Roles of Perceived Provider Cultural Sensitivity and Health Care Justice in African American/Black Patients’ Satisfaction with Provider

The present study tests a refined first component of the Patient-Centered Culturally Sensitive Health Care (PC-CSHC) Model—the evidence supported component that links perceived provider cultural sensitivity to patient satisfaction with provider care and identifies trust of provider as the mediator of this linkage. The refined first component of the PC-CSHC Model tested in the present study is novel in that it includes the three dimensions of provider cultural sensitivity and includes perceived provider impartiality (fairness), a core aspect of perceived health care justice, as a mediator in addition to trust of provider (the other core aspect of perceived health care justice). Study participants were 298 African American/Black primary care clinic patients with low household incomes. Mediation analyses revealed that the three dimensions of patients’ perceived provider cultural sensitivity were significant predictors of the participating patients’ reported satisfaction with their provider, and that some of these predictive relationships were partially mediated by (1) patients’ perceived provider impartiality (fairness), and (2) patients’ trust of their provider. Implications of these findings for providers’ interactions with patients, development of the PC-CSHC Model, and the roles of psychologists in facilitating patient-provider interactions are discussed.     

Managing boundaries under pressure: A qualitative study of therapists’ experiences of sexual attraction in therapy

Aim: To identify therapists’ views on sexual boundaries and the strategies they employ to manage them in therapeutic practice. Method: In‐depth qualitative interviews were conducted with a sample of 13 accredited, experienced practitioners of psychotherapy or counselling. A grounded theory approach, informed by principles from Free Association Narrative methodology, was employed, in which team members used debriefing sessions for extending depth of understanding of the interviews. Findings: There is consensus about boundaries at the extremes, but variability about fantasy, flirtation and touch. A core process was generated from accounts of successful management of sexual attraction. We identified four problematic ways of reacting to boundary pressure, each with potential to harm clients and therapy. Discussion: A participant‐observer stance was conceptualised as essential for managing threats to boundaries, consistent with the empathic stance. Minor boundary crossings were viewed by interviewees as both potential precursors of more serious transgressions, and as opportunities for understanding the client's difficulties. Implications for practice: These span training, accrediting organisations, supervision and therapy practice.     

Tribute to Don S. Browning (1934–2010)

This tribute adapts words originally written to honor Don S. Browning, one of the foremost pastoral and practical theologians and ethicists of his time, on the occasion of his death on June 3, 2010. The tribute appeared in the funeral worship bulletin on June 10, 2010 at Hyde Park Union Church in Chicago and was revised for a newsletter of a major educational institution with which he had many significant relationships and responsibilities (The Disciples Divinity House of the University of Chicago Bulletin 80, no. 1 (Spring/Summer 2010); used with permission). Although we embellished the tribute slightly, we did not change its main intent: It captures the remarkable depth and breath of Browning’s scholarly achievement, the mark he made on public and academic discussion, and the extent to which he is missed by his colleagues, friends, and family.     

Workplace support, discrimination, and person-organization fit: tests of the theory of work adjustment with LGB individuals

The present study explored the links of 2 workplace contextual variables--perceptions of workplace heterosexist discrimination and lesbian, gay, and bisexual (LGB)-supportive climates--with job satisfaction and turnover intentions in a sample of LGB employees. An extension of the theory of work adjustment (TWA) was used as the conceptual framework for the study; as such, perceived person-organization (P-O) fit was tested as a mediator of the relations between the workplace contextual variables and job outcomes. Data were analyzed from 326 LGB employees. Zero-order correlations indicated that perceptions of workplace heterosexist discrimination and LGB-supportive climates were correlated in expected directions with P-O fit, job satisfaction, and turnover intentions. Structural equation modeling (SEM) was used to compare multiple alternative measurement models evaluating the discriminant validity of the 2 workplace contextual variables relative to one another, and the 3 TWA job variables relative to one another; SEM was also used to test the hypothesized mediation model. Comparisons of multiple alternative measurement models supported the construct distinctiveness of the variables of interest. The test of the hypothesized structural model revealed that only LGB-supportive climates (and not workplace heterosexist discrimination) had a unique direct positive link with P-O fit and, through the mediating role of P-O fit, had significant indirect positive and negative relations with job satisfaction and turnover intentions, respectively. Moreover, P-O fit had a significant indirect negative link with turnover intentions through job satisfaction.     

Building the perfect curse word: A psycholinguistic investigation of the form and meaning of taboo words

Taboo words represent a potent subset of natural language. It has been hypothesized that “tabooness” reflects an emergent property of negative valence and high physiological arousal of word referents. Many taboo words (e.g., dick, shit) are indeed consistent with this claim. Nevertheless, American English is also rife with negatively valenced, highly arousing words the usage of which is not socially condemned (e.g., cancer, abortion, welfare). We evaluated prediction of tabooness of single words and novel taboo compound words from a combination of phonological, lexical, and semantic variables (e.g., semantic category, word length). For single words, physiological arousal and emotional valence strongly predicted tabooness with additional moderating contributions from form (phonology) and meaning (semantic category). In Experiment 2, raters judged plausibility for combinations of common nouns with taboo words to form novel taboo compounds (e.g., shitgibbon). A mixture of formal (e.g., ratio of stop consonants, length) and semantic variables (e.g., ± receptacle, ± profession) predicted the quality of novel taboo compounding. Together, these studies provide complementary evidence for interactions between word form and meaning and an algorithmic prediction of tabooness in American English. We discuss applications for models of taboo word representation.

     

The influence of Sociocultural Paradigms

This research examined the influence of sociocultural paradigms of menopause on attitudes toward menopause. Five hundred eighty-one women and men, between the ages of 18 and 85, were assigned to one of three groups distinguished by the context within which they expressed their attitudes toward menopause. The contexts were designed to reflect particular paradigms: one group described their attitudes toward three medical problems, including menopause; a second group described their attitudes toward three life transitions, including menopause; and a third group described their attitudes toward three symbols of aging, including menopause. Positive and negative subscales of the attitude questionnaires for menopause were analyzed for context and age/experience. Results indicated that the medical context elicited significantly more negative and fewer positive attitudes than did the other two contexts, particularly among older participants. In general, women's attitudes were more positive than were men's, and attitudes became increasingly positive with age and/or experience. The discussion includes the potential role of attitudes as mediating the impact of sociocultural paradigms on experience and behavior.