December 2012 Archives

Patient-centered relationship increases pain tolerance

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A doctor-patient relationship built on trust and empathy doesn't just put patients at ease - it actually changes the brain's response to stress and increases pain tolerance, according to new findings from a Michigan State University research team.

Medical researchers have shown in recent studies that doctors who listen carefully have happier patients with better health outcomes, but the underlying mechanism was unknown, said Issidoros Sarinopoulos, professor of radiology at MSU. "This is the first study that has looked at the patient-centered relationship from a neurobiological point of view," said Sarinopoulos, the lead researcher. "It's important for doctors and others who advocate this type of relationship with the patient to show that there is a biological basis."

The study involved randomly assigning patients to one of two types of interview with a doctor before undergoing an MRI scan. In the patient-centered approach, doctors addressed any concerns participants had about the procedure and asked open-ended questions allowing them to talk freely about their jobs, home life and other psychological and social factors affecting health. The other patients were asked only specific questions about clinical information such as their medical history and what drugs they were taking. As expected, those who had the patient-focused interview reported greater satisfaction and confidence in their doctor in a post interview questionnaire.

The participants then were placed in the MRI scanner and given a series of mild electric shocks, similar to the discomfort of having an IV needle inserted, while looking at a photo of a doctor who they were told was supervising the procedure. The scans measured activity in the anterior insula - the part of the brain that makes people aware of pain - in anticipation of the shocks and when they actually occurred.

The brain scans revealed those who had the patient-centered interview showed less activity in the anterior insula when they were looking at a photo of the interviewing doctor than when the doctor in the photo was unknown. Those participants also self-reported less pain when the photos showed the known doctor.

Sarinopoulos said the study had a small sample of just nine women and will need to be replicated on a larger scale. "We need to do more research to understand this mechanism," he said, "but this is a good first step that puts some scientific weight behind the case for empathizing with patients, getting to know them and building trust."

"Medicine has for too long focused just on the physical dimensions of the patient," said Smith, who co-authored the paper. "Those clinical questions are important and necessary, but we're trying to demonstrate that when you let patients tell their story in an unfettered way, you get more satisfied patients who end up healthier."

In this research, not only the difference of the questions they asked, but also the doctors' attitudes toward the patients such as tone, manner and non-verbal cues would be one of the influential factors that affected satisfaction in their doctors. This article does not mention whether they controlled non-verbal cues or not. However, for the more correct result, they should control non-verbal cues, as well as verbal interview questions.
Also there is a possibility that the patient felt less pain just because they saw a picture of someone they know. In other words, if the researchers show the patients pictures of someone they know other than their doctors, such as their family members or friends, the result might be similar. For this study to be more clear and stronger, they need to compare when they show the picture of the doctor and when they show the picture of someone the patient know other than their doctors.
In addition, like this article mentions, the study had a small sample of just nine women and will need to be replicated on a larger scale to get more solid result.

Women and Men See Things Differently

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According to Nationalgeographic, when University of Bristol researchers asked 52 men and women to study various images, gender differences emerged in terms of where the subjects focused their attention and in how much of a picture they explored.

The 26 female and 26 male study participants--ranging in age from 19 to 47--tended to focus on anywhere from one to five "hot spots" in still images made from films and taken of artwork. The images included scenes from movies such as The Sound of Music, Inside Man, and The Blue Planet, and artwork including "People in the Sun" by Edward Hopper and "Three Graces" by David Bowers.

This diagram shows the most eye-catching areas of the photo above for women (red) and men (blue). Illustration courtesy Felix Mercer Moss

Most of the hot spots involved the faces of people in the pictures, especially eyes, as well as other body parts, such as hands. Women, however, explored more of an image than men did, often focusing on nonfacial areas and places slightly below where men fixed their gaze.

Lead author Felix Mercer Moss, a vision researcher and doctoral student at the University of Bristol in the United Kingdom, speculates that risk aversion may explain some of the differences. In Western culture, a direct gaze can be construed as threatening. "Women may be attaching more risk to looking people in the eye," Mercer Moss noted, which is why they may focus their gaze on a lower part of the face than men do.

This research concluded that men and women gaze things differently, and this is for avoiding the risk of a direct gaze. Also women may be attaching more risk to looking people in the eye, which is why they may focus their gaze on a lower part of the face than men do. However, this research couldn't explain why women tent to gaze on a lower part of face than men do. They need a further research to explore 'why'.

This research used eye-tracking method. This kind of experiment may have distorted gender ratio or stereotypes. Because this method includes both computer science where male are dominant and psychology department where female are dominant. For this reason, this research might not be broadly applicable.

Questionnaire about attributes toward the use of laptop

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I got an assignment from one of my classes and I needed to interview or survey a subculture group which is different from my background. I decided to conduct a survey about the use of laptop and social influence on their purchase decision making. I made 12 questions and conducted the survey with five Malaysian female students at the University of Minnesota via email. For this assignment, I needed to survey only five people. However, the number of my sample was too small to generalize the population of the subculture group. If there is a chance to survey more Malaysian female students, I want to conduct a further survey about this subject matter. Also I want to ask more questions about the difference between their social relationship with Malaysian and with American.

1. Which brand's laptop do you own?

2. What is your favorite laptop brand? If you don't have any specific favorite brand, say "I don't have any".

3. If you have your favorite brand, why do you like the brand the most?
a. Good design
b. Reasonable price
c. Convenient after-sale service
d. Favorable brand image
e. Great specs
f. Others (Specify: )

4. When you buy a laptop, what is the most important consideration factor?
a. Brand name
b. Price
c. Specs
d. Design
e. Others (Specify: )

5. Where did you buy your laptop?
a. The U.S.
b. Malaysia
c. Another place (Specify: )

6. Which channel did you use when you bought your laptop?
a. The brand's own website
b. Online retail stores (Amazon, e-bay, etc.)
c. Electronics retail stores (Best Buy etc.)
d. Warehouse stores (Walmart, Target, K-mart, etc.)
e. Others (Specify: )

7. What was the most influential factor that affected your choice when you bought your laptop? (Choose all that apply)
a. Friends
b. Family members
c. Advertisements
d. Sales person
e. Brand image
f. Product reviews
g. Special deal
h. Others (Specify: )

8. Please rate your personal feelings toward the following laptop brands on a scale of 1-5
(1=very negative, 2=negative, 3=neutral, 4=positive, 5=very positive):
a. Apple:
b. Samsung:
c. Dell:
d. HP:
e. LG:
f. Toshiba:
g. Sony:
h. Asus:

9. Do you think that which brand's laptop you own affects your social image?
a. Yes
b. Somewhat
c. No

10. Do you think which factor is more important when you buy a laptop?
a. The brand image of a laptop
b. The specs or price of a laptop

11. Do you have Malaysian friends more than American friends in the U.S.?
a. Yes
b. No

12. Do you feel more comfortable with your Malaysian friends than American friends?
a. Yes
b. Sometimes
c. No

A focus group interview without group dynamic

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This video shows a focus group interview about a music video. The interviewees answered the questions in the same order of how they seat from the left to the right for the whole time. They did not seat around a round table rather they sat in a row horizontally on separate desk chairs. So they did not see each other the whole time and just looked at somewhere else while others are answering. There is no group dynamic at all which is one of the pros for group interview, encouraging participants to answer more actively and getting fresh insights from them. They looked boring the whole time, and I can't tell the mediator is promoting group dynamic in this focus group interview. He is neither in the middle of them nor close to them. This focus interview couldn't maximize the pros of group interview method.

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