J. Regis McNamara

How perceptions of a simulated physician-patient interaction influence intended satisfaction and compliance

A frequent problem encountered in the evaluation of medical services is that patients intertwine or confound perceptions of technical medical skills (competence) with those of interpersonal and communication skills (courtesy). The present study investigated the extent to which competence and courtesy influenced enacted patient perceptions of medical care; as well as how those perceptions related to satisfaction and compliance with the care delivered. Small groups of undergraduates viewed one of four videotapes on which were depicted a physician-patient interaction for a sore throat problem. Differential levels of competence and courtesy were displayed in the various tapes. While watching the videotape, subjects were asked to assume the role of the sore throat patient. Factor analysis of semantic differential items administered subsequent to the videotapes revealed the presence of two strong and distinct clusters, one labeled courtesy and the other competence. Univariate ANOVAs indicated that the courtesy manipulation influenced the perception of courtesy and general medical satisfaction, while the competence manipulation influenced not only perceived competence but perceived courtesy, general medical satisfaction, and compliance as well. Subjects were able to accurately discriminate the extremes of good and poor physician behavior. The limitations of the study as well as its implications for developing better understanding of how perceptions of health care providers are formed were explored.

“Feminization” of Psychology: The Changing Sex Ratio and Its Implications for the Profession

Women are participating in the field of psychology in increasing numbers relative to men. This development has been referred to as the “feminization of psychology,” and it carries with it a number of implications. This article reviews statistical data relating to the changing sex ratio and discusses their implications. Participation rates of women in psychology are examined as they pertain to enrollment in doctoral programs, graduation from baccalaureate programs, and career progress within the profession. Implications of changing sex ratios for occupational prestige, income and economics, work structure, education and training, and theory, research, and practice are then discussed. In conclusion, the concept of “feminization” is challenged as questions are raised about whether the increase in the number of women in psychology is a problem, as has been alleged, or a symptom of other problems within the field.

Expectancy factors in behavioral observation

One hundred and twenty-five undergraduate students, selected on the basis of their competency in making behavioral observations, were given differential expectations concerning the trait-state of a child observee. Then they viewed video tape recordings of that child, making time sample behavior recordings of six categories simultaneously. In addition, subjects completed post-experimental questionnaires with regard to their subjective impressions of the child observee. The subjective impressions differed significantly across expectation groups while the behavioral records did not. It was suggested that differential expectations for aggression and hyperactivity were internalized as a single pathology dimension. Although subjects apparently held differential expectations concerning the trait-state of the observee, their objective recordings of that observees behavior were not influenced in any noticeable manner.

The social impact of assertiveness. Research findings and clinical implications

Recent studies on the social impact of assertiveness have revealed that although assertiveness is perceived as a dimension that is regarded as highly competent and skillful, it also is viewed as unfavorable interpersonal behavior. Such factors as sex, empathy, assertiveness level, and race appear to moderate the perceptions of assertiveness, attesting to the highly complex, situationally specific nature of assertiveness and its social impact. Various findings about these moderators have been reported, but conclusive generalizations regarding this new area must await the results of future studies. Finally, several clinical implications for assertiveness training are explored.

Enhancing acne medication compliance : a comparison of strategies

Abstract The effectiveness of noncontingent contracts, contingent contracts and self-monitoring were compared in order to ascertain which would increase compliance with an over-the-counter acne medication. Forty-two S s who possessed moderate to severe acne, were selected to participate in the study. S s were randomly assigned to one of the following four groups: a No-treatment (Control) group, a Self-monitoring group, a Noncontingent Contract group and a Contingent Contract group. Each S had a photograph taken before and after the treatment. The treatment lasted 12 weeks. An a priori contrast comparing the change in the number of acne lesions between the Control group and the three treatment groups was significant with the three treatment groups having less acne than the Control group. The efficiency and possible cost-effectiveness of the procedures for increasing adherence with acne medication was discussed.

Role Playing to Assess Social Competence Ecological Validity Considerations

Role playing is increasingly being used as a method by which to assess social competence. Role playing has demonstrated its usefulness at reflecting differences between treatment and control groups in studies concerned with the modification of social competence and those attempting to differentiate levels of social competence in known groups. The ability of role plays to accurately represent more naturalistically occurring social behavior is less well established, however. Current evidence suggests that there is only modest correspondence between behavior in role play and naturalistic settings. Further, this correspondence occurs at the molar and not at the molecular behavior level. Additional research is needed to better understand how adequate role plays are at portraying naturally occurring behavior.

Matching to prevent adoption disruption

The number of children being freed for adoption placement is increasing due to legislation. These children are frequently the victims of chaotic environments. Their exposure to adversity makes it more difficult for them to maintain long term placements. Suggestions are made toward the utilization of standardized instruments in the matching of adoptive parents and children to prevent adoption disruption.

Prediction of compliance with an over-the-counter acne medication.

As part of a larger study investigating treatment compliance with an over-the-counter acne medication, 28 undergraduates were administered the Health Belief Questionnaire (HBQ), the Self-Consciousness Scale (SCS), and a Self-Efficacy Scale (SES). Stepwise regression analyses were performed with these scales as the predictors and the following measures as criterion variables: compliance rate, change in acne severity, change in number of acne lesions, dropout, and satisfaction. Results indicate that the HBQ significantly predicted outcome on a number of measures and was a better predictor than self-consciousness or self-efficacy.

Ethical considerations in psychological research: A comparative review

Four representative psychological journals (Behavior Therapy, Journal of Applied Behavior Analysis, Journal of Educational Psychology, and Journal of Personality and Social Psychology) were reviewed for their degree of reported concern with ethical standards established to guide psychological research on human subjects from 1971 through 1974. After surveying 1430 articles it was noted that there was a great deal of variability among journals in both the type and amount of ethical concern presented. All of the journals failed to report the obtaining of consent in a high percentage of cases when stress was present. It was speculated that underreporting of ethical procedures is related to the factors of: poor acceptance of the current ethical standards, a lack of their operational clarity, inadequate training, professional indolence, and ineffective editorial policies.

The Assertion Inventory: Its Relationship to Social Desirability and Sensitivity to Rejection

The Assertion Inventory and measures of social desirability and sensitivity to rejection were administered to 355 undergraduates. Mixed findings on the Assertion Inventorys validity were noted. Scorers low in assertion have greater sensitivity to rejection. This corroborates earlier research and strengthens the usefulness of the measure, however, the inventory is confounded with social desirability responding. A comparison of the present undergraduate sample with historically earlier samples indicated: assertive responding has changed little over the last 10 years; the current Ohio University student sample reports lower need for social approval than an Ohio State University student sample of 20 years ago; and there is more sensitivity to rejection now than there was 8 yr. ago.