Social science & medicine
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Social science & medicine · Jul 1994
Multidimensional health locus of control beliefs and psychological health for a sample of mothers.
Five multidimensional health locus of control (MHLC) types for 772 women whose children are enrolled in a longitudinal study of their health and development were identified. The MHLC is composed of an internal and two external dimensions (chance and powerful others). The five independent MHLC clusters were: pure internal; believer in control; pure chance; yea-sayer; and nay-sayer. ⋯ Help-seeking for children's problem behaviour did not vary significantly with MHLC groups. The present study replicated five out of six MHLC types identified in an earlier study, and established the external validity of the MHLC types on measures of health status. The findings support the use of MHLC types in future research on health locus of control.
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Social science & medicine · Jun 1994
ReviewInterests in health care technology assessment (HCTA) and HCTA training needs in eight European countries: COMETT-ASSESS.
Between mid-1991 and mid-1992, nearly 300 different organisations involved in European health care contributed their views to a survey covering a range of topics relevant to health care technology assessment (HCTA) and economic appraisal of health technologies. Organisations who participated included manufacturers, health care institutions, professional associations, health care reimbursement or funding agencies, academic institutions and policy making agencies in eight European countries. The study was carried out as part of a larger project, COMETT-ASSESS, funded partially by the EC COMETT programme, to design and deliver training in health care technology assessment and socioeconomic evaluation. ⋯ In contrast, to date the major emphasis in many HCTA programmes has been on technologies which are yet to enter the service setting. More thought now needs to be given to developing methodologies for assessing technologies once they have reached the service setting. For this the presence of a skilled and well-trained group of health personnel will also be necessary.(ABSTRACT TRUNCATED AT 400 WORDS)
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Social science & medicine · May 1994
Older patient satisfaction with communication during an initial medical encounter.
There has been extensive research on the factors associated with patient satisfaction with communication during medical encounters, however, little attention has been paid to satisfaction among subgroups of patients, including the elderly. It is inappropriate to assume that all patients have the same physician-patient relationship needs, and thus, they will all be satisfied with the same communication approaches during medical visits. In this study, we examine the interactional correlates of older patient satisfaction with an initial visit with a general internist. ⋯ These findings suggest that older patients prefer encounters in which: (1) there is physician supportiveness and shared laughter; (2) they are questioned about and given an opportunity to provide information on their own agenda items; and (3) physicians provide some structure for the first meeting through their use of questions worded in the negative. The authors caution that although this sample of older patients appears to be satisfied with a communication style usually considered characteristic of the traditional model of the physician-patient relationship (i.e. a warm interpersonal style and physician-generated structure for the visit), older patients in other settings and future cohorts of elderly patients may prefer other communication approaches. It is also suggested that aspects of communication which provide satisfaction to patients in first visits may be different than aspects of communication associated with patient satisfaction in follow-up visits.
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This paper discusses a kind of interview whose narrative structure has the interviewee-narrator assuming different personas during its course. In these kinds of interviews the narrator not only reflects on experience, but uses the interview situation to actively configure future experience, in this case to change a frustrating, overwhelming experience of mysterious, intractable pain into something more meaningful. The paper links narrative to experience by examining certain dialogic processes in narratives that engage in, as well as reflect on, practice, in this case, a kind of self-therapy.
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Social science & medicine · Feb 1994
Are bereaved family members a valid proxy for a patient's assessment of dying?
To compare assessments made retrospectively by bereaved family members (or the nearest carer to the patient) with assessments made before death by palliative staff and, where available, by patients themselves or the family member. ⋯ Retrospective assessments by bereaved family members may be valid for some items related to service provision, but not as the sole assessment of a patient's pain, symptoms or anxiety. We suggest that studies which rely on these retrospective ratings should assess the validity of their responses and record more information about the mood and grief of the family member.