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Moral distress

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https://www.readbyqxmd.com/read/28426307/how-california-prepared-for-implementation-of-physician-assisted-death-a-primer
#1
Laura A Petrillo, Elizabeth Dzeng, Krista L Harrison, Lindsay Forbes, Benjamin Scribner, Barbara A Koenig
Physician-assisted death is now legal in California, and similar laws are being considered in many other states. The California law includes safeguards, yet health care providers will face practical and ethical issues while implementing physician-assisted death that are not addressed by the law. To help providers and health care facilities in California prepare to provide optimal care to patients who inquire about physician-assisted death, we brought together experts from California, Oregon, and Washington...
April 20, 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28425313/moral-distress-among-school-nurses
#2
Shannon Baker Powell, Martha Keehner Engelke, Melvin S Swanson
School nurses are well positioned to provide care to a diverse population of school-age children, but their role and work environment can present a variety of moral dilemmas leading to moral distress. The purpose of this study is to identify the moral distress level that exists in school nurses and to describe its relationship to common moral dilemmas and school nurse characteristics. Data were collected through face-to-face attendance at school nurse meetings in North Carolina where 307 school nurses participated in the survey...
January 1, 2017: Journal of School Nursing: the Official Publication of the National Association of School Nurses
https://www.readbyqxmd.com/read/28421865/it-s-not-all-about-moral-reasoning-understanding-the-content-of-moral-case-deliberation
#3
Mia Svantesson, Marit Silén, Inger James
BACKGROUND: Moral Case Deliberation is one form of clinical ethics support described as a facilitator-led collective moral reasoning by healthcare professionals on a concrete moral question connected to their practice. Evaluation research is needed, but, as human interaction is difficult to standardise, there is a need to capture the content beyond moral reasoning. This allows for a better understanding of Moral Case Deliberation, which may contribute to further development of valid outcome criteria and stimulate the normative discussion of what Moral Case Deliberation should contain...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28399846/palliative-sedation-challenging-the-professional-competency-of-health-care-providers-and-staff-a-qualitative-focus-group-and-personal-written-narrative-study
#4
Danièle Leboul, Régis Aubry, Jean-Michel Peter, Victor Royer, Jean-François Richard, Frédéric Guirimand
BACKGROUND: Despite recent advances in palliative medicine, sedating a terminally ill patient is regarded as an indispensable treatment to manage unbearable suffering. With the prospect of widespread use of palliative sedation, the feelings and representations of health care providers and staff (carers) regarding sedation must be carefully explored if we are to gain a better understanding of its impact and potential pitfalls. The objective of the study was to provide a comprehensive description of the opinions of carers about the use of sedation practices in palliative care units (PCU), which have become a focus of public attention following changes in legislation...
April 11, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28395907/emotion-based-learning-systems-and-the-development-of-morality
#5
R J R Blair
In this paper it is proposed that important components of moral development and moral judgment rely on two forms of emotional learning: stimulus-reinforcement and response-outcome learning. Data in support of this position will be primarily drawn from work with individuals with the developmental condition of psychopathy as well as fMRI studies with healthy individuals. Individuals with psychopathy show impairment on moral judgment tasks and a pronounced increased risk for instrumental antisocial behavior. It will be argued that these impairments are developmental consequences of impaired stimulus-aversive conditioning on the basis of distress cue reinforcers and response-outcome learning in individuals with this disorder...
April 7, 2017: Cognition
https://www.readbyqxmd.com/read/28388484/making-punishment-palatable-belief-in-free-will-alleviates-punitive-distress
#6
Cory J Clark, Roy F Baumeister, Peter H Ditto
Punishing wrongdoers is beneficial for group functioning, but can harm individual well-being. Building on research demonstrating that punitive motives underlie free will beliefs, we propose that free will beliefs help justify punitive impulses, thus alleviating the associated distress. In Study 1, trait-level punitiveness predicted heightened levels of anxiety only for free will skeptics. Study 2 found that higher state-level incarceration rates predicted higher mental health issue rates, only in states with citizens relatively skeptical about free will...
April 4, 2017: Consciousness and Cognition
https://www.readbyqxmd.com/read/28344714/moral-distress-and-burnout-in-internal-medicine-residents
#7
Sharareh Sajjadi, Monica Norena, Hubert Wong, Peter Dodek
BACKGROUND: Residents frequently encounter situations in their workplace that may induce moral distress or burnout. The objective of this study was to measure overall and rotation-specific moral distress and burnout in medical residents, and the relationship between demographics and moral distress and burnout. METHODS: The revised Moral Distress Scale and the Maslach Burnout Inventory (Human Service version) were administered to Internal Medicine residents in the 2013-2014 academic year at the University of British Columbia...
February 2017: Canadian Medical Education Journal
https://www.readbyqxmd.com/read/28337687/assessing-the-culture-of-residency-using-the-c-change-resident-survey-validity-evidence-in-34-u-s-residency-programs
#8
Linda H Pololi, Arthur T Evans, Janet T Civian, Sandy Shea, Robert T Brennan
BACKGROUND: A practical instrument is needed to reliably measure the clinical learning environment and professionalism for residents. OBJECTIVE: To develop and present evidence of validity of an instrument to assess the culture of residency programs and the clinical learning environment. DESIGN: During 2014-2015, we surveyed residents using the C - Change Resident Survey to assess residents' perceptions of the culture in their programs. PARTICIPANTS: Residents in all years of training in 34 programs in internal medicine, pediatrics, and general surgery in 14 geographically diverse public and private academic health systems...
March 23, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28332946/ethnic-differences-in-psychosocial-services-use-among-non-latina-white-and-latina-breast-cancer-survivors
#9
Rosario Costas-Muñiz, Migda Hunter-Hernández, Olga Garduño-Ortega, Jennifer Morales-Cruz, Francesca Gany
Background This study examined the use of psychosocial services (i.e. social work, psychiatric, psychological, and spiritual/pastoral services) among Latina and Non-Latina White breast cancer survivors. Methods Survivors who received treatment in a Comprehensive Cancer Center in New York completed a mailed questionnaire about interest in help for distress, and psychosocial service use. Descriptive and non-parametric statistics were used to explore ethnic differences in use of, and interest in, psychosocial services...
March 23, 2017: Journal of Psychosocial Oncology
https://www.readbyqxmd.com/read/28319986/perceived-ethics-dilemmas-among-pioneer-accountable-care-organizations
#10
Craig R Westling, Thom Walsh, William A Nelson
This study of Pioneer accountable care organizations (ACOs) suggests that the ACO model is creating moral distress for physicians and business leaders in seven critical ways:Despite an overall sense of optimism associated with the ACO model, our research identified an underlying sense of moral distress at most sites. A clear opportunity exists for ACOs to use a more comprehensive, coordinated approach to proactively resolving ethical dilemmas while continuing the march toward risk-based contracts.
January 2017: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/28294318/impact-of-killing-in-war-a-randomized-controlled-pilot-trial
#11
Shira Maguen, Kristine Burkman, Erin Madden, Julie Dinh, Jeane Bosch, Jessica Keyser, Martha Schmitz, Thomas C Neylan
OBJECTIVE: The purpose of this pilot study was to test the effectiveness of Impact of Killing (IOK), a novel, cognitive-behavioral treatment (CBT) aimed at reducing mental health symptoms and functional impairment. METHOD: Participants were 33 combat Veterans with a posttraumatic stress disorder (PTSD) diagnosis who had completed trauma-focused psychotherapy and reported distress regarding killing or feeling responsible for the deaths of others in war. Veterans were randomized to either IOK treatment or a 6-week waitlist condition, after which Veterans could receive IOK...
March 10, 2017: Journal of Clinical Psychology
https://www.readbyqxmd.com/read/28292414/concerns-about-care-and-communication-are-key-causes-of-moral-distress-in-intensive-care-staff
#12
REVIEW
M A Coombs
No abstract text is available yet for this article.
March 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/28277329/sevoflurane-compared-with-isoflurane-minimizes-lung-damage-in-pulmonary-but-not-in-extrapulmonary-acute-respiratory-distress-syndrome-in-rats
#13
Mariana N Araújo, Cíntia L Santos, Cynthia S Samary, Luciana B B Heil, Vinicius C M Cavalcanti, Fernanda F Cruz, Nathane S Felix, Johnatas D Silva, Marcelo M Morales, Paolo Pelosi, Fatima C Fernandes, Nivaldo R Villela, Pedro L Silva, Patricia R M Rocco
BACKGROUND: Volatile anesthetics modulate inflammation in acute respiratory distress syndrome (ARDS). However, it is unclear whether they act differently depending on ARDS etiology. We hypothesized that the in vivo and in vitro effects of sevoflurane and isoflurane on lung damage would not differ in pulmonary (p) and extrapulmonary (exp) ARDS. METHODS: Twenty-four Wistar rats were randomized to undergo general anesthesia (1-2 minutes) with sevoflurane and isoflurane...
March 8, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28270034/inuit-interpreters-engaged-in-end-of-life-care-in-nunavik-northern-quebec
#14
Shawn Renee Hordyk, Mary Ellen Macdonald, Paul Brassard
BACKGROUND: Inuit interpreters are key players in end-of-life (EOL) care for Nunavik patients and families. This emotionally intensive work requires expertise in French, English and Inuit dialects to negotiate linguistic and cultural challenges. Cultural differences among medical institutions and Inuit communities can lead to value conflicts and moral dilemmas as interpreters navigate how best to transmit messages of care at EOL. OBJECTIVES: Our goal was to understand the experience of Inuit interpreters in the context of EOL care in Nunavik in order to identify training needs...
2017: International Journal of Circumpolar Health
https://www.readbyqxmd.com/read/28257350/executive-summary-transforming-moral-distress-into-moral-resilience-in-nursing
#15
Cynda Hylton Rushton, Kathy Schoonover-Shoffner, Maureen Shawn Kennedy
To examine practices for addressing moral distress, a collaborative project was developed by the Johns Hopkins Berman Institute of Bioethics, the Johns Hopkins School of Nursing, the American Journal of Nursing, and the Journal of Christian Nursing, along with the American Association of Critical-Care Nurses and the American Nurses Association. Its purpose was to identify strategies that individuals and systems can use to mitigate the detrimental effects of moral distress and foster moral resilience. On August 11 and 12, 2016, an invitational symposium, State of the Science: Transforming Moral Distress into Moral Resilience in Nursing, was held at the Johns Hopkins School of Nursing in Baltimore, Maryland...
April 2017: Journal of Christian Nursing: a Quarterly Publication of Nurses Christian Fellowship
https://www.readbyqxmd.com/read/28257342/what-about-moral-distress
#16
Kathy Schoonover-Shoffner
No abstract text is available yet for this article.
April 2017: Journal of Christian Nursing: a Quarterly Publication of Nurses Christian Fellowship
https://www.readbyqxmd.com/read/28253430/moral-distress-in-nurses-providing-direct-patient-care-at-an-academic-medical-center
#17
Janet Sirilla, Kathrynn Thompson, Todd Yamokoski, Mark D Risser, Esther Chipps
BACKGROUND: Moral distress is the psychological response to knowing the appropriate action but not being able to act due to constraints. Previous authors reported moral distress among nurses, especially those that work in critical care units. AIMS: The aims of this study were: (1) to examine the level of moral distress among nurses who work at an academic health system, (2) to compare the level of moral distress in nurses who work across specialty units at an academic health system, (3) to compare moral distress by the demographic characteristics of nurses and work experience variables, and (4) to identify demographic characteristics and type of clinical setting that may predict which nurses are at high risk for moral distress...
March 2, 2017: Worldviews on Evidence-based Nursing
https://www.readbyqxmd.com/read/28247529/the-kaempf-periviability-guidelines-return-of-the-god-committee
#18
Patrick J Marmion
Not all births are happy occasions. As an obstetrician, I have helped many families as they experienced stillbirths and untimely deliveries over the last thirty years. During the last ten years I have witnessed a disturbing phenomenon: preterm babies dying needlessly because they are being denied life-sustaining interventions. I remember the families who were simply told their 23-week newborns would die because "all of them do". I remember the families who were told "we do not recommend intensive care for babies born at 24 weeks because when they survive their outcomes are bleak"...
March 1, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28235603/val158met-polymorphism-in-the-comt-gene-is-associated-with-hypersomnia-and-mental-health-related-quality-of-life-in-a-colombian-sample
#19
Karen M Jiménez, Angela J Pereira-Morales, Diego A Forero
The identification of genes that are risk factors for major depressive disorder remains a main task for global psychiatric research. The Catechol-O-methyltransferase (COMT) gene has been an important candidate risk factor for several psychiatric disorders. Previous studies have shown that a functional polymorphism (Val158Met) in this gene has an effect on several brain circuits and endophenotypes of psychiatric relevance. The aim of this study was to explore the association of a functional polymorphism in the COMT gene with psychological distress, sleep problems and health-related quality of life...
February 22, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/28219363/to-change-or-not-to-change-translating-and-culturally-adapting-the-paediatric-version-of-the-moral-distress-scale-revised-mds-r
#20
Margareta Af Sandeberg, Marika Wenemark, Cecilia Bartholdson, Kim Lützén, Pernilla Pergert
BACKGROUND: Paediatric cancer care poses ethically difficult situations that can lead to value conflicts about what is best for the child, possibly resulting in moral distress. Research on moral distress is lacking in paediatric cancer care in Sweden and most questionnaires are developed in English. The Moral Distress Scale-Revised (MDS-R) is a questionnaire that measures moral distress in specific situations; respondents are asked to indicate both the frequency and the level of disturbance when the situation arises...
February 20, 2017: BMC Medical Ethics
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