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Moral distress

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https://www.readbyqxmd.com/read/29465176/nurses-experiences-of-providing-care-to-bereaved-families-who-experience-unexpected-death-in-intensive-care-units-a-narrative-overview
#1
Aalia Shariff, Joanne Olson, Anna Santos Salas, Lisa Cranley
BACKGROUND: Death is a common occurrence in intensive care units (IC Us) and the complexity of care makes it difficult for nurses to find a balance between the patient's physical needs and the family's emotional needs, especially in circumstances of unexpected death. Cumulative or unresolved grief for families can have lasting negative repercussions. Nurses, therefore, need access to bereavement education in order to provide optimal- bereavement support. PURPOSE: The purpose of this review is to identify challenges and facilitators that nurses experience in delivering bereavement support during and after sudden or unexpected death in ICUs...
May 2017: Canadian Journal of Critical Care Nursing
https://www.readbyqxmd.com/read/29463566/evaluating-the-inpatient-pediatric-ethical-consultation-service
#2
Kelsey Watt, Matthew P Kirschen, Joel A Friedlander
OBJECTIVES: Pediatric ethical consultation services (ECSs) have been proliferating at medical centers, with little data available on evaluating their implementation. The objective of this study was to evaluate the pediatric ECS and understand the ethical issues occurring within a single quaternary-level pediatric hospital. METHODS: A retrospective chart review of documented ethics consultations at a large pediatric hospital from November 2010 to November 2013 was performed and data was abstracted per the US Department of Veterans Affairs' Domains of Ethics in Health Care...
February 20, 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29460561/modified-moral-distress-scale-mds-11-validation-study-among-italian-nurses
#3
Sondra Badolamenti, Roberto Fida, Valentina Biagioli, Rosario Caruso, Francesco Zaghini, Alessandro Sili, Teresa Rea
BACKGROUND: Moral distress (MD) has significant implications on individual and organizational health. However there is a lack of an instrument to assess it among Italian nurses. AIM: The main aim of this study was to validate a brief instrument to assess MD, developed from the Corley's Moral Distress Scale (MDS). METHOD: The modified MDS scale was subjected to content and cultural validity. The scale was administered to 347 nurses. Psychometric analysis were performed to assess construct validity...
October 2017: Professioni Infermieristiche
https://www.readbyqxmd.com/read/29457924/factors-influencing-audiologists-perception-of-moral-climate-in-the-workplace
#4
Andrea Simpson, Kendall Phillips, Danny Wong, Sandy Clarke, Michelle Thornton
OBJECTIVE: The purpose of this study was to assess audiologists' perceptions of ethics and moral climate in the workplace. DESIGN: The Ethics Environmental Questionnaire (EEQ) was sent out to all audiologists registered with the professional body Audiology Australia. Participants were also invited to undertake a semi-structured interview. STUDY SAMPLE: A total of 301 audiologists completed the questionnaire. Eight of these participants also agreed to complete the interview...
February 19, 2018: International Journal of Audiology
https://www.readbyqxmd.com/read/29441840/the-ethics-of-real-time-ems-direction-suggested-curricular-content
#5
Jay M Brenner, Andrew L Aswegan, Laura E Vearrier, Jesse B Basford, Kenneth V Iserson
Ethical dilemmas can create moral distress in even the most experienced emergency physicians (EPs). Following reasonable and justified approaches can help alleviate such distress. The purpose of this article is to guide EPs providing Emergency Medical Services (EMS) direction to navigate through common ethical issues confronted in the prehospital delivery of care, including protecting privacy and confidentiality, decision-making capacity and refusal of treatment, withholding of treatment, and termination of resuscitation (TOR)...
February 14, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29412013/moral-incongruence-and-pornography-use-a-critical-review-and-integration
#6
Joshua B Grubbs, Samuel L Perry
Internet pornography use (IPU) remains a controversial topic within sexual behavior research fields. Whereas some people report feeling dysregulated in their use of pornography, mental health and medical communities are divided as to whether IPU can be addictive. The present review sought to examine this issue more closely, with a focus on how variables other than pornography use, such as moral disapproval and moral incongruence (i.e., feeling as if one's behaviors and one's values about those behaviors are misaligned), might specifically contribute to self-perceived problems around pornography use...
February 7, 2018: Journal of Sex Research
https://www.readbyqxmd.com/read/29409031/a-typology-of-social-workers-in-long-term-care-facilities-in-israel
#7
Sagit Lev, Liat Ayalon
This article explores moral distress among long-term care facility (LTCF) social workers by examining the relationships between moral distress and environmental and personal features. Based on these features, authors identified a typology of LTCF social workers and how they handle moral distress. Such a typology can assist in the identification of social workers who are in a particular need for assistance. Overall, 216 LTCF social workers took part in the study. A two-step cluster analysis was conducted to identify a typology of LTCF social workers based on features such as ethical environment, support in workplace, mastery, and resilience...
February 2, 2018: Social Work
https://www.readbyqxmd.com/read/29396240/discussing-conservative-management-with-older-patients-with-ckd-an-interview-study-of-nephrologists
#8
Keren Ladin, Renuka Pandya, Allison Kannam, Rohini Loke, Tira Oskoui, Ronald D Perrone, Klemens B Meyer, Daniel E Weiner, John B Wong
BACKGROUND: Although dialysis may not provide a large survival benefit for older patients with kidney failure, few are informed about conservative management. Barriers and facilitators to discussions about conservative management and nephrologists' decisions to present the option of conservative management may vary within the nephrology provider community. STUDY DESIGN: Interview study of nephrologists. SETTING & PARTICIPANTS: National sample of US nephrologists sampled based on sex, years in practice, practice type, and region...
January 31, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29388276/involvement-of-nurses-in-end-of-life-discussions-for-severely-disabled-children
#9
I H Zaal-Schuller, D I Willems, F Ewals, J B van Goudoever, M A de Vos
BACKGROUND: In children with profound intellectual and multiple disabilities (PIMD), discussions about end-of-life decisions (EoLDs) are comparatively common. Nurses play a crucial role in the care for these children, yet their involvement in EoLD discussions is largely unknown. The objective of this research was to investigate the involvement in the hospital of nurses in discussions with parents and physicians about EoLDs for children with PIMD. METHOD: In a retrospective, qualitative study, we conducted semi-structured interviews with the nurses of 12 children with PIMD for whom an EoLD was made within the past 2 years...
January 31, 2018: Journal of Intellectual Disability Research: JIDR
https://www.readbyqxmd.com/read/29375076/end-of-life-futility-conversations-when-language-matters
#10
Connie M Ulrich
Futility is a term that is distressing for many, but it is a concept that merits revisiting for its normative, empirical, and ethical value in understanding end-of-life issues. Ethical concerns surrounding aggressive care and the suffering of patients at end of life are frequently cited as significant ethical issues within institutional settings, leading to clinicians' moral distress. The author responds to the essay on "The Abuse of Futility" by Schneiderman, Jecker, and Jonsen (2017), who support the continual use of futility language with patients and families...
2018: Perspectives in Biology and Medicine
https://www.readbyqxmd.com/read/29357751/navigating-the-dangerous-terrain-of-moral-distress-understanding-response-patterns-in-the-nicu
#11
Sally Thorne, Laura Konikoff, Helen Brown, Susan Albersheim
Moral distress is a well-recognized and ubiquitous aspect of health care professional practice in the neonatal intensive care unit (NICU) context. We used interpretive description methodology to guide a critical exploration of the dynamics of moral distress experience as reflected in the accounts of 28 health care professionals working in this setting. We learned about the kinds of clinical scenarios which triggered distressing experiences, and that the organizational and relational context of clinical work constituted a complex and dynamic working environment that profoundly affected both the individual and the collective experiences with moral distress in these situations...
January 1, 2018: Qualitative Health Research
https://www.readbyqxmd.com/read/29350780/an-evolutionary-concept-analysis-of-futility-in-health-care
#12
Lauren Morata
AIM: To report a concept analysis of futility in health care. BACKGROUND: Each member of the healthcare team: the physician, the nurse, the patient, the family and all others involved perceive futility differently. The current evidence and knowledge in regard to futility in health care manifest a plethora of definitions, meanings and interpretations without consensus. DESIGN: Concept analysis. DATA SOURCES: Databases searched included Medline, Cumulative Index of Nursing and Allied Health Literature, Academic Search Premier, Cochrane Database of Systematic Reviews and PsycINFO...
January 19, 2018: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/29344004/perceived-organizational-support-and-moral-distress-among-nurses
#13
Navideh Robaee, Foroozan Atashzadeh-Shoorideh, Tahereh Ashktorab, Ahmadreza Baghestani, Maasoumeh Barkhordari-Sharifabad
Background: Moral distress is prevalent in the health care environment at different levels. Nurses in all roles and positions are exposed to ethically challenging conditions. Development of supportive climates in organizations may drive nurses towards coping moral distress and other related factors. This study aimed at determining the level of perceived organizational support and moral distress among nurses and investigating the relationship between the two variables. Methods: This was a correlational-descriptive study...
2018: BMC Nursing
https://www.readbyqxmd.com/read/29340954/the-cultural-epigenesis-of-gender-based-violence-in-cambodia-local-and-buddhist-perspectives
#14
Maurice Eisenbruch
Almost one in four women in Cambodia is a victim of physical, emotional or sexual violence. The study aims to provide a comprehensive understanding of the ways in which Cambodians see its causes and effects and to identify and analyse the cultural forces that underpin and shape its landscape. An ethnographic study was carried out with 102 perpetrators and survivors of emotional, physical and sexual violence against women and 228 key informants from the Buddhist and healing sectors. Their views and experiences of it were recorded-the popular idioms expressed and the symptoms of distress experienced by survivors and perpetrators...
January 16, 2018: Culture, Medicine and Psychiatry
https://www.readbyqxmd.com/read/29324089/development-and-content-validation-of-a-questionnaire-to-assess-moral-distress-among-social-workers-in-long-term-care-facilities
#15
Sagit Lev, Liat Ayalon
OBJECTIVE: Despite the significance of ethical issues faced by social workers, research on moral distress among social workers has been extremely limited. The aim of the current study is to describe the development and content validation of a unique questionnaire to measure moral distress among social workers in long-term care facilities for older adults in Israel. METHODS: The construction of the questionnaire was based on a secondary analysis of a qualitative study that addressed the moral dilemma of social workers in nursing homes in Israel...
January 11, 2018: Social Work in Health Care
https://www.readbyqxmd.com/read/29315204/moral-distress-model-reconstructed-using-grounded-theory
#16
Hsun-Kuei Ko, Chi-Chun Chin, Min-Tao Hsu
BACKGROUND: The problems of nurse burnout and manpower shortage relate to moral distress. Thus, having a good understanding of moral distress is critical to developing strategies that effectively improve the clinical ethical climate and improve nursing retention in Taiwan. PURPOSE: The aim of this study was to reconstruct the model of moral distress using the grounded theory. METHODS: Twenty-five staff nurses at work units who attend to the needs of adult, pediatric, acute, and critical disease or end-of-life-care patients were recruited as participants using theoretical sampling from three teaching hospitals in Taiwan...
February 2018: Journal of Nursing Research: JNR
https://www.readbyqxmd.com/read/29313768/from-longshot-to-fantasy-obligations-to-pediatric-patients-and-families-when-last-ditch-medical-efforts-fail
#17
Elliott Mark Weiss, Autumn Fiester
Clinicians at quaternary centers see part of their mission as providing hope when others cannot. They tend to see sicker patients with more complex disease processes. Part of this mission is offering longshot treatment modalities that are unlikely to achieve their stated goal, but conceivably could. When patients embark on such a treatment plan, it may fail. Often treatment toward an initial goal continues beyond the point at which such a goal is feasible. We explore the progression of care from longshot to fantasy using two pediatric cases...
January 2018: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/29310541/family-members-existential-and-moral-dilemmas-with-coercion-in-mental-healthcare
#18
Reidun Norvoll, Marit Helene Hem, Hilde Lindemann
Coercion in mental healthcare does not only affect the patient, but also the patient's families. Using data from interviews with 36 family members of adult and adolescent people with mental health problems and coercion experiences, the present narrative study explores family members' existential and moral dilemmas regarding coercion and the factors influencing these dilemmas. Four major themes are identified: the ambiguity of coercion; struggling to stay connected and establishing collaboration; worries and distress regarding compulsory care; and dilemmas regarding initiating coercion...
January 1, 2018: Qualitative Health Research
https://www.readbyqxmd.com/read/29277132/a-second-order-confirmatory-factor-analysis-of-the-moral-distress-scale-revised-for-nurses
#19
Hamid Sharif Nia, Vida Shafipour, Kelly-Ann Allen, Mohammad Reza Heidari, Jamshid Yazdani-Charati, Armin Zareiyan
BACKGROUND: Moral distress is a growing problem for healthcare professionals that may lead to dissatisfaction, resignation, or occupational burnout if left unattended, and nurses experience different levels of this phenomenon. OBJECTIVES: This study aims to investigate the factor structure of the Persian version of the Moral Distress Scale-Revised in intensive care and general nurses. RESEARCH DESIGN: This methodological research was conducted with 771 nurses from eight hospitals in the Mazandaran Province of Iran in 2017...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/29261818/update-in-hospital-palliative-care-symptom-management-communication-caregiver-outcomes-and-moral-distress
#20
Rachel D Havyer, Daniel H Pomerantz, Robert L Jayes, Patricia F Harris, Stephanie M Harman, Aziz A Ansari
BACKGROUND: Updated knowledge of the palliative care (PC) literature is needed to maintain competency and best address the PC needs of hospitalized patients. We critiqued the recent PC literature with the highest potential to impact hospital practice. METHODS: We reviewed articles published between January 2016 and December 2016, which were identified through a handsearch of leading journals and a MEDLINE search. The final 9 articles selected were determined by consensus based on scientific rigor, relevance to hospital medicine, and impact on practice...
December 20, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
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