Browsing by Subject "Disclosure"
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Item Do Harm Severity and Incident Apparentness Influence Physicians’ Willingness to Disclose Medical Errors and Adverse Events to Patients and Their Families?(2021-08) Garavalia, LesleyThis study examines how harm severity and apparentness influence physicians’ willingness to disclose medical errors and adverse events to patients and their families using a cross-sectional, mixed-mode study design. A simple random sample of 1,565 physicians was selected from a list of licensed Minnesota physicians provided by the Minnesota Board of Medical Practice. In total, 341 physicians had only a postal address on file. The remaining 1,224 physicians had both a postal and email address on file, so they were randomly assigned to one of four modes of survey administration: mail-only, mail-web, web-mail, and web-only. Afterwards, all physicians were randomly assigned to receive one of the Disclosure of Medical Errors or Disclosure of Adverse Events Surveys. All data was collected between November of 2017 and February of 2018.The overall response rate was 18% ( n = 292), and there was not a statistically significant difference in the response rate across survey modes. Most respondents were non-Hispanic (98%), white (89%), and male (69%). On average, respondents reported that they are likely to disclose medical errors (x ̅=7.47;sd=1.56) and adverse events ((x ̅=9.04;sd=1.14) to patients and their families. Across all model specifications, the probability of physicians being highly likely to disclose medical errors and adverse events is high, regardless of harm severity and malpractice risk. As apparentness increases so does the probability that physicians will be highly likely to disclose medical errors (not readily apparent: 0.66, somewhat apparent: 0.72, readily apparent: 0.95; p < 0.001) and adverse events (not readily apparent: 0.59, somewhat apparent: 0.67, readily apparent: 0.93; p < 0.001). While physicians reported being likely to disclose medical errors and adverse events, they may not disclose when faced with a situation that warrants disclosure. Future research should examine whether physicians’ actions align with their beliefs as well as whether the information they provide to patients during disclosure conversations is meetings patients’ informational needs.Item Evaluate the Association between Disclosure and Child Adjustment within Family Communication Climate(2015-05) Chen, MuziBACKGROUND: With the increasing use of Medically Assisted Reproduction (MAR) in conception, telling children how they were conceived becomes an important issue. Grounded in the Family Communication Patterns Theory (FCPT), this study examined the moderating effect of family communication climate on the association between disclosure and child adjustment problems. METHODS: Participants were 84 6- to 12-year-old children conceived using MAR with the intended parents' own gametes or gametes provided by a donor. Parents self-reported if children knew about their conception method and child adjustment problems through an online survey. Family communication climate was determined by observed family communication behavior of parents and children. RESULTS: Multiple regression models supported the hypothesized moderating effect of family communication climate on the association between disclosure and child adjustment problems. The statistically significant negative interaction suggested, in families with an open communication climate, disclosure tended to be associated with fewer child adjustment problems. In families with a closed communication climate, disclosure was associated with more child adjustment problems. CONCLUSIONS: While limited by a small sample size of disclosed children and a cross-sectional design, this study's findings provide preliminary but sound demonstration of the potentially important role of family communication climate. Rethinking the outcomes of disclosure through the lens of family communication climate is needed.Item How do contextual factors and family support influence disclosure of child sexual abuse during forensic interviews and service outcomes in child protection cases?(2014-06) Anderson, Gwendolyn DavinaFor child survivors of sexual abuse, the decision to disclose is complex and fraught with uncertainty. Even when sexual abuse is disclosed and an investigation ensues, children don't always disclose their experiences readily or with much detail. While most research has focused on understanding factors related to initial disclosure, little research has examined the factors related to active or tentative disclosure in the context of forensic interviews, and its relationship with family support, and outcomes after disclosure. Understanding the factors related to an active or tentative disclosure is important in since the child's ability to provide details of the abuse, and to appear credible, may influence short-term and long-term outcomes. The purpose of this research was to understand whether child characteristics, abuse specific factors, and the level of family support significantly predict both how children disclose sexual abuse during forensic interviews and outcomes in child protection cases. The Process of Disclosure Model and Social Exchange Theory provided frameworks to examine significant factors that may influence children when they consider how to disclose abuse within a forensic interview. Using a secondary data analysis of existing records, this quantitative study examined factors related to active and tentative disclosure of child sexual abuse during forensic interviews. Content analysis was used to code 196 previously conducted video-taped forensic interviews and corresponding case files. Cases were then matched to corresponding child protection cases to examine service and family living situation outcomes. Using logistic regression, findings indicate that older children, Multi/Bi-racial children, delayed and witnessed initial disclosure, abuse by an adult, and children with unsupportive families were significantly more likely to tentatively disclose. Children were significantly more likely to receive counseling and referrals for basic needs services if they had experienced more severe abuse and had unsupportive families. Children were more likely to be removed from the home if they were African American or Multi/Bi-racial, had an unsupportive family, and who were related to the perpetrator. Children were also significantly more likely to have a safety plan implemented in the home if they were Hispanic, experienced more severe abuse, and were related to the perpetrator. Implications for child welfare policy and social work practice include a need to better understand tentative disclosure, more integration of cultural competency into training for forensic interviewers and child welfare workers, and an emphasis on using strengths based practice to engage non-offending family members.Item Parent-child communication in families with children conceived with assisted reproductive technology: associations with disclosure and parent-child relationship quality(2014-06) Yang, YunxiExisting research on parental disclosure of Assisted Reproductive Technology (ART) use to the resultant child has largely neglected the family disclosure context when investigating the impact of disclosure. This study proposed that, in order to fully understand that impact, the disclosure context must be considered. Parent-child communication, as conceptualized in the Family Communication Pattern Theory, was the focus of this study. I examined the associations among parent-child communication, disclosure, and parent-child relationship using data from 51 ART families with children between 7 and 12 years old. Probit regression and path analysis showed that parental listener responsiveness was significantly associated with both disclosure and parent-child relationship quality, but disclosure did not mediate the association between this communication characteristic and parent-child relationship quality. Study finding suggests that ART disclosure may not be associated with parent-child relationship quality for children in this age group and general parent-child communication dynamics remain central to parent-child relationship quality in ART families.