States

The Unpublished Works for Clarinet by Alexander Grechaninov: Preparing a Performance Edition of the Sonata No. 1 for Clarinet and Piano, Op. 161 (open access)

The Unpublished Works for Clarinet by Alexander Grechaninov: Preparing a Performance Edition of the Sonata No. 1 for Clarinet and Piano, Op. 161

Alexander Grechaninov was one of the most important composers of the late Russian Romantic School. By the second half of the twentieth century he remained one of the few living composers who continued the traditions of the great Russian Romantic masters, such as Tchaikovsky and Rimsky-Korsakov. He is primarily known for his liturgical works, which are truly masterpieces of this genre. Because many of his instrumental works remain unpublished, particularly the chamber works, they continue to be undeservedly ignored in the concert hall. Grechaninov's unpublished works for clarinet include Septet for Clarinet, Bassoon and String Quintet, Op. 172a, Serenade for Clarinet and String Orchestra (without opus number), and Sonata No. 1 for Clarinet and Piano, Op. 161. This project not only brings to light Grechaninov's unpublished clarinet works, but also emphasizes the importance of his published clarinet pieces which have to date been forgotten, especially in the United States. The writer prepares a performance edition of the Sonata No. 1, Op.161 from Grechaninov's original autograph manuscript which is held in the New York Public Library's Toscanini Archives. After a brief introduction, the document describes Grechaninov's biography, including his historical and societal background, compositional growth throughout his career, and outside influences …
Date: August 2008
Creator: Perevertailenko, Dmytro Olexandrovich
System: The UNT Digital Library
Dallas, Poverty, and Race: Community Action Programs in the War on Poverty (open access)

Dallas, Poverty, and Race: Community Action Programs in the War on Poverty

Dallas is a unique city whose history has been overshadowed by its elite. The War on Poverty in Dallas, Texas, has been largely overlooked in the historical collective. This thesis examines the War on Poverty, more specifically, Community Action Programs (Dallas County Community Action Committee) and its origin and decline. It also exams race within the federal program and the push for federal funding among the African American and Mexican American communities. The thesis concludes with findings of the politicization of the Mexican American community and the struggle with African Americans for political equality.
Date: August 2008
Creator: Rose, Harriett DeAnn
System: The UNT Digital Library
What Went Wrong?  How Arrogant Ignorance and Cultural Misconceptions Turned Deadly at the San Antonio Courthouse, March 19, 1840 (open access)

What Went Wrong? How Arrogant Ignorance and Cultural Misconceptions Turned Deadly at the San Antonio Courthouse, March 19, 1840

Although the Council House Fight is well written about in the annals of early Texas history, this all-encompassing study will reveal a whole new picture. Unlike previous works that maintained one point of view, multiple perspectives were analyzed and explored to allow a more comprehensive view of the Council House Fight to emerge. Primary focus on social and cultural misunderstandings, as well as the mounting hostility between the Penateka Comanche and Texians across the frontier, will demonstrate their general distrust and hatred of the other. Detailing their complicated relationship will prove that neither the Texians nor the Comanche were without blame, and both shared responsibility for the deterioration of events on and before March 19, 1840.
Date: May 2008
Creator: Copeland, Cristen Paige
System: The UNT Digital Library
Evaluation of the Quick Inventory of Depressive Symptomatology - Self-Report (QIDS-SR) in a spinal cord injury population. (open access)

Evaluation of the Quick Inventory of Depressive Symptomatology - Self-Report (QIDS-SR) in a spinal cord injury population.

Spinal cord injury (SCI) is an acute and devastating event that results in significant and permanent life changes for the individuals who are injured, as well as their families and friends. Depression has received more attention from clinicians and researchers than any other psychological issue among persons with SCI. Measurement of depression in this population has a variety of methodological issues, including inconsistent assessments used (self-report versus clinical interviews), varying definitions of depression, inclusion and exclusion of physical symptoms in the assessment process, and use of measures that do not represent DSM-IV criteria for major depressive disorder. The primary goal of this study was to evaluate the Quick Inventory of Depressive Symptomatology - Self-Report (QIDS-SR) and provide descriptive analyses of this measure with persons with SCI. Results showed that somatic symptoms were more frequently endorsed than psychological symptoms in this population. Additionally, scores on the QIDS-SR were significantly associated with a depression diagnosis in the patient's medical chart. However, QIDS-SR scores were not found to be correlated inversely with quality of life scores as predicted. The QIDS-SR was shown to have good internal consistency and convergent validity with patients with SCI. However, it failed to demonstrate construct validity. The QIDS-SR …
Date: August 2008
Creator: Reed, Kristin
System: The UNT Digital Library
Neurocognitive Variables Underlying Group Performance on a Measure of Effort: The Medical Symptom Validity Test (MSVT) (open access)

Neurocognitive Variables Underlying Group Performance on a Measure of Effort: The Medical Symptom Validity Test (MSVT)

This study utilized the Medical Symptom Validity Test (MSVT) and a set of standard neuropsychological instruments to determine the underlying construct of the MSVT that accounts for effort in mild traumatic brain injury (mTBI) patients by comparing/contrasting mTBI with dementia and an analog simulation. The results indicate that a common underlying neurocognitive construct (memory) exists between mTBI and dementia patients, which may account for poor effort as measured by the MSVT. Other underlying factors emerged for both groups, though they did not point to a common construct. This finding suggests that the overall effect of brain injury in neurologically impaired groups also impacts effort performance as measured by the MSVT. Similarly impaired performance patterns also emerged between mTBI and dementia groups in sub-groups that failed effort measures. Thus, failed effort tests may be a function of more pronounced deficits in these groups, rather than a function of effort. Finally, although similar effort profiles were noted between mTBI and analog simulators, the analog group was unable to mimic the neurocognitive effects of mTBI.
Date: December 2008
Creator: Covert, Julie Hart
System: The UNT Digital Library
Psychological characteristics contributing to performance on neuropsychological tests and effort testing. (open access)

Psychological characteristics contributing to performance on neuropsychological tests and effort testing.

The issue of effortful patient performance has been an area of clinical interest in individuals with minor traumatic brain injury (mTBI). Clinical attention to this area has increased largely because of an increase in the number of worker's compensation claims, injury-related lawsuits and/or insanity defense pleas. As patients are presented with the opportunity for secondary gain, the issue of optimum performance on neuropsychological measures becomes salient. In addition to neurocognitive deficits, there are psychological characteristics associated with mTBI including depression, emotional disturbance, personality changes, and other psychopathology. This study utilized the MSVT, a set of standard neuropsychological instruments, and the Minnesota Multiphasic Inventory-2 (MMPI-2) to investigate the relationships between effort, psychological characteristics, and neuropsychological functioning in individuals with minor traumatic brain injuries. The first objective of this study was to determine which psychological factors were related to effort in mTBI. The second objective was to determine if there were differences between groups that performed poorly on effort testing and groups that performed adequately on effort testing, based on relevant psychological characteristics. The results of the analyses supported the first hypothesis. Hysteria was inversely related to effort, and Mania was positively related to effort on one of five measures of effort. …
Date: August 2008
Creator: Hilborn, Robert Scott
System: The UNT Digital Library
Functions of self-injurious thoughts and behaviors within adolescent inpatients. (open access)

Functions of self-injurious thoughts and behaviors within adolescent inpatients.

The primary interest of this investigation concerned the self-injurious thoughts and behaviors (SITBs) of inpatient adolescents. Previous researchers have provided descriptive information regarding either automatic (or intrinsic) and social components using the Self-Injurious Thoughts and Behaviors Interview (SITBI). However, the presence and trends of these components have not firmly been established, suggesting the need to explore this area further. Eighty-two adolescent inpatients were selected and interviewed using the SITBI to evaluate the predictive ability of self-reported self-injurious behavior with regard to social and automatic, negative and positive functions. Results showed that depending on the type of thought or behavior displayed one could discern the motivation behind their actions. Automatic-Negative was seen to have the strongest relationship across all SITB behaviors while Automatic-Negative was not found to be relatively low compared to other SITB behaviors. Both Social-Positive and Social-Negative were found to be present in moderate relationships compared to Automatic in general.
Date: December 2008
Creator: Thomas, Peter F.
System: The UNT Digital Library
Penile plethysmography: Validation with a juvenile sex offending population. (open access)

Penile plethysmography: Validation with a juvenile sex offending population.

Traditionally, juvenile sex offenders have been ignored in the literature. More recently the research has expanded particularly in the area of assessment and treatment. This study focused on the assessment of sexual arousal to deviant stimuli using the penile plethysmography (PPG) since it likely plays a significant role in juvenile sex offending behaviors. The goal of this study assessed its validity and reliability using Becker et al.'s set of PPG scenarios with a population of juvenile sex offenders. Significant differences were found between groups of (a) admitters versus partial admitters and (b) offenders with and without male victims. This study also examined the latent structure of the PPG results and found three dimensions: arousal to male stimuli, arousal to females and paraphilias, and arousal to non-sexual acts. These findings provide important implications for assessment of juvenile sex offenders and add to the clinical utility of PPG assessments.
Date: December 2008
Creator: Martinez, Tonantzin Dionisia
System: The UNT Digital Library
Extermination Warfare? The Conduct of the Second Marine Division at Saipan (open access)

Extermination Warfare? The Conduct of the Second Marine Division at Saipan

Historians John W. Dower, Craig Cameron, and Ronald Takaki argue that the Pacific War was a war of extermination fueled by race hate. Therefore, the clash between the military forces of the Japanese Empire and United States of America yielded a "kill or be killed" environment across the battlefields of the Pacific. This work examines the conduct of the Second Marine Division during its campaign of conquest against the Japanese held island of Saipan from June 15, 1944-July 9, 1944. It is based upon traditional military history sources to test their theories in context of the conduct of Marines toward Japanese soldiers and civilians during the Saipan campaign. Did Marines practice a war of extermination or conduct themselves in a humane manner?
Date: May 2008
Creator: Hegi, Benjamin P.
System: The UNT Digital Library
With their hearts in their hands: Forging a Mexican community in Dallas, 1900-1925. (open access)

With their hearts in their hands: Forging a Mexican community in Dallas, 1900-1925.

Mexican immigration to the United States increased tremendously from 1900-1925 as factors such as the Mexican Revolution and the recruitment of Mexican laborers by American industry drew Mexicans north. A significant number of Mexicans settled in Dallas and in the face of Anglo discrimination and segregation in the workplace, public institutions, and housing, these immigrants forged a community in the city rooted in their Mexican identity and traditions. This research, based heavily on data from the 1900, 1910, and 1920 census enumerations for Dallas and on articles from Dallas Morning News, highlights the agency of the Mexican population - men and women - in Dallas in the first three decades of the twentieth century.
Date: May 2008
Creator: Mercado, Bianca
System: The UNT Digital Library
Neurocognitive implications of diabetes on dementia as measured by an extensive neuropsychological battery. (open access)

Neurocognitive implications of diabetes on dementia as measured by an extensive neuropsychological battery.

Diabetes is a disease with a deleterious pathology that currently impacts 4.5 million individuals within the United States. This study examined the ability of a specific neuropsychological battery to identify and classify dementia type, investigated the impact of diabetes on cognition and analyzed the ability of the memory measures of the 7 Minute Screen (7MS) and the Rey-Osterrieth Recall to correctly categorize dementia type when not used in combination with a full battery. The battery in addition to exhaustive patient history, medical chart review and pertinent tests were used in initial diagnosis. Results indicated the battery was sufficient in the identification and classification of dementia type. Within the sample, diabetes did not appear to significantly impact overall battery results whereby only two measures were minimally affected by diabetes. Finally, the memory measures of the 7MS and the Rey-Osterrieth Recall were sufficient to predict membership into the Alzheimer's (AD) and vascular dementia (VD) groups with 86.4% accuracy. The classification percentage dropped to 68.3% with addition of the mild cognitive impairment category. The full battery correctly classified AD and VD dementia 87.5% and appeared to be the most robust.
Date: December 2008
Creator: Harris, Rebekah Lynn
System: The UNT Digital Library
Traumatic Brain Injury in Children and Adolescents: An Evaluation of the WISC-III Four Factor Model and Individual Cluster Profiles (open access)

Traumatic Brain Injury in Children and Adolescents: An Evaluation of the WISC-III Four Factor Model and Individual Cluster Profiles

Traumatic brain injury (TBI) is the leading cause of death and disability among children and adolescents in the US. Children and adolescents who sustain moderate and severe head injuries are much more likely to evidence significant deficits in neuropsychological functioning when compared with children with mild head injuries. Information about the recovery process and functional sequelae associated with moderate and severe head injuries remains limited, despite clear indications that children who experience such injuries typically exhibit notable deficits in intellectual functioning, particularly during the acute phase of recovery. Thus, the present study was conducted to augment research on intellectual functioning in children with moderate or severe head injuries. To accomplish this, the study first examined the proposed factor model of the WISC-III in children with moderate and severe TBI. Given high prevalence rates and similar trends in cognitive impairment, particularly within the frontal lobe structures (e.g., disrupted cognitive flexibility and divided attention), the study also examined this same factor model for a group of children with attention-deficit/hyperactivity disorder (ADHD) and compared it with the model fit from the TBI group. In the second phase of the study, both the TBI and AHDH groups were evaluated to determine if distinct WISC-III …
Date: August 2008
Creator: Shafer, Micheal E.
System: The UNT Digital Library
"Victory is Our Only Road to Peace": Texas, Wartime Morale, and Confederate Nationalism, 1860-1865 (open access)

"Victory is Our Only Road to Peace": Texas, Wartime Morale, and Confederate Nationalism, 1860-1865

This thesis explores the impact of home front and battlefield morale on Texas's civilian and military population during the Civil War. It addresses the creation, maintenance, and eventual surrender of Confederate nationalism and identity among Texans from five different counties: Colorado, Dallas, Galveston, Harrison, and Travis. The war divided Texans into three distinct groups: civilians on the home front, soldiers serving in theaters outside of the state, and soldiers serving within Texas's borders. Different environments, experiences, and morale affected the manner in which civilians and soldiers identified with the Confederate war effort. This study relies on contemporary letters, diaries, newspaper reports, and government records to evaluate how morale influenced national dedication and loyalty to the Confederacy among various segments of Texas's population.
Date: May 2008
Creator: Lang, Andrew F.
System: The UNT Digital Library
Personality and the prediction of outcome following rehabilitation in persons with acquired brain injuries: The Millon Behavioral Medicine Diagnostic (MBMD). (open access)

Personality and the prediction of outcome following rehabilitation in persons with acquired brain injuries: The Millon Behavioral Medicine Diagnostic (MBMD).

Neuropsychological rehabilitation following acquired brain injury is increasingly recognized as essential with the advancements in research evidence of its effectiveness, particularly as current estimates of disability following the most common forms of brain injury (traumatic brain injury and cerebrovascular accident) are so high. Improvements in predictive capabilities of researchers and clinicians are paramount in designing effective interventions. As many variables associated with outcome following brain injury are not controllable (e.g. severity of the injury, age, education), it is essential that rehabilitation programs design interventions to target those variables that are susceptible to amelioration. While personality factors have been shown to affect outcome in other medical illnesses, only a few studies have examined the influence of personality on outcome following neurorehabilitation for acquired brain injury. The results of these studies have been mixed. This study used the Millon Behavioral Medicine Diagnostic (MBMD) to predict outcome as measured by the Mayo-Portland Adaptability Index (MPAI-4) following brain injury rehabilitation in a heterogeneous sample of persons with acquired brain injuries (N = 50). It was hypothesized that specific coping styles scales from the MBMD (Introversive, Dejected, Oppositional), which are based on Millon's personality system, would predict outcome. Results indicated that both the Introversive and …
Date: August 2008
Creator: Beck, Kelley D.
System: The UNT Digital Library
The Effectiveness of the Geriatric Depression Scale to Distinguish Apathy From Depression in Alzheimer's Disease and Related Dementias. (open access)

The Effectiveness of the Geriatric Depression Scale to Distinguish Apathy From Depression in Alzheimer's Disease and Related Dementias.

Early detection of Alzheimer's disease (AD) and related dementias in the elderly is critical for improving treatment methods and is a necessary component for improving public health interventions. One of the earliest and most common behavioral syndromes of AD is apathy and is associated with executive dysfunction. Apathy in AD is often misdiagnosed as depression due to an overlap in symptoms. Studies that have found depression to be associated with executive dysfunction have not always controlled for the presence of apathy. The Geriatric Depression Scale (GDS) is a widely used instrument designed to assess depression in the elderly. This study utilized the GDS and a set of standard neuropsychological instruments to investigate the relationship between apathy, depression, and executive functions in individuals with AD and related dementias. The first objective of this study was to determine if apathy has a greater impact on executive functions compared to depression in AD and related dementias. The second objective was to determine the effectiveness of the GDS as a screen for apathy. The results of the analyses did not support the hypotheses. However, exploratory analyses suggested a possible non-linear relationship with apathy and various levels of dementia severity. Exploratory analysis also suggested mean …
Date: August 2008
Creator: Davis, Tommy E., Jr.
System: The UNT Digital Library
Gods, Have Merced! A Documentary Film (open access)

Gods, Have Merced! A Documentary Film

Gods, Have Merced! chronicles the struggle of Jose Merced, a Santeria priest, with the city of Euless, Texas, where he has been residing for 17 years in an effort to overrule an ordinance that bans the most critical element of his faith: animal sacrifice. As the city officials justify the ban on the basis of public health, Merced thinks he is merely a victim of selective code enforcement aimed a restricting his freedom of religion. Local and national media covered the lawsuit he filed against the City of Euless, and Merced seems ready to take the fight over animal sacrifice to the United States Supreme Court. He wants American justice to give his African-originated religion recognized in a city where people seem uneasy about a practice that brings back the historic fears of Voodoo and its popularly assumed malefic practices. The film explores the complex structure of Santeria, its African roots, its renaissance in the Americas and the very controversial issue of animal sacrifice in the US.
Date: December 2008
Creator: Lakpassa, Komlan Daholega
System: The UNT Digital Library
Teenager's doing history out-of-school: An intrinsic case study of situated learning in history. (open access)

Teenager's doing history out-of-school: An intrinsic case study of situated learning in history.

This intrinsic case study documents a community-based history expedition implemented as a project-based, voluntary, out-of-school history activity. The expedition's development was informed by the National Education Association's concept of the intensive study of history, its structure by the history seminary, and its spirit by Webb's account of seminar as history expedition. Specific study objectives included documentation of the planning, implementation, operation, and outcomes of the expedition, as well as the viability of the history expedition as a vehicle for engaging teenagers in the practice of history. Finally, the study examined whether a history expedition might serve as a curriculum of identity. Constructivist philosophy and situated learning theory grounded the analysis and interpretation of the study. Undertaken in North Central Texas, the study followed the experiences of six teenagers engaged as historians who were given one year to research and write a historical monograph. The monograph concerned the last horse cavalry regiment deployed overseas as a mounted combat unit by the U.S. Army during World War II. The study yielded qualitative data in the form of researcher observations, participant interviews, artifacts of participant writing, and participant speeches. In addition, the study includes evaluations of the historical monograph by subject matter experts. …
Date: May 2008
Creator: Johnston, Glenn T.
System: The UNT Digital Library
A weak link in the chain: The Joint Chiefs of Staff and the Truman-MacArthur controversy during the Korean War. (open access)

A weak link in the chain: The Joint Chiefs of Staff and the Truman-MacArthur controversy during the Korean War.

This work examines the actions of the Joint Chiefs of Staff during the first year of the Korean War. Officially created in 1947, the Joint Chiefs saw their first true test as an institution during the conflict. At various times, the members of the JCS failed to issue direct orders to their subordinate, resulting in a divide between the wishes of President Truman and General MacArthur over the conduct of the war. By analyzing the interaction between the Joint Chiefs and General Douglas MacArthur, the flaws of both the individual Chiefs as well as the organization as a whole become apparent. The tactical and strategic decisions faced by the JCS are framed within the three main stages of the Korean War.
Date: May 2008
Creator: Sager, John
System: The UNT Digital Library
An item response theory analysis of the Rey Osterrieth Complex Figure Task. (open access)

An item response theory analysis of the Rey Osterrieth Complex Figure Task.

The Rey-Osterrieth Complex Figure Task (ROCFT) has been a standard in neuropsychological assessment for six decades. Many researchers have contributed administration procedures, additional scoring systems and normative data to improve its utility. Despite the abundance of research, the original 36-point scoring system still reigns among clinicians despite documented problems with ceiling and floor effects and poor discrimination between levels of impairment. This study is an attempt to provide a new method based upon item response theory that will allow clinicians to better describe the impairment levels of their patients. Through estimation of item characteristic curves, underlying traits can be estimated while taking into account varying levels of difficulty and discrimination within the set of individual items. The ultimate goal of the current research is identification of a subset of ROCFT items that can be examined in addition to total scores to provide an extra level of information for clinicians, particularly when they are faced with a need to discriminate severely and mildly impaired patients.
Date: December 2008
Creator: Everitt, Alaina
System: The UNT Digital Library
The Anglo-Iraqi Relationship Between 1945 and 1948. (open access)

The Anglo-Iraqi Relationship Between 1945 and 1948.

This paper discuses the British Labour government's social, economic and military policies in Iraq between 1945 and 1948. The ability of the Iraqi monarchy to adapt to the British policies after World War II is discussed. The British were trying to put more social justice into the Iraqi regime in order to keep British influence and to increase the Iraqi regime's stability against the Arab nationalist movement.
Date: December 2008
Creator: Alburaas, Theyab M.
System: The UNT Digital Library
In justice to our Indian allies:  The government of Texas and her Indian allies, 1836-1867. (open access)

In justice to our Indian allies: The government of Texas and her Indian allies, 1836-1867.

Traditional histories of the Texas frontier overlook a crucial component: efforts to defend Texas against Indians would have been far less successful without the contributions of Indian allies. The government of Texas tended to use smaller, nomadic bands such as the Lipan Apaches and Tonkawas as military allies. Immigrant Indian tribes such as the Shawnee and Delaware were employed primarily as scouts and interpreters. Texas, as a result of the terms of her annexation, retained a more control over Indian policy than other states. Texas also had a larger unsettled frontier region than other states. This necessitated the use of Indian allies in fighting and negotiating with hostile Indians, as well as scouting for Ranger and Army expeditions.
Date: August 2008
Creator: Yancey, William C.
System: The UNT Digital Library
Association Between Folate, Vitamin B12 and Cognitive Performance in Demented Elderly. (open access)

Association Between Folate, Vitamin B12 and Cognitive Performance in Demented Elderly.

Dementia is prevalent among elderly people. As the world population ages, it is projected that the number of people affected by dementia may triple in the next 50 years. Over the last two decades, research has focused on identifying potentially modifiable risk factors in development and progression of dementia, such as vitamin B12 and folate. Results concerning the effects of low folate and vitamin B12 on cognitive performance are mixed. The main objective of the present study was to investigate the effects of vitamin deficiency on cognitive functioning in a clinical sample of elderly individuals with cognitive problems using a comprehensive neuropsychological assessment. A retrospective chart-review was performed on the 102 records of patients from the Geriatrics Clinic at the University of North Texas Health Science Center who presented with cognitive deficits. Charts were reviewed to obtain data on vitamin supplementation, vitamin status, history of chronic conditions and other biochemical data. The available database was used to obtain data on neuropsychological assessment. The study demonstrated mild association between vitamin B12 and folate status and cognitive deficits. There appeared to be a higher cut-off level that is above the traditionally used levels for vitamin B12 and folate deficiency concentrations at which …
Date: August 2008
Creator: Serova, Svetlana
System: The UNT Digital Library
The Historical Development and Future of the Southern Bible Institute (open access)

The Historical Development and Future of the Southern Bible Institute

This study represents qualitative, historical research. The study documented the origins, milestones, and development of the Southern Bible Institute in Dallas, Texas. This study provided data leading to a better understanding of the impact of segregation on the African American religious community in Dallas, Texas. Data from this study also shows how African Americans responded to segregation in the area of theological higher education through the establishment of the Southern Bible Institute. The research methodology was heavily dependent on oral data from various sources and pertinent data were extrapolated from oral history interviews and historical, internal and external institutional documents. Analysis was based on accuracy, consistency and authenticity. Triangulation was the method used to determine the accuracy and authenticity of the oral interviews. The data were also analyzed for extrapolating factors that lend themselves to inclusion on an institutional assessment. Based on the factors extrapolated from the data and from a strengths, weaknesses, opportunities, and threats (SWOT) analysis, an internal institutional assessment checklist was created to assist the leadership in evaluating various aspects of the school. It was concluded that the future seems bright for the Southern Bible Institute, but it is recommended that the administration leverage off identified strengths …
Date: May 2008
Creator: Cooks, Michael J.F.
System: The UNT Digital Library
Informed Consent in Obstetric Anesthesia: The Effect of the Amount, Timing and Modality of Information on Patient Satisfaction (open access)

Informed Consent in Obstetric Anesthesia: The Effect of the Amount, Timing and Modality of Information on Patient Satisfaction

Using mainly quantitative methods of evaluation, as well as patient comment assessment, this study evaluated whether changing the current informed consent process for labor epidural analgesia to a longer, more informational process resulted in a more satisfied patient. Satisfaction with the labor epidural informed consent process was evaluated using a questionnaire that was mailed and also available online. Half of the patient population was given a written labor epidural risk/benefit document at their 36-week obstetric check up. All patients received the standard informed consent. Survey responses were evaluated based on three independent variables dealing with the modality, timing, amount of informed consent information and one dependent variable, whether the patient's expectations of the epidural were met, which is equated with satisfaction. Patients in this study clearly indicated that they want detailed risk/benefit information on epidural analgesia earlier in their pregnancy. A meaningfully larger percentage of patients who received the written risk/benefit document were satisfied with the epidural process as compared to those who did not receive the document.
Date: December 2008
Creator: Hicks, Michelle, B.
System: The UNT Digital Library