Arthur G. Cryns

The hierarchical structure of geriatric patient satisfaction. An Older Patient Satisfaction Scale designed for HMOs.

This paper describes an instrument design effort aimed at measuring patient- satisfaction among older (65 years and over) subscribers of HMOs. The study was conducted in a multi-satellite prepaid group practice in Buffalo, New York. In order to be able to construct a satisfaction measure that would reflect the interests of the actual consumers of HMO-services, a series of four focused group interviews were held with 24 randomly selected elderly enrollees. The substantive content of these interviews was systematically analyzed for both topics and ideas, yielding a total of 173 distinct ideas about the perceived satisfaction with the services received expressed over 3,176 lines of narrative. From this substantive pool, sixty attitudinal statements were constructed with the ideas represented in these statements being proportional to the number of lines of transcribed discussion devoted to each topic. This 60-item Older Patient Satisfaction Scale (OPSS) was submitted to a systematic sample of 229 elderly HMO subscribers. They also were asked to complete two existing scales: the Ware PSQ, and the Larsen CSQ-8. Factor analysis performed on the OPSS-items yielded 14 primary factors of geriatric patient satisfaction, two second-order and one third order general factor. As the second-order factors accounted for the largest proportion of the common variance, those items of the original 60-item OPSS were identified that had highest loadings on these second-order factors, yielding 7 such items for one and 5 for the other. These scales had alpha-reliabilities of .83 and .80, respectively. It was also found that the OPSS had good convergent validity with the PSQ and CSQ-8. The overall psychometric properties identified for the OPSS, as well as the fact that it was constructed from a health-care consumers perspective, makes it well suited for use with a unique and rapidly expanding geriatric patient population.

Effects of Surgery on the Mental Status of Older Persons. A Meta-analytic Review

The data bases of 18 empirical studies were combined into one comprehensive data set and subjected to meta-analysis. The following trends were observed: (1) surgery has a significantly decompensating impact on the mental status of older persons, and the average effect size observed is modest (r = .37); (2) for all mental status measures included in the review (cognition, delirium and affect), effect size appears to be significantly moderated by patient age; (3) patient sex may be predictive of the kind of mental impairment that is most likely to occur within an older surgery population, with women manifesting a greater affinity for delirious and men for cognitive decompensation; (4) most existing research within this domain of study is either purely descriptive or anecdotal: of 46 studies reviewed, only 18, or 39.1% of the total published output, were of sufficient methodologic rigor to allow for scientifically valid effect-size computations. The implications of these findings for future research are discussed. ( J Geriatr Psychiatry Neurol 1990;3:184-191).

Lack of racial differences in behavior: A quantitative replication of Rushton's (1988) review and an independent meta-analysis

Rushton (Personality and Individual Differences, 9, 1009–1024, 1988) hypothesized that racial group differences exist across a range of behaviors from intelligence to social organization. Such differences were then discussed within the context of an evolutionary continuum (Negroid < Caucasoid < Mongoloid). For example, his observations that blacks compared to whites are less intelligent, physically mature more rapidly, and are more aggressive and impulsive (less law abiding) were said to support the evolutionary hypothesis. Quantitative replication of the 100 studies included in Rushtons original ‘review and evolutionary analysis’ and a meta-analysis of 100 randomly selected studies infer that any behavioral differences which do exist between blacks, whites and Asian Americans for example, can be explained in toto by environmental differences which exist between them.

Personality Characteristics of Heroin Addicts in a Methadone Treatment Program: An Exploratory Study

The present study was designed to assess some of the personality attributes of heroin addicts in a methadone maintenance program. The Shostrom Personal Orientation Inventory (POI) was administered to a randomly selected sample of 70 such addicts and to a control group of 11 nontreated heroin addicts. Multivariate and univariate comparisons of the two groups did indicate that the methadone group scored significantly higher in terms of level of maturational attainment and of self-actualization than did the control group. As for within-group differences in the methadone sample, no sex or race differences in personality scores were observed. It was also found that duration of methadone treatment is not significantly related to any change in addict self-perception over time. The only consistent difference noted was between methadone-treated addicts who did receive some form of psychotherapeutic counseling and those who did not. The former group was found to be significantly more expressive socioemotionally and...

Faculty Productivity and Costs: A Multivariate Analysis.

There is increasing pressure on higher education to document results and to rationalize them within specific budgetary constraints. At margin, how much can universities influence the productivity of faculty through budgetary allocations? Are allocations for senior faculty more or less productive than for junior faculty, and in which sectors of performance — teaching, research, or services to the university and the community? A methodology is presented for analyzing faculty productivity and costs at the level of a department or school. Its application provides mixed support for the notion that university administrators can use annual budget decisions to influence faculty productivity and costs.

Personal and Social Value Concerns of Scandinavian Elderly: A Multivariate Study

This study is a descriptive account of the results obtained by a set of three attitudes scales, as part of a larger study on the value concerns of two samples of Scandinavian elderly, one Danish and the other Norwegian. The measuring instruments were the Cantril Self Anchoring Scale, the Life Satisfaction Index-A and Rosencranz-McNevins Semantic Differential. The results indicate that both samples are equally preoccupied with personal security rather than economic concerns. The Danish sample perceives greater congruence between life goals and achievements than the Norwegians. The Norwegians see their young as deviant from the modal ideology of the adult world, while the Danes perceive the young as drifters, but functionally efficient. No correlation was found between personal life satisfaction and acceptance of youth, a finding at variance with results obtained by the authors among previous U.S. samples of aged.

Attitudes toward youth as a function of adult age: a multivariate study in intergenerational dynamics.

This study explores the social attitudes of three groups of adult males-young adult, middle-aged, and elderly-toward three, present-day youth groups (young people today, our boys in Vietnam, college students). Utilizing a semantic differential measure of attitude and testing for adult age group differences in attitudes toward the young, the study establishes that young adults are least accepting of youth, that elderly males are most accepting, and that middle-aged males assume an intermediate position between the other two age groups. These results suggest that acceptance of youth is a linearly increasing function of age. It was further observed that the subjects of this study, irrespective of their position on the adult age range, are significantly more positively inclined toward the young military in Vietnam than they are toward the generalized young or to college students. The latter receive the least favorable attitudinal ratings. The authors discuss a number of possible interpretations of the results obtained.

CONTINUING EDUCATION NEEDS IN GERIATRICS/ GERONTOLOGY: SPECIFYING OCCUPATIONAL AND ORGANIZATIONAL ATTRIBUTES OF SERVICE PROFESSIONALS

An analysis was made of gerontological continuing education (CE) needs of a systematic sample of health care professionals providing services to the aged in New York State (U.S.). Professionals with previous exposure to gerontological CE programs were found to have higher need levels than those without such experi‐ence. Those with less than 1 year and those with 5 to 9 years of work experience with, the aged appear significantly less interested in acquiring new gerontological skills and knowledge than those with either limited (2‐4 years) or extensive (> 10 years) experience. This nonlinear need pattern is established for all care providers, regardless of educational background. Interest in the CE topics listed is higher among nurses, social workers, and allied health professionals than among M.D.s and Ph.D.s. Clearly, professionals who have extensive daily contacts with the aged express the highest need for CE in gerontology. They appreciate multiple didactic formats and formal credit for CE attendance. ...