Willingness to get vaccinated against Ebola: A mapping of Guinean people positions

Objective: To map the different personal positions of Guinean people regarding vaccination against Ebola. Methods: From January to April 2016, 304 adults in Guinea were presented with 48 vignettes depicting situations in which getting vaccinated would be possible. These situations varied as a function of the constructs of health-protective behavior theories. The participants indicated the likelihood they would get vaccinated in each case. Results: Seven qualitatively different positions were found: Always Vaccinate (38%), Never Vaccinate (25%), Hesitant (19%), Depends on Cost Only (7%), Depends on Neighbors' Attitude and Cost (5%), Mainly Depends on Risk (4%), and Mistrust of Cheap Vaccines (2%). Conclusion: The diversity of Guinean people's positions implies that Ebola vaccination campaigns in Guinea, and probably in other sub-Saharan African countries, must not be “one size fits all,” but must be multifaceted and tailored in design and implementation to match the diversity of these people's needs and views

Under what conditions is euthanasia acceptable to lay people and health professionals?

Euthanasia is legal only in the Netherlands and Belgium, but it is on occasion performed by physicians elsewhere. We recruited in France two convenience samples of 221 lay people and of 189 professionals (36 physicians, 92 nurses, 48 nurse's aides, and 13 psychologists) and asked them how acceptable it would be for a patient's physician to perform euthanasia in each of 72 scenarios. The scenarios were all combinations of three levels of the patient's life expectancy (3 days, 10 days, or 1 month), four levels of the patient's request for euthanasia (no request, unable to formulate a request because in a coma, some form of request, repeated formal requests), three of the family's attitude (do not uselessly prolong care, no opinion, try to keep the patient alive to the very end), and two of the patient's willingness to undergo organ donation (willing or not willing). We found that most lay people and health care professionals structure the factors in the patient scenarios in the same way: they assign most importance to the extent of requests for euthanasia by the patient and least importance (the lay people) or none (the health professionals) to the patient's willingness to donate organs. They also integrate the information from the different factors in the same way: the factors of patient request, patient life expectancy, and (for the lay people) organ donation are combined additively, and the family's attitude toward prolonging care interacts with patient request (playing a larger role when the patient can make no request). Thus we demonstrate a common cognitive foundation for future discussions, at the levels of both clinical care and public policy, of the conditions under which physician-performed euthanasia might be acceptable.Euthanasia Patient autonomy Information integration The Functional Theory of Cognition France

Is it acceptable for a psychiatrist to break confidentiality to prevent spousal violence?

International audienceStudy question: When is it acceptable for a psychiatrist to break confidentiality to protect the wife of a potentially violent patient?Methods: 153 lay persons, 13 nursing personnel, 10 physicians, and 10 psychologists in France indicated this acceptability in 48 scenarios. The scenarios were all combinations of 5 factors: gravity of threat (death or beating), certainty of mental illness (certain or not), time spent talking with patient (considerable or little), his attitude toward psychotherapy (rejection, indecision, or acceptance), and whether the physician consulted an expert.Results: Lay people favored breaking confidentiality more than did nursing personnel or psychologists. Consulting an expert had greatest impact. Lay participants were composed of groups that found breaking confidentiality “always acceptable” (22 participants), “depending on many circumstances” (106), requiring “consultation with an expert” (31), and “never acceptable” (27).Conclusion: Lay people in France are influenced by situational factors when deciding if a psychiatrist should break confidentiality to protect a patient's wife

Addictive substances, users’ health, and the Government’s perceived responsibility: French people’s perspective

International audienc

Is it Acceptable for a Psychologist to Break A Young Client Confidentiality? Comparing Latin American (Chilean) and Western European (French) Viewpoints

En el presente estudio, fueron examinadas y comparadas las perspectivas de adultos chilenos y franceses respecto a la ruptura de la confidencialidad, frente al tema del consumo de drogas ilícitas. A 12 psicólogos chilenos, 143 adultos chilenos, y 100 adultos franceses se les presentó una serie de 64 viñetas, en las cuales un psicólogo conversa con su joven cliente que presenta consumo de drogas. Estas viñetas fueron compuestas de acuerdo a un diseño factorial de 6 factores intra-sujeto: la edad del cliente, la peligrosidad de la droga, el tiempo que lleva consumiendo la droga, si el cliente está de acuerdo en recibir tratamiento para la adicción, la estabilidad de su familia y si el psicólogo consulta a un experto antes de informar a la familia. Los resultados evidenciaron cuatro tipo de posiciones diferentes: “Nunca aceptable” (20%), “Siempre aceptable” (27%), “Principalmente dependiendo de la edad del cliente” (20%), y “Principalmente dependiendo del tipo de problemas familiares” (33%). Un alto porcentaje de participantes chilenos expresaron la perspectiva llamada “nunca aceptable”, en comparación a los participantes franceses, y un alto porcentaje de participantes franceses expresaron la perspectiva “dependiendo de la edad del cliente”, comparado con los participantes chilenos. Los participantes chilenos expresaron posiciones que son generalmente compatibles con el código de ética chileno.The views of Chilean and French adults concerning breaking confidentiality about illicit drug consumption were examined and compared. Twelve Chilean psychologists, 143 Chilean adults, and 100 French adults were presented with a series of 64 vignettes of a psychologist told by her young client that he is using illicit drugs. They were composed according to a six within-subject factor design: client’s age, dangerousness of the drug, duration of drug consumption, whether he agreed to be treated for addiction, stability of his family, and whether the psychologist consulted an expert before informing the family. Four qualitatively different personal positions were found, called Never acceptable (20% of the participants), Always acceptable (27%), Mainly depends on client’s age (20%), and Mainly depends on family problems (33%). A larger percentage of Chileans expressed the never acceptable view compared to French lay people, and a larger percentage of French expressed the mainly depends on client’s age view, compared to Chilean lay people. Chilean psychologists infrequently endorsed positions that are not fully compatible with the Chilean code of ethics

Evaluando los procesos de integración de la información utilizando diseños entre- o intra- sujetos: más evidencia

Within-subject designs (WSDs) remain unappreciated in psychology although many experimental tactics can reduce or eliminate the demand and order effects that WSDs tend to create. Comparative studies conducted in the Information Integration Theory (IIT) framework have shown that patterns of results observed using WSDs can largely be replicated using between-subject designs (BSDs). In order to add evidence to these findings, three additional studies were conducted in order to complement data obtained in previous studies. One of these studies was about health risk perception and tested the possibility to find evidence for a disjunctive rule of information integration using a BSD. The other two studies focused on the valuation process of IIT. The new findings regarding the disjunctive rule added support to the view that equivalent results can be obtained either with a highly economical repeated-measures design or with a much costlier independent factorial group arrangement. However, when the focus was on the valuation process and not on the integration process, ratings obtained in the BSD condition seemed to be restricted to a limited range of values by comparison with ratings obtained in the WSD condition. An explanation in terms of context effect is offered.Los diseños intra sujetos (WSD) no se aprecian en la psicología, aunque existen muchas tácticas experimentales que pueden reducir o eliminar la demanda y los efectos de orden que tienden a crear los WSD. Los estudios comparativos realizados en el marco de la Teoría de Integración de la Información (IIT) han demostrado que los patrones de resultados observados con WSD se pueden replicar en gran medida utilizando diseños entre sujetos (BSD). Para agregar evidencia a estos hallazgos, se realizaron tres estudios adicionales para complementar los datos obtenidos en estudios anteriores. Uno de estos estudios fue sobre la percepción de riesgo en salud y evaluó la posibilidad de encontrar evidencia de regla disyuntiva de integración de la información utilizando un BSD. Los otros dos estudios se centraron en el proceso de valoración de IIT. Los nuevos hallazgos con respecto a la regla disyuntiva sustentaron la opinión de que se pueden obtener resultados equivalentes tanto con un diseño altamente económico de medidas repetidas o con un acuerdo de grupo factorial independiente mucho más costoso. Sin embargo, cuando la atención se centró en el proceso de valoración y no en el proceso de integración, las calificaciones obtenidas en la condición BSD parecían estar restringidas a un rango limitado de valores en comparación con las calificaciones obtenidas en la condición WSD. Se ofrece una explicación en términos del efecto de contexto

Judging the possibility of the onset of diabetes mellitus type 2 from reported behavioral changes and from family history

Abstract Background Undiagnosed type 2 diabetes is common and can lead to unrecognized health complications. Given that earlier detection can reduce the damage to vital organs, it is important for all persons to be able to make the connection between certain new manifestations in their bodies and the possibility of diabetes. This study examined the extent to which people use the behavioral changes they observe in others (or in themselves), as well as relevant family history, to judge the possibility of the onset of diabetes. Methods One hundred and fifty-six adults living in France examined a set of realistic vignettes describing a person with (or without) signs suggestive of diabetes (e.g., increased thirst, family antecedents) and judged the possibility of the disease in each case. Results Overall, 36% of participants focused on reported symptoms when judging the possibility of diabetes, 37% focused on family history, and 29% were not able to use the information or tended systematically to minimize the possibility of diabetes. Conclusions People in France and probably around the world need a greater awareness not only of the factors putting them at risk of diabetes, but also of the specific signs and symptoms suggesting that they might be developing it

Infant vaccination against malaria in Mozambique and in Togo: mapping parents’ willingness to get their children vaccinated

Background: Malaria is one of the most widespread and deadly diseases worldwide and large majority of malaria cases and deaths occurs in Africa. Efforts to develop an effective vaccine against malaria are underway and several vaccine prototypes are on different clinical trial phases. Objective: As many sub-Saharan African countries have shown interest in introducing large-scale infant vaccination against malaria when a definitively approved vaccine will be available, the present study aimed at mapping Mozambican parents’ willingness to get their children vaccinated and comparing the results with findings from a similar study we conducted in Togo (209 participants). Methods: In Mozambique, 227 parents indicated their willingness to get their children vaccinated (using an 11-point scale) against malaria under different conditions varying as a function of the main constructs of health-protective theories: perceived risk of getting malaria, perceived severity of malaria, effectiveness of the vaccine, cost of the vaccine, and neighbors’ attitude toward vaccination. The participant responses were subjected to cluster analysis, ANOVA and Ch2 test. Results: Six qualitatively different positions were found, which were labeled Cost (12%); Neighbors, Risk, and Cost (28%); Treatment, Risk, and Cost (10%); Always Vaccinate (7%); Risk and Cost (13%); and Risk, Treatment, Effectiveness, and Cost (22%). These positions were associated with participants’ socio-demographic characteristics. Conclusion: A similar variety of parental positions on malaria vaccination was found in Mozambique and in Togo, which suggests that malaria vaccination campaigns in sub-Saharan African countries must be tailored in design and implementation to match the diversity of parents’ needs and views

Is it Acceptable for a Psychologist to Break A Young Client Confidentiality? Comparing Latin American (Chilean) and Western European (French) Viewpoints

En el presente estudio, fueron examinadas y comparadas las perspectivas de adultos chilenos y franceses respecto a la ruptura de la confidencialidad, frente al tema del consumo de drogas ilícitas. A 12 psicólogos chilenos, 143 adultos chilenos, y 100 adultos franceses se les presentó una serie de 64 viñetas, en las cuales un psicólogo conversa con su joven cliente que presenta consumo de drogas. Estas viñetas fueron compuestas de acuerdo a un diseño factorial de 6 factores intra-sujeto: la edad del cliente, la peligrosidad de la droga, el tiempo que lleva consumiendo la droga, si el cliente está de acuerdo en recibir tratamiento para la adicción, la estabilidad de su familia y si el psicólogo consulta a un experto antes de informar a la familia. Los resultados evidenciaron cuatro tipo de posiciones diferentes: “Nunca aceptable” (20%), “Siempre aceptable” (27%), “Principalmente dependiendo de la edad del cliente” (20%), y “Principalmente dependiendo del tipo de problemas familiares” (33%). Un alto porcentaje de participantes chilenos expresaron la perspectiva llamada “nunca aceptable”, en comparación a los participantes franceses, y un alto porcentaje de participantes franceses expresaron la perspectiva “dependiendo de la edad del cliente”, comparado con los participantes chilenos. Los participantes chilenos expresaron posiciones que son generalmente compatibles con el código de ética chileno.The views of Chilean and French adults concerning breaking confidentiality about illicit drug consumption were examined and compared. Twelve Chilean psychologists, 143 Chilean adults, and 100 French adults were presented with a series of 64 vignettes of a psychologist told by her young client that he is using illicit drugs. They were composed according to a six within-subject factor design: client’s age, dangerousness of the drug, duration of drug consumption, whether he agreed to be treated for addiction, stability of his family, and whether the psychologist consulted an expert before informing the family. Four qualitatively different personal positions were found, called Never acceptable (20% of the participants), Always acceptable (27%), Mainly depends on client’s age (20%), and Mainly depends on family problems (33%). A larger percentage of Chileans expressed the never acceptable view compared to French lay people, and a larger percentage of French expressed the mainly depends on client’s age view, compared to Chilean lay people. Chilean psychologists infrequently endorsed positions that are not fully compatible with the Chilean code of ethics