The practice of empathy as a prerequisite for informed consent

The patient-physician relationship, as formulated in the traditional biomedical model of medicine, is inherently flawed. In entering this relationship, most patients seek simply to be delivered from illness back to normal psychosocial functioning. The physician, however, almost invariably responds with a purely biologic approach to diagnosis and treatment that often does not effectively address the patient's needs. This precludes the opportunity for a consensus between them, and may in fact lead to the physician manipulating the patient's decisions about the course of therapy. The relationship should be reshaped within a new scientific model of patient care that combines the biomedical analysis of disease with an empathic understanding of the patient's illness experience. Truly informed consent is viewed as a natural outcome of the application of this more comprehensive framework.     

A STAFF MANAGEMENT SYSTEM FOR MAINTAINING IMPROVEMENTS IN CONTINENCE WITH ELDERLY NURSING HOME RESIDENTS

We developed a staff management system for maintaining treatment gains achieved on a specialized continence unit located in a geriatric nursing home. Geriatric assistants learned to use a prompted voiding procedure to maintain improved dryness for 4 elderly residents. The staff management system included self-monitoring and recording of prompted voiding activities and supervisory monitoring and feedback based on group performance of these activities. Results show that the system was effective in maintaining prompted voiding activities with corresponding maintenance of improved patient continence. However, a gradual decline in staff performance was noted 4 to 5 months after the initiation of the system. During a subsequent phase of the study, provision of individual feedback restored staff performance to previous levels. Results are discussed in relation to the practicality of prompted voiding interventions in nursing home environments and the applicability of staff management systems in this setting.     

The children's depression adjective check lists (C-DACL) with emotionally disturbed adolescent boys

In this study of the reliability and validity of the Children's Depression Adjective Check Lists (C-DACL; Brewer & Lubin, 1987) with emotionally disturbed adolescent boys (N=50),data were collected on two occasions. Internal consistency (alpha) was .89 and .94 for form H and .89 and .95 for form I. Alternate form reliabilities were .86 and .95. Split-half reliabilities were .80 and .89 for form H and .68 and .86 for form I. Concurrent validity was determined by correlations between C-DACL and the Self-Rating Scale of Depressed Mood. Correlations were .65 and .80 for H and .54 and .80 for I. Data from the present study were tested against data from emotionally disturbed adolescent girls (Sokoloff & Lubin, 1983), with boys scoring significantly lower on both forms (H and I) of the C-DACL.     

Psychometric evaluation of the dating anxiety survey: A self-report questionnaire for the assessment of dating anxiety in males and females

The Dating Anxiety Survey (DAS) was constructed to assess dating anxiety in males and females. Factor analysis of the survey revealed three factors: passive contact, active intentions for dating, and dating interactions. The reliabilities of the three subscales, as determined by coefficient alpha, were .87, .91, and .93 for males and .90, .90, and .92 for females, respectively. Correlations with dating history and a measure of social anxiety were generally of a low but significant magnitude, providing some support for concurrent validity. The results of the factor analysis lend support to the construct validity of the DAS. These findings suggest that the DAS is a potentially useful instrument in the self-report of dating anxiety.Portions of this paper were presented at the meeting of the Southeastern Psychological Association, Atlanta, GA, March 1983.     

The role of regression and range effects in determination of the power function for electric shock

A scale for the apparent intensity of electric shock applied to the forearm was derived from cross-modality matching functions relating noise level, number, and force of handgrip to both line length and shock. For each response mode, the effects of psychophysical regression were estimated from the line judgments and used to make adjustments in the corresponding shock judgments. For shocks ranging from (1.0 to 5.5 mA, combined estimates of subjective magnitude were found to grow as the 2.26 power of the stimulating current.