematically correlated with "analysis of covariance" reasoning; and (5) law of large numbers reasoning of young adults was superior to that of adolescents, but young adults were no less biased in their reasoning than adolescents. The potential functions and consequences of adolescents' biased reasoning, the relation of everyday reasoning to general intellectual abilities, and the influences of motivation and depth of processing are discussed.

Adolescent↗

PubMed1998

Reasons for initiation and cessation of eating in obese men and women and the affective consequences of eating in everyday situations.

Reasons for the initiation and termination of eating were investigated in 78 female and 36 male obese subjects following a weight control programme. Self-monitoring diaries were completed during a 24-h period, in which subjects selected the main reason for starting and stopping an eating episode. Additionally, subjects recorded mood before and after eating using visual analogue scales. Hunger was chosen as a reason to start eating in only 20% of cases. Environmental cues such as mealtime were selected as the main reason for the initiation of the majority of eating episodes. In contrast, self-assessments such as "I felt I had eaten enough" was the main reason for terminating eating (39.4%). Gender differences in the reasons for initiating eating revealed a greater tendency for men to initiate eating for environmental reasons than women, whereas the opposite was found for the termination of eating, with women more likely to stop eating for environmental reasons than men. Changes in affect during eating revealed a significant decline in negative emotions such as tension and tiredness, and in the heavier subjects a trend for increased happiness was observed following eating. As hunger was less commonly reported as a reason to start eating than external reasons, treatment strategies for the obese might benefit by targeting individual reasons for meal initiation.

Affective Symptoms↗

PubMed2006

Neural bases of motivated reasoning: an FMRI study of emotional constraints on partisan political judgment in the 2004 U.S. Presidential election.

Research on political judgment and decision-making has converged with decades of research in clinical and social psychology suggesting the ubiquity of emotion-biased motivated reasoning. Motivated reasoning is a form of implicit emotion regulation in which the brain converges on judgments that minimize negative and maximize positive affect states associated with threat to or attainment of motives. To what extent motivated reasoning engages neural circuits involved in "cold" reasoning and conscious emotion regulation (e.g., suppression) is, however, unknown. We used functional neuroimaging to study the neural responses of 30 committed partisans during the U.S. Presidential election of 2004. We presented subjects with reasoning tasks involving judgments about information threatening to their own candidate, the opposing candidate, or neutral control targets. Motivated reasoning was associated with activations of the ventromedial prefrontal cortex, anterior cingulate cortex, posterior cingulate cortex, insular cortex, and lateral orbital cortex. As predicted, motivated reasoning was not associated with neural activity in regions previously linked to cold reasoning tasks and conscious (explicit) emotion regulation. The findings provide the first neuroimaging evidence for phenomena variously described as motivated reasoning, implicit emotion regulation, and psychological defense. They suggest that motivated reasoning is qualitatively distinct from reasoning when people do not have a strong emotional stake in the conclusions reached.

Acoustic Stimulation↗

PubMed1999

Pupils' reasons for learning and behaving and for not learning and behaving in English and maths lessons in a secondary school.

BACKGROUND: There is renewed interest in motivation and school learning, though there has been relatively little theory-linked research in English schools. AIMS: In the first stage, to explore pupils' reasons for learning and behaving and for not learning and behaving in English, maths and other subjects. In the second stage, to examine differences in reasons across subjects, for learning and behaving and for not learning and behaving for boys and girls in two year groups in one secondary school. SAMPLE: Stage 1, 16 pupils in years 7, 8 and 9 in two London secondary schools; Stage 2, 267 pupils in years 7 and 9 in one of these schools. METHODS: Stage 1--semi-structured interviews were conducted to elicit different kinds of reasons conceptualised in terms of the Deci & Ryan's (1985) framework of self-determination. From these elicited reasons, an inventory 'Why I Learn' was designed. Stage 2--the inventory was administered to identify reasons for learning and behaving and for not learning and behaving in English and maths. RESULTS: Parent introjected reasons were the highest for learning and behaving while teacher introjected and intrinsic reasons were the lowest. Intrinsic reasons were highest for not learning and behaving. Year group differences in reason levels were more significant than gender or subject differences. Reasons for learning and behaving were more differentiated from each other than reasons for not learning and behaving. DISCUSSION: The results are discussed in terms of their significance for self-determination theory, research into the conditions promoting greater self-determination in school learning and further development of the inventory for programme evaluation.

Adolescent↗

PubMed2002

Reasons for alcohol use in young adulthood: validation of a three-dimensional measure.

OBJECTIVE: To evaluate the reliability and validity of a measure of reasons for use, which is based on a cognitive mediational view of alcohol use as a means for affect regulation. METHOD: Data for this study were obtained from the Rutgers Health and Human Development Project. Self-reports of young men and women aged 25 to 31 years (N = 1,176; 598 women) were used to obtain measures of reasons for use, coping use, sex-enhancing use, use intensity and use problems. Regression analyses and structural equation modeling were used to assess a hypothesized model of relationships between these variables. RESULTS: Factor analysis of 33 reasons for use yielded three hypothesized dimensions: social reasons, disinhibition reasons and suppression reasons. Although moderately correlated with each other, they exhibited distinct relationships with other use variables. Increases in social reasons were related to decelerating increases in use intensity, but increases in disinhibition and suppression reasons were associated with accelerating increases in use intensity Social reasons did not relate to use problems, whereas suppression reasons were strongly related to use problems even when controlling for use intensity. CONCLUSIONS: Suppression reasons not only motivate reactive coping use in response to the appraisal of stressful situations, they are also likely to instigate "prophylactic" or proactive coping use in anticipation of the possible occurrence of stressors, thereby blunting the emotional impact of encounters that would otherwise have been appraised as stressful and aversive.

Adolescent↗

PubMed1996

Analysis of the orthopedic content in an occupational therapy curriculum from a clinical reasoning perspective.

OBJECTIVES: Recent studies have suggested that occupational therapists working with adults with physical disabilities do not use narrative reasoning in practice as much as they use procedural reasoning. This focus on procedural reasoning may be partially shaped by the occupational therapy educational process. The purpose of this analysis was to see whether one accredited occupational therapy curriculum was promoting narrative reasoning relative to its information on adult orthopedics. METHOD: An accredited occupational therapy undergraduate and certificate curriculum was analyzed from both student and faculty perspectives to see what types of clinical reasoning were most emphasized relative to treatment of adults with orthopedic injuries. The student analysis, done by a senior as part of an independent study, looked at the clinical reasoning content of journal articles, an occupational therapy textbook, and occupational therapy lectures relative to adult orthopedic injuries. The faculty analysis, part of a curriculum revision process and independent of the student analysis, looked at the clinical reasoning content of all courses in the curriculum. RESULTS: The student and faculty analyses concurred that although narrative reasoning is taught in this curriculum, narrative reasoning concepts are not well integrated into the adult physical dysfunction course that deals with adult orthopedic injuries. CONCLUSION: Occupational therapy educators may not be integrating narrative reasoning into more procedurally oriented physical dysfunction courses as fully as possible and may, therefore, be fostering procedurally oriented practice in physical dysfunction settings. Curricula evaluations, like the one described in this article, can be a mechanism for examining the types of clinical reasoning emphasized in a given curriculum for a given diagnostic group.

Adult↗

PubMed2003

Physical therapy students' self-reports of development of clinical reasoning: a preliminary study.

Reports of student perceptions about the efficacy of educational tools used by academic and clinical instructors to facilitate clinical reasoning are limited. Physical therapist students' (PTSs') perceptions of tools for developing clinical reasoning and problem-solving skills were surveyed to determine the effectiveness of various teaching methods and to identify factors associated with clinical reasoning development. The purposes of this descriptive investigation were to determine (1) if factors, such as learning mode, life experience, and curriculum, influence PTS' perception of their clinical reasoning mastery; (2) the relative roles of academic and clinical instructors and the value of their pedagogic tools in assisting PTS with clinical reasoning development; and (3) how PTS rate their degree of mastery of clinical reasoning as they progress through training. A survey was mailed to 17 physical therapy schools in New York and 2 in New Jersey; 156 PTS near graduation responded, yielding a 22% response rate. The survey instrument had 6 open-ended and 19 multiple-choice questions. Frequency analysis showed (1) PTS' opinion about how they would teach clinical reasoning varied with their preferred learning mode, (2) prior life experiences were associated with clinical reasoning for some individuals, (3) academic and clinical instructors contribute to development of clinical reasoning, (4) the best pedagogic tools involved case study presentations/ assignments using actual patients or videotapes, and (5) PTS gained confidence in their clinical reasoning ability while progressing through clinical education experiences. Results support inclusion of diverse pedagogic tools, such as case studies, and emphasizing a variety of learning modes to facilitate PTS' development of clinical reasoning.

Allied Health Personnel↗

PubMed2001

Clinical reasoning of an experienced physiotherapist: insight into clinician decision-making regarding low back pain.

BACKGROUND AND PURPOSE: Investigation of the clinical reasoning skills of experienced clinicians provides insight into decision-making in the practice of physiotherapy. The purpose of the present study was to analyse the clinical reasoning skills of an experienced physiotherapist during her assessment and treatment of clients with low back pain. METHOD: Deconstruction of the physiotherapist's reasoning process was accomplished through observation of encounters between her and each of six patient subjects. Reconstruction and analysis of the physiotherapist's decision-making process was performed through retrospective interviews and reflective analysis of her clinical reasoning during each encounter. RESULTS: A working model of the physiotherapist's clinical reasoning was created from an integration of theoretical elements in the literature and the data. Through analysis of this framework, two core dimensions of her clinical reasoning were revealed: the influence of clinical experience and the influence of advanced training in a specific philosophy of treating the spine. CONCLUSIONS: The construction of these themes has contributed to the growing understanding of clinical reasoning strategies and skills used in orthopaedic physical therapy practice. Detailed description of the physiotherapist's reasoning process provides more meaningful understanding of physiotherapy treatments. In this case the physiotherapist employed a pattern recognition strategy and forward reasoning process in making a diagnosis. Further research is necessary to expand knowledge on the development of clinical reasoning skills.

Adult↗

PubMed2006

Resource allocation and the duty to give reasons.

In a much cited phrase in the famous English 'Child B' case, Mr Justice Laws intimated that in life and death cases of scarce resources it is not sufficient for health care decision-makers to 'toll the bell of tight resources': they must also explain the system of priorities they are using. Although overturned in the Court of Appeal, the important question remains of the extent to which health-care decision-makers have a duty to give reasons for their decisions. In this paper, I examine the philosophical foundations of the legal obligation to give reasons in English law. Why are judges sometimes supportive of the imposition of a duty to give reasons and sometimes not? What is it about the context of life and death health care allocation problems that makes it unsuitable in their view for such a duty; and is this stance justified? What is it to give a reason for a decision? I examine Frederick Schauer's account of reason-giving in terms of generalisation and commitment and I suggest that it provides an overstated account of what giving a reason commits one to. I go on to examine an idea of judicial creation: that where value judgements are "inexpressible" there is a strong reason not to impose a duty to give reasons on to public bodies. The strongest case for a duty to give reasons is in terms of the value of respect for citizens. I argue that there is nothing in the very nature of reason-giving that ought to preclude the imposition of such a duty in this context, but concede that there is a serious danger of legalism that could result in a hamstringing of health care decision-making. It is up to judges and lawyers to seek to avoid this danger.

Decision Making, Organizational↗

PubMed2000

Patients' own reasons and patient-perceived recommendations for orthognathic surgery.

In an attempt to learn more about patients' decision-making processes, an analysis was performed to examine patients' reasons for undergoing orthognathic surgery and their understanding of the reasons surgery was recommended. Before surgery, 105 females and 38 males completed an open-ended questionnaire in which they listed their reasons for choosing orthognathic surgery and their perceptions of their orthodontists' recommendations. Three raters classified the responses into 7 categories: esthetics, psychosocial, functional, TMJ/pain, authority, prevention, and other. Rater agreement ranged from a kappa of.55 to 1.00. Patients reported undergoing orthognathic surgery primarily for esthetic, functional, and TMJ improvements, 71%, 47%, and 28%, respectively. Females reported more TMJ-related reasons than males (P <.05). Patients reporting function (P <. 05), TMJ (P <.05), and prevention of future problems (P <.05) were older than patients not reporting these reasons. Mexican American patients indicated more psychosocial reasons (P <.05) than European Americans. Patients understood that orthognathic surgery was recommended primarily for esthetic, functional, and TMJ improvements, 52%, 44%, and 18%, respectively. Males reported receiving more preventative recommendations (23%) than females (10%). Mexican American patients reported receiving more psychosocial recommendations (P <.05) than European Americans. Agreement between each paired patient/patient-perceived reason was highest for TMJ problems (kappa = 0.588). In conclusion, patients underwent orthognathic surgery to improve esthetic, functional and TMJ problems and interpreted orthodontists' recommendations for similar reasons. On a case-to-case basis, agreement between patient and orthodontist-represented reasons was modest, suggesting differences between patients' own reasons and their perceptions of orthodontists' recommendations.

Adolescent↗

PubMed1997

Reasons for not using condoms of clients at urban sexually transmitted diseases clinics.

BACKGROUND AND GOAL: Greater understanding of the factors related to inconsistent condom use is essential in the development of strategies to promote condom use among clients who access public, inner-city sexually transmitted diseases (STD) clinics. Therefore, this study aimed to explore reasons for not using condoms among 260 predominantly African American heterosexual male and female clients presenting for care at two inner-city STD clinics. STUDY DESIGN: Clients selected for this descriptive analysis reported having had at least one unprotected episode of sexual intercourse in the last 10 episodes. In face-to-face interviews, clients provided information about sexual activity, sexual partners, and condom use in the previous 30 days. In addition, they were asked to indicate the main reason for not using condoms when having unprotected sex. RESULTS: Content analysis showed six major categories of reasons for not using condoms: reasons related to partner relationships, reasons related to sexual sensation, reasons related to situational constraint, reasons related to condoms themselves, reasons related to pregnancy, and reasons related to types of sexual activity. Most frequent explanations given for not using condoms included partner trust (19.6%), the feel of condoms (11.9%), and lack of condom availability (11.5%). Clients also reported barriers to condom use that included beliefs about condom sensation and partner relationships. CONCLUSIONS: These results show the continued barriers that exist with respect to condom use in at-risk populations and emphasize the need to tailor meaningful interventions in order to promote condom use among persons who, for differing reasons, choose not to use them.

Adult↗

PubMed2004

The hippocampal system mediates logical reasoning about familiar spatial environments.

It has recently been shown that syllogistic reasoning engages two dissociable neural systems. Reasoning about familiar situations engages a frontal-temporal lobe system, whereas formally identical reasoning tasks involving unfamiliar situations recruit a frontal-parietal visuospatial network. These two systems may correspond to the "heuristic" and "formal" methods, respectively, postulated by cognitive theory. To determine if this dissociation generalizes to reasoning about transitive spatial relations, we studied 14 volunteers using event-related fMRI, as they reasoned about landmarks in familiar and unfamiliar environments. Our main finding is a task (reasoning and baseline) by spatial content (familiar and unfamiliar) interaction. Modulation of reasoning toward unfamiliar landmarks resulted in bilateral activation of superior and inferior parietal lobules (BA 7, 40), dorsal superior frontal cortex (BA 6), and right superior and middle frontal gyri (BA 8), regions widely implicated in visuospatial processing. By contrast, modulation of the reasoning task toward familiar landmarks, engaged the right inferior/orbital frontal gyrus (BA 11/47), bilateral occipital (BA 18, 19), and temporal lobes. The temporal lobe activation included the right inferior temporal gyrus (BA 37), posterior hippocampus, and parahippocampal gyrus, regions implicated in spatial memory and navigation tasks. These results provide support for the generalization of dual mechanism theory to transitive reasoning and highlight the importance of the hippocampal system in reasoning about familiar spatial environments.

Adult↗

PubMed1998

Clinical reasoning case studies as teaching tools.

OBJECTIVE: Students are taught how to apply clinical reasoning methods through a variety of teaching methods, including the use of case studies. Various types of case studies have been described in the literature: paper cases, videotape cases, simulated client cases, and real client cases. This study examined the effectiveness of a new type of paper case study--the clinical reasoning case study--in teaching the clinical reasoning process to occupational therapy students. METHOD: Four seniors in an undergraduate occupational therapy program completed intervention plans in response to both traditional medical model and clinical reasoning paper case studies. Qualitative methods were used to analyze intervention plans and videotaped discussion about this learning experience. RESULTS: Themes discovered in the data sources suggest that compared with traditional case studies, the clinical reasoning case studies increased the quality of participants' intervention plans, participants' confidence levels about their plans, and participants' understanding of the clinical reasoning process. Participants also reported preferring clinical reasoning case studies over traditional paper case studies. CONCLUSION: The clinical reasoning case studies are effective teaching tools because they provide students with a holistic picture of the client and his or her occupational therapy treatment. In addition, these case studies model the clinical reasoning process by organizing client information according to the types of clinical reasoning that would be used to gather that information. Occupational therapy educators may find this type of paper case study useful in introducing students to the intervention planning process.

Female↗

PubMed2006

Structure of visits persons with diabetes in Croatian family practice--analysis of reasons for encounter and treatment procedures using the ICPC-2.

The reasons for encounter and the procedures conducted during the visit persons with diabetes to family practice have been investigated. Five family practitioners located in two Croatian counties took part in this study. In this study patients with diagnoses E10-E14 according to International Classification Disease-10 (ICD-10), were involved. There were 543 persons with diabetes (women 324) in the total population of 10,150 patients Data were registered according to the International Classification Primary Care-2 (ICPC-2) (components 1-7 for reasons of encounter, and components 2-6 for procedures during the visit), in period october till december 2005. 871 visits of persons with diabetes (average age 65.7 +/- 12.5 were registered. Patients presented in total 1921 reasons for encounter or 2.1 +/-1.1 per visit. Family practitioner made in total 2,341 procedures or 2.6 +/- 1.5 procedures per visit. 85.0% of patients had 1 to 3 reasons for encounter, 78.4% of patients had 1 to 3 procedures per visit. 64.4% of patients with diabetes presented at least one reason for encounter connected to diabetes. The most common reasons for encounter were prescriptions of medication 46.4 per 100 reasons for encounter, the second was dignostic procedure 19.9, request for analysis of findings 11.1, symptoms complaints 11, request for referrals to diagnostic procedures or specialist consultation 8.9 and administrative reuqests 1.6 per 100 reasons for encounter. Family practitioner performed procedure prescriptions of medication 47 per 100 procedures. The second was dignostic procedure 32.8 per 100 procedures, referrals to diagnostic procedures or specialist consultation 14.7 and administrative procedures 1.7 per 100 procedures. From the total number of 100 referrals to specialist, 23 were to diabetologist, 15 to ophtalmologist, 13 to cardiologist. The largest proportion of procedure belong to diabetics 33.8%, followed by the circulatory system 25.4%, musculosceletal 6.9%, symptoms 5.1%, respiratory 4.5%. The reasons for encounter and the procedures conducted during the visit have direct influence to the quality of care for persons with diabetes. It is necessery collecting the data and research in the field of reasons for encounter and procedures during the visit of person with diabetes. The results then can be compared to the results already found in literature.

Aged↗

PubMed1986

Moral reasoning, parental sex attitudes, and sex guilt in female college students.

Forty-eight female college students completed the Mosher Forced-Choice Guilt Inventory, the Rest Defining Issues Test, and the Family Attitude and Communication Scale in order to study the relationship between sex guilt, moral reasoning, and perceived parental sex attitudes. Analysis of variance indicated that Stage 4 moral reasoners had significantly higher sex guilt scores than Stage 5 reasoners. There was also a significant interaction effect between moral reasoning and perceived parental sex attitudes with respect to sex guilt, with Stage 5 reasoners from permissive family backgrounds having very low levels of guilt. The findings suggested that there is an overall negative relationship between sex guilt and moral reasoning, supporting prior studies. However, the relationship between sex guilt and permissive/restrictive family background is more complicated. Paradoxically, more advanced Stage 5 reasoners seemed more influenced by family sexual attitudes than Stage 4 reasoners. The authors offer an explanation for this finding and stress the importance of moral reasoning as a variable in understanding sexual attitudes and behavior.

Adolescent↗