Autonomy

BACKGROUND: Sjögren's syndrome (SS) is the second most common autoimmune rheumatic disease, and the range of symptoms includes fatigue, dryness, sleep disturbances, and pain. Smartphone apps may help deliver a variety of cognitive and behavioral techniques to support self-management in SS. However, app-based interventions must be carefully designed to promote engagement and motivate behavior change. OBJECTIVE: We aimed to explore self-management approaches and challenges experienced by people living with SS and produce a corresponding set of design recommendations that inform the design of an engaging, motivating, and evidence-based self-management app for those living with SS...

It is widely reported that image-based sexual abuse (IBSA) victimization is linked to a wide range of detrimental outcomes, including anxiety, depression, and suicidal ideation. However, knowledge about what shapes victims' experiences remains limited. To explore underlying mechanisms of harm in IBSA incidents, the present study drew on the concept of appraisal to elucidate the various meanings that victims attach to IBSA. For this purpose, we carried out a reflexive thematic analysis of 20 individual in-depth interviews with young male and female victims (ages 16-26) of IBSA...

OBJECTIVE: To describe the functional clinical profile of elderly people linked to primary health care, using the Functional Clinical Vulnerability Index (IVCF-20) and to spatialize those with the greatest functional decline by primary health care units in the municipality of Uberlândia, in the state of Minas Gerais (MG), in the year 2022. METHODS: A cross-sectional study with secondary data from the Municipal Health Department of Uberlândia-MG. The variables were compared using Student's t-test, Mann Whitney test, Pearson's chi-square, and multinomial logistic regression to obtain the independent effect of each variable...

In intensive care units, patients are often restrained to ensure their safety, with physical restraints being the most commonly used method. However, physical restraints compromises the patient's freedom, health and comfort, and nurses often face moral dilemmas when deciding whether to use physical restraints. This article examines physical restraints through the four universal principles of autonomy, beneficence, non-maleficence and justice. Through these principles, the authors will critically explore whether the physical restraints of patients by nurses is ethical in practice and what moral issues exist...

BACKGROUND: The provision of graded supervision affording progressive autonomy is fundamental to the progression of a medical learner toward competency for independent practice; the decision of how much supervision versus autonomy to provide a trainee in the execution of clinical care constitutes an entrustment decision. Despite entrustment decision making occurring both daily in practice and summatively at points of matriculation through stages of medical training, the factors influencing entrustment decisions remain poorly understood across clinical contexts...

BACKGROUND: Suture knotting is the basis of surgical skills. In the process of surgical skills learning, the surrounding environment, especially the light, will affect the efficiency of learning. This study investigated the effect of optical environment on the learning of stitching and knotting skills. METHODS: A total of 44 medical students were randomly divided into four groups and participated in the study of suture knotting in four different optical environments...

BACKGROUND: This study addresses the issue of shared decision-making (SDM) in a Norwegian home-based palliative care setting. The significance of patient involvement in SDM is widely acknowledged, and many patients want to participate in decisions about care and treatment. Yet, it remains a need for more knowledge regarding the initiators and approaches of SDM in the context of home-based palliative care, particularly from the patients' perspective. The aim of this study is to understand patients' experiences and preferences for SDM in home-based palliative care, seeking to enhance the quality of care and direct the planning of healthcare services...

The aging process leads to the degeneration of body structure and function. The objective of this study is to conduct a systematic review and meta-analysis of the effects of resistance circuit training (RCT) on comprehensive health indicators of older adults. PubMed, Embase, and Web of Science were searched until August 2023. Primary outcomes were body composition, muscle strength, cardiorespiratory endurance, blood pressure, and functional autonomy. Muscle function and exercise intensity subgroups were analyzed...

BACKGROUND: Performing clinical trials in palliative cancer care is known to be challenging. OBJECTIVE: This study aimed to explore how patients with advanced cancer experienced their participation in a randomised, placebo-controlled trial while receiving palliative cancer care at end of life. METHOD: A descriptive design with a qualitative approach was used. 14 patients who had participated in the 'Palliative-D' study were interviewed. Data were analysed using content analysis...

DESIGN/METHODOLOGY/APPROACH: This article employs qualitative thematic modeling to gather insights from 30 informants. The study explores various aspects related to the impact of the COVID-19 pandemic on AI ChatGPT technologies. PURPOSE: The purpose of this research is to examine how the COVID-19 pandemic has influenced the increased usage and adoption of AI ChatGPT. It aims to explore the pandemic's impact on AI ChatGPT and its applications in specific domains, as well as the challenges and opportunities it presents...

Social workers aiding older adults facing abuse from their adult child confront an ethical dilemma: whether to honor autonomy or prevent harm. The study explores how social workers perceive legal intervention against the older adult's will. Twenty-one aging-specialized social workers took part in semi-structured interviews using a vignette. The analysis was conducted inductively, guided by content analysis principles. Two main themes emerged, focusing on the disadvantages and benefits of legal intervention...

Reproductive coercion and abuse is a hidden and poorly recognised form of violence against women. It refers broadly to behaviours that interfere with or undermine a person's reproductive autonomy, specifically to promote or prevent pregnancy. Reproductive coercion and abuse can involve physical, sexual, financial or psychological abuse in order to achieve these aims, and is overwhelmingly perpetrated by men against women. As an emerging field of scholarship, conceptual understanding of reproductive coercion and abuse is still in its infancy; however, it is often described as being linked to coercive control...

PURPOSE: Opportunities and challenges in home healthcare are discussed from the perspective of a gerontological clinical nurse specialist who has served as an expert clinician, administrator, and compliance director of a home health agency in the Midwest United States. DESCRIPTION: Home-based nursing care requires a distinct set of knowledge and skills centered on the home environment and the way the home health patient responds emotionally and physically to become confident and self-sufficient...

PURPOSE: To investigate patients' perceptions of participating in self-directed activities, outside supervised occupational and physiotherapy, within rehabilitation settings. METHODS: Semi-structured interviews were undertaken with 16 patients and in three instances, their carers, from three health services in Victoria, Australia, two offering inpatient and one offering home-based rehabilitation care. A thematic analysis was performed using a framework approach...

INTRODUCTION: The currently accepted best practice radiation treatment for left breast cancer patients is Deep Inspiration Breath Hold (DIBH) where patients hold a deep breath to reduce late cardiac and pulmonary effects from treatment. DIBH can be challenging and induce or exacerbate anxiety in patients due to the perceived pressure to reduce radiation treatment side effects. This study explored the experiences of patients treated with Deep Inspiration Breath Hold Radiation Therapy (DIBH-RT) to improve patient-centred care and inform the design of multimedia educational tools for future patients undergoing DIBH...

OBJECTIVE: Assess how child involvement in making rules about screen time relates to age, child prosocial functioning, and amount of screen use. METHODS: NORC's AmeriSpeak Panel was used to recruit a nationally representative sample of parents or guardians of school-aged children (age 5-17) in the United States (n = 2084). Parents completed survey that included measures of screen time, child involvement in rule making about screen use, family functioning, and dimensions of child psychosocial functioning...

This study investigated how individualism, collectivism and conformity are associated with parenting and child adjustment in 1297 families with 10-year-old children from 13 cultural groups in nine countries. With multilevel models disaggregating between- and within-culture effects, we examined between- and within-culture associations between maternal and paternal cultural values, parenting dimensions and children's adjustment. Mothers from cultures endorsing higher collectivism and fathers from cultures endorsing lower individualism engage more frequently in warm parenting behaviours...

INTRODUCTION: Subjective well-being has numerous indicators of global well-being, however, the most important are life satisfaction and attachments, which can be both positive and negative. The leadership of the coach is an integral part of the process that cares for the relationship of the athlete and coach, where the coach has a fundamental role on the athlete, and consequently on his subjective well-being. OBJECTIVE: The study has the purpose to analyse if and in what way the Basic Psychological Needs-relationship, autonomy and social relationship (mediator 1, M1) and the autonomous motivation (mediator 2, M2) mediate the relationship of the variables of democratic style (independent variable, X) with subjective well-being-life satisfaction and positive attachment (dependent variable, Y)...

PURPOSE: Variability in necrosis patterns and operative techniques in surgical necrotizing enterocolitis (NEC) necessitates a standardized classification system for consistent assessment and comparison. This study introduces a novel intraoperative reporting system for surgical NEC, focusing on reliability and reproducibility. METHODS: Analyzing surgical NEC cases from January 2018 to June 2023 at two tertiary neonatal and pediatric surgery units, a new classification system incorporating anatomical details and intestinal involvement extent was developed...

INTRODUCTION: More than 50% of patients diagnosed with multiple sclerosis report problems with manipulative function and impairments in their daily lives due to this disorder. Therefore, the aim of the present study is to determine how pinch strength, prey strength and manipulative dexterity affect the quality of life and personal autonomy of people diagnosed with multiple sclerosis and to study whether there is a difference in these aspects between different types of multiple sclerosis...