Requirements and Implementation of Maintaining Patient Records

Summary

This article will discuss the need for psychotherapists to document the statements of patients, the techniques they use, and other aspects of their work to avoid ethical and legal problems. Elements of session notes and written informed consent will be identified. No informed consent can legitimize some actions and they will be addressed.     

Measuring moral reasoning using moral dilemmas: evaluating reliability,validity, and differential item functioning of the behavioural defining issues test (bDIT)

ABSTRACT

We evaluated the reliability, validity, and differential item functioning (DIF) of a shorter version of the Defining Issues Test-1 (DIT-1), the behavioural DIT (bDIT), measuring the development of moral reasoning. About 353 college students (81 males, 271 females, 1 not reported; age M = 18.64 years, SD = 1.20 years) who were taking introductory psychology classes at a public University in a suburb area in the Southern United States participated in the present study. First, we examined the reliability of the bDIT using Cronbach’s α and its concurrent validity with the original DIT-1 using disattenuated correlation. Second, we compared the test duration between the two measures. Third, we tested the DIF of each question between males and females. Findings reported that first, the bDIT showed acceptable reliability and good concurrent validity. Second, the test duration could be significantly shortened by employing the bDIT. Third, DIF results indicated that the bDIT items did not favour any gender. Practical implications of the present study based on the reported findings are discussed.     

The Genetic Counseling Workplace—An Australasian Perspective. A National Study of Workplace Issues for Genetic Counselors and Associate Genetic Counselors

Genetic counseling in Australasia (Australia and New Zealand) has been recognized as a profession since the 1980s and has steadily expanded over the past 20 years. The demography of major cities with metropolitan sprawl and sparsely populated rural areas has led to the establishment of 3 types of genetics units: main units in cities, metropolitan outreach, and rural outreach units. A questionnaire was developed to obtain information about the needs, resources, and day-to-day operation of the genetic counselors. The questionnaire addressed the areas of resource availability, professional development, responsibility of genetic counselors in the clinical setting, and their involvement in promotion of the service and public education. Differences observed between the 3 settings in all of these areas included large clinical loads for metropolitan outreach counselors, varying responsibilities in the clinical setting, and a lack of support and resources for rural outreach counselors. Australasian Genetic counselors were found to have a significant interest in developing mechanisms for supervision and were keenly interested in maintaining credentials and professional role development. The results of this study allows genetic counselors themselves to have a better understanding of the roles of their colleagues in the different units; they can also be used by service providers in establishing and supporting genetic counselors, and identifying inequalities and deficiencies in the different practice areas.     

Toward an Alliance Between the Issue-Processing Approach and Pragma-Dialectical Analysis

On the approach to discussions of policy choices that treats such discussions as instances of issue-processing, the joint use of the logic of questions and the logic of rules gives precise formulation to two sorts of issues. To one sort of issue belong issue-circumscribing questions; to another sort, issues-simplicter, which consist of disjunctions of policy proposals – so many proposed social rules – that are answers, in the case of each disjunction, to a given issue-circumscribing question. Work in pragma-dialectics can take over the issue-processing approach; and by doing so add to the pragma-dialectical repertory further dimensions in the analysis of issues and in protocol-narratives of discussion. The analysis and narratives would now include accounts of how issue-circumscribing questions generate initial standpoints and how discussions sometimes end with compromises between standpoints. Further research questions follow about transformations of issues and the comparison of successive rounds of discussion. A narrative of one period of discussion during `the War on Drugs' in the United States illustrates these points.     

The role of anxiety sensitivity in the relationship between posttraumatic stress symptoms and negative outcomes in trauma-exposed adults

Background: The development of posttraumatic stress symptoms (PTSs) following a trauma is related to impairment, diminished quality of life, and physical health issues. Yet it is not clear why some trauma-exposed individuals experience negative outcomes while others do not. The purpose of this study was to determine the role of several influential factors related to PTS severity and negative outcomes. Methods: One hundred and twenty-two trauma-exposed adults were administered the following self-report measures: the Posttraumatic Stress Disorder Checklist-Civilian, the Trauma History Questionnaire-Short, the Anxiety Sensitivity Index-3, Depression and Anxiety Stress Scale 21, Sheehan Disability Scale, World Health Organization Quality of Life-BREF, and an abbreviated Patient Health Questionnaire. Primary Results: PTS severity was positively correlated with depressive symptom severity (r = 0.54, p < 0.001), chronicity of the most distressing trauma (r = 0.21, p = 0.017), and number of traumas (r = 0.22, p = 0.012). Main effects were found for PTS severity (β = ?0.38, p < 0.01) and anxiety sensitivity (AS; β = ?0.39, p < 0.01) on quality of life. No interaction was found between PTS severity and AS with any negative outcome. PTS severity mediated the relationship between AS and physical health issues (0.05; 95% CI: 0.02–0.08). Conclusion: This study helps clarify the role of various factors in the relationship between trauma and negative outcomes. Clinical and research implications are discussed.     

Trading Sex for Money or Compensation: Prevalence and Associated Characteristics from a Sexually Transmitted Infection (STI) Clinic Sample

The purpose of this study was to determine the prevalence and individual risk factors of people who trade or sell sex among sexually active individuals seeking HIV and sexually transmitted infection (STI) testing. Using electronic agency records, an analysis of the characteristics of 5,029 youth and adults who voluntarily obtained HIV and STI testing was conducted. Multiple imputation procedures for missing data from 3 variables and logistic regression were conducted. A total of 128 individuals reported having traded sex. Nine variables had statistically significant associations with trading sex. Individuals who identified as White and female had lesser odds of trading sex, whereas individuals who were transgender, were living in a shelter, had been sexually assaulted, had a previous STI, had high-risk sex, or used drugs had greater odds of trading sex. Elevated levels of high-risk behavior in addition to sexual trauma should be considered in intervention research and community health practice. Implications for service providers and researchers are discussed.     

Career development and counselling needs of LGBTQ high school students

There is a dearth of research concerning the career development and counselling issues that are relevant for high school students who identify as lesbian, gay, bisexual, transgender and queer (LGBTQ). As such, little is known to understand LGBTQ students when it comes to their career-related struggles and needs. This article attempts to examine the career development needs of LGBTQ high school students, addressing and analysing career problems from the unique circumstances of this student population. To do so, it provides an overview of the various career-related issues afflicting LGBTQ high school students. It then proposes a series of career guidance and counselling intervention considerations that are tailored to address the specific career needs and challenges of the LGBTQ high school students.     

The stress of food allergy issues in daily life

Objective: Food allergies are a growing health concern, but their implications for daily psychological functioning are unknown. This micro-longitudinal study investigated the daily frequency of food allergy issues and how this related to experiences of stress, mood and physical energy.

Design: One hundred and eight adults with physician-diagnosed food allergies completed an initial Internet survey followed by a 2-week Internet daily diary survey.

Main outcome measures: The initial survey collected socio-demographic and food allergy information. The daily survey collected information about the participants’ experiences of stress, mood, physical energy and food allergy issues during that day.

Results: Commonly experienced allergy issues included negative physical symptoms, higher food prices, anxiety about safety of food, trouble maintaining a healthy diet and anxiety/stress at social occasions. Furthermore, multilevel modelling analyses showed that stress and negative mood were significantly higher on days with more allergy issues. Older adults experienced lower positive mood and physical energy on days with more issues.

Conclusion: This is the first study to incorporate near to real-time tracking to examine the frequency of food allergy issues and the implications for daily psychological functioning. Targeting the issues we identified could reduce stress in patients with food allergies and improve their overall quality of life.     

IRB and Research Regulatory Delays Within the Military Health System: Do They Really Matter? And If So,Why and for Whom?

Institutional review board (IRB) delays may hinder the successful completion of federally funded research in the U.S. military. When this happens, time-sensitive, mission-relevant questions go unanswered. Research participants face unnecessary burdens and risks if delays squeeze recruitment timelines, resulting in inadequate sample sizes for definitive analyses. More broadly, military members are exposed to untested or undertested interventions, implemented by well-intentioned leaders who bypass the research process altogether. To illustrate, we offer two case examples. We posit that IRB delays often appear in the service of managing institutional risk, rather than protecting research participants. Regulators may see more risk associated with moving quickly than risk related to delay, choosing to err on the side of bureaucracy. The authors of this article, all of whom are military-funded researchers, government stakeholders, and/or human subject protection experts, offer feasible recommendations to improve the IRB system and, ultimately, research within military, veteran, and civilian populations.