Specific Professional Groups Research Articles

Using the Theory of Reasoned Action to Explain Physician Intention to Prescribe Emergency Contraception

CONTEXT:: Although research has examined providers' knowledge, attitudes and prescribing behaviors with regard to emergency contraception, none has used a theory‐based approach to understanding the interplay of these factors.METHODS:: A cross‐sectional survey of 96 faculty physicians from one Southern and three Midwestern universities was conducted in 2004 to assess factors associated with intention to prescribe emergency contraception. The theory of reasoned action guided the study hypotheses and survey design. Correlation and regression analyses were used to examine the data.RESULTS:: Only 42% of respondents strongly intended to prescribe emergency contraception for teenagers, but 65–77% intended to do so for all other specified groups (women who ask for the method, who have had a method problem, who have experienced rape or incest, and who have had unprotected sex). Consistent with the theory of reasoned action, high intention to prescribe emergency contraception was associated with positive attitudes toward doing so and with the perception that specific colleagues or professional groups support prescribing it; however, the perception of support by colleagues or professional groups in general did not predict intention. Also consistent with the theory, physicians' knowledge about emergency contraception and their demographic characteristics were not significant.CONCLUSIONS:: Interventions to encourage physicians to provide emergency contraception should take into account their attitudes toward the method and the components of those attitudes.

Construction work and risk of occupational disability: a ten year follow up of 14 474 male workers

Aims: Most industrialised countries have public income maintenance programmes to protect workers in case of disability but studies addressing disability risk of specific professional groups are rare. The objective of...

Attitudes Toward Israel's Equal Rights for People With Disabilities Law: A Multiperspective Approach.

Objective: To examine attitudes toward the new Equal Rights for People With Disabilities Law in Israel among members of specific professional groups. Study Design: An exploratory, descriptive, crosssectional survey, using convenience samples. Measure: The Disability Rights Attitude Scale—Israel (DRASI) was designed. Results: Factor analysis yielded 4 defined factors. The most positive attitudes were found for the factor of punishment, followed by accessibility, governmental support, and, finally, employment. The most positive attitudes were expressed by the social workers and the teachers, followed by the employers, the architects, and the lawyers. Conclusions: Findings shed light on the important role of professional identity in shaping the attitudes toward disability rights. Results may contribute to the development of appropriate rehabilitation and support services. In 1998, the Equal Rights for People With Disabilities Law (1998) was accepted by the Israeli parliament. Following the passage of legislation advancing the rights of persons with disabilities in the United States and other countries, this law is a major milestone, marking the beginning of a process of real legal and social change in Israeli society. The law that has been legislated includes only chapters regarding employment, public transport services, and the establishment of the commission office for the implementation of the Equal Rights for People With Disabilities Law. Issues of accessibility, education, health, leisure time, and more are included in the complete law proposal planned to be legislated in the future. In intention, this law is similar to the Americans with Disabilities Act (ADA; 1991). It, too, is a declaration that persons with disabilities should be enabled to be equal members of society (West, 1993). Thus, it also shares the ADA’s aim of achieving full inclusion for individuals with disabilities. In this sense, legislation such as Israel’s Equal Rights for Persons With Disabilities Law and the United States’ ADA constitute a clear message that society’s attitude toward persons with disabilities should be one of respect, inclusion, and support (Hernandez, Keys, Balcazar, & Drum, 1998; West, 1993).

The Reliability of Willingness to Pay for Changes in Health Status

One of the most common means to test for the temporal reliability of willingness-to-pay (WTP) values is the 'test-retest' method. However, few such tests have been conducted in healthcare, and the few that are focus on specific patient or professional groups, limiting their generalisability. In this article, a test-retest analysis of WTP for changes in health status from a general population sample found good reliability overall, with the level of reliability increasing with the overall amount of WTP and/or level of WTP as a proportion of income. The possible implications for the design and use of WTP studies in healthcare are outlined.

Hard-to-Reach Providers: Targeted HIV Education by the National AIDS Education and Training Centers

A national system of AIDS Education and Training Centers (AETCs) has received federal funding since 1987 to provide education to health care personnel (HCP) about HIV infection. The purpose of this study is to describe how AETC program personnel define and recognize HCP who are hard to reach and educate about HIV and to clarify the issues that make providers hard to reach. Twenty-three semistructured telephone interviews were used to collect data from AETC faculty and staff. Respondents were asked to identify the types of HCP who are hard to reach and to discuss why they are hard to reach. Themes identified to establish which HCP are hard to reach include specific professional groups (especially physicians and dentists) as well as providers who treated less than 10 HIV-infected clients and some HIV-expert clinicians. Themes identified to establish why they are hard to reach include convenience, isolation, and attitudes. Analysis posits that hard-to-reach HCP fall into identifiable categories: "already know the information," "don't know they don't know the information," "don't think they need to know the information," or "don't want to know the information." Respondents also identified innovative ways to approach hard-to-reach providers.

Patient education in The Netherlands

This article presents the development of patient education (PE) in The Netherlands from a historical perspective. A description is given of the first pioneering years from the 70s till the late 80s, in which early topics like the organization of PE, the orchestration of PE between different disciplines, the role of the social environment, the provision of PE in difficult patient groups and — most of all — the technical development of educational materials took the time and attention of the growing group of professionals that were engaged in patient education. Recent developments concern the legal aspects of PE, national policy, the role of health insurance, the position of patient organizations and the development of patient education in specific professional groups, e.g. general practitioners, nurses, physiotherapists, pharmacists, and dentists. There is no doubt that patient education has been professionalized considerably during the last decades. Nevertheless, new issues emerge and some old issues still need to be solved. The effective use of information material, the need for counseling as part of PE, and the relevance of coordination of care are longtime, but still actual problems in PE. More recent issues are the pressures on PE because of capacity restraints, the influence of the media and perhaps most of all: the apparent need for a patient-centered attitude and a more two-sided way of communication. Finally, the future policy topics in the Dutch patient education are discussed.

Aboriginal society and health: critical issues demand what from sociologists?

The author explores the position of Aboriginal people prior to and subsequent to the 1967 referendum. He notes the impact of organised medicine's resistance to nationalised health care in Australia and the impact this had on Indigenous people. He provides a social and historical analysis of the Constitution and other legal and quasi-legal regulations as factors in the provision or lack of health care for Aboriginal people. He raises questions about the impact of specific health professional groups and their professional structures on the kinds of health are provided. The ebb and flow of power between doctors, nurses and Aboriginal health workers illustrates the way Indigenous health and health beliefs and practices are constructed and understood. (non-author abstract)

Communal orientation may not buffer burnout.

Communal orientation (a desire to give and receive benefits in response to the needs of and out of concern for others) has had a buffer effect on burnout, in particular when the helping relationship is perceived by the helper as inequitable. This result, however, comes from research involving a specific professional group, medical personnel, that is, a group with a medical helping model wherein recipients are neither held responsible for their problem nor for the solution. We hypothesized that among professional helpers with a compensatory model wherein recipients are not held responsible for their problem but for the solution, and who perceive the relationship as inequitable, not only will a communal orientation not have effect on burnout, but it will reduce personal accomplishment. We present some results supporting this hypothesis.

Effect of signal word and source attribution on judgments of warning credibility and compliance likelihood

Social-communication models frequently include message source as an important factor in persuasion. However, research on the contribution of source characteristics to warning effectiveness is virtually non-existent. The present research involved two experiments. Experiment 1 examined the effects of the presence (vs. absence) of the signal word WARNING, supplementing it with the source-related term GOVERNMENT to the signal word, and the addition of more specific terms (i.e., US and FEDERAL) on ratings of credibility and compliance likelihood for alcohol, cigarette, and iron supplement warnings. Higher ratings were produced with the signal word's presence than its absence and adding more specificity (and length) to the source. The highest ratings accompanied the longest, most specific prefix: US FEDERAL GOVERNMENT WARNING. Experiment 2 investigated three types of sources on credibility and compliance likelihood: (1) specific regulatory governmental agencies (e.g., US FOOD AND DRUG ADMINISTRATION), (2) specific scientific professional groups (e.g., AMERICAN MEDICAL ASSOCIATION), and (3) general statements in which an explicit source is not mentioned (e.g., Important Health Warning). The inclusion of specific sources produced higher ratings compared to a signal word (WARNING) alone. Implications for warning design and further research are discussed. Relevance to industry Warning messages are used to communicate information about potential hazards and how to avoid injury and property damage. This research shows that the presence of a signal word and adding specific source information (telling who is giving the message) was found to increase credibility judgments and compliance intentions. Implications for enhancing warning effectiveness are discussed.

Modeling the Information Seeking of Professionals: A General Model Derived from Research on Engineers, Health Care Professionals, and Lawyers

Drawing upon existing research and previous attempts at modeling the information-seeking behavior of specific professional groups, this article posits an original model of information seeking that is applicable to all professionals. The model was developed through a careful analysis and interpretation of empirical studies on the information habits and practices of three groups: engineers, health care professionals, and lawyers. The general model and its six major components are presented in detail. These six components are (1) work roles, (2) associated tasks, and (3) characteristics of information needs and three factors affecting information seeking: (4) awareness, (5) sources, and (6) outcomes. In turn, each component contains a number of variables that are described with examples from the literature. The complexity of the information-seeking process is conceptualized in terms of the interaction and simultaneous occurrence of the model's components and variables, including a feedback mechanism. The article concludes with suggestions as to the potential usefulness of the model.

Quality in health care: traditions, influences and future directions.

In tracing developments in health care quality, a number of different approaches to quality evaluation can be identified, differing in terms of the specific focus and means of achieving quality. This paper attempts to classify the development of quality in health care, drawing on experiences within the industrial quality movement. Three distinct models of quality evaluation are described, according to whether they define quality at an individual level, as an exercise in inspection, or as a method for continuous improvement. Developments in quality and audit in health care are explored in relation to the models and specific experiences within nursing and medicine are compared. The need to be aware of the history of quality within specific professional groups is highlighted, particularly within the context of future developments in health care quality and the growing focus on multi-professional collaboration.

The Effects of Hospital Characteristics and Radical Organizational Change on the Relative Standing of Health Care Professions

This paper examines the effects of hospital characteristics and radical organizational change on the relative representation of health care professions in hospitals over the period of the 1980s. Health care organizations, and hospitals in particular, represent organizations where multiple professional groups make competing claims of expertise that often conflict. The question our research seeks to answer is whether different constellations of organizational characteristics and organizational changes affect the outcome of these professional conflicts. Using the annual census of hospitals compiled by the American Hospital Association, we examine the effects of several characteristics of community hospitals on the relative representation of specific professional groups. We find that hospital mergers favor physicians at the expense of administrators, and multihospital system affiliation favors technical core occupations at the expense of administrators. Measures of organizational growth and decline increase the relative representation of physicians and administrators compared to nurses, and increase the probability that hospitals will employ physicians' assistants and nurse practitioners. Our results are evaluated in light of recent developments in the sociology of medicine and research on the relative standing of occupations in other industries.

Values and Counselors 1968–1978: Stability or Change?

The signs of the times of the 1960s seem very different from those of the 1970s, as different popular movements emphasized different values. Yet there is doubt about the change in values of specific professional groups. In this study students in counselor education at one university were compared regarding values—one group in 1968 and another group in 1978—using the Rokeach Value Survey. Katz and Beech indicate the likenesses and differences in values between the two groups and analyze similarities and dissimilarities of the future counselors with the general population during the 1960s and 1970s.

Hepatitis B

IN A COMMUNICATION to the New England Journal of Medicine in September 1971, Chalmers and Alter 1 pointed out that, at least at that time, the degree of risk that hepatitis B antigen-positive health-care personnel represent to their patient contacts was obscure. They further raised the question as to whether or not any restrictions should be imposed on the professional activities of such individuals. The following year, the Committee on Viral Hepatitis of the National Academy of Sciences-National Research Council, having reviewed the available information on this subject, published their initial statement on the Public Health Implications of the Presence of Hepatitis B Antigen in Human Serum. 2 The Committee did not recommend either the routine antigen testing of any specific professional group or the imposition of any restrictions on the professional activities of individuals known to be antigen-positive. Are we now in a position to consider a different recommendation?

Hepatitis B. Risk of infection from antigen-positive medical personnel and patients.

IN A COMMUNICATION to the New England Journal of Medicine in September 1971, Chalmers and Alter 1 pointed out that, at least at that time, the degree of risk that hepatitis B antigen-positive health-care personnel represent to their patient contacts was obscure. They further raised the question as to whether or not any restrictions should be imposed on the professional activities of such individuals. The following year, the Committee on Viral Hepatitis of the National Academy of Sciences-National Research Council, having reviewed the available information on this subject, published their initial statement on the "Public Health Implications of the Presence of Hepatitis B Antigen in Human Serum." 2 The Committee did not recommend either the routine antigen testing of any specific professional group or the imposition of any restrictions on the professional activities of individuals known to be antigen-positive. Are we now in a position to consider a different recommendation?

Future changes in mental health care.

A NUMBER of existing forces must be taken into account when attempts are made to predict changes in mental health practice in the coming years. They include the increasing demand for services from mental health, social welfare, and community agencies; the failure of current therapeutic approaches; changing public attitudes; and more sophisticated approaches to administration of mental health facilities. All of these forces, and perhaps many more, acting together over time will bring drastic changes in mental health care. The predicdons I make here are based partly on a realistic analysis and largely on wish-fulfilling dreams. The first force to be considered is the increasing demand for mental health services. The insufficient number of highly trained personnel, particularly psychiatrists, has already brought an evolution in staffing patterns of mental health programs. Both nonprofessionals and professionals from a wide variety of disciplines are carrying out many functions once considered the domain of a specific professional group. Role-blurring is so extensive that disciplines are becoming almost of secondary importance in staff recruitment, pushed aside by considerations such as personality, experience, color, and ethnic background. There is growing use of nonprofessional workers who have relatively brief training in specialized areas such as drug abuse, abortion counseling, and suicide prevention. The failure of traditional therapeutic approaches points up the clear necessity of finding more productive ways to care for the emotionally disturbed. The social disability resulting from prolonged institutionalization has become widely recognized and deplored.1 The inpatient therapeutic communities of the fifties and sixties have failed to