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International Journal of Environmental... Feb 2021Healthcare organisations are social systems in which human resources are the most important factor. Leadership plays a key role, affecting outcomes for professionals,... (Review)
Review
Healthcare organisations are social systems in which human resources are the most important factor. Leadership plays a key role, affecting outcomes for professionals, patients and work environment. The aim of this research was to identify and analyse the knowledge present to date concerning the correlation between leadership styles and nurses' job satisfaction. A systematic review was carried out on PubMed, CINAHL and Embase using the following inclusion criteria: impact of different leadership styles on nurses' job satisfaction; secondary care; nursing setting; full-text available; English or Italian language. From 11,813 initial titles, 12 studies were selected. Of these, 88% showed a significant correlation between leadership style and nurses' job satisfaction. Transformational style had the highest number of positive correlations followed by authentic, resonant and servant styles. Passive-avoidant and laissez-faire styles, instead, showed a negative correlation with job satisfaction in all cases. Only the transactional style showed both positive and negative correlation. In this challenging environment, leaders need to promote technical and professional competencies, but also act to improve staff satisfaction and morale. It is necessary to identify and fill the gaps in leadership knowledge as a future objective to positively affect health professionals' job satisfaction and therefore healthcare quality indicators.
Topics: Humans; Job Satisfaction; Leadership; Nurse Administrators; Nursing Staff, Hospital; Surveys and Questionnaires; Workforce
PubMed: 33562016
DOI: 10.3390/ijerph18041552 -
Journal of Medical Internet Research Nov 2021As we are witnessing the evolution of social media (SM) use worldwide among the general population, the popularity of SM has also been embraced by health care... (Review)
Review
BACKGROUND
As we are witnessing the evolution of social media (SM) use worldwide among the general population, the popularity of SM has also been embraced by health care professionals (HCPs). In the context of SM evolution and exponential growth of users, this scoping review summarizes recent findings of the e-professionalism of HCPs.
OBJECTIVE
The purpose of this scoping review is to characterize the recent original peer-reviewed research studies published between November 1, 2014, to December 31, 2020, on e-professionalism of HCPs; to assess the quality of the methodologies and approaches used; to explore the impact of SM on e-professionalism of HCPs; to recognize the benefits and dangers of SM; and to provide insights to guide future research in this area.
METHODS
A search of the literature published from November 1, 2014, to December 31, 2020, was performed in January 2021 using 3 databases (PubMed, CINAHL, and Scopus). The searches were conducted using the following defined search terms: "professionalism" AND "social media" OR "social networks" OR "Internet" OR "Facebook" OR "Twitter" OR "Instagram" OR "TikTok." The search strategy was limited to studies published in English. This scoping review follows the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines.
RESULTS
Of the 1632 retrieved papers, a total of 88 studies were finally included in this review. Overall, the quality of the studies was satisfactory. Participants in the reviewed studies were from diverse health care professions. Medical health professionals were involved in about three-quarters of the studies. Three key benefits of SM on e-professionalism of HCPs were identified: (1) professional networking and collaboration, (2) professional education and training, and (3) patient education and health promotion. For the selected studies, there were five recognized dangers of SM on e-professionalism of HCPs: (1) loosening accountability, (2) compromising confidentiality, (3) blurred professional boundaries, (4) depiction of unprofessional behavior, and (5) legal issues and disciplinary consequences. This scoping review also recognizes recommendations for changes in educational curricula regarding e-professionalism as opportunities for improvement and barriers that influence HCPs use of SM in the context of e-professionalism.
CONCLUSIONS
Findings in the reviewed studies indicate the existence of both benefits and dangers of SM on e-professionalism of HCPs. Even though there are some barriers recognized, this review has highlighted existing recommendations for including e-professionalism in the educational curricula of HCPs. Based on all evidence provided, this review provided new insights and guides for future research on this area. There is a clear need for robust research to investigate new emerging SM platforms, the efficiency of guidelines and educational interventions, and the specifics of each profession regarding their SM potential and use.
Topics: Health Personnel; Humans; Professional Misconduct; Professionalism; Social Media; Social Networking
PubMed: 34662284
DOI: 10.2196/25770 -
Stem Cell Research & Therapy Jul 2022Organoids are 3D structures grown from pluripotent stem cells derived from human tissue and serve as in vitro miniature models of human organs. Organoids are expected to... (Review)
Review
Organoids are 3D structures grown from pluripotent stem cells derived from human tissue and serve as in vitro miniature models of human organs. Organoids are expected to revolutionize biomedical research and clinical care. However, organoids are not seen as morally neutral. For instance, tissue donors may perceive enduring personal connections with their organoids, setting higher bars for informed consent and patient participation. Also, several organoid sub-types, e.g., brain organoids and human-animal chimeric organoids, have raised controversy. This systematic review provides an overview of ethical discussions as conducted in the scientific literature on organoids. The review covers both research and clinical applications of organoid technology and discusses the topics informed consent, commercialization, personalized medicine, transplantation, brain organoids, chimeras, and gastruloids. It shows that further ethical research is needed especially on organoid transplantation, to help ensure the responsible development and clinical implementation of this technology in this field.
Topics: Animals; Biomedical Research; Brain; Humans; Organoids; Pluripotent Stem Cells; Precision Medicine
PubMed: 35870991
DOI: 10.1186/s13287-022-02950-9 -
Journal of Nursing Management Oct 2022The aim of this review was to explore literature from January 2017 to December 2021 for specific aspects of care ethics related to nursing workload in the acute care... (Review)
Review
AIM
The aim of this review was to explore literature from January 2017 to December 2021 for specific aspects of care ethics related to nursing workload in the acute care setting.
BACKGROUND
High nursing workload is associated with adverse outcomes for nurses as well as patients. Nursing workload goes beyond patient-to-nurse ratios and encompasses patient, nurse and organizational factors.
EVALUATION
This qualitative systematic review was conducted according to the Joanna Briggs Institute Manual for Evidence Synthesis. The four features of care ethics related to nursing workload guided the review of qualitative studies in MEDLINE, CINAHL and PsycINFO, and synthesized findings were presented in the four phases of caring.
KEY ISSUES
Key issues include ethical dilemmas, time pressure, shared moral burden and managerial support.
CONCLUSION
To reduce nursing workload, a care ethics perspective can provide solutions through fortifying interprofessional relationships and enhancing empathetic actions.
IMPLICATIONS FOR NURSING MANAGEMENT
Situational, individual and team approaches to management allows for incorporation of personal values and ethics of care to support patient-centred care. Leadership initiating conversations and being proactive about workload can lead to an improved work environment for both the nurse and the nurse manager.
Topics: Humans; Workload; Nurse-Patient Relations; Qualitative Research; Leadership; Morals; Ethics, Nursing
PubMed: 35704019
DOI: 10.1111/jonm.13723 -
Scandinavian Journal of Caring Sciences Dec 2021This literature study describes caring science research on human dignity in different clinical practice. We already know a good deal about human dignity in nursing care... (Review)
Review
BACKGROUND
This literature study describes caring science research on human dignity in different clinical practice. We already know a good deal about human dignity in nursing care but how do patients, nurses, healthcare professionals and next of kin experience human dignity in clinical practice?
AIM
To summarise studies on human dignity to gain a deeper understanding of how it can be achieved in caring science research and to gain a broader understanding of the differences and similarities across caring contexts. The aim was also to gain a broader understanding of the differences and similarities of human dignity across different clinical practice.
METHOD
The literature review re-analysed 28 empirical studies on human dignity are experienced from acute, psychiatric, elderly and rehabilitation care. The data analysis strategy was conducted in a systematic and critical way and consisted of a five-step method.
RESULT
Maintaining dignity was described when caregivers had the time and the will to see and listen to patient and had the courage to see what they did not want to see, allowing their inner powers to act with the purpose of doing good. In elderly care, it was important that elderly persons are involved as members of society and experience respect, confidence, security and charity. Indignity was described when caregivers did not allow patients to have their will and when they had unethical attitudes, ignoring patients and creating powerlessness. The feeling of being abandoned and not being taken seriously are also described in elderly care.
CONCLUSION
Findings show how caregivers fulfil their ethical responsibility by seeing, listening and being a part of the time and place. The will to do good includes the courage to preserve dignity and human value rests on being created as a human being. More research is needed about ethical and moral responsibility in clinical practice.
Topics: Aged; Humans; Nursing Care; Personhood; Qualitative Research; Respect
PubMed: 33104271
DOI: 10.1111/scs.12922 -
International Journal of Environmental... Sep 2022Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that is characterized by clinical heterogeneity and irregularities in its course. The etiology and... (Review)
Review
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that is characterized by clinical heterogeneity and irregularities in its course. The etiology and pathogenesis of this pathology are not well-understood, so there is difficulty in establishing a diagnosis and treatment plan with certainty. The aim of this systematic review is to present a qualitative synthesis of studies referring to the oral manifestations of systemic lupus erythematosus (SLE). This systematic review was performed following the PRISMA guideline. On this basis, a search for articles was performed in the PubMed, Web of Science, and Scopus databases on 19 November 2021 and updated on 15 February 2022. We chose articles published between 2012 and 2022 that analyzed the oral manifestations of SLE patients. The quality of all these studies was analyzed following the STROBE scale. A total of 15 articles were included in this study after selection. The selected articles were cross-sectional, case-control, and cohort studies. The most frequently associated oral manifestations with SLE were oral ulcers, hyposalivation, pigmentations, glossodynia, cleft tongue, cheilitis, arthritis, and secondary Sjögren's syndrome. However, despite the importance of the perception of these oral manifestations in the early diagnosis of SLE, there are still not enough studies about them.
Topics: Arthritis; Autoimmune Diseases; Humans; Lupus Erythematosus, Systemic; Sjogren's Syndrome; Xerostomia
PubMed: 36231212
DOI: 10.3390/ijerph191911910 -
Nursing Ethics Sep 2021Ethical and legal issues are increasingly being reported by health caregivers; however, little is known about the nature of these issues in geriatric care. These issues...
BACKGROUND
Ethical and legal issues are increasingly being reported by health caregivers; however, little is known about the nature of these issues in geriatric care. These issues can improve work and care conditions in healthcare, and consequently, the health and welfare of older people.
AIM
This literature review aims to identify research focusing on ethical and legal issues in geriatric care, in order to give nurses and other health care workers an overview of existing grievances and possible solutions to take care of old patients in a both ethical and legally correct way.
METHODS
Using a systematic approach based on Aveyard, a search of the PubMed, CINAHL, and Ethicshare databases was conducted to find out the articles published on ethical and legal issues in geriatric care.
ETHICAL CONSIDERATIONS
The approval for the study was obtained from UMIT-The Health and Life Sciences University, Austria.
RESULTS
Only 50 articles were included for systematic analysis reporting ethical and legal issues in the geriatric care. The results presented in this article showed that the main ethical issues were related to the older people's autonomy, respect for their needs, wishes and values, and respect for their decision-making. The main legal issues were related to patients' rights, advance directives, elderly rights, treatment nutrition dilemma, and autonomy.
CONCLUSION
Further education for professional caregivers, elderly people, and their families is needed on following topics: care planning, directive and living wills, and caregiver-family member relationships to guide and support the elderly people within their decision-making processes and during the end-of-life care.
Topics: Advance Directives; Aged; Hospice Care; Humans; Morals; Patient Rights; Terminal Care
PubMed: 32468910
DOI: 10.1177/0969733020921488 -
Journal of the National Medical... Oct 2019In spite of emphasis on patient-centered cares and promotion of their quality, shortcomings have been seen in health systems due to lack of compassion.
BACKGROUND
In spite of emphasis on patient-centered cares and promotion of their quality, shortcomings have been seen in health systems due to lack of compassion.
PURPOSE
The aim of the present study was to determine the definition, fields, facilitating and inhibiting factors of compassionate care in healthcare systems and the interventions designed to promote it.
METHODS
This study was conducted through narrative synthesis which is supposed to do systematic and synthesized review. Searching was done in English databases including Pub Med, CINAHL, Google Scholar, Web of Science, and Cochrane library, Ovid, Science Direct, WILEY by using keywords of Compassionate Care, Delivery of Health Care, Healthcare Systems, Compassion and Health Care Providers from 1987 to 2017.
RESULTS
Compassionate care has some dimensions including ethical, professional, effective communication, human, spiritual/religious and getting involve with patients. Facilitating and inhibiting factors consisted of the nurse's personal characteristics, patients' behavior and organizational factors included workload, role model, and value of compassionate care in healthcare systems. Educational interventions such as providing feedback and reorienting have been mostly used to improve the compassionate care.
CONCLUSIONS
Although compassionate care has been known as the main element of improving services quality in health care system, it has been studied restrictively from the viewpoints of the patients and all personnel in healthcare systems. The improvement of compassionate care through education cannot remove completely the gap between theory and practice, because it seems that clinical environment and organizational values of healthcare system are the largest facilitating and inhibiting factors for filling this gap. Therefore, it is necessary to take measures for promoting organizational culture.
Topics: Attitude of Health Personnel; Communication; Delivery of Health Care; Empathy; Humanism; Humans; Organizational Culture; Patient-Centered Care; Professionalism; Quality Improvement; Spirituality; Workload
PubMed: 31060872
DOI: 10.1016/j.jnma.2019.04.002 -
Journal of General Internal Medicine Nov 2021Professional identity formation (PIF) in medical students is a multifactorial phenomenon, shaped by ways that clinical and non-clinical experiences, expectations and...
BACKGROUND
Professional identity formation (PIF) in medical students is a multifactorial phenomenon, shaped by ways that clinical and non-clinical experiences, expectations and environmental factors merge with individual values, beliefs and obligations. The relationship between students' evolving professional identity and self-identity or personhood remains ill-defined, making it challenging for medical schools to support PIF systematically and strategically. Primarily, to capture prevailing literature on PIF in medical school education, and secondarily, to ascertain how PIF influences on medical students may be viewed through the lens of the ring theory of personhood (RToP) and to identify ways that medical schools support PIF.
METHODS
A systematic scoping review was conducted using the systematic evidence-based approach. Articles published between 1 January 2000 and 1 July 2020 related to PIF in medical students were searched using PubMed, Embase, PsycINFO, ERIC and Scopus. Articles of all study designs (quantitative and qualitative), published or translated into English, were included. Concurrent thematic and directed content analyses were used to evaluate the data.
RESULTS
A total of 10443 abstracts were identified, 272 full-text articles evaluated, and 76 articles included. Thematic and directed content analyses revealed similar themes and categories as follows: characteristics of PIF in relation to professionalism, role of socialization in PIF, PIF enablers and barriers, and medical school approaches to supporting PIF.
DISCUSSION
PIF involves iterative construction, deconstruction and inculcation of professional beliefs, values and behaviours into a pre-existent identity. Through the lens of RToP, factors were elucidated that promote or hinder students' identity development on individual, relational or societal levels. If inadequately or inappropriately supported, enabling factors become barriers to PIF. Medical schools employ an all-encompassing approach to support PIF, illuminating the need for distinct and deliberate longitudinal monitoring and mentoring to foster students' balanced integration of personal and professional identities over time.
Topics: Education, Medical; Education, Medical, Undergraduate; Humans; Professionalism; Schools, Medical; Social Identification; Students, Medical
PubMed: 34406582
DOI: 10.1007/s11606-021-07024-9 -
Frontiers in Psychology 2022Advances in artificial intelligence (AI) technologies, together with the availability of big data in society, creates uncertainties about how these developments will...
BACKGROUND
Advances in artificial intelligence (AI) technologies, together with the availability of big data in society, creates uncertainties about how these developments will affect healthcare systems worldwide. Compassion is essential for high-quality healthcare and research shows how prosocial caring behaviors benefit human health and societies. However, the possible association between AI technologies and compassion is under conceptualized and underexplored.
OBJECTIVES
The aim of this scoping review is to provide a comprehensive depth and a balanced perspective of the emerging topic of AI technologies and compassion, to inform future research and practice. The review questions were: How is compassion discussed in relation to AI technologies in healthcare? How are AI technologies being used to enhance compassion in healthcare? What are the gaps in current knowledge and unexplored potential? What are the key areas where AI technologies could support compassion in healthcare?
MATERIALS AND METHODS
A systematic scoping review following five steps of Joanna Briggs Institute methodology. Presentation of the scoping review conforms with PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews). Eligibility criteria were defined according to 3 concept constructs (AI technologies, compassion, healthcare) developed from the literature and informed by medical subject headings (MeSH) and key words for the electronic searches. Sources of evidence were Web of Science and PubMed databases, articles published in English language 2011-2022. Articles were screened by title/abstract using inclusion/exclusion criteria. Data extracted (author, date of publication, type of article, aim/context of healthcare, key relevant findings, country) was charted using data tables. Thematic analysis used an inductive-deductive approach to generate code categories from the review questions and the data. A multidisciplinary team assessed themes for resonance and relevance to research and practice.
RESULTS
Searches identified 3,124 articles. A total of 197 were included after screening. The number of articles has increased over 10 years (2011, = 1 to 2021, = 47 and from Jan-Aug 2022 = 35 articles). Overarching themes related to the review questions were: (1) (7 themes) Concerns about AI ethics, healthcare jobs, and loss of empathy; Human-centered design of AI technologies for healthcare; Optimistic speculation AI technologies will address care gaps; Interrogation of what it means to be human and to care; Recognition of future potential for patient monitoring, virtual proximity, and access to healthcare; Calls for curricula development and healthcare professional education; Implementation of AI applications to enhance health and wellbeing of the healthcare workforce. (2) (10 themes) Empathetic awareness; Empathetic response and relational behavior; Communication skills; Health coaching; Therapeutic interventions; Moral development learning; Clinical knowledge and clinical assessment; Healthcare quality assessment; Therapeutic bond and therapeutic alliance; Providing health information and advice. (3) (4 themes) Educational effectiveness of AI-assisted learning; Patient diversity and AI technologies; Implementation of AI technologies in education and practice settings; Safety and clinical effectiveness of AI technologies. (4) (3 themes) Enriching education, learning and clinical practice; Extending healing spaces; Enhancing healing relationships.
CONCLUSION
There is an association between AI technologies and compassion in healthcare and interest in this association has grown internationally over the last decade. In a range of healthcare contexts, AI technologies are being used to enhance empathetic awareness; empathetic response and relational behavior; communication skills; health coaching; therapeutic interventions; moral development learning; clinical knowledge and clinical assessment; healthcare quality assessment; therapeutic bond and therapeutic alliance; and to provide health information and advice. The findings inform a reconceptualization of compassion as a comprising six elements: (1) Awareness of suffering (e.g., pain, distress, risk, disadvantage); (2) Understanding the suffering (significance, context, rights, responsibilities etc.); (3) Connecting with the suffering (e.g., verbal, physical, signs and symbols); (4) Making a judgment about the suffering (the need to act); (5) Responding with an intention to alleviate the suffering; (6) Attention to the effect and outcomes of the response. These elements can operate at an individual (human or machine) and collective systems level (healthcare organizations or systems) as a cyclical system to alleviate different types of suffering. New and novel approaches to human-AI intelligent caring could enrich education, learning, and clinical practice; extend healing spaces; and enhance healing relationships.
IMPLICATIONS
In a complex adaptive system such as healthcare, human-AI intelligent caring will need to be implemented, not as an ideology, but through strategic choices, incentives, regulation, professional education, and training, as well as through joined up thinking about human-AI intelligent caring. Research funders can encourage research and development into the topic of AI technologies and compassion as a system of human-AI intelligent caring. Educators, technologists, and health professionals can inform themselves about the system of human-AI intelligent caring.
PubMed: 36733854
DOI: 10.3389/fpsyg.2022.971044