-
Nursing Ethics 2023The wide proliferation of Covid-19 has impacted billions of people all over the world. This catastrophic pandemic outbreak and ostracism at work have posed challenges...
BACKGROUND
The wide proliferation of Covid-19 has impacted billions of people all over the world. This catastrophic pandemic outbreak and ostracism at work have posed challenges for all healthcare professionals, especially for nurses, and have led to a significant increase in the workload, several physical and mental problems, and a change in behavior that is more negative and counterproductive. Therefore, leadership behaviors that are moral in nature serve as a trigger and lessen the adverse workplace effects on nurses' conduct.
AIM
this research is directed to explore the impact of post-COVID-19 workplace ostracism on nurses' counterproductive behavior and examine the role of moral leadership as a mediating factor in post-COVID-19 workplace ostracism and nurses' counterproductive behavior.
ETHICAL CONSIDERATION
Ethical review and approval Was received from Ethical Committee at the Faculty of Nursing, Alexandria University, Egypt.
METHODS
A cross-sectional and correlation study was implemented in all units of medical, surgical, critical and intensive care units by using three tools; moral leadership questionnaire, Workplace Ostracism Instrument (WOS), and Counterproductive Work Behaviors Questionnaire (CWBs). A convenient sample of 340 from 699 bedside nurses was granted.
RESULTS
This study revealed that nurses' perceived moderate mean percent (55.49 ± 3.46) of overall workplace ostracism and counterproductive behavior (74.69 ± 6.15). However, they perceived a low mean percentage of moral leadership. There was a significant positive correlation between workplace ostracism and counterproductive behavior. Otherwise, a significant negative correlation was found between moral leadership, workplace ostracism and counterproductive behavior. Also, this study proved the mediating effect of moral leadership in decreasing workplace ostracism by 79.3% and counterproductive behavior by 36.7%.
CONCLUSION
Hospital administrators need to be aware of the significance of moral leadership and apply integrity in the clinical setting to reduce the drawback of isolation on nurses' conduct and increase value for the organization as a whole and nurses in particular.
Topics: Humans; Leadership; Cross-Sectional Studies; Ostracism; COVID-19; Workplace; Morals; Surveys and Questionnaires
PubMed: 37161665
DOI: 10.1177/09697330231169935 -
Cognition Feb 2024Despite the importance of uncertainty in decision-making, few published studies have examined how individuals make moral judgments under uncertainty. Across four...
Despite the importance of uncertainty in decision-making, few published studies have examined how individuals make moral judgments under uncertainty. Across four experiments (N = 445), we examined whether a relatively small shift in probability affected participants' judgments of both moral acceptability and choice. Overall, reading dilemmas where the characters were either certain or likely to die, the probability of the sacrificed individual and the group at risk dying both had independent effects on participants' responses. That is, participants were more accepting of sacrificing the individual if they were not certain to die, but less accepting if the group was only likely to die when the individual was not sacrificed. Furthermore, a number of participants made acceptability ratings that did not match the action they endorsed, either finding the sacrificial decision more acceptable but refusing to make it, or choosing the sacrificial decision while viewing it as less acceptable. Many participants also stated that this was because they recognised a crucial difference between what they viewed as morally acceptable in a dilemma and what they were actually willing to do. Such mismatches may reflect the sensitivity and complexity of the moral principles that individuals employ during their moral decision-making.
Topics: Humans; Decision Making; Uncertainty; Judgment; Morals; Moral Obligations
PubMed: 38101081
DOI: 10.1016/j.cognition.2023.105692 -
BMC Psychology Aug 2023Cyberbullying has become more prevalent, more difficult to detect, and more harmful to the victims. Whereas considerable prior work has investigated predictors and...
BACKGROUND
Cyberbullying has become more prevalent, more difficult to detect, and more harmful to the victims. Whereas considerable prior work has investigated predictors and consequences of cyberbullying, additional research is needed to better understand the mechanisms by which these factors relate to cyberbullying perpetration and victimization. The goal of the present study was to examine the extent to which the link between individual differences in moral disengagement and cyberbullying perpetration is mediated by low self-control and, if so, whether this mediation effect varies by individuals' degree of callous-unemotional traits.
METHOD
To explore these questions, we used cyberbullying, moral disengagement, self-control, and callous-unemotional traits scales and collected online survey data from a sample of 860 Chinese internet users aged 18 years old or older.
RESULT
As hypothesized, a significant positive relation between moral disengagement and cyberbullying emerged that was mediated by individual differences in self-control. Additionally, evidence of moderated mediation was found. That is, the indirect effect varied by degree of callous-unemotional traits, with a significantly stronger mediation effect (and association between self-control and cyberbullying) for individuals who were relatively higher in callous-unemotional traits.
CONCLUSION
We conclude that moral disengagement partially predicts cyberbullying through self-control, while callous-unemotional traits moderate the pathway between self-control and cyberbullying.
Topics: Humans; Adolescent; Adult; Aged; Cyberbullying; Conduct Disorder; Morals; Self-Control; Bullying
PubMed: 37626425
DOI: 10.1186/s40359-023-01287-z -
Revista Da Associacao Medica Brasileira... 2024
Topics: Humans; Physician-Patient Relations; Humanism
PubMed: 38656015
DOI: 10.1590/1806-9282.20231497 -
PloS One 2023Clinician moral distress has been documented over the past several decades as occurring within numerous healthcare disciplines, often in relation to clinicians'...
Clinician moral distress has been documented over the past several decades as occurring within numerous healthcare disciplines, often in relation to clinicians' involvement in patients' end-of-life decision-making. The resulting harms impact clinician well-being, patient well-being, and healthcare system functioning. Given Covid-19's catastrophic death toll and associated demands on end-of-life decision-making processes, the pandemic represents a particularly important context within which to understand clinician moral distress. Thus, we conducted a convergent mixed methods study to examine its prevalence, associations with clinicians' demographic and professional characteristics, and contributing circumstances among Veterans Health Administration (VA) clinicians. The study, conducted in April 2021, consisted of a cross-sectional on-line survey of VA clinicians at 20 VA Medical Centers with professional jurisdiction to place life-sustaining treatment orders working who were from a number of select specialties. The survey collected quantitative data on respondents' demographics, clinical practice characteristics, attitudes and behaviors related to goals of care conversations, intensity of moral distress during "peak-Covid," and qualitative data via an open-ended item asking for respondents to describe contributing circumstances if they had indicated any moral distress. To understand factors associated with heightened moral distress, we analyzed quantitative data using bivariate and multivariable regression analyses and qualitative data using a hybrid deductive/inductive thematic approach. Mixed methods analysis followed, whereby we compared the quantitative and qualitative datasets and integrated findings at the analytic level. Out of 3,396 eligible VA clinicians, 323 responded to the survey (9.5% adjusted response rate). Most respondents (81%) reported at least some moral distress during peak-Covid. In a multivariable logistic regression, female gender (OR 3.35; 95% CI 1.53-7.37) was associated with greater odds of moral distress, and practicing in geriatrics/palliative care (OR 0.40; 95% CI 0.18-0.87) and internal medicine/family medicine/primary care (OR 0.46; 95% CI 0.22-0.98) were associated with reduced odds of moral distress compared to medical subspecialties. From the 191 respondents who completed the open-ended item, five qualitative themes emerged as moral distress contributors: 1) patient visitation restrictions, 2) anticipatory actions, 3) clinical uncertainty related to Covid, 4) resource shortages, and 5) personal risk of contracting Covid. Mixed methods analysis found that quantitative results were consistent with these last two qualitative themes. In sum, clinician moral distress was prevalent early in the pandemic. This moral distress was associated with individual-, system-, and situation-level contributors. These identified contributors represent leverage points for future intervention to mitigate clinician moral distress and its negative outcomes during future healthcare crises and even during everyday clinical care.
Topics: Humans; Female; COVID-19; Clinical Decision-Making; Cross-Sectional Studies; Uncertainty; Family Practice; Death; Morals
PubMed: 37713379
DOI: 10.1371/journal.pone.0291542 -
Annual Review of Psychology Jan 2024There is always room for moral improvement. However, very few prior reviews have focused on the phenomenon of moral improvement of self, social relations, or society. We... (Review)
Review
There is always room for moral improvement. However, very few prior reviews have focused on the phenomenon of moral improvement of self, social relations, or society. We first consider prevailing notions of the self-concept by highlighting the niche of theory and research that identifies an improving self as a possible identity and basis of motivation to act better and to be better. Second, we discuss moral improvement in the context of social relations, especially the close interpersonal relations that should most facilitate moral improvement. Third, we examine the moral improvement of society, focusing on the factors that facilitate or inhibit caring about potential immorality despite the fact that issues such as inequality, discrimination, and the climate crisis seem to be morally distant and impersonal. Finally, we discuss future directions for theory, research, and application.
Topics: Humans; Morals; Interpersonal Relations; Motivation; Self Concept
PubMed: 37827197
DOI: 10.1146/annurev-psych-032420-031614 -
Nursing Ethics Sep 2023The Covid-19 pandemic has impacted compassion fatigue and the mental health of health care providers, particularly midwives and nurses. Although there are studies...
BACKGROUND
The Covid-19 pandemic has impacted compassion fatigue and the mental health of health care providers, particularly midwives and nurses. Although there are studies involving health workers such as nurses and physicians affected by the pandemic's compassion fatigue, few studies include midwives.
RESEARCH OBJECTIVE
The present study seeks to investigate the effects of compassion fatigue experienced by midwives working under intense stress during the third wave of the COVID-19 pandemic on the level of moral sensitivity.
RESEARCH DESIGN
This is a descriptive-correlation study.
PARTICIPANTS
The statistical population consisted of all the midwives in Türkiye hospitals in 2021. This cross-sectional study was collected through a questionnaire using convenience sampling. Three hundred and ten midwives working in different units of the country participated in the study.
ETHICAL CONSIDERATIONS
Approval from the researcher's university Institutional Review Board for ethical review was obtained with the code of IRB 20/510.
FINDINGS
The average age of the midwives is 34.29 ± 8.39. It has been noticed that 43.5% of the midwives work in public hospitals and 38.1% in family health and community health centers. Midwives' mean MR-CS score is 67.11 ± 25.13, secondary trauma sub-dimension average 15.77 ± 6.23, and occupational burnout sub-dimension 40.69 ± 16.35. The mean moral sensitivity questionnaire score is determined as 93.86 ± 19.51. It has been observed that the working style and working time are effective on compassion fatigue. In the linear regression model, 98% of compassion fatigue was explained. Age, secondary trauma, and occupational burnout sub-dimensions affect the model.
DISCUSSION
Working year, working style, second trauma, age, and occupational burnout parameters may help explain some of the links between midwives' symptoms of compassion fatigue.
CONCLUSION
The pandemic affects the compassion fatigue of midwives. It is crucial to provide social support to midwives and health workers to prevent compassion fatigue and examine and control groups at risk in mental health.
Topics: Pregnancy; Humans; Female; Compassion Fatigue; Burnout, Professional; Midwifery; COVID-19; Cross-Sectional Studies; Pandemics; Morals; Surveys and Questionnaires; Job Satisfaction; Quality of Life; Empathy
PubMed: 36927231
DOI: 10.1177/09697330221146224 -
Medicine, Health Care, and Philosophy Dec 2023Generative artificial intelligence (AI) has the potential to transform many aspects of scholarly publishing. Authors, peer reviewers, and editors might use AI in a...
Generative artificial intelligence (AI) has the potential to transform many aspects of scholarly publishing. Authors, peer reviewers, and editors might use AI in a variety of ways, and those uses might augment their existing work or might instead be intended to replace it. We are editors of bioethics and humanities journals who have been contemplating the implications of this ongoing transformation. We believe that generative AI may pose a threat to the goals that animate our work but could also be valuable for achieving those goals. In the interests of fostering a wider conversation about how generative AI may be used, we have developed a preliminary set of recommendations for its use in scholarly publishing. We hope that the recommendations and rationales set out here will help the scholarly community navigate toward a deeper understanding of the strengths, limits, and challenges of AI for responsible scholarly work.
Topics: Humans; Publishing; Scholarly Communication; Artificial Intelligence; Bioethics
PubMed: 37863860
DOI: 10.1007/s11019-023-10176-6 -
BMC Medical Ethics Oct 2023Medical assistance in dying (MAiD) sparks debate in several countries, some of which allow or plan to allow MAiD where a mental disorder is the sole underlying medical... (Review)
Review
BACKGROUND
Medical assistance in dying (MAiD) sparks debate in several countries, some of which allow or plan to allow MAiD where a mental disorder is the sole underlying medical condition (MAiD-MD). Since MAiD-MD is becoming permissible in a growing number of jurisdictions, there is a need to better understand the moral concerns related to this option. Gaining a better understanding of the moral concerns at stake is a first step towards identifying ways of addressing them so that MAiD-MD can be successfully introduced and implemented, where legislations allow it.
METHODS
Thus, this article aims (1) to better understand the moral concerns regarding MAiD-MD, and (2) to identify potential solutions to promote stakeholders' well-being. A qualitative thematic review was undertaken, which used systematic keyword-driven search and thematic analysis of content. Seventy-four publications met the inclusion criteria.
RESULTS
Various moral concerns and proposed solutions were identified and are related to how MAiD-MD is introduced in 5 contexts: (1) Societal context, (2) Healthcare system, (3) Continuum of care, (4) Discussions on the option of MAiD-MD, (5) MAiD-MD practices. We propose this classification of the identified moral concerns because it helps to better understand the various facets of discomfort experienced with MAiD-MD. In so doing, it also directs the various actions to be taken to alleviate these discomforts and promote the well-being of stakeholders.
CONCLUSION
The assessment of MAiD-MD applications, which is part of the context of MAiD-MD practices, emerges as the most widespread source of concern. Addressing the moral concerns arising in the five contexts identified could help ease concerns regarding the assessment of MAiD-MD.
Topics: Humans; Canada; Medical Assistance; Mental Disorders; Morals; Psychotic Disorders; Suicide, Assisted
PubMed: 37875867
DOI: 10.1186/s12910-023-00971-4 -
Nursing Open Aug 2023This study aimed to: (1) assess the level of moral sensitivity of nurses and the quality of nursing care for patients with COVID-19 in Iran; and (2) identify the...
AIM
This study aimed to: (1) assess the level of moral sensitivity of nurses and the quality of nursing care for patients with COVID-19 in Iran; and (2) identify the relationship between the moral sensitivity of nurses and the quality of nursing care for patients with COVID-19 in Iran.
DESIGN
This study was designed as a descriptive, cross-sectional, and correlational research.
METHOD
A total of 211 nurses working in four hospitals affiliated with the Hamadan University of Medical Sciences in Iran from December 2021 to April 2022 were selected via the stratified proportional random sampling method. Demographic information, a moral sensitivity questionnaire, and the Good Nursing Care Scale were used for data collection. The data were analysed by SPSS 24 based on descriptive and inferential statistics (Pearson correlation coefficient and multiple regression).
RESULTS
Results revealed that 188 of the nurses (89.1%) had a moderate level of moral sensitivity. Furthermore, 160 of the participants (75.8%) reported a relatively low level of the quality of nursing care. The results of the Pearson correlation coefficient test indicated that there was an inverse and significant relationship between the moral sensitivity of nurses and the quality of nursing care (r = -0.528, p < 0.001). The results of multiple regression indicated that the model of moral sensitivity components explained 27.9% of the variance in the quality of nursing care. The components of moral sensitivity, including relation (β = -0.246, p < 0.001), meaning (β = -0.188, p = 0.003), conflict (β = -0.170, p = 0.008), benevolence (β = -0.153, p = 0.012), and rules (β = -0.144, p = 0.019) had inverse and significant effects on the quality of nursing care.
CONCLUSION
Since higher mean scores of moral sensitivity reflect lower moral sensitivity, it can be stated that with the increase in moral sensitivity of nurses, the quality of nursing care for patients with COVID-19 grows.
Topics: Humans; Cross-Sectional Studies; Stress, Psychological; Attitude of Health Personnel; COVID-19; Nursing Care; Morals; Nurses
PubMed: 37073584
DOI: 10.1002/nop2.1763