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Patient Education and Counseling Feb 2023To provide an overview of healthcare practitioners' experiences of breaking bad news. (Review)
Review
OBJECTIVE
To provide an overview of healthcare practitioners' experiences of breaking bad news.
METHOD
Interpretative meta synthesis of 14 qualitative papers identified through a systematic search. Data were extracted and constructs elicited via reciprocal translational analysis.
RESULTS
Findings comprised four inter-connected themes: (1) Discomfort, particularly difficult emotional and physical responses to breaking bad news; (2) Relational distress, connected to attachment and identification with patients; (3) Inadequate clinician, indicating the fear and rumination about the possibility of getting it wrong and the subsequent self-blame; and (4) Only human, highlighting a culture of invulnerability where practitioner self-care is deprioritised.
CONCLUSIONS
Breaking bad news provokes significant distress for practitioners, particularly where they experience strong attachment to or identification with a patient. Breaking bad news was understood as an isolating experience and staff's non-disclosure of difficulties appeared to sustain a culture of invulnerability in which admission of distress was not encouraged.
PRACTICE IMPLICATIONS
Given the adverse impacts and potential for practitioner burnout, organisations should acknowledge ramifications and offer time for staff to process the delivery of bad news, promote a culture of collective care and provide space for reflective practice.
Topics: Humans; Truth Disclosure; Physician-Patient Relations; Attitude of Health Personnel; Emotions; Fear
PubMed: 36459829
DOI: 10.1016/j.pec.2022.107574 -
Seizure Oct 2021Disclosure of epilepsy is a relevant but under-researched topic in epilepsy research. This study was done to assess the disclosure strategies in parents of CWE in a...
PURPOSE
Disclosure of epilepsy is a relevant but under-researched topic in epilepsy research. This study was done to assess the disclosure strategies in parents of CWE in a developing country with conservative culture. The study also assessed the influence of demographic factors and seizure characteristics on the choice of disclosure. Enablers and barriers behind disclosure and the consequences after disclosure were evaluated.
METHODS
A cross-sectional analytical, self-report survey was done in 284 parents of CWE with the help of a semi-structured questionnaire over a 7-month period in the paediatric epilepsy clinic. Disclosure was considered present if epilepsy was revealed to two or more of the five target groups (extended family, school, friends, neighbours, and peers of children). Separate set of questions was given for reasons behind their choice and consequences after disclosure. For continuous variables, unpaired T test or Mann - Whitney U test between group and for categorized variables, Pearson's Chi square test or Fisher's exact test was used.
RESULTS
92.96 % of 284 subjects disclosed their child's epilepsy while 7.04% concealed. Demographic factors and seizure characteristics did not influence the disclosure choice. Most parents revealed to the extended family followed by teachers. Type of seizure was the commonest information revealed. The main reason behind disclosure was better acceptance of the child followed by safety while main barrier was considering epilepsy as private grief. 92.8% felt their children were better accepted after disclosure.
CONCLUSION
Disclosure practices have improved in parents of CWE in India and well-being and safety of the child has overridden the fear of stigma and discrimination. This could be the first major step to bring epilepsy out of the shadows at national and global levels.
Topics: Child; Cross-Sectional Studies; Disclosure; Epilepsy; Humans; India; Parents
PubMed: 34371247
DOI: 10.1016/j.seizure.2021.07.026 -
Deutsches Arzteblatt International Oct 2023
Topics: Humans; Conflict of Interest; Disclosure
PubMed: 37970670
DOI: 10.3238/arztebl.m2023.0197 -
Philosophical Transactions of the Royal... Jun 2024Transnational companies have substantive impacts on nature: a hallmark of living in the Anthropocene. Understanding these impacts through company provision of...
Transnational companies have substantive impacts on nature: a hallmark of living in the Anthropocene. Understanding these impacts through company provision of information is a precursor to holding them accountable for nature outcomes. The effect of increasing disclosures (of varying quality) is predicated on 'information governance', an approach that uses disclosure requirements to drive company behaviour. However, its efficacy is not guaranteed. We argue that three conditions are required before disclosures have the possibility to shape nature outcomes, namely: (1) radical traceability that links company actions to outcomes in particular settings; (2) developing organizational routines, tools and approaches that translate strategic intent to on-the-ground behaviour; and (3) mobilizing and aligning financial actors with corporate nature ambitions. While disclosure is key to each of these conditions, its limits must be taken into account and it must be nested in governance approaches that shape action, not just reporting. This article is part of the theme issue 'Bringing nature into decision-making'.
Topics: Conservation of Natural Resources; Humans; Disclosure; Nature; Commerce; Decision Making
PubMed: 38643791
DOI: 10.1098/rstb.2022.0325 -
PloS One 2023With the increasing attention of the capital market to environmental, social and governance information, sustainability reporting has become an important carrier for...
With the increasing attention of the capital market to environmental, social and governance information, sustainability reporting has become an important carrier for stakeholders to gain insight into sustainability of companies. But the emerged "greenwashing" problem has also brought haze to the value creation of capital market. To study the consequences of the pseudo-social responsibility behavior of "greenwashing", this paper takes China's listed companies as the research sample to empirically examine the relationship between sustainability reporting "greenwashing" and "shared value" creation. It is found that the "greenwashing" behavior of corporate sustainability reporting significantly reduces the "shared value" creation, while the degree of sustainability information asymmetry and the quality of information disclosure play a partial mediation role between them. Further analysis shows that the more effective internal control of a company and the greater pressure of external media supervision, the more conducive to weaken the negative impact of "greenwashing" on "shared value" creation. This paper enriches the literature on the economic consequences of "greenwashing" in sustainability disclosure and the influencing factors of "shared value" creation, extends the research on information disclosure and "shared value" from financial information to non-financial information. The results call for the state to promote legislative work, formulate unified standards and compress the "greenwashing" gray space; Governments could implement mandatory disclosure, implement independent authentication and strengthen "greenwashing" social supervision; Companies should strengthen capacity building and improve the "greenwashing" governance mechanism with the help of digital empowerment.
Topics: Social Responsibility; Organizations; Social Behavior; Government; Disclosure; China
PubMed: 36652406
DOI: 10.1371/journal.pone.0279904 -
Journal of Studies on Alcohol and Drugs Sep 2022Despite evidence that social support is beneficial for people living with opioid use disorders (OUDs), research has yet to investigate whether social support within...
OBJECTIVE
Despite evidence that social support is beneficial for people living with opioid use disorders (OUDs), research has yet to investigate whether social support within certain relationships is more or less effective. The current study examined whether social support, relationship closeness with a disclosure partner, and/or the history of joint substance use between participants and disclosure partners affect commitment to sobriety among people receiving medications for OUD.
METHOD
Over a period of 3 months (two time points), participants taking OUD medications took part in a mixed-methods egocentric social network study exploring their relationships with disclosure partners before and following OUD disclosure (i.e., first telling a disclosure partner about one's OUD history or treatment). Data included 131 disclosure events/relationships clustered within 106 participants.
RESULTS
Greater relationship closeness was associated with increased commitment to sobriety over time. Further, significant interactions were found between social support and disclosure partner closeness, partner closeness and history of joint substance use, and social support and history of joint substance use. Higher social support was associated with greater commitment to sobriety among those disclosing to close partners. In contrast, receiving social support or disclosing to a close partner with whom there was a history of joint substance use was associated with decreased commitment to sobriety.
CONCLUSIONS
Findings highlight the complexities of social support among people in treatment for OUD and demonstrate that relationship closeness and a history of joint substance use with a disclosure partner may be important factors to consider before disclosure.
Topics: Disclosure; HIV Infections; Humans; Opioid-Related Disorders; Sexual Partners; Social Support
PubMed: 36136434
DOI: 10.15288/jsad.21-00225 -
Reproductive Health Dec 2019Domestic violence is common public health problem. Domestic violence related disclosure is an important first step in the process of prevention, control and treatments... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Domestic violence is common public health problem. Domestic violence related disclosure is an important first step in the process of prevention, control and treatments of domestic violence related adverse effect. Thus, this systematic review and meta-analysis aimed to determine the pooled prevalence of domestic violence related disclosure and synthesize its associated factors.
METHODS
We followed the PRISMA Guidelines to report the results of the finding. Databases including PubMed, Cochrane Library and Web of Sciences were searched. The heterogeneity between studies was measured by the index of heterogeneity (I statistics) test. Funnel plots and Egger's test were used to determine publication bias. Moreover, sensitivity analysis was carried out. To calculate the pooled prevalence, a random effects model was utilized.
RESULTS
Twenty one eligible studies were included in this systematic review and meta-analysis. The pooled prevalence of domestic violence related non-disclosure was found to be 36.2% (95% CI, 31.8-40.5%). Considering violence as normal or not serious, shame, embarrassment and fear of disclosure related consequences were the common barriers for non-disclosure.
CONCLUSION
More than one third of women and girls were not disclosed their experience of domestic violence. The finding of this study suggests the need of evaluation and strengthening of the collaborative work among different sectors such as: policy-makers, service providers, administrative personnel and community leaders including the engagement of men partner. This study also suggests the needs of women empowerments against the traditional belief, attitude, and practice.
Topics: Adolescent; Adult; Disclosure; Domestic Violence; Ethiopia; Female; Humans; Prevalence; Sexual Partners
PubMed: 31870388
DOI: 10.1186/s12978-019-0845-z -
International Journal of Environmental... Oct 2022The current challenges of a circular economy exert a high pressure on manufacturing companies that generate waste to track and implement policies to reduce them and...
The current challenges of a circular economy exert a high pressure on manufacturing companies that generate waste to track and implement policies to reduce them and eliminate the toxicity of residues. Hence, the purpose of this study is to analyze the waste management information disclosure linked to the financial performance of companies and test the moderating effect of internal and external variables. The average waste management information disclosure index shows a poor disclosure score for the analyzed period, however, the waste disclosure index after reaching a minimum threshold in 2019 recorded an encouraging increase at the end of 2021. Applying the fixed effects model, ordinary least squares, and two-stage least squares method, the results revealed a positive and statistically significant relationship between management information disclosure and the return on assets, while for the current ratio the connection has been invalidated. A statistically significant influence of the environmental-sensitive industry status, board size, and productivity on the moderating variables was found for the return on assets, while for current ratio, there was none. As for the alternative metrics of financial performance, the results showed that a higher degree of management information disclosure will increase the return on equity and earnings per share, while in the case of liquidity, the results are not conclusive.
Topics: Disclosure; Industry; Commerce; Waste Management
PubMed: 36293648
DOI: 10.3390/ijerph192013068 -
Journal of Occupational Rehabilitation Jun 2023Purpose Disclosure of mental illness to a supervisor can have positive (e.g. supervisor support) and negative consequences (e.g. stigma). However, research on the...
Purpose Disclosure of mental illness to a supervisor can have positive (e.g. supervisor support) and negative consequences (e.g. stigma). However, research on the association between disclosure and sustainable employability and well-being at work is scarce. The aim of this study was to investigate the association between the disclosure decision (yes/no), experiences with the decision (positive/negative) and sustainable employment and well-being at work among military personnel with mental illness (N = 323). Methods A cross-sectional questionnaire study was conducted. Descriptive and regression (linear and ordinal) analyses were performed. Comparisons were made between those with positive and negative disclosure experiences. Results Disclosure decision (yes/no) was not significantly associated with any of the measures of sustainable employability and well-being at work. However, positive disclosure experiences were significantly associated with higher scores on almost all measures of sustainable employability and well-being at work. Those with negative disclosure experiences reported significantly more shame (M = 2.42, M = 2.78, p < .05) and discrimination (M = 1.70, M = 2.84, p < .001). Those with a positive disclosure experience, reported significantly more supervisor support (M = 3.20, M = 1.94, p < .001). Conclusion We did not find evidence that the disclosure decision itself is related to measures of sustainable employment and well-being at work. In contrast, how participants had experienced their (non-)disclosure decision was significantly related to almost all measures. This emphasizes the importance of the work environments reactions to disclosure and mental illness in the workplace. Future research and interventions should focus on increasing the likelihood of positive disclosure experiences through creating a more inclusive work environment, with more supervisor support and less stigma.
Topics: Humans; Mental Health; Cross-Sectional Studies; Disclosure; Military Personnel; Mental Disorders; Workplace; Social Stigma
PubMed: 36376748
DOI: 10.1007/s10926-022-10083-2 -
Journal of Autism and Developmental... Dec 2023For autistic young adults, deciding whether to disclose their autism at work is complex. Minimal research explores what they need to support disclosure and what...
For autistic young adults, deciding whether to disclose their autism at work is complex. Minimal research explores what they need to support disclosure and what influences decisions. To understand disclosure needs and influencers, we explored (i) disclosure decision-making experiences and (ii) perceptions of the disclosure process among autistic young adults. We conducted focus groups using the Capability, Opportunity, Motivation, Behaviour Model and Theoretical Domains Framework (TDF). We analyzed data from 23 participants and mapped onto the TDF to develop five themes: (1) workplace environment, (2) perceptions of disclosure outcomes, (3) personal factors and identity, (4) disclosure-related ambitions and determination, and (5) know-hows of disclosure. Future work should prioritize developing disclosure decision-making supports and investigate employer roles in fostering inclusive workplaces.
Topics: Humans; Young Adult; Disclosure; Autistic Disorder; Autism Spectrum Disorder; Workplace
PubMed: 36171492
DOI: 10.1007/s10803-022-05766-x