The Effect of Patient Self-Advocacy on Patient Satisfaction: Exploring Self-Compassion as a Mediator

The purpose of this study was to examine the role of self-compassion as a predictor and mediator of the relationship between patient self-advocacy and patient satisfaction in health care. A sample of 522 patients completed a questionnaire that asked for their perceptions of their own self-compassion, patient self-advocacy behaviors, including illness education, assertiveness, and mindful nonadherence, and patient satisfaction. This study found that both patient self-advocacy and self-compassion were positive predictors of patient satisfaction. More specifically, patients’ illness education and assertiveness positively influenced patients’ satisfaction with their physician. Self-compassion was also shown to be a mediator between patient self-advocacy and patient satisfaction. The implications of these findings and future directions are also discussed.     

Borders to cross: Identifying sources of tension in mentor–intern relationships

We used border crossing as a theoretical framework to explore the tensions that developed between two mentor–intern pairs during the course of a yearlong internship in high schools in the United States. Interviews with mentors and interns, and observations of planning sessions, teaching episodes, and follow-up conferences indicated that differing conceptions of mentoring, expectations related to communication, and beliefs about teaching formed the primary borders that the pairs had to navigate. Findings from the study suggest that the university must take a greater role in fostering communication between mentors and interns, and in providing on-going support to mentors engaged in teacher education.     

A multinomial logit model of college stopout and dropout behavior

Studies of college attrition typically assume that all attrition is permanent. We use data from the 1990/94 Beginning Postsecondary Survey to distinguish between long-term dropout and short-term stopout behavior in order to test that assumption. We find significant differences between those who stop out and those who drop out in the first year. Failure to recognize these differences biases the results of standard attrition models and hence may cause policy makers to pursue inappropriate policy initiatives or incorrectly target at-risk populations. Furthermore, the type of financial aid received is found to have a differential impact on stopout versus dropout probabilities.     

Are the Factors Affecting Dropout Behavior Related to Initial Enrollment Intensity for College Undergraduates?

We use data from the 1990/1994 Beginning Post-Secondary Survey to determine whether the factors associated with long-term attrition from higher education differ for students who initially enrolled part-time as compared to for students who initially enrolled full-time. Using a two-stage sequential decision model to analyze the initial enrollment intensity decision jointly with attrition, we find no evidence of correlation in the unobservables that necessitates joint estimation, but substantial evidence that the factors associated with attrition differ by initial enrollment status. The timing of initial enrollment, academic performance, parental education, household characteristics, and economic factors had a substantially greater impact on those initially enrolled full-time, while racial and ethnic characteristics had a greater impact on those initially enrolled part-time. The results of our study suggest that separate specifications are necessary to identify at-risk full-time as compared with at-risk part-time students. The data employed here were generated while working under a grant supported in part by the Association for Institutional Research, the National Center for Education Statistics, and the National Science Foundation under the Association for Institutional Research 1999 Improving Institutional Research in Post-secondary Educational Institutions Grant Program. The Spencer Foundation Small Grants program provided funding for the analysis. Leslie Stratton gratefully acknowledges additional support from a 2001 Faculty Excellence Award from Virginia Commonwealth University. Referees from the 2005 Southern Economic Association meetings and from Research in Higher Education provided very helpful comments. Any opinions, findings, conclusions, or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the Spencer Foundation, the Association for Institutional Research, the National Center for Education Statistics, or the National Science Foundation.     

Outpatient mental health services for children in foster care: a national perspective

OBJECTIVE: To determine factors influencing the use of outpatient mental health services provided by mental health professionals (OMHS) for children in foster care using a national probability sample in the United States. METHOD: As part of the National Survey of Child and Adolescent Well-being, detailed survey data were collected on 462 children, ages 2-15, who had been in out-of-home care for approximately 12 months at the time of sampling. A multivariate logistic regression model was used to determine how clinical need, as measured by a Total Problem, Externalizing, or Internalizing Scale T-score of 64 or greater on the Achenbach Child Behavior Checklist (CBCL), and non-clinical factors affected OSMHS use. RESULTS: Over half of the children in the sample received at least one OMHS. Need, older age, and history of sexual abuse history all positively predicted OMHS. A history of physical neglect negatively predicted OSMHS. African-Americans used fewer services than children of Caucasian ancestry at all values on the CBCL. This finding was particularly salient at lower levels of CBCL scores; at higher levels, the discrepancy in the use of services diminished but the proportion of children receiving services remained lower for African-American children. CONCLUSIONS: This national study confirms previous findings regarding the use of mental health services based on regional data. Limitations in the use of services imposed by non-clinical factors, specifically, age, race/ethnicity and type of abuse, need to be examined in order to address implicit and explicit policies and practices that may result in inequitable distribution of services.     

Bias and Bias Correction Method for Nonproportional Abilities Requirement (NPAR) Tests

Test items must often be broad in scope to be ecologically valid. It is therefore almost inevitable that secondary dimensions are introduced into a test during test development. A cognitive test may require one or more abilities besides the primary ability to correctly respond to an item, in which case a unidimensional test score overestimates the primary ability and creates interpretability problems. In this article, we demonstrate the nonproportional abilities requirement, a phenomenon with which secondary abilities are more required for difficult items. A novel and practical method for correcting bias in the primary ability is proposed and illustrated using a real data set from an international assessment. Simulation data are also used to evaluate the performance of the method.     

States of Insecurity: Cold War memory, “global citizenship” and its discontents

This article situates the dominant discourses of “global citizenship” employed in North American universities to internationalize the curricula, drawing in part on evidence from one Pacific northwestern Canadian university in the post-September-11 context of recent restrictive immigration policies, anti-terrorist measures and evocative Cold War memories. Far from weakening the Canadian nation-state or jettisoning neoliberalism, it argues that authoritarian post-Fordism constitutes a supra-juridical state that offers fewer social services but governs with more entrepreneurship through its globalization, immigration and “national security” policies. The article shows how the post-September-11 changes to Canada's immigration and refugee legislation from 1978 to 2001, write evocative fears about “terrorists” and “invading immigrants” on the national body politic. These changes provide literal and metaphorical transnational, economic and socio-legal mobility with substantive and specific human rights to those prospective immigrants deemed “highly skilled global citizens”. Yet, such policy efforts and legislation also reproduce the exclusions and differential hierarchies of gendered, classed, ableist and racialized notions of skill, flexible work and vulnerable or unobtuinuble citizenship for those it deems “non-immigrants”, migrants or non-citizens. The conclusion asks: Is “global citizenship” an oxymoronic slogan; a well-meaning but naïve equation of transnational mobility or “belonging” with formal legal substantive citizenship and human rights; or an opportunity to claim democratic praxis through a decolonized curricular, pedagogical and educational policy?     

A case study in defining literacy: David Olson's journey from the Great Divide to the Great Beyond

David Olson writes his reply to Snyder in this issue ofInterchange. See page 56.     

Decentralization and Social Partnership: The Development of Vocational Education at Shanghai and Shenzhen in China

In 1985, the Chinese Mainland introduced a policy of decentralization in order to help facilitate the spread of basic education. By looking specifically at the developmental experiences of Shanghai and Shenzhen, we can gain an in depth understanding of the specific circumstances incurred under new education reforms. While undergoing decentralization, the local government’s main responsibility was to implement the state directives and to act as the central government agency. During the development of vocational education, the level of decentralization in these two cities was situated somewhere between deconcentration and delegation. At the school level, the principal was mainly responsible for disseminating the state’s requirements. Teachers had to firmly follow the state’s instructions on teaching and learning. Other stakeholders’ roles were left unclear and informal. It is believed that the indigenous meaning of education and an authentic social partnership can only develop if formal channels are established through which stakeholders can express their ideas on education in the locality.