Formal performance appraisal interviews: Can they really be objective, and are they useful anyway?

This paper reports on a qualitative field study conducted in Australia which examined what is occurring in formal performance appraisal interviews in relation to their objectivity and resultant outcomes. Supervisors and subordinates who had recently been involved in performance appraisals were interviewed about their experiences of the process. Perceptions of the utility of, and satisfaction with the interview process were examined. Further, the effect of the relationship between the participants on objectivity was investigated. Results indicated that formal appraisal interviews were not perceived to be of great utility, and that the relationship of the participants influenced the interview.

Relations between social support, appraisal and coping and both positive and negative outcomes for children of a parent with multiple sclerosis and comparisons with children of healthy parents

Objective: To examine adjustment in children of a parent with multiple sclerosis within a stress and coping framework and compare them with those who have 'healthy' parents. Subjects: A total of 193 participants between 10 and 25 years completed questionnaires; 48 youngsters who had a parent with multiple sclerosis and 145 youngsters who reported that they did not have a parent with an illness or disability. Method: A questionnaire survey methodology was used. Variable sets included caregiving context (e.g. additional parental illness, family responsibilities, parental functional impairment, choice in helping), social support (network size, satisfaction), stress appraisal, coping (problem solving, seeking support, acceptance, wishful thinking, denial), and positive (life satisfaction, positive affect, benefits) and negative (distress, health) adjustment outcomes. Results: Caregiving context variables significantly correlated with poorer adjustment in children of a parent with multiple sclerosis included additional parental illness, higher family responsibilities, parental functional impairment and unpredictability of the parent's multiple sclerosis, and less choice in helping. As predicted, better adjustment in children of a parent with multiple sclerosis was related to higher levels of social support, lower stress appraisals, greater reliance on approach coping strategies (problem solving, seeking support and acceptance) and less reliance on avoidant coping (wishful thinking and denial). Compared with children of 'healthy' parents, children of a parent with multiple sclerosis reported greater family responsibilities, less reliance on problem solving and seeking social support coping, higher somatization and lower life satisfaction and positive affect. Conclusions: Findings delineate the key impacts of young caregiving and support a stress and coping model of adjustment in children of a parent with multiple sclerosis.

Doctors and their patients: A context for understanding the wish to hasten death

There is a paucity of research that has directly examined the role of the health professional in dealing with a terminally ill patient's wish to hasten death (WTHD) and the implications of this for the support and services needed in the care for a dying patient. Themes to emerge from a qualitative analysis of interviews conducted on doctors (n = 24) involved in the treatment and care of terminally ill patients were (i) the doctors' experiences in caring for their patients (including themes of emotional demands/expectations, the duration of illness, and the availability of palliative care services); (ii) the doctors' perception of the care provided to their respective patients (comprising themes concerning satisfaction with the care for physical symptoms, for emotional symptoms, or overall care); (iii) the doctors' attitudes to euthanasia and (iv) the doctors' perception of their patients' views/beliefs 'regarding euthanasia and hastened death. When responses were categorised according to the patients' level of a WTHD, the theme concerning the prolonged nature of the patients' illnesses was prominent in the doctor group who had patients with the highest WTHD, whereas there was only a minority of responses concerning support from palliative care services and satisfaction with the level of emotional care in this group. This exploratory study presents a set of descriptive findings identifying themes among a small group of doctors who have been involved in the care of terminally ill cancer patients, to investigate factors that may be associated with the WTHD among these patients. The pattern of findings suggest that research investigating the doctor-patient interaction in this setting may add to our understanding of the problems (for patients and their doctors) that underpins the wish to hasten death in the terminally ill. Copyright (C) 2003 John Wiley Sons, Ltd.

Clinical reporting by occupational therapists and speech pathologists: Therapists' intentions and parental satisfaction

This study employed a qualitative research design to explore therapists' and parents' perspectives of paediatric occupational therapy and speech pathology assessment reports. Aims of the study were to explore the intentions of therapists when writing reports, to expand upon existing literature on parental satisfaction and preferences with respect to paediatric clinical reports, to highlight documentation practices that would serve to maximize parental use of allied health reports, and to develop specific guidelines on how reports can be written to ensure they are useful and beneficial to therapists and parents. Participants were 15 parents of children who had been assessed at 1 of 2 university clinics and subsequently received a written report, and 11 therapists employed at the same university clinics. Questionnaires were used to seek information from therapists concerning the purpose of assessment reports and essential aspects to include when writing reports for parents. In-depth interviews were used to seek information about how understandable and beneficial clinical reports were to parents. The data were subjected to thematic analysis. From comments of therapists' intentions and parents' stated needs, and in accordance with literature reviewed, guidelines were identified for the production of parent-oriented reports. Conclusions drawn from this study can be specifically applied to services producing paediatric occupational therapy or speech pathology assessment reports, but are widely relevant to paediatric allied health services. (author abstract)

Predictive genetic test decisions for Huntington's disease: context, appraisal and new moral imperatives

Predictive testing is one of the new genetic technologies which, in conjunction with developing fields such as pharmacogenomics, promises many benefits for preventive and population health. Understanding how individuals appraise and make genetic test decisions is increasingly relevant as the technology expands. Lay understandings of genetic risk and test decision-making, located within holistic life frameworks including family or kin relationships, may vary considerably from clinical representations of these phenomena. The predictive test for Huntington's disease (HD), whilst specific to a single-gene, serious, mature-onset but currently untreatable disorder, is regarded as a model in this context. This paper reports upon a qualitative Australian study which investigated predictive test decision-making by individuals at risk for HD, the contexts of their decisions and the appraisals which underpinned them. In-depth interviews were conducted in Australia with 16 individuals at 50% risk for HD, with variation across testing decisions, gender, age and selected characteristics. Findings suggested predictive testing was regarded as a significant life decision with important implications for self and others, while the right not to know genetic status was staunchly and unanimously defended. Multiple contexts of reference were identified within which test decisions were located, including intra- and inter-personal frameworks, family history and experience of HID, and temporality. Participants used two main criteria in appraising test options: perceived value of, or need for the test information, for self and/or significant others, and degree to which such information could be tolerated and managed, short and long-term, by self and/or others. Selected moral and ethical considerations involved in decision-making are examined, as well as the clinical and socio-political contexts in which predictive testing is located. The paper argues that psychosocial vulnerabilities generated by the availability of testing technologies and exacerbated by policy imperatives towards individual responsibility and self-governance should be addressed at broader societal levels. (C) 2003 Elsevier Science Ltd. All rights reserved.

The combined SPE : ToxY-PAM phytotoxicity assay; application and appraisal of a novel biomonitoring tool for the aquatic environment

Mounting concerns regarding the environmental impact of herbicides has meant a growing requirement for accurate, timely information regarding herbicide residue contamination of, in particular, aquatic systems. Conventional methods of detection remain limited in terms of practicality due to high costs of operation and the specialised information that analysis provides. A new phytotoxicity bioassay was trialled for the detection of herbicide residues in filter-purified (Milli-Q) as well as natural waters. The performance of the system, which combines solid-phase extraction (SPE) with the ToxY-PAM dual-channel yield analyser (Heinz Walz GmbH), was tested alongside the traditional method of liquid chromatography-mass spectrometry (LC-MS). The assay methodology was found to be highly sensitive (LOD 0.1 ng L-1 diuron) with good reproducibility. The study showed that the assay protocol is time effective and can be employed for the aquatic screening of herbicide residues in purified as well as natural waters.

The positive impact of multiple sclerosis (MS) on carers: Associations between carer benefit finding and positive and negative adjustment domains

Purpose. This study examined benefit finding in MS carers including the dimensionality of benefit finding, relations between carer and care recipient benefit finding, and the effects of carer benefit finding on carer positive and negative adjustment domains. Method. A total of 267 carers and their care recipients completed questionnaires at Time 1 and 3 months later, Time 2 (n=155). Illness data were collected at Time 1, and number of problems, stress appraisal, benefit finding, negative (global distress, negative affect) and positive (life satisfaction, positive affect, dyadic adjustment) adjustment domains were measured at Time 2. Results. Qualitative data revealed seven benefit finding themes, two of which were adequately represented by the Benefit Finding Scale (BFS) [1] (Mohr et al. Health Psychology 1999; 18: 376). Factor analyses indicated two factors (Personal Growth, Family Relations Growth) which were psychometrically sound and showed differential relations with illness and adjustment domains. Although care recipients reported higher levels of benefit finding than carers, their benefit finding reports regarding personal growth were correlated. The carer BFS factors were positively related to carer and care recipient dyadic adjustment. Care recipient benefit finding was unrelated to carer adjustment domains. After controlling for the effects of demographics, care recipient characteristics, problems and appraisal, carer benefit finding was related to carer positive adjustment domains and unrelated to carer negative adjustment domains. Conclusion. Findings support the role of benefit finding in sustaining positive psychological states and the communal search for meaning within carer-care recipient dyads.

Parental attachment and conflict behavior: Implications for offspring's attachment, loneliness, and relationship satisfaction

This study assessed the implications of parental attachment security and parental conflict behavior for offspring's relational adjustment (attachment security, loneliness, and relationship satisfaction). Further, reports of parental conflict behavior were obtained from both parents and offspring, addressing questions regarding agreement between reporters and the origin and extent of discrepant perceptions. Results revealed consistent patterns of conflict behavior and moderate agreement between reporters. However, offspring reported parental conflict behavior more negatively than parents, especially when offspring or parents were anxious about relationships. Parental attachment security had direct associations with offspring's relationship anxiety, whereas associations between parental attachment and offspring's loneliness and discomfort with closeness were mediated by parental conflict behavior. Parental conflict behavior was also associated with offspring's relationship satisfaction. The results are discussed in terms of the mechanisms involved in the intergenerational transmission of relationship difficulties.

Understanding consumer evaluation criteria for repurchase in a performing arts context

The purpose of this paper is to examine consumers' experience of a performing arts service to identify the predictors of audience behaviour especially as related to positive repurchase intention. Experiential service settings such as the performing arts have been cited in recent research as service contexts that may challenge current theory that repurchase intention is driven by service quality and customer satisfaction. It is posited that consumer emotions and the hedonic nature of the consumption experience may complicate the evaluation process to repurchase intention in a setting such as the performing arts. Qualitative semi-structured indepth interviews were undertaken of twenty-six performing arts consumers using a pool of questions and prompts developed from a review of the extant literature. Transcribed field notes were examined for key words and phrases and data was divided into the main emergent themes related to each of the questions and also coded for confirmation and is-confirmation of the extant literature constructs and relationships. The dimensions of service experience,price, service quality, target goal-directed emotions and non-target appraisal emotions were identified as driving repurchase intention in a performing arts setting. Customer satisfaction in this setting appears to result from emotional factors rather than expectancy dis-confirmation. This research supports the notion that an experiential consumption experience such as the performing arts will challenge the current theory of the drivers of repurchase intention and suggests that a more thorough large scale examination of these dimensions in this service setting is warranted.

Test–retest repeatability of self-reported environmental exposures in Parkinson’s disease cases and healthy controls

There is substantial disagreement among published epidemiological studies regarding environmental risk factors for Parkinson’s disease (PD). Differences in the quality of measurement of environmental exposures may contribute to this variation. The current study examined the test–retest repeatability of self-report data on risk factors for PD obtained from a series of 32 PD cases recruited from neurology clinics and 29 healthy sex-, age-and residential suburb-matched controls. Exposure data were collected in face-to-face interviews using a structured questionnaire derived from previous epidemiological studies. High repeatability was demonstrated for ‘lifestyle’ exposures, such as smoking and coffee/tea consumption (kappas 0.70–1.00). Environmental exposures that involved some action by the person, such as pesticide application and use of solvents and metals, also showed high repeatability (kappas>0.78). Lower repeatability was seen for rural residency and bore water consumption (kappa 0.39–0.74). In general, we found that case and control participants provided similar rates of incongruent and missing responses for categorical and continuous occupational, domestic, lifestyle and medical exposures.

A Critical Appraisal of Narrative in Sport History: Reading the Surf Lifesaving Debate

All debates in history—who started the Cold War, how successful were the Chartists in achieving their aims, to what extent was the recession of the American frontier culturally significant in American history— are debates between competing narrative interpretations. Moreover, because the historical imagination itself exists intertextually within our own social and political environment, the past is never discovered set aside from everyday life. History is designed and composed in the here and now.

Breastfeeding and the responsibilities of GPs: a qualitative study of general practice registrars

The most recent National Health Survey reports that more than 80% of women initiate breastfeeding, while recent studies describe initiation rates of more than 90%. Yet fewer than 50% of women continue to breastfeed for 6 months or longer. This is at odds with National Health and Medical Research Council recommendations that 80% of infants be exclusively breastfed for the first 6 months of life. Women are more likely to initiate and continue to breastfeed if their doctor supports and encourages them to do so. Conversely, women perceive a neutral attitude by doctors toward breastfeeding to be similar to a negative attitude. Therefore, while doctors may not perceive their support or encouragement to be a determining factor in a woman’s breastfeeding decisions, women often place great emphasis on their GP's attitude to breastfeeding and are much more likely to think that information provided by a doctor is important. No previous research in Australia has addressed the issue of how GPs perceive their roles and responsibilities regarding breastfeeding. As part of a larger research project investigating the breastfeeding skills and knowledge of general practice registrars, this article reports the results of qualitative interviews with eight general practice registrars and their views and beliefs about GPs’ responsibilities to breastfeeding women.

Using household survey data to inform policy decisions regarding the delivery of evidence-based parenting interventions.

Background: This study used household survey data on the prevalence of child, parent and family variables to establish potential targets for a population-level intervention to strengthen parenting skills in the community. The goals of the intervention include decreasing child conduct problems, increasing parental self-efficacy, use of positive parenting strategies, decreasing coercive parenting and increasing help-seeking, social support and participation in positive parenting programmes. Methods: A total of 4010 parents with a child under the age of 12 years completed a statewide telephone survey on parenting. Results: One in three parents reported that their child had a behavioural or emotional problem in the previous 6 months. Furthermore, 9% of children aged 2–12 years meet criteria for oppositional defiant disorder. Parents who reported their child's behaviour to be difficult were more likely to perceive parenting as a negative experience (i.e. demanding, stressful and depressing). Parents with greatest difficulties were mothers without partners and who had low levels of confidence in their parenting roles. About 20% of parents reported being stressed and 5% reported being depressed in the 2 weeks prior to the survey. Parents with personal adjustment problems had lower levels of parenting confidence and their child was more difficult to manage. Only one in four parents had participated in a parent education programme. Conclusions: Implications for the setting of population-level goals and targets for strengthening parenting skills are discussed.