Self-reported Need Research Articles

Stigma Beliefs of Asian Americans with Depression in an Internet Sample

To study the beliefs of Asian Americans with depression about stigma associated with depression treatment among friends, employers, and family. Participants completed the Center for Epidemiologic Studies-Depression Scale (CES-D) anonymously on the Internet. In this cross-sectional design, those who screened positive for depression were asked questions regarding stigma (n = 68 656). We used analysis of variance (ANOVA) and analysis of covariance (ANCOVA) to compare Asian Americans with whites and also to make comparisons by age and sex. Further, we stratified for Asian Americans and used ANOVA and ANCOVA to compare age and sex. We used linear regression to assess how stigma beliefs were associated with self-reported need for depression treatment. Asian Americans overall had greater stigma beliefs than did whites for all 3 stigma outcomes (P < 0.001), especially those related to family. Although this same pattern existed for subjects aged between 16 and 29 years and between 30 and 45 years (P < 0.001), among those aged under 16 years, this existed for family stigma (P < 0.001) but not for friends or employer stigma. In our stratified analyses among Asian Americans, male participants had greater stigma beliefs than did female participants for friends (P < 0.001) and employer (P < 0.05) but not for family. The pattern of Asian Americans having greater stigma levels than whites may be changing among younger Asian Americans because of acculturation. Also, among Asian Americans, unlike previous research showing no sex differences for stigma, we show that male participants had greater stigma levels than did female participants. Future directions should include measuring stigma after culture-specific interventions.

Adolescents' Self-Reported Substance Risks and Need to Talk About Them in Mental Health Counseling

Summary Although adolescents seeking mental health services may not consider them related, the prevalent co-morbidity of substance use and mental health problems makes it imperative that practitioners find ways of engaging troubled youth about substance issues. Based on their responses to a clinical self-assessment questionnaire (Adquest), this study shows that mental health service applicants are willing to disclose their substance use behaviors and are open to talking about them to intake workers. Age and gender differences in substance use patterns and willingness to talk are explored.

Oral health of building construction workers: an epidemiological approach

This cross-sectional study aimed at evaluating the oral health conditions of building construction workers from a city in the mid-west region of São Paulo, Brazil. This study involved 219 male subjects, aged 17 to 72. The definition of a random sample utilized the functional number of each worker as a criterion to the raffle, which took into account all 450 subjects registered in the Working Accidents Prevention Program. The examination of oral health conditions by DMFT index and need of treatment were carried out according to WHO criteria (1997). This paper reports the prevalence of caries according to age, occupation, and educational level. Among the 219 workers examined, the mean DMFT was 16.9. Amongst the younger workers (<25 years-old), 21.3 teeth showed no need of treatment, while the older ones showed increasing treatment needs (p<0.001). The DMFT values were 15.6 for the administrative duties and 21.7 for foremen and bricklayers, although the differences were not statistically significant. The DMFT index showed an increase with age for all groups (p<0.001). The self-reported need of treatment was associated with a smaller DMFT for people that reported a positive response when compared with subjects that did not report these needs (p<0.05). These differences were statistically significant, as tested by ANOVA and Student t test. Among the building construction workers, in this study, important oral lesions were not observed, despite the daily exposition to some risk factors for oral cancer.

Satisfaction With Provider Communication Among Spanish-Speaking Medicaid Enrollees

To determine if differences between English- and Spanish-speaking parents in ratings of their children's health care can be explained by need for interpretive services. Using the Consumer Assessment of Health Plans Survey-Child-Survey (CAHPS), reports about provider communication were compared among 3 groups of parents enrolled in a Medicaid managed care health plan: 1) English speakers, 2) Spanish speakers with no self-reported need for interpretive services, and 3) Spanish speakers with self-reported need for interpretive services. Parents were asked to report how well their providers 1) listened carefully to what was being said, 2) explained things in a way that could be understood, 3) respected their comments and concerns, and 4) spent enough time during medical encounters. Multivariate logistic regression was used to compare the ratings of each of the 3 groups while controlling for child's gender, parent's gender, parent's educational attainment, child's health status, and survey year. Spanish-speaking parents in need of interpretive services were less likely to report that providers spent enough time with their children (odds ratio = 0.34, 95% confidence interval = 0.17-0.68) compared to English-speaking parents. There was no statistically significant difference found between Spanish-speaking parents with no need of interpretive services and English-speaking parents. Among Spanish- versus English-speaking parents, differences in ratings of whether providers spent enough time with children during medical encounters appear to be explained, in part, by need for interpretive services. No other differences in ratings of provider communication were found.

Drug Treatment, Health, and Social Service Utilization by Substance Abusing Women From a Community-Based Sample

Substance abuse is an escalating problem among poor urban Latina women; little is known about their access to drug treatment and to needed social and health services. Our objectives were to (1) examine the need and use of substance abuse treatment, health services, government entitlement programs, and social service programs among cocaine and heroin using Puerto Rican women and (2) identify whether service use predicts their prospective entry into drug treatment. This was a 3-wave longitudinal study of community substance abusing women evaluated on substance abuse and dependence using diagnostic measures, and hair and urine toxicological screens. Information was collected on self-reported need and receipt of substance abuse treatment, social services, general health services, and government entitlement programs. A community sample of cocaine-, crack-, and/or heroin-using women from copping areas in low-income urban centers of Puerto Rico were interviewed in 1997-1998 with 2 follow-up periods. Drug treatment, health, and social service utilization were low relative to need for services throughout all data waves. Social service utilization predicted prospective entry into drug treatment but not contacts with general health services or government entitlement programs. Drug-abusing women in low-income urban areas in Puerto Rico have substantial unmet substance abuse treatment, health, and social service needs. Mandated treatment by social service agencies may explain their clients' higher likelihood of entering drug treatment. Building linkages between service sectors to augment entry into drug treatment is essential for meeting the complex needs of this underserved population.

Experts Disagree Over Claim That Access Has Improved

Experts Disagree Over Claim That Access Has Improved

Self-Reported Psychiatric Treatment Needs Among Felony Drug Offenders

Among 280 felony drug sale offenders with substance use disorders, self-reported psychiatric treatment, medication, and symptoms yielded estimates that 40% to 60% had comorbid psychiatric disorders. Two thirds reported recent psychiatric symptoms or emotional problems, or were troubled by these symptoms/problems, and more than one third of them felt they needed psychiatric treatment; only 4 were currently receiving treatment. More than two thirds of those reporting current symptomatology and a need for mental health treatment had never received treatment. Offenders who reported a need for treatment were more likely to recently experience cognitive difficulties, mental or emotional problems, or be troubled by psychiatric symptoms. Those reporting current treatment need were more likely to have a history of outpatient psychiatric treatment. The strongest predictor for self-reported psychiatric treatment need was being troubled by psychiatric symptoms, independently or in combination with recent cognitive difficulties, experiencing any emotional problems recently, or outpatient treatment history.

An Assessment of the Training Needs of State Vocational Rehabilitation Counselors

The primary purpose of this study was to identify the training needs of state vocational rehabilitation counselors. One hundred and sixty-seven vocational rehabilitation counselors completed the Rehabilitation Counseling Knowledge Inventory (Linkowski et al., 1993). The self-reported need for training across 10 components of rehabilitation counseling is described. A secondary purpose was to compare the self-perceived training needs of a sample of state vocational rehabilitation counselors with the self-perceived training needs of certified rehabilitation counselors (CRCs; Szymanski, Linkowski, Leahy, Diamond, &amp; Thoreson, 1993a). The current sample reported significantly higher ratings of the need for training in foundations of rehabilitation, individual counseling and development, and assessment, whereas the CRC sample reported higher needs for training in the area of workers' compensation, employer services, and technology. A third purpose was to evaluate the relationship between counselor demographic variables and training needs. The highest earned degree was a significant predictor of perceived training need in the areas of group and family issues, foundations of rehabilitation, research, and individual counseling and development.

Does Gender Matter?

When facing dependency, the majority of elderly men receive care from spouses whereas elderly women more often rely on relatives or public elder care. This Swedish population-based study of persons between ages 81 and 100 concerns public elder care and informal support in relation to having a coresiding caregiver. Findings indicate that men had higher odds of receiving care when coresident and/or extraresident and/or public home help services were included, compared to women, after controlling for functional and cognitive impairment as well as self-reported need of assistance with instrumental activities of daily living. After controlling also for coresiding, the gender differences disappeared. The main distinction was found between persons living alone and persons coresiding, not between men and women. Thus, when studying use of public elder care and support from relatives or friends, it is vital to include household composition, and thereby the possibility of receiving care from a coresiding caregiver, in the analyses.

Darkness and near work: Myopia and its progression in third-year law students

Purpose To evaluate myopia prevalence, myopia progression, and various potential myopia risk factors in third-year law students. Design Cross-sectional study and survey. Participants One hundred seventy-nine third-year law students at the University of Pennsylvania. Methods We administered a questionnaire to assess the prevalence of myopia, myopia progression, and risk factors, including near work, family history, and daily light/dark exposure. We conducted a screening eye examination to ascertain myopia status. Myopia was defined as the mean spherical equivalent of the two eyes of ≤−0.5 diopters; myopia progression was defined by the self-reported need for a stronger eyeglass prescription during law school. Main outcome measures (1) prevalence of myopia, (2) progression of myopia. Results Seventy-nine percent of the class participated (n = 179, two were excluded for amblyopia leaving 177 students). Fifty-eight percent were male, 75% were Caucasian, and the mean age was 27 years. Seventy-nine percent reported parental myopia. The mean amount of near work was 7.4 hours/day; mean sleep was 7.9 hours/day; mean darkness was 5.3 hours/day. Sixty-six percent of the students were myopic. Of 96 participants myopic before law school, myopia increased in 83 (86%) during law school. Among 75 students not myopic at the beginning of law school, 14 (19%) became myopic. The onset of myopia could not be determined for 6 patients. There were trends for higher myopia prevalence among those with a parental myopia history ( P = 0.14) and for increased myopia progression among those reporting more daily near work ( P = 0.18). Students with ≤5.6 hours of daily darkness were more likely to report myopia progression than those with >5.6 hours of darkness per day (95% vs. 80%, P = 0.07). To account for possible confounding effects of risk factors with myopia progression, logistic regression with categorization of the continuous exposure variables (hours of near work, sleep, and darkness) above or below median values weakened the near work association (odds ratio 1.8, 95% confidence interval 0.5–6.7, P = 0.35) but continued to identify darkness association with daily hours of darkness (odds ratio 4.8, 95% confidence interval 1.0 ≥ 23.3, P < 0.05). Among the 77 students with myopia onset before college, those with ≤5.6 hours of daily darkness were more likely to progress than those with more hours of daily darkness (97% vs. 76%, P = 0.01). Conclusions This study confirms high rates of myopia prevalence and myopia progression among law students. The strongest association, especially in those with myopia onset before college, was a relation of myopia progression during law school with less daily exposure to darkness, a potential risk factor previously identified in childhood myopia. The role of exposure to darkness in refractive development warrants additional study.

A survey of speech-language pathology and audiology needs of older adults

A needs assessment for an agency that serves older adults in a northwestern Ohio county in the United States was conducted by a team of researchers. Data obtained from 301 completed survey questionnaires, from an original 850 that were mailed, pertaining to the disciplines of speech-language pathology and audiology are presented. Specifically, results are discussed that relate to a self-reported need or desire for speech-language pathology or audiology services, self-perceptions of needs related to basic functional communication skills, and current and previous diagnoses of communicative and cognitive disorders. Implications for practicing clinical speech-language pathologists and audiologists are also discussed.

Older Adults' Mobility Device Use After In-Patient Rehabilitation

This study explored intention to use mobility devices (canes, crutches, walkers, and wheelchairs), expressed during in-patient rehabilitation, as a predictor of actual use after discharge. Additionally, appropriate and inappropriate use and discontinuation of use was determined through comparison of self-reported need to actual use of a device. A mobility device questionnaire was pilot tested with seventy-five older adults, who had received occupational and physical therapy. Subjects rated levels of intention to use mobility devices and identified reasons for continuing and discontinuing use. Use and need were determined via mail survey to examine the relationship between intention, use, and need. Results indicate that those who express intention use devices after discharge. Older adults seem to make rational judgments about device use, either continuing or discontinuing use according to perceptions of need for a device.

Three-year changes in global oral health rating by elderly dentate adults

Abstract– The single item global rating is an economical way of summarizing the state of a person's oral health, and thus is a potentially valuable oral health outcome measure. This research describes the nature, magnitude, and direction of changes in oral health as measured by the global rating with the goal of furthering our understanding of older adults' oral health perceptions over time. Data from a randomized trial of a comprehensive geriatric assessment and prevention program in community-dwelling adults aged 75+ years living in Santa Monica, California, collected between 1988 and 1993 were analyzed. Descriptive techniques as well as a transition matrix were used to examine changes in the global rating and compare these changes to variation, over time, in two relevant measures: the Geriatric Oral Health Assessment Index (GOHAI) and self-reported need for dental treatment. The global rating varied over time and the changes were consistent with those measured by the GOHAI and self-reported treatment need. Whether the change in oral health as measured by the global rating is clinically meaningful, and what specific dental conditions account for these changes remain important topics for future investigation. However, the changes that occur in oral health ratings at the individual level are much more pronounced than the distribution of global rating at each point in time would suggest.

Three-year changes in global oral health rating by elderly dentate adults

Abstract– The single item global rating is an economical way of summarizing the state of a person's oral health, and thus is a potentially valuable oral health outcome measure. This research describes the nature, magnitude, and direction of changes in oral health as measured by the global rating with the goal of furthering our understanding of older adults' oral health perceptions over time. Data from a randomized trial of a comprehensive geriatric assessment and prevention program in community-dwelling adults aged 75+ years living in Santa Monica, California, collected between 1988 and 1993 were analyzed. Descriptive techniques as well as a transition matrix were used to examine changes in the global rating and compare these changes to variation, over time, in two relevant measures: the Geriatric Oral Health Assessment Index (GOHAI) and self-reported need for dental treatment. The global rating varied over time and the changes were consistent with those measured by the GOHAI and self-reported treatment need. Whether the change in oral health as measured by the global rating is clinically meaningful, and what specific dental conditions account for these changes remain important topics for future investigation. However, the changes that occur in oral health ratings at the individual level are much more pronounced than the distribution of global rating at each point in time would suggest.

Three‐year changes in global oral health rating by elderly dentate adults

The single item global rating is an economical way of summarizing the state of a person's oral health, and thus is a potentially valuable oral health outcome measure. This research describes the nature, magnitude, and direction of changes in oral health as measured by the global rating with the goal of furthering our understanding of older adults' oral health perceptions over time. Data from a randomized trial of a comprehensive geriatric assessment and prevention program in community-dwelling adults aged 75+ years living in Santa Monica, California, collected between 1988 and 1993 were analyzed. Descriptive techniques as well as a transition matrix were used to examine changes in the global rating and compare these changes to variation, over time, in two relevant measures: the Geriatric Oral Health Assessment Index (GOHAI) and self-reported need for dental treatment. The global rating varied over time and the changes were consistent with those measured by the GOHAI and self-reported treatment need. Whether the change in oral health as measured by the global rating is clinically meaningful, and what specific dental conditions account for these changes remain important topics for future investigation. However, the changes that occur in oral health ratings at the individual level are much more pronounced than the distribution of global rating at each point in time would suggest.

Self-reported need of information, counselling and education: needs and interests of re-applicants.

An interview study was performed to establish and evaluate the need for education and counselling of hearing aid users (HA users) in order to review present procedures of information and potential referral to the educational sector. The study comprises 102 consecutively selected hearing-impaired adults (>18 years), the only inclusion criterion being experienced HA user. The interview took place immediately after the patient's latest HA fitting appointment and consisted of 24 structured and closed questions. The findings indicate that a significant proportion of HA users, especially the elderly, do not experience a need for or show an interest in further education and counselling concerning their hearing handicap. It is concluded that the present organization of services meets the demands of a majority of re-applicants.

Do we operate too many cataracts?

A questionnaire was sent to 379 patients referred for cataract extraction, asking them to assess their visual disability and their need for surgery. Two hundred and seventy-nine patients (73.6%) answered the questionnaire, this group being representative for the 379 patients regarding all relevant variables. The patient's answers were analyzed in relation to data extracted from their referral notes (visual acuity, monocular pseudophakia, age, sex, place of residence, referring ophthalmologist). The overall level of self-reported visual problems and need for cataract surgery were significantly correlated to a reduced best-eye visual acuity, although the correlation factor was low. A similar correlation between the subjective need for surgery and a worst-eye visual acuity < or = 6/24 was also found. Forty-seven patients (16.9%) answered that cataract surgery was not needed for the time being, and this attitude was not significantly correlated to the visual acuity, provided the acuity was > or = 6/24 in the best eye and > or = 6/36 in the worst eye. One hundred and twenty patients (43.0%) felt that their visual disability was so severe that they had to be operated within 1 month and 67 patients (24.0%) within 3 months, while 45 patients (16.1%) felt that surgery could be postponed for at least 6 months. Age, sex, place of residence and the presence of monocular pseudophakia were not found to significantly influence the level of self-reported visual problems. Only 18.3% preferred to be treated as out-patients.

Homeless veterans' utilization of medical, psychiatric, and substance abuse services.

This study focuses on the association between homeless veterans' prior utilization of medical, psychiatric, and substance abuse services and biopsychosocial characteristics reported at admission into a domiciliary care program. Given the large number of veterans in the US homeless population and their health care needs, understanding factors associated with health service use among homeless veterans is significant. Research participants were 429 homeless male veterans who had been admitted to the Domiciliary Care for Homeless Veterans Program site at the West Los Angeles Veterans Affairs Medical Center between February 1988 and July 1992 for treatment of medical, psychiatric, or substance disorders. Results of logistic regression analyses indicated that self-reported need (chronic medical problems, serious psychiatric symptoms, combat stress, alcohol use) and evaluated need for care (evidence of liver dysfunction) were important to veterans' use of health services in the 6 months before program admission. Predisposing social structure factors (education, residential stability, and usual sleeping place) were also significant predictors of service utilization. Overall, need factors were more strongly related to service use. Supplementary logistic regression analyses indicated that comorbidity of need factors deserves attention in understanding homeless veterans' use of services. In conclusion, it is important to attend to predisposing social structure factors as potential barriers to care for homeless veterans.

Self-Reported Variability and Enhancement of Prediction

The present study examined the role of self-reported variability in facilitating the prediction of behavior. Anxiety and extraversion scores based on the 16 PF were obtained for 100 (50 male and 50 female) students in introductory psychology. Each participant also was asked to judge how variable he was in each trait and to judge how anxious he would be in each of 18 situations and how extraverted he would behave in each of 17 situations. Multiple regression analyses showed that self-reported variability enhanced prediction of experiences of anxiety in 13 of 18 situations but had minimal impact on enhancing prediction of extravertive behavior. The results, in contrast with other research, suggest that self-reported variability need not undermine prediction of behavior and support the use of aggregate criteria and predictors to facilitate prediction.

Relationship of Projective to Direct Expression of Selected Needs for Nonpsychotic SS

TAT-assessed need strengths of Aggression, Achievement, and Nurturance were compared with self-reported strength of these needs for groups of nonpsychotic Ss differing in the presumed strength of the needs, sex, years of schooling, and socioeconomic status. The following conclusions appear justified: (a) Interjudge reliabilities greater than .90 can be obtained for assessing need strengths from TAT protocols; (b) Projectively assessed and self-reported need strengths were not highly related for any need investigated for any group of Ss; (c) The relationship of projectively assessed to self-reported need strength of any need was not meaningfully differential across groups.