Quality-of-life measures: hospital interview versus home questionnaire

Measures adapted from social survey research were used to assess the quality of life of 33 end-stage renal disease (ESRD) patients in a 2-week test-retest design that varied both location and format of administration (hospital interview vs. home self-administered questionnaire). The measures were found to have substantial consistency over time, location, and format. These results indicate that quality of life is a stable construct and support the usefulness of questionnaire quality-of-life measures for evaluating medical interventions.     

Health care and the poor: psychological implications of restrictive policies

Medicaid proposals increasingly focus on cost-saving strategies that restrict clients' control over where and when they may receive services. This study used a field experiment in an urban welfare office to examine the possible effects of two aspects of restrictive policies: the loss of choice of providers and adverse patient mix (i.e., when the majority of a provider's clients are Medicaid beneficiaries). Results indicate that health care presented within the context of not having a choice is derogated and that choice and patient mix combine to influence intentions to seek care. Persons who did not choose the health plan in a simulated choice, who had fewer choices than expected, and who did not accept restricted choice also had negative perceptions.     

Reactivity and response to pain

Male and female volunteers (N = 144) answered the Reactivity Scale (RS) and underwent testing for their perceived intensity and tolerance for finger-pressure pain. Half the Ss were randomly assigned to a low-intensity treatment (1150 g) and half to a high-intensity treatment (2300 g). Pain was rated at 30 and 60 sec., and Ss were asked to endure it as long as possible up to 5 min. The major findings were as follows: (1) women outscored men on reactivity; (2) the three pain measures intercorrelated highly; (3) high-intensity stimulation produced higher pain ratings and shorter tolerance than did low-intensity stimulation; (4) men gave lower intensity ratings than women and tolerated the pain longer; (5) reactivity related positively to judged pain at 30 and 60 sec, and negatively to pain tolerance; (6) there were no significant interaction effects among stimulus intensity, sex and reactivity for any pain measure; (7) the variance in the pain measures accounted for by stimulus intensity, sex and reactivity ranged from 26 to 32%. The implications were briefly discussed for the validity of the RS and factors explaining responses to experimentally-induced pain.     

Children and cigarettes: The effect of a model who quits

Twenty-six previous studies were reviewed which demonstrated a consistent link between children's smoking uptake and exposure at home to an actively smoking older family member. The present study included another variable: the family model of smoking cessation. The smoking practices, intentions, and attitudes of 344 children aged 10–14 in Western Australia were anonymously assessed. Those with ex-smokers but no active smokers at home resembled children who had never been exposed to a smoking family model in being less likely to smoke now or intend to in the future, having fewer smoking chums, and believing that cigarettes had more personal and social disadvantages than their peers who shared households with active smokers. This suggested that any pro-smoking modeling while the ex-smoker was active had been counteracted by modeling of quitting. Implications for intervention were discussed.     

Access to spoken language and the acquisition of orthographic structure: Evidence from deaf readers

Sensitivity to two types of orthographic structure was investigated: linguistically based orthographic regularity and summed single letter positional frequency. Deaf college students were found to make use of positional frequency information no less than hearing college students; however, the extent to which they made use of orthographic regularities in word recognition was related to their speech production skills. In one task, subjects were presented nonword letter strings for short durations, each followed by a masking stimulus and a target letter. They were asked to indicate whether or not the target had been present in the letter string. It was found that the accuracy of deaf subjects with good speech, like that of hearing subjects, was considerably greater for orthographically regular than irregular strings. In contrast, the accuracy of deaf subjects with poor speech was much less related to orthographic regularity. In a second task, in which subjects made judgements about how word-like various letter strings appeared, the judgements of the hearing subjects were more influenced by regularity than those of deaf subjects with poor speech. These results are discussed in terms of how expertise in speech relates to appreciation of orthographic regularity.     

A comparison of three predictors of an individual's memory performance: the individual's feeling of knowing versus the normative feeling of knowing versus base-rate item difficulty

Distinctions are drawn between different predictors of an individual's memory performance, with emphasis on the notion of privileged access to idiosyncratic knowledge. Research is reported in which undergraduates attempted to recall the answers to general-information questions, then made feeling-of-knowing judgments on nonrecalled items, and subsequently had a criterion test (relearning, perceptual identification, or one of two versions of recognition). For predicting an individual's criterion performance, the individual's own feeling-of-knowing predictions were intermediate between two kinds of normative predictions: The individual's feeling-of-knowing predictions were more accurate than predictions derived from normative feeling-of-knowing ratings but were less accurate than predictions derived from base-rate item difficulty (normative probabilities of correct recall). Subsidiary analyses showed that factors other than unreliability are responsible for the partial inaccuracy of the individual's feeling of knowing. Ramifications are discussed for possible ways to improve the accuracy of an individual's feeling-of-knowing predictions.     

Cognitive, motivational, social, and environmental influences on children's food choices

This study tested the applicability of a cognitive-motivational model of health behavior to children's food choices. A sample of 107 elementary schoolchildren provided ratings of 15 foods in terms of possible choice criteria (e.g., how tasty or healthful specific foods were) and social or environmental influences (e.g., whether foods were eaten by friends or were easy to get). Several measures of food consumption were taken, and cognitive-developmental level was assessed. Within-person correlations were calculated between food choices and each choice criterion and social/environmental factor. These "correlational indices" of influences on food choice subsequently were used to identify five distinct subgroups in the sample. Children at the operational level of cognitive development tended to be in one of three groups characterized by health orientation in food choice, taste orientation, or multiple-motive orientation. Dietary quality was poorest in the taste-oriented group. Children at the preoperational level tended to have one of two undifferentiated patterns of values across the correlational indices. Results provide evidence of: the viability of cognitive-motivational models to explain children's food choices, the promise of within-person research methodology, and the potential for enhanced health behavior-change programs by use of population segmentation and tailored interventions.     

Relationship of physicians' nonverbal communication skill to patient satisfaction, appointment noncompliance, and physician workload

A field study of 28 residents in family practice was conducted. Physicians' self-reports of empathy, self-monitoring ability, and affective communication skill as well as their objectively measured nonverbal communication skills were examined as predictors of patient satisfaction, appointment noncompliance, and physician workload (schedule density). Physicians completed the Hogan Empathy Scale, Snyder Self-Monitoring Scale, Affective Communication Test, short form of the Profile of Nonverbal Sensitivity, and a nonverbal encoding task. Patient satisfaction with communication, affective care, and technical care was assessed using a 25-item, visit-specific satisfaction scale. Appointment records were used to determine the number of patients seen by each physician and the compliance of patients with scheduled appointments. Results indicated that the three self-report measures were unrelated to the measures of patient noncompliance and patient satisfaction, but self-reported affective communication ability was significantly correlated with physician workload. Objectively measured physician sensitivity to audio communication predicted patient compliance: More sensitive physicians experienced fewer unrescheduled appointment cancellations. Nonverbal encoding skill was significantly related to patient satisfaction with affective care and to physician workload.     

A University-Sponsored Career Development Center for Nonstudents

As colleges and universities grow increasingly more responsive to the communities in which they reside, programs are required that address the needs of the nonstudent. Georgia State University's program for nonstudents is reviewed after 5 years of operation, and recommendations are made for adapting it to other settings.