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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 -
International Journal of Nursing Studies Dec 2018Nurses are often responsible for the care of many patients at the same time and have to prioritise their daily nursing care activities. Prioritising the different...
BACKGROUND
Nurses are often responsible for the care of many patients at the same time and have to prioritise their daily nursing care activities. Prioritising the different assessed care needs and managing consequential conflicting expectations, challenges nurses' professional and moral values.
OBJECTIVE
To explore and illustrate the key aspects of the ethical elements of the prioritisation of nursing care and its consequences for nurses.
DESIGN, DATA SOURCES AND METHODS
A scoping review was used to analyse existing empirical research on the topics of priority setting, prioritisation and rationing in nursing care, including the related ethical issues. The selection of material was conducted in three stages: research identification using two data bases, CINAHL and MEDLINE. Out of 2024 citations 25 empirical research articles were analysed using inductive content analysis.
RESULTS
Nurses prioritised patient care or participated in the decision-making at the bedside and at unit, organisational and at societal levels. Bedside priority setting, the main concern of nurses, focused on patients' daily care needs, prioritising work by essential tasks and participating in priority setting for patients' access to care. Unit level priority setting focused on processes and decisions about bed allocation and fairness. Nurses participated in organisational and societal level priority setting through discussion about the priorities. Studies revealed priorities set by nurses include prioritisation between patient groups, patients having specific diseases, the severity of the patient's situation, age, and the perceived good that treatment and care brings to patients. The negative consequences of priority setting activity were nurses' moral distress, missed care, which impacts on both patient outcomes and nursing professional practice and quality of care compromise.
CONCLUSIONS
Analysis of the ethical elements, the causes, concerns and consequences of priority setting, need to be studied further to reveal the underlying causes of priority setting for nursing staff. Prioritising has been reported to be difficult for nurses. Therefore there is a need to study the elements and processes involved in order to determine what type of education and support nurses require to assist them in priority setting.
Topics: Ethics, Nursing; Health Priorities; Humans; Morals; Nursing Care; Qualitative Research
PubMed: 30179768
DOI: 10.1016/j.ijnurstu.2018.08.006 -
International Nursing Review Dec 2022To summarize the findings from literature regarding the prevalence of plagiarism and its various types, knowledge, and attitudes of students toward plagiarism, factors... (Meta-Analysis)
Meta-Analysis Review
AIM
To summarize the findings from literature regarding the prevalence of plagiarism and its various types, knowledge, and attitudes of students toward plagiarism, factors associated with plagiarism, and the applied interventions to decrease the incidence of plagiarism.
BACKGROUND
Plagiarism is a major form of academic dishonesty practiced by students at all educational levels.
INTRODUCTION
Academic dishonesty was defined as any unauthorized help that adds to students' formal academic performance. These dishonest behaviors can be categorized as falsifying information, hiding errors, collaborating with colleagues when not allowed, and plagiarism.
METHODS
Systematic search of databases was conducted in September 2021 to identify studies that discussed plagiarism in nursing studies. We included 31 studies in this systematic review and meta-analysis, with a total of 9,175 nursing students. The analysis was conducted using RevMan software.
RESULTS
Plagiarism was the most frequent academic misconduct among nursing students (practiced by 55.3%). Paraphrasing without referencing was the most practiced form (39.53%), while submitting others' work without acknowledgment was the least one (9.61%). Most students were aware of the concept of plagiarism (80.8%) and had positive ethical attitudes toward it (88.26%). Plagiarism was negatively associated with age, parenting, and completing semester credits. However, it was positively correlated with average grades and liberal educators. Plagiarism was a significant predictor of clinical misconduct.
DISCUSSION
A gap in the students' knowledge and skills were noticed. These gaps may be contributing to the high occurrence of plagiaristic acts, besides the unethical attitudes.
CONCLUSION
Plagiarism is a serious academic misconduct practice that can be associated with subsequent clinical misconduct. There is a need to fill the knowledge and skills gap, and to set effective policies.
IMPLICATION FOR NURSING AND HEALTH POLICY
In their attempts to eliminate plagiarism, nurse educators are encouraged to provide effective educational training and practical tasks, in order to fill the gaps in knowledge and skills. Additionally, implementing clear and effective punishment policies would prevent intentional plagiaristic acts. This would aid in introducing qualified nurses accountable for the health of patients.
Topics: Humans; Plagiarism; Students, Nursing; Faculty, Nursing; Morals
PubMed: 35397177
DOI: 10.1111/inr.12755 -
Nursing Ethics May 2023Moral distress is a common challenge among professional nurses when caring for their patients, especially when they need to make rapid decisions. Therefore, leaving... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Moral distress is a common challenge among professional nurses when caring for their patients, especially when they need to make rapid decisions. Therefore, leaving moral distress unconsidered may jeopardize patient quality of care, safety, and satisfaction.
AIM
To estimate moral distress among nurses.
METHODS
This systematic review and meta-analysis conducted systematic search in Scopus, PubMed, ProQuest, ISI Web of Knowledge, and PsycInfo up to end of February 2022. Methodological quality of included studies was assessed using the Newcastle Ottawa checklist. Data from included studies were pooled by meta-analysis with random effect model in STATA software version 14. The selected key measure was mean score of moral distress total score with its' 95% Confidence Interval was reported. Subgroup analyses and meta-regressions were conducted to identify possible sources of heterogeneity and potentially influencing variables on moral distress. Funnel plots and Begg's Tests were used to assess publication bias. The Jackknife method was used for sensitivity analysis.
ETHICAL CONSIDERATION
The protocol of this project was registered in the PROSPERO database under decree code of CRD42021267773.
RESULTS
Eighty-six manuscripts with 19,537 participants from 21 countries were included. The pooled estimated mean score of moral distress was 2.55 on a 0-10 scale [95% Confidence Interval: 2.27-2.84, I: 98.4%, Tau:0.94]. Publication bias and small study effect was ruled out. Moral distress significantly decreased in the COVID-19 pandemic versus before. Nurses working in developing countries experienced higher level of moral distress compared to their counterparts in developed countries. Nurses' workplace (e.g., hospital ward) was not linked to severity of moral disturbance.
CONCLUSION
The results of the study showed a low level of pooled estimated score for moral distress. Although the score of moral distress was not high, nurses working in developing countries reported higher levels of moral distress than those working in developed countries. Therefore, it is necessary that future studies focus on creating a supportive environment in hospitals and medical centers for nurses to reduce moral distress and improve healthcare.
Topics: Humans; Pandemics; Attitude of Health Personnel; Job Satisfaction; Surveys and Questionnaires; COVID-19; Morals; Nurses
PubMed: 36704986
DOI: 10.1177/09697330221135212 -
Journal of Nursing Management Oct 2022To investigate the outcomes and the effect sizes of ethical leadership in nursing practice. (Meta-Analysis)
Meta-Analysis Review
AIM
To investigate the outcomes and the effect sizes of ethical leadership in nursing practice.
BACKGROUND
Many meta-analysis of ethical leadership have been conducted in other fields, but there are none for the effects of ethical leadership of nurse leaders and should be investigated.
EVALUATION
For a systematic literature review, we searched PubMed, EMBASE, the Cochrane Library, CINAHL, OVID, Web of Science and Korean databases for studies published in Korean or English. We used Comprehensive Meta-Analysis (CMA) 2.0 and R 3.6.2 for the meta-analysis.
KEY ISSUES
We divided the outcomes of ethical leadership into three categories and investigated the effect sizes: subordinates' perceptions of their leaders (ES = 0.65), subordinates' ethical behaviours (ES = 0.04) and job or organisational outcomes (ES = 0.45). In addition, we identified 14 outcome variables, and transformational leadership showed the greatest effect size (ES = 0.77) among them.
CONCLUSION
This study confirmed the positive effects of ethical nursing leadership on individual nurses' perceptions about their leaders, their jobs and organisations.
IMPLICATIONS FOR NURSING MANAGEMENT
Nursing organisations and nurse administrators should make efforts to highlight ethical leadership of nurse leaders to improve outcomes of organisational performance including individual nurses' perceptions about their leaders, their jobs and organisations.
Topics: Humans; Leadership; Ethics, Nursing; Nurse Administrators; Morals
PubMed: 35761760
DOI: 10.1111/jonm.13726 -
Disaster Medicine and Public Health... Aug 2019Disaster ethics is a developing field of inquiry recognizing the wide variety of ethical issues confronting various professionals involved in planning for and responding...
Disaster ethics is a developing field of inquiry recognizing the wide variety of ethical issues confronting various professionals involved in planning for and responding to different types of disasters. This article explores how ethical issues related to floods are addressed in academic literature. The review involved analysis of publications on ethics and floods identified in a systematic literature search of electronic databases that included sociological, biomedical, and geophysical sources. The review methods were guided by the PRISMA Statement on systematic reviews, adapted to this topic area, and followed by a qualitative analysis of the included publications. All articles were analyzed using NVivo software version 11. The qualitative analysis showed that further research is needed on the ethical issues involved in flood disasters. Ethical guidelines are needed for flood planners and responders that are based on the consistent application of well-established ethical principles, values, and virtues to the specific circumstances arising with each flood. Flexibility is required in applying such approaches. The results suggest that interdisciplinary collaboration (sociological, biomedical, geophysical, engineering, and ethical) could contribute significantly to the development of ethics in floods. (Disaster Med Public Health Preparedness. 2019;13:817-828).
Topics: Ethics, Medical; Floods; Humans
PubMed: 30626460
DOI: 10.1017/dmp.2018.154 -
Psychological Bulletin Jan 2021We investigate the relationship of morality and political orientation by focusing on the influential results showing that liberals and conservatives rely on different... (Meta-Analysis)
Meta-Analysis
We investigate the relationship of morality and political orientation by focusing on the influential results showing that liberals and conservatives rely on different moral foundations. We conducted a comprehensive literature search from major databases and other sources for primary studies that used the Moral Foundations Questionnaire and a typical measure of political orientation, a political self-placement item. We used a predefined process for independent extraction of effect sizes by two authors and ran both study-level and individual-level analyses. With 89 samples, 605 effect sizes, and 33,804 independent participants, in addition to 192,870 participants from the widely used YourMorals.org website, the basic differences about conservatives and liberals are supported. Yet, heterogeneity is moderate, and the results may be less generalizable across samples and political cultures than previously thought. The effect sizes obtained from the YourMorals.org data appear inflated compared with independent samples, which is partly related to political interest and may be because of self-selection. The association of moral foundations to political orientation varies culturally (between regions and countries) and subculturally (between White and Black respondents and in response to political interest). The associations also differ depending on the choice of the social or economic dimension and its labeling, supporting both the bidimensional model of political orientation and the findings that the dimensions are often strongly correlated. Our findings have implications for interpreting published studies, as well as designing new ones where the political aspect of morality is relevant. The results are primarily limited by the validity of the measures and the homogeneity of the included studies in terms of sample origins. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Topics: Effect Modifier, Epidemiologic; Humans; Morals; Politics; Reproducibility of Results
PubMed: 33151704
DOI: 10.1037/bul0000308 -
The British Journal of Social Psychology Oct 2023The role of empathy in morality is a subject of ongoing scientific debate due to the lack of systematic reviews and meta-analyses on this topic. To address this gap, we... (Meta-Analysis)
Meta-Analysis
The role of empathy in morality is a subject of ongoing scientific debate due to the lack of systematic reviews and meta-analyses on this topic. To address this gap, we conducted a PRISMA-based systematic quantitative review to investigate the role of empathy in moral judgements, decision-making, and inclinations using trolley problems and variants, which are popular types of moral dilemmas that explore utilitarianism and deontology. We searched for articles in four databases (PsycINFO, Pubmed, WorldWideScience, and Scopus) and performed citation searches. Out of 661 records, we selected 34 that studied the associations between empathy and moral judgements, moral decision-making, and/or moral inclinations. Six meta-analyses and systematic reviews of these records consistently showed small to moderate associations between affective empathy and these moral parameters, particularly in personal moral dilemmas involving intentional harm (although some approaches highlighted more complex associations between these parameters). Regarding other empathy domains, most studies found limited or insignificant links between cognitive empathy domains and moral judgements, decision-making, and inclinations. We discuss the nuances and implications of these results.
Topics: Humans; Empathy; Decision Making; Judgment; Morals; Ethical Theory
PubMed: 37314211
DOI: 10.1111/bjso.12654 -
Hospital Pediatrics Jun 2021Pediatric family-centered rounds (FCRs) have been shown to have benefits in staff satisfaction, teaching, and rounding efficiency, but no systematic review has been... (Meta-Analysis)
Meta-Analysis
CONTEXT
Pediatric family-centered rounds (FCRs) have been shown to have benefits in staff satisfaction, teaching, and rounding efficiency, but no systematic review has been conducted to explicitly examine the humanistic impact of FCRs.
OBJECTIVE
The objective with this review is to determine if FCRs promote the core values of humanism in medicine by answering the question, "Do FCRs promote humanistic pediatric care?"
DATA SOURCES
Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we conducted a search of PubMed, Web of Science, Cumulative Index of Nursing and Allied Health Literature, and Dissertation Abstracts for peer-reviewed pediatric studies through January 1, 2020. We used search terms including FCRs, communication, humanism, and the specific descriptors in the Gold Foundation's definition of humanism.
STUDY SELECTION
Abstracts ( = 1003) were assessed for 5 primary outcomes: empathy, enhanced communication, partnership, respect, and satisfaction and service. We evaluated 158 full-text articles for inclusion, reconciling discrepancies through an iterative process.
DATA EXTRACTION
Data abstraction, thematic analysis, and conceptual synthesis were conducted on 29 studies.
RESULTS
Pediatric family-centered rounds (FCRs) improved humanistic outcomes within all 5 identified themes. Not all studies revealed improvement within every category. The humanistic benefits of FCRs are enhanced through interventions targeted toward provider-family barriers, such as health literacy. Patients with limited English proficiency or disabilities or who were receiving intensive care gained additional benefits.
CONCLUSIONS
Pediatric FCRs promote humanistic outcomes including increased empathy, partnership, respect, service, and communication. Limitations included difficulty in defining humanism, variable implementation, and inconsistent reporting of humanistic outcomes. Future efforts should include highlighting FCR's humanistic benefits, universal implementation, and adapting FCRs to pandemics such as coronavirus disease 2019.
Topics: Attitude of Health Personnel; Child; Child, Hospitalized; Communication; Empathy; Humanism; Humans; Pediatrics; Professional-Family Relations; Teaching Rounds
PubMed: 34021029
DOI: 10.1542/hpeds.2020-000240