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Nursing Open Sep 2023To examine Registered Nurses (RNs') and nursing students' perspectives on factors contributing to moral distress and the effects on their health, well-being and... (Review)
Review
AIM
To examine Registered Nurses (RNs') and nursing students' perspectives on factors contributing to moral distress and the effects on their health, well-being and professional and career intentions.
DESIGN
Joanna Briggs Institute mixed-methods systematic review and thematic synthesis. Registered in Prospero (Redacted).
METHODS
Five databases were searched on 5 May 2021 for studies published in English since January 2010. Methodological quality assessment was conducted in parallel with data extraction.
RESULTS
Searches yielded 2343 hits. Seventy-seven articles were included. Most were correlational design and used convenience sampling. Studies were mainly from North America and Asia and situated in intensive and critical care settings. There were common, consistent sources of moral distress across continents, specialities and settings. Factors related to perceived inability or failure to enact moral agency and responsibility in moral events at individual, team and structural levels generated distress. Moral distress had a negative effect on RNs health and psychological well-being.
PATIENT OR PUBLIC CONTRIBUTION
No patient or public contribution to this systematic review.
Topics: Humans; Students, Nursing; North America; Morals; Job Satisfaction; Nurses
PubMed: 37458290
DOI: 10.1002/nop2.1913 -
International Journal of Environmental... Jul 2023Research focused on elucidating moral injury amongst healthcare workers (HCWs) is essential due to the deep connection with morality and individuals' overall wellbeing.... (Review)
Review
Research focused on elucidating moral injury amongst healthcare workers (HCWs) is essential due to the deep connection with morality and individuals' overall wellbeing. Examining moral injury provides an avenue through which researchers can connect individual experiences with systemic level causes (i.e., structural power imbalances between clinicians and health systems) to better study workplace wellbeing. The omnipresence of the COVID-19 pandemic has amplified the need to study moral injury. This paper describes a systematic review conducted using PRISMA-P guidelines to answer the question, "what is the association between moral injury and professional wellbeing and mental health amongst healthcare workers." Twelve databases were searched to identify specified studies. This study's criteria included: (1) articles published through December 2022; (2) qualitative and quantitative empirical studies; (3) articles written in English; (4) articles including moral injury; and (5) articles including at minimum one other measure of professional or personal wellbeing. The initial search produced 248 articles, and 18 articles were ultimately included in the final review. To confirm that no articles were left out of this study, the first author of each included article was contacted to inquire about any additional works that met the inclusion criteria of this study. The elements of the 18 included articles described in this review are discussed. The results indicate that moral injury is associated with both professional wellbeing factors and mental health outcomes. Further theoretical development, including (professional- and identity-based) exploratory research on moral injury, and evidenced-based interventions for moral injury are needed.
Topics: Humans; Burnout, Professional; COVID-19; Delivery of Health Care; Pandemics; Stress Disorders, Post-Traumatic
PubMed: 37444147
DOI: 10.3390/ijerph20136300 -
BMC Medical Ethics Jul 2023Healthcare providers have to make ethically complex clinical decisions which may be a source of stress. Researchers have recently introduced Artificial Intelligence...
BACKGROUND
Healthcare providers have to make ethically complex clinical decisions which may be a source of stress. Researchers have recently introduced Artificial Intelligence (AI)-based applications to assist in clinical ethical decision-making. However, the use of such tools is controversial. This review aims to provide a comprehensive overview of the reasons given in the academic literature for and against their use.
METHODS
PubMed, Web of Science, Philpapers.org and Google Scholar were searched for all relevant publications. The resulting set of publications was title and abstract screened according to defined inclusion and exclusion criteria, resulting in 44 papers whose full texts were analysed using the Kuckartz method of qualitative text analysis.
RESULTS
Artificial Intelligence might increase patient autonomy by improving the accuracy of predictions and allowing patients to receive their preferred treatment. It is thought to increase beneficence by providing reliable information, thereby, supporting surrogate decision-making. Some authors fear that reducing ethical decision-making to statistical correlations may limit autonomy. Others argue that AI may not be able to replicate the process of ethical deliberation because it lacks human characteristics. Concerns have been raised about issues of justice, as AI may replicate existing biases in the decision-making process.
CONCLUSIONS
The prospective benefits of using AI in clinical ethical decision-making are manifold, but its development and use should be undertaken carefully to avoid ethical pitfalls. Several issues that are central to the discussion of Clinical Decision Support Systems, such as justice, explicability or human-machine interaction, have been neglected in the debate on AI for clinical ethics so far.
TRIAL REGISTRATION
This review is registered at Open Science Framework ( https://osf.io/wvcs9 ).
Topics: Humans; Artificial Intelligence; Clinical Decision-Making; Beneficence
PubMed: 37415172
DOI: 10.1186/s12910-023-00929-6 -
Journal of Orthodontic Science 2023Coronavirus disease of 2019 (COVID-19), which has affected almost all medical professions, has had a significant negative influence on dental care. Additionally,... (Review)
Review
Coronavirus disease of 2019 (COVID-19), which has affected almost all medical professions, has had a significant negative influence on dental care. Additionally, non-urgent dental procedures were stopped during the epidemic in a number of countries. The purpose of this systematic review was to examine the impact of COVID-19 on individuals who had undergone or are currently having orthodontic treatment in any capacity during/after the pandemic's occurrence. After a thorough search of the online journals, a total of 634 documents were found, and 416 of the papers were initially chosen. The removal of 362 similar or duplicate publications that followed led to the initial availability of 54 separate papers. The final selection consisted of 23 documents, mostly in vitro investigations, cross-sectional studies, and comparative evaluations, which satisfied the necessary inclusion and exclusion criteria. COVID-19 had a significant impact on nearly every sphere of the patients' lives who were undergoing orthodontic treatment. However, people who are currently availing of various orthodontic treatment modalities did not experience the same issues as the ones faced by patients earlier. Teleorthodontics emerged as a viable option to access treatment during the lockdown period caused due to the pandemic. COVID-19 also had an overall negative impact on the psyche and morale of orthodontists around the world. .
PubMed: 37351409
DOI: 10.4103/jos.jos_118_22 -
BMC Health Services Research Jun 2023Trustful relationships play a vital role in successful organisations and well-functioning hospitals. While the trust relationship between patients and providers has been...
BACKGROUND
Trustful relationships play a vital role in successful organisations and well-functioning hospitals. While the trust relationship between patients and providers has been widely studied, trust relations between healthcare professionals and their supervisors have not been emphasised. A systematic literature review was conducted to map and provide an overview of the characteristics of trustworthy management in a hospital setting.
METHODS
We searched Web of Science, Embase, MEDLINE, APA PsycInfo, CINAHL, Scopus, EconLit, Taylor & Francis Online, SAGE Journals and Springer Link from database inception up until Aug 9, 2021. Empirical studies written in English undertaken in a hospital or similar setting and addressed trust relationships between healthcare professionals and their supervisors were included, without date restrictions. Records were independently screened for eligibility by two researchers. One researcher extracted the data and another one checked the correctness. A narrative approach, which involves textual and tabular summaries of findings, was undertaken in synthesising and analysing the data. Risk of bias was assessed independently by two researchers using two critical appraisal tools. Most of the included studies were assessed as acceptable, with some associated risk of bias.
RESULTS
Of 7414 records identified, 18 were included. 12 were quantitative papers and 6 were qualitative. The findings were conceptualised in two categories that were associated with trust in management, namely leadership behaviours and organisational factors. Most studies (n = 15) explored the former, while the rest (n = 3) additionally explored the latter. Leadership behaviours most commonly associated with employee's trust in their supervisors include (a) different facets of ethical leadership, such as integrity, moral leadership and fairness; (b) caring for employee's well-being conceptualised as benevolence, supportiveness and showing concern and (c) the manager's availability measured as being accessible and approachable. Additionally, four studies found that leaders' competence were related to perceptions of trust. Empowering work environments were most commonly associated with trust in management.
CONCLUSIONS
Ethical leadership, caring for employees' well-being, manager's availability, competence and an empowering work environment are characteristics associated with trustworthy management. Future research could explore the interplay between leadership behaviours and organisational factors in eliciting trust in management.
Topics: Humans; Hospitals; Health Personnel; Leadership
PubMed: 37340412
DOI: 10.1186/s12913-023-09610-5 -
Clinical & Translational Oncology :... Sep 2023Breast cancer is the leading cause of cancer in women in Spain and its annual incidence is rapidly increasing. Thanks to the screening programs in place, nearly 90% of...
Breast cancer is the leading cause of cancer in women in Spain and its annual incidence is rapidly increasing. Thanks to the screening programs in place, nearly 90% of breast cancer cases are detected in early and potentially curable stages, despite the COVID-19 pandemic possibly having impacted these numbers (not yet quantified). In recent years, locoregional and systemic therapies are increasingly being directed by new diagnostic tools that have improved the balance between toxicity and clinical benefit. New therapeutic strategies, such as immunotherapy, targeted drugs, and antibody-drug conjugates have also improved outcomes in some patient subgroups. This clinical practice guideline is based on a systematic review of relevant studies and on the consensus of experts from GEICAM, SOLTI, and SEOM.
Topics: Female; Humans; Breast Neoplasms; Pandemics; COVID-19; Consensus; Drug Delivery Systems
PubMed: 37326826
DOI: 10.1007/s12094-023-03215-4 -
Healthcare (Basel, Switzerland) Jun 2023Biomechanical methods are frequently used to provide information about the kinematics and kinetics of posture and movement during musical performance. The aim of this... (Review)
Review
Biomechanical methods are frequently used to provide information about the kinematics and kinetics of posture and movement during musical performance. The aim of this review was to identify and analyze the biomechanical methods performed on woodwind musicians to understand their musculoskeletal demands. A systemic review was carried out following the guidelines of the document Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). It was registered in PROSPERO (code 430304).The databases PubMed, Cochrane, CINAHL, Scopus, and Web of Science were consulted between January 2000 and March 2022. The search in the databases identified 1625 articles, and 16 different studies were finally included in the review, with a sample size of 390 participants. Pressure sensors, surface electromyography, infrared thermography, goniometry in two dimensions, and ultrasound topometry in three dimensions were biomechanical methods useful to broaden the knowledge of musculoskeletal demands during musical practice. Piezoresistive pressure sensors were the most widely used method. The great heterogeneity of the studies limited the comparability of the results. The findings raised the need to increase both the quantity and the quality of studies in future research.
PubMed: 37297764
DOI: 10.3390/healthcare11111621 -
The International Journal on Drug Policy Jul 2023In the past decade, a body of evidence has reported that dietary supplement use is related to prohibited performance enhancing substance use (i.e., doping). To help... (Meta-Analysis)
Meta-Analysis Review
In the past decade, a body of evidence has reported that dietary supplement use is related to prohibited performance enhancing substance use (i.e., doping). To help international and national sport organisations understand the degree to which dietary supplement use is related to doping, the objectives of this systematic review and meta-analysis were to 1) compare the prevalence of doping between dietary supplement users and non-users and 2) identify whether supplement use is related to doping social cognitive factors. We searched for studies sampling athletes and that measured both dietary supplement use and doping in EMBASE, MEDLINE, PsychINFO, CINAHL and SPORTDiscus from database creation to May 2022. Risk of bias was assessed using JBI Critical Appraisal Checklist for cross-sectional studies and the STROBE checklist. Twenty-six cross-sectional studies, involving 13,296 athletes were included. Random-effect models revealed that doping was 2.74 (95% CI=2.10 to 3.57) times more prevalent in dietary supplement users (pooled prevalence = 14.7%) than non-users (6.7%), and that users reported stronger doping intentions (r=0.26, 0.18 to 0.34) and attitudes (r=0.21, 0.13 to 0.28) compared to non-users. Preliminary evidence also suggests that dietary supplement users were less likely to dope if they were more task oriented and had a stronger sense of morality. Results of the review are limited by the cross-sectional design used in all studies and lack of consistency in measurement of dietary supplement use and doping. Data indicate that athletes using dietary supplements are more likely to self-report doping Anti-doping policy should, therefore, target dietary supplement use in anti-doping education programmes by providing alternative strategies for performance enhancement or highlighting the safest ways they can be consumed. Similarly, as a large proportion of athletes use dietary supplements without doping, further research is needed to understand the factors that protect a dietary supplement user from doping. No funding was received for the review. A study protocol can be found here: https://osf.io/xvcaq.
Topics: Humans; Cross-Sectional Studies; Dietary Supplements; Sports; Athletes; Intention; Doping in Sports
PubMed: 37267738
DOI: 10.1016/j.drugpo.2023.104077 -
Health Psychology Open 2023Regulatory health policies facilitate desired health behaviours in communities, and among them, smoke-free policies and COVID-19 restrictions have been widely... (Review)
Review
Regulatory health policies facilitate desired health behaviours in communities, and among them, smoke-free policies and COVID-19 restrictions have been widely implemented. Qualitative research studies have explored how these measures and other environmental influences shape preventive behaviours. The objective of this systematic review was to synthesize previously published qualitative research, generate across-study themes, and propose recommendations for behaviour change interventions. We used a comprehensive search strategy, relevance screening and confirmation, data extraction, quality assessment, thematic synthesis, and quality-of-evidence assessment. In total, 87 relevant studies were identified. Findings were grouped under six overarching themes and mapped under three categories: (i) the political environment, (ii) the sociocultural environment, and (iii) the physical environment. These findings provide insights into the environmental influences of behaviour and indicate future interventions may be more effective by considering moral norms, community norms, policy support, and group identity.
PubMed: 37255528
DOI: 10.1177/20551029231179157 -
Frontiers in Psychology 2023Compulsory citizenship behaviors (CCBs) are increasingly endorsed and expected of workers in contexts where managerial worker protections are low and performance demands...
BACKGROUND
Compulsory citizenship behaviors (CCBs) are increasingly endorsed and expected of workers in contexts where managerial worker protections are low and performance demands on workers are high. Although studies on compulsory citizenship behaviors have shown a significant increase in recent years, the literature still lacks a comprehensive meta-analysis. To fill this gap the purpose of this study is to synthesize the collective outcomes of prior quantitative research on CCBs with the objective of identifying the factors linked to the concept and offering a primary reference for future researchers.
METHODS
Forty-three different correlates with CCBs were synthesized. The dataset of this meta-analysis consists of 53 independent samples with a sample size of 17.491, contributing to 180 effect sizes. PRISMA flow diagram and PICOS framework were used for the study design.
RESULT
Results showed only gender and age were significant among demographic characteristics related to CCBs. Correlates between CCBs and counterproductive workplace behaviors, felt obligation, work-family conflict, organizational-based self-esteem, organizational cynicism, burnout, anger toward the organization, and work alienation were found as large. We also found turnover intention, moral disengagement, careerism, abusive supervision, citizenship pressure, job stress, facades of conformity, and feeling trusted to be moderately related to CCBs. Next, there was a small relationship between CCBs and social loafing. On the other hand, LMX, psychological safety, organizational identification, organizational justice, organizational commitment, job satisfaction, and job autonomy were found as significant deterrents of CCBs. These results suggest that CCBs flourish in contexts with low levels of worker protection and low road practices to people management.
CONCLUSION
In sum, we found solid cumulative evidence that CCBs are a harmful and undesirable phenomenon for employees and organizations. Also, positive correlations of felt obligation, feeling trusted, and organization-based self-esteem with CCBs, showed that, contrary to general acceptance, positive factors could also cause CCBs. Lastly, we found CCBs as a dominant phenomenon in eastern culture.
PubMed: 37213371
DOI: 10.3389/fpsyg.2023.1120209