Physician Burnout and Patient Satisfaction with Consultation in Primary Health Care Settings: Evidence of Relationships from a one-with-many Design

Physician burnout, as a prolonged response to chronic emotional and interpersonal stressors on the job, has been associated with suboptimal patient care and deterioration in the patient?Cprovider relationship. Although prior studies have identified a range of factors associated with decreased patient satisfaction, most have been conducted in tertiary care settings, with staff burnout examined at the hospital unit-level. To examine the impact of physician burnout on patient satisfaction from consultation in the primary care setting, a cross-sectional survey was conducted in Western Greece. Using a one-with-many design, 30 physicians and 300 of their patients, randomly selected, responded to the survey. Results showed that patient satisfaction correlated significantly with physician emotional exhaustion (r = ?.636, p < .01) and physician depersonalization (r = ?.541, p < .01). Mixed-effects multilevel models indicated that 34.4% of total variation in patients?? satisfaction occurred at the physician level, after adjustment for patients?? characteristics. Moreover, physician emotional exhaustion and depersonalization remained significant factors associated with patient satisfaction with consultation, after controlling for patient and physician characteristics. Patients of physicians with high-exhaustion and high-depersonalization had significantly lower satisfaction scores, compared with patients of physicians with low-exhaustion and low-depersonalization, respectively. Future studies need to explore the mechanisms by which physician burnout affects patient satisfaction.     

Does the A-not-B error in adult pet dogs indicate sensitivity to human communication?

Recent dog-infant comparisons have indicated that the experimenter's communicative signals in object hide-and-search tasks increase the probability of perseverative (A-not-B) errors in both species (Topál et al. 2009). These behaviourally similar results, however, might reflect different mechanisms in dogs and in children. Similar errors may occur if the motor response of retrieving the object during the A trials cannot be inhibited in the B trials or if the experimenter's movements and signals toward the A hiding place in the B trials ('sham-baiting') distract the dogs' attention. In order to test these hypotheses, we tested dogs similarly to Topál et al. (2009) but eliminated the motor search in the A trials and 'sham-baiting' in the B trials. We found that neither an inability to inhibit previously rewarded motor response nor insufficiencies in their working memory and/or attention skills can explain dogs' erroneous choices. Further, we replicated the finding that dogs have a strong tendency to commit the A-not-B error after ostensive-communicative hiding and demonstrated the crucial effect of socio-communicative cues as the A-not-B error diminishes when location B is ostensively enhanced. These findings further support the hypothesis that the dogs' A-not-B error may reflect a special sensitivity to human communicative cues. Such object-hiding and search tasks provide a typical case for how susceptibility to human social signals could (mis)lead domestic dogs.     

Responsibility: The tie that binds

People share significantly more money with others in common lab paradigms like the dictator game than they do in real life. What accounts for this difference? Paradigms like the dictator game link each recipient to a single dictator with the implication that each recipient can receive funds from only one person. We argue that this “burden” of responsibility to a single recipient helps to explain high levels of laboratory sharing. In two experiments—a modified dictator game experiment and a charitable giving experiment—participants donated significantly more to others when they were solely responsible for a recipient's outcome than when the responsibility for a recipient was potentially shared. Taken together with past findings from social psychology and experimental economics, the results show how unambiguous responsibility for a single recipient increases generosity.     

Manipulating the role of cognitive control while taking the implicit association test

The Implicit Association Test (IAT) is one of the most widely used methods for measuring attitudes in the behavioral and social sciences. Recent studies have found that individual differences in cognitive control correlate with IAT scores. However, these studies did not collect independent measures of attitude, which makes it difficult to isolate the construct of attitude separate from cognitive control. Furthermore, no study has examined whether the role of cognitive control can be manipulated, which is necessary to establish a causal link between cognitive control and IAT performance. By collecting independent measures of attitude (explicit attitude ratings and the Affect Misattribution Procedure: AMP), Experiment 1 factored out the role of attitude for two different IATs and still found a relationship between IAT scores and cognitive control (Stroop and stop-signal). Experiments 2 and 3 manipulated the role of cognitive control through instructions and feedback regarding the race IAT's measurement goal. These manipulations increased average IAT scores (i.e., stronger preference for whites), increased the relationship with cognitive control (Stroop), and decreased the relationship with attitude (AMP). These results demonstrate that cognitive control influences IAT performance rather than merely correlating with IAT performance.     

Don’t wait to incubate: Immediate versus delayed incubation in divergent thinking

Previous evidence for the effectiveness of immediate incubation in divergent creative tasks has been weak, because earlier studies exhibited a range of methodological problems. This issue is theoretically important, as a demonstration of the effects of immediate incubation would strengthen the case for the involvement of unconscious work in incubation effects. For the present experiment, we used a creative divergent-thinking task (alternative uses) in which separate experimental groups had incubation periods that were either delayed or immediate and that consisted of either spatial or verbal tasks. Control groups were tested without incubation periods, and we carried out checks for intermittent conscious work on the target task during the incubation periods. The results showed significant incubation effects that were stronger for immediate than for delayed incubation. Performance was not different between the verbal and spatial incubation conditions, and we found no evidence for intermittent conscious working during the incubation periods. These results support a role for unconscious work in creative divergent thinking, particularly in the case of immediate incubation.     

The Interference of Introversion–Extraversion and Depressive Symptomatology with Reasoning Performance: A Behavioural Study

The objective of this study was to investigate the link between the Eysenck Personality Questionnaire (EPQ) scores and depressive symptomatology with reasoning performance induced by a task including valid and invalid Aristotelian syllogisms. The EPQ and the Zung Depressive Scale (ZDS) were completed by 48 healthy subjects (27 male, 21 female) aged 33.5 ± 9.0 years. Additionally, the subjects engaged into two reasoning tasks (valid vs. invalid syllogisms). Analysis showed that the judgment of invalid syllogisms is a more difficult task than of valid judgments (65.1% vs. 74.6% of correct judgments respectively, p < 0.01). In both conditions, the subjects’ degree of confidence is significantly higher when they make a correct judgment than when they make an incorrect judgment (83.8 ± 11.2 vs. 75.3 ± 17.3, p < 0.01). Subjects with extraversion as measured by EPQ and high sexual desire as rated by the relative ZDS subscale are more prone to make incorrect judgments in the valid syllogisms, while, at the same time, they are more confident in their responses. The effects of extraversion/introversion and sexual desire on the outcome measures of the valid condition are not commutative but additive. These findings indicate that extraversion/introversion and sexual desire variations may have a detrimental effect in the reasoning performance.     

Global and local pitch perception in children with developmental dyslexia

This study investigated global versus local pitch pattern perception in children with dyslexia aged between 8 and 11 years. Children listened to two consecutive 4-tone pitch sequences while performing a same/different task. On the different trials, sequences either preserved the contour (local condition) or they violated the contour (global condition). Compared to normally developing children, dyslexics showed robust pitch perception deficits in the local but not the global condition. This finding was replicated in a simple pitch direction task, which minimizes sequencing and short term memory. Results are consistent with a left-hemisphere deficit in dyslexia because local pitch changes are supposedly processed by the left hemisphere, whereas global pitch changes are processed by the right hemisphere. The present data suggest a link between impaired pitch processing and abnormal phonological development in children with dyslexia, which makes pitch pattern processing a potent tool for early diagnosis and remediation of dyslexia.     

Mothers' voices: Coping with their children's initial disability diagnosis

For parents of infants and toddlers receiving a diagnosis of disability, a variety of responses may result. Yet, little is known about the specific ways families cope with the initial diagnosis. This qualitative study investigated 6 mothers' memories of their children's diagnoses. Mothers described their use of both palliative strategies (denying, questioning, and wishful thinking) and problem‐solving strategies (searching for information, seeking social support, reframing, and seeking spiritual support) to cope with their children's initial diagnoses. The results of this study may improve professionals' understanding of parents' need for information and support at the time of initial diagnosis.