Efficacy of behavioral management and patient education on vascular access cleansing compliance in hemodialysis patients

Compared four treatment conditions to test their ability to enhance compliance with vascular access cleansing (VAC) procedures in a group of 56 hemodialysis patients. The conditions were patient education, behavioral management with monetary incentive, patient education/behavioral management, and attention control. Behavioral observers rated VAC behavior at pretreatment, posttreatment 1-month follow-up, and 1-year follow-up. Knowledge of VAC procedures was also assessed via a questionnaire at pretreatment and posttreatment. Data were analyzed using repeated-measures multivariate analyses of variance. Results indicated that the patients in the education/behavioral, behavioral, and education groups gave significantly more correct answers on our VAC knowledge questionnaires at posttreatment than did patients in the attention control group. Further, patients in the education/behavioral and behavioral groups completed significantly more VAC steps at posttreatment and 1-month follow-up than did patients in the education group and in the attention control group. Differences were not maintained at 1-year follow-up, although more than 50% of the patients were lost to follow-up. Implications of the present findings for behavioral and educational interventions are discussed.     

A further validation of the bem sex role inventory: A multitrait-multimethod study

The present study used a multitrait-multimethod technique [D.T. Campbell and D. W. Fiske (1959) “Convergent and Discriminant Validation by the Multitrait-Multimethod Matrix,” Psychological Bulletin, 56, 81–105] to examine Bem's [(1974) “The Measurement of Psychological Androgyny,” Journal of Consulting and Clinical Psychology, 42, 152–162] use of an instrumental-expressive dichotomy to conceptualize the Masculinity and Femininity scales of the Bem Sex Role Inventory as statistically orthogonal constructs. Results indicate that while perhaps reliable, masculinity and femininity lack clear convergent and discriminant validity. Therefore, Bem's contention that masculinity and femininity are orthogonal constructs is questioned. Results are discussed in light of trait- vs. method-driven research.     

Towards a general theory of representation

Summary The models of science are representations of a part of reality. Every science has its own specific rules of constructing models, but there are many common rules that must be followed. These rules are to be part of what may be called a general theory of representation. This paper discusses some general aspects of representation that must be considered before such a general theory can be created. There are five sections: (1) an introduction to the topic of representation in general; (2) an overview of some general types of representation, such as goal-directed and self-organizational representations; (3) a short discussion of representation in some specific disciplines; (4) some formal aspects of representations; and (5) a discussion of epistemological aspects of representation, especially scientific reduction and mental causation.This paper was written during participation in the Research Project Mind and Brain, at the Centre for Interdisciplinary Research, University of Bielefeld, BRD.     

Visual perception and the guidance of locomotion without vision to previously seen targets

Two experiments were performed to assess the accuracy and precision with which adults perceive absolute egocentric distances to visible targets and coordinate their actions with them when walking without vision. In experiment 1 subjects stood in a large open field and attempted to judge the midpoint of self-to-target distances of between 4 and 24 m. In experiment 2 both highly practiced and unpracticed subjects stood in the same open field, viewed the same targets, and attempted to walk to them without vision or other environmental feedback under three conditions designed to assess the effects on accuracy of time-based memory decay and of walking at an unusually rapid pace. In experiment 1 the visual judgments were quite accurate and showed no systematic constant error. The small variable errors were linearly related to target distance. In experiment 2 the briskly paced walks were accurate, showing no systematic constant error, and the small, variable errors were a linear function of target distance and averaged about 8% of the target distance. Unlike Thomson's (1983) findings, there was not an abrupt increase in variable error at around 9 m, and no significant time-based effects were observed. The results demonstrate the accuracy of people's visual perception of absolute egocentric distances out to 24 m under open field conditions. The accuracy of people's walking without vision to previously seen targets shows that efferent and proprioceptive information about locomotion is closely calibrated to visually perceived distance. Sensitivity to the correlation of optical flow with efferent/proprioceptive information while walking with vision may provide the basis for this calibration when walking without vision.     

'It's who you know, not what you know!': Penetrating the credentialling ideology

The kinds of messages teachers give students regarding the value of credentials in the job-getting package during a period of high youth unemployment are explored. The response made by students to the credentialling ideology promoted in schools, and their construction of the job-getting formula, are also described. The validity of the two versions of job-getting strategies is considered in the light of evidence provided by a number of empirical research projects. The superiority of student knowledge in this area is used to present a case for a critical and democratic education which appropriates and legitimises the student voice.     

Having it all? Combining work and family in a male and a female profession

Are women in a female-dominated profession more successfully able to combine work and family obligations than women in a male-dominated profession? To explore this question, a comparison was made between the family status and careers of 747 women librarians (a female-dominated profession) and those of 449 women MBAs (a male-dominated profession). It was expected that the librarians would marry earlier and have more children. This general prediction was not supported. Over half of both groups of women were married, and after controlling for age, there were no differences in number of children. However, many women without children in both groups reported that they would like to be mothers. This disparity between wanting children and not having them was more common for women MBAs than women MLSs. MBAs and librarians were about equally likely to have had job interruptions, but librarians were more likely to have worked part-time. Reasons for an interruption to full-time work were as likely to be for problems finding (full-time) work as for family responsibilities. Librarians' salaries were much lower, but job interruptions and part-time work had a more negative effect on the salaries of women in business. In sum, the data suggest that many of the women surveyed have not combined motherhood with a professional career and that it is probably somewhat more difficult to combine a family with a career in business than with a career in library science.     

Toward a Process Analysis of Emotions: The Case of Surprise

Based on an earlier model of the processes elicited by surprising events, the present studies provide evidence for one of these processes, the evaluation of the surprising event's relevance for ongoing activities (action-relevance check). The central prediction tested was that, if unexpected events elicit among other processes an action-relevance check, then response delay on a concurrent task will be more pronounced in a condition where this process is more elaborate and hence takes more time. In accord with this prediction, Experiment 1 found that an unexpected appearance change of the imperative stimulus in a choice reaction time (RT) task caused greater response delay than an equivalent appearance change of a distractor stimulus. Experiment 2 replicated this finding and tested several additional predictions that concerned the effects on response delay of a second appearance change of either the imperative or the distractor stimuli. These predictions, which were also mostly confirmed, were derived by combining the logic underlying the first study with the assumption that once made, appraisals of unexpected events are stored as part of the situational schema and are reused when the same or similar events reoccur leading to an abbreviation of appraisal processes. Experiment 3 once more replicated the basic finding of the previous studies and ruled out a possible alternative explanation. It is suggested that the proposed RT method of process verification may be of broader interest as a tool to study appraisal processes in emotion.     

Therapeutic Interaction and Dropout: Measuring Relational Communication in Solution-focused Therapy

The relational communication of sixteen dropout versus sixteen continuation sessions of solution-focused therapy was studied using two different coding schemes. On the Topic Initiation/Topic Following coding scheme (Tracey, 1986) no differences were found between dropout and continuation sessions, whereas the Family-Relational Communication Control Coding Scheme (Heatherington and Friedlander, 1987) yielded a number of significant findings. Both in 'successful' and in 'unsuccessful' dropout sessions, therapeutic interaction was found to be more conflictive than in continuation cases, with clients showing more domineering behaviour in dropout than in continuation sessions. Markovian and lag sequential analysis are used to clarify some of these findings, and their implications are discussed.     

The Future of Psychology in Medicaid's Health Delivery System for People with Disabilities

State Medicaid programs are rapidly converting fee-for-service health delivery systems to managed care for people with disabilities. In theory, managed care models of health delivery will substantially improve the quality of care for people with disabilities, but in reality, few successful models exist. This period of transition holds both opportunities and challenges for psychologists in medical settings. Because Medicaid reforms for people with disabilities may herald similar reforms for both the public and the private sectors, psychology's response will determine its role in the future of health care delivery for this population. Changes in training and increased attention to outcomes research, innovations in practice, and advocacy will be the keys to success.