Personal autonomy in discharge planning decision -making in mentally alert hospitalized elderly individuals: The social workers' perspective

This study was conducted to understand (a) hospital social workers' perspectives about patients' personal autonomy and self-determination, (b) their experiences, and (c) their beliefs and behaviors. The study used the maximum variation sampling strategy to select hospitals and hospital social work respondents. Individual interviews were conducted with 31 medical/surgical and mental health hospital social workers who worked in 13 hospitals. The data suggest the following four points. First, the hospital setting as an outside influence as it relates to illness and safety, and its four categories, mentally alert patients, family members, health care professionals, and social work respondents, seems to enhance or diminish patients' autonomy in discharge planning decision making. Second, respondents report they believe patients must be safe both inside and outside the hospital. In theory, respondents support autonomy and self-determination, respect patients' wishes, and believe patients are the decision makers. However, in practice, respondents respect autonomy and self-determination to a point. Third, a model, The Patient's Decision in Discharge Planning: A Continuum, is presented where a safe discharge plan is at one end of a continuum, while an unsafe discharge plan is at the other end. Respondents respect personal autonomy and the patient's self-determination to a point. This point is likely to be located in a gray area where the patient's decision crosses from one end of the continuum to the other. When patients decide on an unsafe discharge plan, workers' interventions range from autonomy to paternalism. And fourth, the hospital setting as an outside influence may not offer the best opportunity for patients to make decisions (a) because of beliefs family members and health care professionals hold about the value of patient self-determination, and (b) because patients may not feel free to make decisions in an environment where they are surrounded by family members, health care professionals, and social work respondents who have power and who think they know best. Workers need to continue to educate elderly patients about their right to self-determination in the hospital setting. ^

Assessing the effects of professionals' career decision -making on their participation reasons in continuing education in Taiwan

The purpose of this study was to assess the relationship between working professionals' Career Decision-Making Self-Efficacy beliefs (CDMSE beliefs) and their reasons for participating in in-service master's level programs in Taiwan. ^ The data collection instruments used were Grotelueschen's (1985) Participation Reasons Scale (PRS), and Betz, Klein, and Taylor's (1996) Career Decision-Making Self-Efficacy-Short Form (CDMSE-SF), and a Demographic Data Form (DDF) developed specifically for this study. ^ Surveys were administered to 800 working professionals who participated in inservice master's level programs at 22 Taiwanese universities. The survey was conducted in May 2004. Data were analyzed by simple descriptive statistics, principal component factor analysis, and multiple regression. Four factors of participation reasons were found and five components of CDMSE beliefs were scored. ^ Five components of CDMSE beliefs are structured into the CDMSE-SF instrument: Self-Appraisal, Occupational Information, Goal-Selection, Planning, and Problem Solving. The reasons for participation found in this study were: Professional Improvement and Development, Professional Service, Personal Benefit and Job Security, and Professional Competence and Collegial Interaction. Pearson-product moment correlations revealed significant positive correlations between the five CDMSE subscales and the four factors of participation reasons. Multiple regression analysis revealed that participants' beliefs in their abilities to obtain information about occupations accounted for the preponderance of variance of scores on the Participation Reasons Scale (PRS). ^ This study concluded that professionals who believed that they were efficacious in obtaining information about occupations or professions tended to believe that the four reasons for participation represented by the factors of the PRS were important to them in making the decision to participate in continuing education. Additionally, it was noted that the reasons for participations for professionals who did not feel confident in their abilities to find such information could not be determined. ^ Recommendations are offered to assist those individuals responsible for developing recruiting programs in continuing education for professionals in Taiwan. These recommendations focus only on strategies intended to attract this target population of professionals who believe that they are efficacious in obtaining information about occupations. ^

Examining moderators of the hindsight bias in the context of civil legal decision -making: Counterfactuals, causal proximity, and self -referencing

The current research sought to clarify the diverging relationships between counterfactual thinking and hindsight bias observed in the literature thus far. In a non-legal context, Roese and Olson (1996) found a positive relationship between counterfactuals and hindsight bias, such that counterfactual mutations that undid the outcome also increased participants’ ratings of the outcome’s a priori likelihood. Further, they determined that this relationship is mediated by causal attributions about the counterfactually mutated antecedent event. Conversely, in the context of a civil lawsuit, Robbennolt and Sobus (1997) found that the relationship between counterfactual thinking and hindsight bias is negative. The current research sought to resolve the conflicting findings in the literature within a legal context. ^ In Experiment One, the manipulation of the normality of the defendant’s target behavior, designed to manipulate participants’ counterfactual thoughts about said behavior, did moderate the hindsight effect of outcome knowledge on mock jurors’ judgments of the foreseeability of that outcome as well as their negligence verdicts. Although I predicted that counterfactual thinking would increase, or exacerbate, the hindsight bias, as found by Roese and Olson (1996), my results provided some support for Robbenolt and Sobus’s (1997) finding that counterfactual thinking decreases the hindsight bias. Behavior normality did not moderate the hindsight effect of outcome knowledge in Experiment Two, nor did causal proximity in Experiment Three. ^ Additionally, my hypothesis that self-referencing may be an effective hindsight debiasing technique received little support across the three experiments. Although both the self-referencing instructions and self-report measure consistently decreased mock jurors’ likelihood of finding the defendant negligent, and self-referencing instructions decreased their foreseeability ratings in studies two and three, the self-referencing manipulation did not interact with outcome knowledge to moderate a hindsight bias effect on either foreseeability or negligence judgments. The consistent pattern of results across the three experiments, however, suggests that self-referencing may be an effective technique in reducing the likelihood of negligence verdicts.^

Twelve certain men: The impact of emotional appraisals on juror decision-making

Our jury system is predicated upon the expectation that jurors engage in systematic processing when considering evidence and making decisions. They are instructed to interpret facts and apply the appropriate law in a fair, dispassionate manner, free of all bias, including that of emotion. However, emotions containing an element of certainty (e.g., anger and happiness, which require little cognitive effort in determining their source) can often lead people to engage in superficial, heuristic-based processing. Compare this to uncertain emotions (e.g., hope and fear, which require people to seek out explanations for their emotional arousal), which instead has the potential to lead them to engage in deeper, more systematic processing. The purpose of the current research is in part to confirm past research (Tiedens & Linton, 2001; Semmler & Brewer, 2002) that uncertain emotions (like fear) can influence decision-making towards a more systematic style of processing, whereas more certain emotional states (like anger) will lead to a more heuristic style of processing. Studies One, Two, and Three build upon this prior research with the goal of improving methodological rigor through the use of film clips to reliably induce emotions, with awareness of testimonial details serving as measures of processing style. The ultimate objective of the current research was to explore this effect in Study Four by inducing either fear, anger, or neutral emotion in mock jurors, half of whom then followed along with a trial transcript featuring eight testimonial inconsistencies, while the other participants followed along with an error-free version of the same transcript. Overall rates of detection for these inconsistencies was expected to be higher for the uncertain/fearful participants due to their more effortful processing compared to certain/angry participants. These expectations were not fulfilled, with significant main effects only for the transcript version (with or without inconsistencies) on overall inconsistency detection rates. There are a number of plausible explanations for these results, so further investigation is needed.

Essays in Environmental Economic Valuation and Decision Making in the Presence of an Environmental Disaster

The first essay developed a respondent model of Bayesian updating for a double-bound dichotomous choice (DB-DC) contingent valuation methodology. I demonstrated by way of data simulations that current DB-DC identifications of true willingness-to-pay (WTP) may often fail given this respondent Bayesian updating context. Further simulations demonstrated that a simple extension of current DB-DC identifications derived explicitly from the Bayesian updating behavioral model can correct for much of the WTP bias. Additional results provided caution to viewing respondents as acting strategically toward the second bid. Finally, an empirical application confirmed the simulation outcomes. The second essay applied a hedonic property value model to a unique water quality (WQ) dataset for a year-round, urban, and coastal housing market in South Florida, and found evidence that various WQ measures affect waterfront housing prices in this setting. However, the results indicated that this relationship is not consistent across any of the six particular WQ variables used, and is furthermore dependent upon the specific descriptive statistic employed to represent the WQ measure in the empirical analysis. These results continue to underscore the need to better understand both the WQ measure and its statistical form homebuyers use in making their purchase decision. The third essay addressed a limitation to existing hurricane evacuation modeling aspects by developing a dynamic model of hurricane evacuation behavior. A household’s evacuation decision was framed as an optimal stopping problem where every potential evacuation time period prior to the actual hurricane landfall, the household’s optimal choice is to either evacuate, or to wait one more time period for a revised hurricane forecast. A hypothetical two-period model of evacuation and a realistic multi-period model of evacuation that incorporates actual forecast and evacuation cost data for my designated Gulf of Mexico region were developed for the dynamic analysis. Results from the multi-period model were calibrated with existing evacuation timing data from a number of hurricanes. Given the calibrated dynamic framework, a number of policy questions that plausibly affect the timing of household evacuations were analyzed, and a deeper understanding of existing empirical outcomes in regard to the timing of the evacuation decision was achieved.

The refinement and validation of the critical decision making and problem solving scale moral dilema (CDP-MD)

This thesis extended previous research on critical decision making and problem solving by refining and validating a measure designed to assess the use of critical thinking and critical discussion in sociomoral dilemmas. The purpose of this thesis was twofold: 1) to refine the administration of the Critical Thinking Subscale of the CDP to elicit more adequate responses and for purposes of refining the coding and scoring procedures for the total measure, and 2) to collect preliminary data on the initial reliabilities of the measure. Subjects consisted of 40 undergraduate students at Florida International University. Results indicate that the use of longer probes on the Critical Thinking Subscale was more effective in eliciting adequate responses necessary for coding and evaluating the subjects performance. Analyses on the psychometric properties of the measure consisted of test-retest reliability and inter-rater reliability.

Examining Moderators of the Hindsight Bias in the Context of Civil Legal Decision-Making: Counterfactuals, Causal Proximity, and Self-Referencing

The current research sought to clarify the diverging relationships between counterfactual thinking and hindsight bias observed in the literature thus far. In a non-legal context, Roese and Olson (1996) found a positive relationship between counterfactuals and hindsight bias, such that counterfactual mutations that undid the outcome also increased participants’ ratings of the outcome’s a priori likelihood. Further, they determined that this relationship is mediated by causal attributions about the counterfactually mutated antecedent event. Conversely, in the context of a civil lawsuit, Robbennolt and Sobus (1997) found that the relationship between counterfactual thinking and hindsight bias is negative. The current research sought to resolve the conflicting findings in the literature within a legal context. In Experiment One, the manipulation of the normality of the defendant’s target behavior, designed to manipulate participants’ counterfactual thoughts about said behavior, did moderate the hindsight effect of outcome knowledge on mock jurors’ judgments of the foreseeability of that outcome as well as their negligence verdicts. Although I predicted that counterfactual thinking would increase, or exacerbate, the hindsight bias, as found by Roese and Olson (1996), my results provided some support for Robbenolt and Sobus’s (1997) finding that counterfactual thinking decreases the hindsight bias. Behavior normality did not moderate the hindsight effect of outcome knowledge in Experiment Two, nor did causal proximity in Experiment Three. Additionally, my hypothesis that self-referencing may be an effective hindsight debiasing technique received little support across the three experiments. Although both the self-referencing instructions and self-report measure consistently decreased mock jurors’ likelihood of finding the defendant negligent, and self-referencing instructions decreased their foreseeability ratings in studies two and three, the self-referencing manipulation did not interact with outcome knowledge to moderate a hindsight bias effect on either foreseeability or negligence judgments. The consistent pattern of results across the three experiments, however, suggests that self-referencing may be an effective technique in reducing the likelihood of negligence verdicts.

Valuation of Ecosystem Services for Environmental Decision Making in South Florida

The Greater Everglades system imparts vital ecosystem services (ES) to South Florida residents including high quality drinking water supplies and a habitat for threatened and endangered species. As a result of the altered Everglades system and regional dynamics, restoration may either improve the provision of these services or impose a tradeoff between enhanced environmental goods and services and competing societal demands. The current study aims at understanding public preferences for restoration and generating willingness to pay (WTP) values for restored ES through the implementation of a discrete choice experiment. A previous study (Milon et al., 1999) generated WTP values amongst Floridians of up to $3.42 -$4.07 billion for full restoration over a 10-year period. We have collected data from 2,905 respondents taken from two samples who participated in an online survey designed to elicit the WTP values for selected ecological and social attributes included in the earlier study (Milon et al. 1999). We estimate that the Florida general public is willing to pay up to $854.1- $954.1 million over 10 years to avoid restrictions on their water usage and up to $90.8- $183.7 million over 10 years to restore the hydrological flow within the Water Conservation Area.