A comparison of two multidimensional health locus of control instruments

This study examined the factor structure, internal consistency reliability, and construct validity of the multidimensional health locus of control (MHLC) instruments developed by K.A. Wallston, B.S. Wallston, and DeVellis (1978) and Lau (Lau, 1982; Lau & Ware, 1981). Both measures were administered to a sample of Veterans Administration (VA) medical outpatients (N = 181). Only minimal evidence of convergence was found between corresponding scales of the two MHLC instruments. Low convergent validity appears attributable to the poor internal consistency reliability of the Lau-Ware subscales. Moreover, results of factor analysis largely supported the a priori factor structure of the K.A. Wallston et al. (1978) MHLC instrument but failed to support the factor structure of the Lau-Ware instrument. Health locus of control (HLC) dimensions that emerged from simultaneous factor analysis of both instruments were most consistent with a three-dimensional typology (i.e., Personal Control, Professional Control, and Chance) rather than the four-dimensional typology proposed by Lau (Lau, 1982; Lau & Ware, 1981). Implications for HLC conceptualization and measurement are discussed.     

THE FATHER,THE FATHER FUNCTION,THE FATHER PRINCIPLE: SOME CONTEMPORARY PSYCHOANALYTIC DEVELOPMENTS

The author discusses Freud's thinking on the role of the father, as well as that of later French theoreticians. To illustrate his remarks, he draws on the poetry of Carlos Drummond de Andrade (1912–1987), a Brazilian poet whose work often dealt with themes of the father, the family, and his own paternal relationship. The author also discusses the psychic formation of the father principle and how this may be evident in the clinical analytic setting, even when the analyst's approach privileges field theory, intersubjectivity, or other concepts emphasizing the relationship between analyst and patient.     

A Comparison of Two Multidimensional Health Locus of Control Instruments

This study examined the factor structure, internal consistency reliability and construct validity of the multidimensional health locus of control (MHLC) instruments developed by K. A. Wallston, B. S. Wallston, and DeVellis (1978) and Lau (Lau, 1982; Lau & Ware, 1981), Both measures were administered to a sample of Veterans Administration (VA) medical outpatients (N = 181). Only minimal evidence of convergence was found between corresponding scales of the two MHLC instruments. Low convergent validity appears attributable to the poor internal consistency reliability of the Lau-Ware subscales. Moreover, results of factor analysis largely supported the a priori factor structure of the K. A. Wallston et at. (1978) MHLC instrument but failed to support the factor structure of the Lau-Ware instrument, Health locus of control (HLC) dimensions that emerged from simultaneous factor analysis of both instruments were most consistent with a three-dimensional typology (i.e., Personal Control, Professional Control and Chance) rather than the four-dimensional typology proposed by Lau (Lau, 1982; Lau & Ware, 1981). Implications for HLC conceptualization and measurement are discussed.     

Promoting social responsibility amongst health care users: medical tourists’ perspectives on an information sheet regarding ethical concerns in medical tourism

Background

Medical tourists, persons that travel across international borders with the intention to access non-emergency medical care, may not be adequately informed of safety and ethical concerns related to the practice of medical tourism. Researchers indicate that the sources of information frequently used by medical tourists during their decision-making process may be biased and/or lack comprehensive information regarding individual safety and treatment outcomes, as well as potential impacts of the medical tourism industry on third parties. This paper explores the feedback from former Canadian medical tourists regarding the use of an information sheet to address this knowledge gap and raise awareness of the safety and ethical concerns related to medical tourism.

Results

According to feedback provided in interviews with former Canadian medical tourists, the majority of participants responded positively to the information sheet and indicated that this document prompted them to engage in further consideration of these issues. Participants indicated some frustration after reading the information sheet regarding a lack of know-how in terms of learning more about the concerns discussed in the document and changing their decision-making. This frustration was due to participants’ desperation for medical care, a topic which participants frequently discussed regarding ethical concerns related to health care provision.

Conclusions

The overall perceptions of former medical tourists indicate that an information sheet may promote further consideration of ethical concerns of medical tourism. However, given that these interviews were performed with former medical tourists, it remains unknown whether such a document might impact upon the decision-making of prospective medical tourists. Furthermore, participants indicated a need for an additional tool such as a website for continued discussion about these concerns. As such, along with dissemination of the information sheet, future research implications should include the development of a website for ongoing discussion that could contribute to a raised awareness of these concerns and potentially increase social responsibility in the medical tourism industry.

     

Developing an informational tool for ethical engagement in medical tourism

Background

Medical tourism, the practice of persons intentionally travelling across international boundaries to access medical care, has drawn increasing attention from researchers, particularly in relation to potential ethical concerns of this practice. Researchers have expressed concern for potential negative impacts to individual safety, public health within both countries of origin for medical tourists and destination countries, and global health equity. However, these ethical concerns are not discussed within the sources of information commonly provided to medical tourists, and as such, medical tourists may not be aware of these concerns when engaging in medical tourism. This paper describes the methodology utilized to develop an information sheet intended to be disseminated to Canadian medical tourists to encourage contemplation and further public discussion of the ethical concerns in medical tourism.

Methods

The methodology for developing the information sheet drew on an iterative process to consider stakeholder feedback on the content and use of the information sheet as it might inform prospective medical tourists’ decision making. This methodology includes a literature review as well as formative research with Canadian public health professionals and former medical tourists.

Results

The final information sheet underwent numerous revisions throughout the formative research process according to feedback from medical tourism stakeholders. These revisions focused primarily on making the information sheet concise with points that encourage individuals considering travelling for medical tourism to do further research regarding their safety both within the destination country, while travelling, and once returning to Canada, and the potential impacts of their trip on third parties. This methodology may be replicated for the development of information sheets intending to communicate ethical concerns of other practices to providers or consumers of a certain service.

     

Time-pressure effects on performance in a base-rate task

Researchers assume that time pressure impairs performance in decision tasks by invoking heuristic processes. In the present study, the authors inquired (a) whether it was possible in some cases for time pressure to improve performance or to alter it without impairing it, and (b) whether the heuristic invoked by base-rate neglect under direct experience can be identified. They used a probability-learning design in 2 experiments, and they measured the choice proportions after each of 2 possible cues in each experiment. In 1 comparison, time pressure increased predictions of the more likely outcome, which improved performance. In 2 comparisons, time pressure changed the choice proportions without affecting performance. In a 4th comparison, time pressure hindered performance. The choice proportions were consistent with heuristic processing that is based on cue matching rather than on cue accuracy, base rates, or posterior probabilities.     

Controlling for causally relevant third variables

In 3 experiments, the authors tested the conditions under which 3rd variables are controlled for in making causal judgments. The authors hypothesized that 3rd variables are controlled for when the 3rd variables are themselves perceived as causal. In Experiment 1, the participants predicted test performance after seeing information about wearing a lucky garment, taking a test-preparation course, and staying up late. The course (perceived as more causally relevant) was controlled for more than was the garment (perceived as less causally relevant) in assessing the effectiveness of staying up late. In Experiments 2 and 3, to obviate the many alternative accounts that arise from the realistic cover story of Experiment 1, participants predicted flowers' blooming after the presentation or nonpresentation of liquids. When one liquid was trained as causal, it was controlled for more in judging another liquid than when it was trained as neutral. Overall, stimuli perceived as causal were controlled for more when judging other stimuli. The authors concluded that the effect of perceived causal relevance on causal conditionalizing is real and normatively reasonable.     

The interaction model of anxiety: An empirical test in a parachute training situation

The interaction model of anxiety was examined by assessing both state and trait anxiety in 64 male military personnel on a Basic Parachutist Course. Two separate tests of the interactional model of anxiety were conducted, involving physical danger and social evaluation situations. The same subjects participated in both studies. In both physical danger and social evaluation studies, measures of state anxiety and cognitive appraisal (perception) of anxiety were obtained in both high-stress and non-stress conditions. Measures of social evaluation and physical danger trait anxiety were obtained in a low-stress condition. The interactional model was strongly supported for the physical danger situation. As predicted, high physical danger trait anxiety subjects experienced greater increases in state anxiety than low physical danger subjects proceeding from the non-stress to the high stress physical danger condition. The interaction model was not supported in the social evaluation situation; although not significant, mean levels of state anxiety were in the predicted direction. Results are discussed in the context of person perception and the need for testing personality models in realistic field settings.     

Preventing Violence Against Women: Engaging the Fathers of Today and Tomorrow

Although fathers play a key role in helping their children develop ideas about gender relations and close relationships, they have been largely overlooked as a resource to help prevent violence against women. This paper explores some of the reasons why fathers have not been successfully engaged in violence prevention. Engaging fathers to promote wider definitions of masculinity for themselves and their children is presented as a major mechanism by which fathers could help prevent violence against women. The information-motivation-behavior model of change, developed for preventing high-risk sexual behavior, is applied to the area to provide structure for understanding previous and current attempts to engage fathers. Examples of innovative programs are used to highlight the application of this model.