A Patient Self‐Disclosure Instrument

Abstract

Four studies in which a patient self-disclosure questionnaire was developed and tested are reported. The instrument was designed to include only content judged by both patients and clinicians as important. Three areas of patient difficulty in disclosing to a health care provider were measured: personal problems and feelings, responses to health care, and life style. Patient difficulty in disclosure was assessed by 21 7-point rating scales, 7 for each disclosure area; ratings were summed to obtain scores. A correlation matrix of the ratings of 216 patients was subjected to a three-factor principal components analysis with varimax rotation; the solution accounted for 59% of the total variance. High internal consistency and test re-test reliability for the total scale and subscales were obtained; Cronbach's alpha .82-.83, n = 214; r = .81-.87, n = 66. In separate tests of construct validity patient self-disclosure was shown to be influenced by locus of control and perception of clinician empathy, and to covary with heart rate changes.

Empathy in Forensic Evaluations: a Systematic Reconsideration

“…At the explicit risk of oversimplifying the choices, we assert our preference for empathic questioning over the possible perception of a “brusque confrontation” (Melton et al, , p. 92) that could negatively impact the quality of information gathered. Research in the non‐forensic clinical context supports the idea that clinical empathy helps to promote patient self‐disclosure during history taking (Dawson, Schirmer, & Beck, ).…”

Hypertension, perceived clinician empathy, and patient self‐disclosure

“…Subscale scores could range from 7 to 49. In studies (Dawson et al, 1984) to test the reliability and validity of the tool, the content areas were confirmed by factor analytic procedures, and self-disclosure scores were shown to be influenced by locus of control, specific patient expectations, and to covary with heart rate changes. High internal consistency and satisfactory test-re-test reliability were obtained for the total scale and the subscales (r = .81-.88).…”

“…Patient self-disclosure. To obtain a measure of how important and difficult patients thought it was to discuss with their health care provider, a 21-item patient self-disclosure questionnaire (Dawson, Schirmer, & Beck, 1984) was used. The instrument contains seven items for each of three content areas: Personal Problems and Feelings, Responses to Health Care, and Life Style.…”

“…The Personal Problems and Feelings scale has items related to stressful situations and feeling states. The topics covered have high-intimacy value because they are not discussed in ordinary social relationships and are difficult to discuss in professional interview situations (Dawson et al, 1984;Jourard, 1971;Young, 1979). Responses to Health Care items reflect the patient-clinician relationship and adherence issues.…”

Personality factors in professional ethical behaviour: Studies of empathy and narcissism

“…Colliver, Willis, Robbs, Cohen, and Swartz (1998), in a study using observer ratings of empathy in conjunction with medical students' clinical performance, found that empathy was related to behaviours that made the patient feel comfortable and important, and also to history taking and physical examination skills. In a study with nurses, Dawson, Schirmer, and Beck (1984) showed that self-disclosure in patients was partly related to perceived clinician empathy. Several studies (e.g., Evans, Stanley, & Burrows, 1993) have demonstrated that empathy, at least in the form of sensitivity to patients, can be taught, and many medical and nursing schools attempt to do so.…”