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Results for “Disclosure”

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At least 127 records · Page 7Linked to original sources

PubMed2002

Expressive disclosure and health outcomes in a prostate cancer population.

OBJECTIVE: This pilot study explored the feasibility and the efficacy of a brief, well-defined psychosocial intervention (expressive disclosure) in improving behavioral, medical, immunological, and emotional health outcomes in men with diagnosed prostate cancer. METHOD: Thirty prostate cancer patients receiving outpatient oncology care were randomized into experimental (disclosure) and control (non-disclosure) groups. All had been previously treated by surgery or radiation within the last 4 years and were being monitored without further intervention for change in PSA levels. Psychological and physical health surveys were administered and peripheral blood for PSA levels and immune assays was obtained upon study enrollment and again at 3 and 6 months post enrollment. Multivariate analyses were used to examine how the expressive disclosure impacted the hypothesized domains of functioning: physical and psychological symptoms; health care utilization; and immunocompetence. RESULTS: Compared to controls, patients in the expressive disclosure condition showed improvements in the domains of physical symptoms and health care utilization, but not in psychological variables nor in disease relevant aspects of immunocompetence. CONCLUSIONS: Study results support the feasibility of an expressive disclosure intervention for men with prostate cancer. The intervention was well accepted by this population, and participation/adherence was quite high. Results provide only limited support for the hypothesis that a written emotional disclosure task can positively impact health outcomes in a cancer population. However, this pilot study may have lacked adequate power to detect possible intervention benefits. Further studies with larger samples are needed to better assess the intervention's impact on psychological well-being and immunocompetence.

Affect↗

PubMed1995

Patterns of self-disclosure across social support networks: elderly, middle-aged, and young adults.

Self-disclosure has generally been examined as a unidimensional construct which relates to intimacy in developing relationships. Self-disclosure also serves many functions in established relationships, such as with close friends and family. Moreover, the functions served by self-disclosure may vary depending upon the adults' gender and stage in the life-span. In this study, such issues are examined with regard to elderly, middle-aged, and young adults' use of four functions of self-disclosure: self-expression, self-clarification, social control, and social validation. Findings support the claim that greater intergenerational distance is related to less self-disclosure among members of a social network. Further, elderly adults self-disclose more often to family than to friends, while young adults self-disclose to friends more often than to family. Implications for self-disclosure within the areas of gender, social support, and social comparison are discussed, and the appropriateness of adults' disclosure patterns within a framework of life stages is considered.

Adult↗

PubMed1994

Adult survivors of childhood sexual abuse: survivor's disclosure and nurse therapist's response.

Recent literature pertinent to adult survivors suggests that childhood sexual abuse is a serious problem, and that disclosure is on the rise. The aftereffects of childhood sexual abuse can cause dysfunction in various aspects of the survivor's physical and mental health. Understanding the traumagenic dynamics of childhood sexual abuse and its aftereffects provides direction for the nurse therapist during both the client's disclosure and intervention planning. This knowledge assists the therapist in promoting mental health and healing, as well as providing comfort for the therapist. The nurse therapist's reactions to the client's disclosure can affect the way the client feels about disclosure and the therapeutic relationship. If a negative message is conveyed to the survivor at the time of disclosure, the feelings of betrayal, stigmatization, and powerlessness that the survivor experienced as a child will be replicated. This can damage the therapeutic relationship and delay the healing process. When disclosure is received and acted upon in a sensitive, therapeutic manner, the survivor is empowered and can enter with the nurse therapist into an effective therapeutic alliance. Nurse therapists should gain awareness of the types of emotional responses that can be engendered in the health professional during disclosure. Awareness of these emotional reactions can lead to the identification of coping strategies useful to both the therapist and the adult survivor. Coping strategies useful to the therapist include maintaining adequate boundaries, understanding oneself and one's responses to sexual-abuse issues, utilizing ongoing consultation or supervision, and preventing burnout.(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Psychological↗

PubMed2004

Rates, barriers and outcomes of HIV serostatus disclosure among women in developing countries: implications for prevention of mother-to-child transmission programmes.

This paper synthesizes the rates, barriers, and outcomes of HIV serostatus disclosure among women in developing countries. We identified 17 studies from peer-reviewed journals and international conference abstracts--15 from sub-Saharan Africa and 2 from south-east Asia--that included information on either the rates, barriers or outcomes of HIV serostatus disclosure among women in developing countries. The rates of disclosure reported in these studies ranged from 16.7% to 86%, with women attending free-standing voluntary HIV testing and counselling clinics more likely to disclose their HIV status to their sexual partners than women who were tested in the context of their antenatal care. Barriers to disclosure identified by the women included fear of accusations of infidelity, abandonment, discrimination and violence. Between 3.5% and 14.6% of women reported experiencing a violent reaction from a partner following disclosure. The low rates of HIV serostatus disclosure reported among women in antenatal settings have several implications for prevention of mother-to-child transmission of HIV (pMTCT) programmes as the optimal uptake and adherence to such programmes is difficult for women whose partners are either unaware or not supportive of their participation. This article discusses these implications and offers some strategies for safely increasing the rates of HIV status disclosure among women.

Attitude to Health↗

PubMed2006

Factors associated with non-disclosure of HIV infection status of new mothers in Bangkok.

The objective of this study was to estimate HIV disclosure rates and identify factors that predict non-disclosure in Thai women who tested HIV positive during pregnancy or at delivery. This was a cohort study evaluating the implementation of prevention of mother-to-child HIV transmission programs at two Bangkok hospitals in 1999-2003. All HIV-infected women who delivered during the study period were enrollment eligible. Thai-language questionnaires were used to collect baseline data before discharge from the hospital. At the 1 and 4 month follow-up visits, women were asked if they had disclosed their HIV status. Of the 799 women who enrolled, 647 (81.0%) completed follow-up at 1 and 4 months. Four hundred fifty-three (70.0%) women disclosed their status by 1 month. Of the 194 women who had not disclosed by 1 month, 48 (24.7%) had disclosed their status by 4 months. An independent increased odds of non-disclosure by 1 month was associated with not having a partner tested for HIV (OR=5.83, 95% CI=3.19-9.08) or not knowing if the partner was ever tested for HIV (OR=1 3.02, 95% Cl=5.26-32.28), first learning of HIV positive status during delivery (OR=6.84, 95% CI=2.36-19.81) or after delivery (OR=3.14, 95% CI=1.57-6.26) and having >2 lifetime sexual partners (OR=1.71, 95% CI=1.04-2.82). Not living with a partner every day was associated with non-disclosure by 4 months in those women who had not disclosed by 1 month (OR=2.28, 95% CI=1.43-3.64). Despite high rates of disclosure by 1 month, 22.6% of women still had not disclosed their HIV status to their partners by 4 months. The benefits of disclosure warrant effective interventions targeted at women at risk for non-disclosure.

Adolescent↗

PubMed1993

Disclosure documents and informed consent: the pros and cons.

This article critically examines the nature, scope, role and function as well as the pros and cons of disclosure documents as a means of procuring a patient's informed consent to proposed medical intervention. The conclusion reached is that, although the disadvantages of disclosure documents outnumber and outweigh their benefits, they should not be denied a role and function. Disclosure documents may be useful instruments for furnishing the basic information that a prudent patient would require to come to a decision whether to undergo or refuse the proposed medical intervention, but individual disclosure tailored to fit the actual circumstances of the particular patient can only be achieved by means of a disclosure conversation between doctor and patient. Hence, disclosure documents may serve as a supplement to but not as a substitute for a disclosure conversation.

Documentation↗

PubMed2001

Preference for disclosure of information among patients with rheumatoid arthritis.

OBJECTIVE: To quantify preference for disclosure of information among patients with rheumatoid arthritis (RA) and to examine sex-specific correlates of information preference. METHODS: We interviewed patients with RA and assessed preference for disclosure of information using 4 questions from the previously validated "Information Preference Seeking Scale." Three questions addressed preference for disclosure of side effects and 1 question addressed preference for disclosure of therapeutic options. Associations between preference for information and patient characteristics were examined using stepwise multiple linear regression. RESULTS: One hundred RA patients (mean age 68+/-12 years; 73% female) were interviewed; 89 respondents agreed or strongly agreed with all 4 statements reflecting a preference for full disclosure, and an additional 8 respondents agreed or strongly agreed with 3 of the 4 statements. The mean score (+/- SD) for information preference was 86+/-13, on a scale from 0 to 100 where 100 reflected a strong preference for full disclosure. In bivariate analyses, female sex and current employment were associated with stronger preferences for being informed (mean score for women 88+/-11, for men 80+/-15 [P = 0.02]; for employed 92+/-11, for unemployed 84+/-13 [P = 0.04]). Multivariate sex-specific analyses demonstrated that current employment and higher education level were positively associated with preference for disclosure among women and men, respectively. CONCLUSION: The results of our survey suggest that RA patients want to be fully informed about the risks associated with medications and about alternative options. The challenge remaining for rheumatologists is how to effectively communicate the risks and benefits related to the many options that are currently available for RA patients.

Adult↗

PubMed2004

The therapist's use of self-disclosure in a relational therapy approach for eating disorders.

One of the critical aspects of Relational Therapy (RT) that distinguishes it from other treatments for eating disorders is the therapist's use of self-disclosure. Self-disclosure is one way the therapist authentically represents her- or himself in the therapeutic relationship to foster relational movement and growth. This article makes use of an initial clinical vignette to compare and contrast the use of therapist self-disclosure within an RT approach with views of therapist self-disclosure from other psychotherapy traditions. Advantages are discussed for using therapist disclosure with eating disordered patients. Criteria are outlined to help the RT therapist decide when to disclose. Additional clinical vignettes show different types of therapist self-disclosure, their therapeutic purposes, and their relational impact. The article ends with implications for future research, training, and practice related to the use of self-disclosure in the treatment of eating disordered patients.

Journal Article↗

PubMed1979

Three aspects of self-disclosure as they relate to quality of adjustment.

Subjects completed two measures of actual self-disclosure (one for intimacy of self-presentation and one for inwardness of self-presentation)and a self-report of past self-disclosure. and California Psychological Inventory. For both sexes the two measures of actual disclosure correlated positively but neither instrument related positively to the self-report measure. Females disclosed more than males on both measures of actual disclosure. Quadratic, inverted-U relationships were hypothesized for the self-disclosure and CPI scales, but by and large they were not found. Linear associations were noted, the major ones being a positive pattern of correlations between the inwardness of actual disclosure and measures of flexible autonomy, responsibility and socialization for the males, a negative set of relations between the intimacy of actual disclosure and scales indicative of good interpersonal adjustment for the females, and a positive relationship between the self-report measure and scales indicative of social poise, extraversion and socialization for both sexes.

Journal Article↗

PubMed2006

Disclosure of HIV serostatus to sex partners in rural Louisiana.

To examine correlates of HIV disclosure, a convenience sample of 273 HIV-infected persons throughout rural Louisiana were interviewed. Disclosure to sexual partners at time of initial HIV-positive diagnosis and the time of the study interview was ascertained (an average of 5.76 years later). The prevalence of disclosure to past and current sex partners was 57.2% and 80.7% respectively. Those who reinitiated sex with their partner since testing positive for HIV and those who received partner notification were more likely to disclose to past partners. Non-African Americans and those with only one partner were more likely to disclose to present sex partners. Much like urban settings, disclosure is not universal, and interventions such as disclosure skills building and/or ongoing partner notification services may be needed to facilitate disclosure.

Adult↗

PubMed2005

To tell or not to tell: primary care patients' disclosure deliberations.

BACKGROUND: Literature on patient disclosure has highlighted policy proposals, practitioner attitude and practices, and issues specific to already identified vulnerable populations (eg, human immunodeficiency virus-positive patients and adolescents). We investigated the topics and concerns that led less-studied primary care patients to deliberate disclosure to their physician and the range of actions taken following such deliberation. METHODS: This descriptive qualitative study used semistructured in-depth interviews with 85 self-selected female primary care patients recruited from 2 hospital-associated primary care practices and through advertisements in local newspapers. RESULTS: Topics that led subjects to deliberate over disclosure included sex, sexually transmitted diseases, reproductive health, drug use, mental health, and domestic circumstances. Concerns prompting this deliberation fell into 2 categories. The first, extraindividual concerns, included fear of information circulating to employers or insurance companies and the need to disclose for adequate treatment. The second, intrapersonal concerns, centered on feelings of comfort, embarrassment, or shame in the act of disclosing during the clinical encounter. While the majority of women did eventually disclose all or part of the information in question, a significant minority did not disclose. There were no significant demographic differences associated with patterns of disclosure. CONCLUSIONS: Primary care patients have concerns that affect and sometimes limit disclosure. Physicians are encouraged to explore patients' concerns about the uses and circulation of medical information, as well as anxiety over anticipated shame or embarrassment at the moment of information disclosure to physicians. This is especially important in primary care settings, where failure to disclose can mean lack of referral to needed specialized care.

Adolescent↗

PubMed2002

Mechanisms behind the failure of residents' longitudinal primary care to promote disclosure and discussion of psychosocial issues.

CONTEXT: Longitudinality (care by a single physician over time) and continuity (receipt of most care from a single physician) are believed to enhance patient-physician relationships and facilitate disclosure of emotional distress, but some studies suggest this potential goes unrealized. OBJECTIVES: To determine whether care in a pediatric residents' continuity clinic promotes, over time, increased discussion, disclosure, and detection of parents' social and emotional distress and to understand physicians' communication behaviors underlying changes with time. DESIGN: Longitudinal, observational study of parent-physician interaction over the course of 1 year. PARTICIPANTS: One hundred ninety parents (90% African American) and their infants' primary care physicians (31 [4 Asians and 27 whites] first- and second-year pediatric residents). MAIN OUTCOME MEASURES: Frequency with which parents and physicians raised topics related to parental mood and family or social functioning; proportion of distressed parents discussing mood or functioning; and physicians' detection of parent distress. RESULTS: Physician initiation of psychosocial topics fell in the course of longitudinal relationships (odds of initiation in visits > or =6 vs odds of initiation in visits 1-5 = 0.46 [95% confidence limits, 0.31%, 0.67%]); parent initiation did not change over time nor was it increased by greater levels of continuity. Length of relationship was not associated with increased physician detection of parental distress or with increased rates of disclosure by distressed parents. Physicians' positively framed leading questions, and their avoidant responses to prior parental disclosures were significantly associated with decreased odds of problem disclosure. In contrast, visits in which parents or physicians raised psychosocial topics were characterized, on average, by 40% higher levels of physicians' "patient-centeredness" (increases of about 100 utterances per visit [95% confidence limits, 65.7%, 133.9%]). CONCLUSIONS: Longitudinal relationships between residents and patients may not be sufficient to promote the discussion, disclosure, and detection of psychosocial issues. Training in communication skills may help residents achieve the potential and goals of longitudinal care.

Adult↗

PubMedDate not supplied

Strategies of information disclosure to Chinese cancer patients in an Asian community.

There is little information available on strategies of information disclosure used by doctors in the care of patients with cancer. This report focuses on the style of disclosure used by doctors when giving diagnostic and prognostic information to patients with cancer. Among 46% of 133 surgeons and radiotherapists interviewed, disclosure of diagnosis involved a sudden approach (information given outright at one sitting). Less commonly used (19%) was a gradual disclosure style. Of the remainder who disclosed, more than half did so through the family or left it to the family to tell the patient. Doctors' specialty and patients' requests for prognostic information dictated disclosure style most frequently. Single people were more likely to have information disclosed to their families than were married people. While anecdotal accounts indicate negative reactions on the part of patients are a major reason for withholding such information, different disclosure style had little effect on doctors' reports of patient reactions to the bad news. Doctors perceived 25% of patients appeared to react 'with depression' but the remaining 75% appeared 'calm'. These results suggest patients are more likely to be told bad news suddenly, and that doctors do not perceive that this impacts too negatively on patients. The high levels of reported preference for information about cancer in Hong Kong (Fielding and Hung, 1996) conflict with actual prevalence patterns. It seems that commonly cited anecdotal reasons for withholding information from cancer patients in Hong Kong are not sustained by the data produced in these studies.

Adolescent↗

PubMed2003

Therapist self-disclosure in cognitive-behavior therapy.

Although cognitive-behavior therapy emphasizes between-session change, therapist self-disclosure within the session can be an effective tool for strengthening the therapeutic bond and facilitating client change. After noting the use of self-disclosure in other theoretical orientations, we place self-disclosure in the context of cognitive-behavioral theories of reinforcement and modeling. Clinical vignettes illustrate the use of therapist self-disclosure to provide feedback on the interpersonal impact made by the client, enhance positive expectations and motivation, strengthen the therapeutic bond, normalize the client's reaction, reduce the client's fears, and model an effective way of functioning. Therapists need to observe appropriate boundaries when self-disclosing, and in particular, should consider their own motivations for self-disclosing. Although more research is needed on the effects of self-disclosure, cognitive-behavior therapists have found that self-disclosure can be a powerful intervention.

Cognitive Behavioral Therapy↗

PubMed2005

Disclosure of HIV status and psychological well-being among Latino gay and bisexual men.

This study examined disclosure of HIV-positive serostatus by 301 Latino gay and bisexual men to members of their social networks and the mental health consequences of such disclosure. The sample was recruited from clinics, hospitals, and community agencies in New York City, Washington, DC, and Boston. Proportions disclosing differed depending on the target, with 85% having disclosed to closest friend, 78% to male main partner, 37% to mother, and 23% to father. Although there were differences depending on the target, disclosure was related to greater quality of social support, greater self-esteem, and lower levels of depression. Moreover, findings indicated that social support mediated the relationship between disclosure of serostatus and both self-esteem and depression. Thus, disclosure resulted in greater social support, which in turn had positive effects on psychological well-being. Findings demonstrate that generally Latino gay men are selective in choosing people to whom they disclose their serostatus and that disclosure tends to be associated with positive outcomes.

Adaptation, Psychological↗

PubMed2006

Is self-disclosure part of the genetic counselor's clinical role?

The role of genetic counselor self-disclosure in clinical practice is unclear as there are few published investigations of this issue. In the present study, 11 genetic counselors who previously received genetic services were interviewed about their opinions and use of disclosure. Several themes were extracted from their responses. All participants reportedly disclosed to patients; however, not all disclosed their receipt of genetic services. Patient requests for self-disclosure influenced many participants' disclosure decisions. Opinions regarding potential benefits of disclosure varied. Nearly all participants stressed the importance of self-disclosing judiciously, stating that it may be counterproductive to client goal attainment. Four individuals with expertise in genetic counseling and psychotherapy were invited to react to these themes and to provide their opinions of self-disclosure. Their views are compared to those of the present sample, and practice and research recommendations are given.

Adult↗

PubMed2001

Conflict of interest policies in science and medical journals: editorial practices and author disclosures.

This study examines the extent to which scientific and biomedical journals have adopted conflict of interest (COI) policies for authors, and whether the adoption and content of such policies leads to the publishing of authors' financial interest disclosure statements by such journals. In particular, it reports the results of a survey of journal editors about their practices regarding COI disclosures. About 16 percent of 1396 highly ranked scientific and biomedical journals had COI policies in effect during 1997. Less than 1 percent of the articles published during that year in the journals with COI policies contained any disclosures of author personal financial interests while nearly 66 percent of the journals had zero disclosures of author personal financial interests. Nearly three fourths of journal editors surveyed usually publish author disclosure statements suggesting that low rates of personal financial disclosures are either a result of low rates of author financial interest in the subject matter of their publications or poor compliance by authors to the journals' COI policies.

Authorship↗

PubMed1976

Self-disclosure in parents of stuttering children.

A review of the literature suggested a possible relationship between low self-disclosure or avoidance of the self in parents and stuttering in the child within the same family. The present research was designed to test whether there are any differences in self-disclosure between parents of stuttering children and parents of nonstuttering children. The Self-Disclosure Questionnaire, devised by Jourard, was administered to 64 mothers and 64 fathers, half of whom comprised the control groups. The results obtained by analyses of variance indicated that parents of stuttering children do not differ from parents of nonstuttering children in their actual self-disclosure. However, findings as to why disclosure did not occur on certain items indicated that, although the parents of stuttering children do not differ in self-disclosure, they may differ in declining to disclose information when asked for it.

Adolescent↗