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https://www.readbyqxmd.com/read/29350780/an-evolutionary-concept-analysis-of-futility-in-healthcare
#1
Lauren Morata
AIM: To report a concept analysis of futility in healthcare. 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 healthcare 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
#2
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/29324089/development-and-content-validation-of-a-questionnaire-to-assess-moral-distress-among-social-workers-in-long-term-care-facilities
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
https://www.readbyqxmd.com/read/29258322/clinical-and-sociocultural-factors-associated-with-failure-to-escalate-care-of-deteriorating-patients
#9
Firas S Elmufdi, Susan L Burton, Nishant Sahni, Craig R Weinert
In-hospital medical emergencies occur frequently. Understanding how clinicians respond to deteriorating patients outside the intensive care unit (ICU) could improve "rescue" interventions and rapid response programs. This was a qualitative study with interviews with 40 clinicians caring for patients who had a "Code Blue" activation or an unplanned ICU admission at teaching hospitals over 7 months. Four study physicians independently analyzed interview transcripts; refined themes were linked to the transcript using text analysis software...
December 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29247313/rethinking-moral-distress-conceptual-demands-for-a-troubling-phenomenon-affecting-health-care-professionals
#10
Daniel W Tigard
Recent medical and bioethics literature shows a growing concern for practitioners' emotional experience and the ethical environment in the workplace. Moral distress, in particular, is often said to result from the difficult decisions made and the troubling situations regularly encountered in health care contexts. It has been identified as a leading cause of professional dissatisfaction and burnout, which, in turn, contribute to inadequate attention and increased pain for patients. Given the natural desire to avoid these negative effects, it seems to most authors that systematic efforts should be made to drastically reduce moral distress, if not altogether eliminate it from the lives of vulnerable practitioners...
December 15, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/29218965/moral-courage-in-undergraduate-nursing-students-a-literature-review
#11
Laurie Bickhoff, Peter M Sinclair, Tracy Levett-Jones
Aim: The aim of this review was to explore factors which facilitate or inhibit undergraduate nursing students’ willingness to demonstrate moral courage when confronted by poor patient care. Methods: Included papers were those that met the criteria of being qualitative research that explored undergraduate nursing students’ depictions of situations where moral courage was or was not demonstrated during clinical placements, with a particular focus on situations that impacted or had the potential to impact the quality of patient care...
2017: Collegian: Journal of the Royal College of Nursing, Australia
https://www.readbyqxmd.com/read/29209622/exploration-of-the-association-between-nurses-moral-distress-and-secondary-traumatic-stress-syndrome-implications-for-patient-safety-in-mental-health-services
#12
Maria Christodoulou-Fella, Nicos Middleton, Elizabeth D E Papathanassoglou, Maria N K Karanikola
Work-related moral distress (MD) and secondary traumatic stress syndrome (STSS) may be associated with compromised health status among health professionals, reduced productivity, and inadequate safety of care. We explored the association of MD with the severity of STSS symptoms, along with the mediating role of mental distress symptoms. Associations with emotional exhaustion and professional satisfaction were also assessed. This cross-sectional survey conducted in 206 mental health nurses (MHNs) was employed across public sector community and hospital settings in Cyprus...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29196079/burnout-moral-distress-work-life-balance-and-career-satisfaction-among-hematopoietic-cell-transplantation-professionals
#13
Joyce L Neumann, Lih-Wen Mau, Sanya Virani, Ellen M Denzen, Deborah A Boyle, Nancy J Boyle, Jane Dabney, Alexandra De KeselLofthus, Marion Kalbacker, Tippu Khan, Navneet S Majhail, Elizabeth A Murphy, Pamela Paplham, Leslie Parran, Miguel-Angel Perales, Todd H Rockwood, Kim Schmit-Pokorny, Tait D Shanafelt, Elaine Stenstrup, William A Wood, Linda J Burns
BACKGROUND: A projected shortage of hematopoietic cell transplantation (HCT) health professionals was identified as a major issue during the National Marrow Donor Program (NMDP)/Be The Match System Capacity Initiative. Work-related distress and work-life balance were noted to be potential barriers to recruitment/retention. This study examined these barriers and their association with career satisfaction across HCT disciplines. METHODS: A cross-sectional, 90-item, web-based survey was administered to advanced practice providers (APP), nurses, physicians, pharmacists, and social workers in 2015...
November 28, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29191724/moral-distress-at-the-end-of-a-life-when-family-and-clinicians-do-not-agree-on-implantable-cardioverter-defibrillator-deactivation
#14
Jill M Steiner, Kristen K Patton, Jordan M Prutkin, James N Kirkpatrick
A 63-year-old man with end-stage ischemic cardiomyopathy presented with incessant ventricular tachycardia. He had been hospitalized multiple times in the past year for severe heart failure. As he approached end of life and was regularly receiving defibrillator shocks, his care team recommended deactivation of his implantable cardioverter-defibrillator. However, his family did not wish to allow deactivation, reporting a religious obligation to prolong his life, regardless of the risk of suffering. The patient was unable to adequately participate in the decision-making process...
November 28, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29187830/the-role-of-moral-suffering-moral-distress-and-moral-injury-in-police-compassion-fatigue-and-ptsd-an-unexplored-topic
#15
Konstantinos Papazoglou, Brian Chopko
No abstract text is available yet for this article.
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/29187107/the-burdens-of-offering-ethical-and-practical-considerations
#16
Roxanne E Kirsch, Jillian Coronado, Peter P Roeleveld, James Tweddell, Antonio M Mott, Stephen J Roth
We reflect upon highlights of a facilitated panel discussion from the 2016 Pediatric Cardiac Intensive Care Society Meeting. The session was designed to explore challenges, share practical clinical experiences, and review ethical underpinnings surrounding decisions to offer intensive, invasive therapies to patients who have a poor prognosis for survival or are likely to be burdened with multiple residual comorbidities if survival is achieved. The discussion panel was representative of a variety of disciplines including pediatric cardiology, cardiac intensive care, nursing, and cardiovascular surgery as well as different health-care delivery systems...
November 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29176338/case-managers-on-the-front-lines-of-ethical-dilemmas-advocacy-autonomy-and-preventing-case-manager-burnout
#17
Charlotte Sortedahl, Nina Mottern, Vivian Campagna
PURPOSE: The purpose of this article is to examine how case managers are routinely confronted by ethical dilemmas within a fragmented health care system and given the reality of financial pressures that influence life-changing decisions. The Code of Professional Conduct for Case Managers (Code), published by the Commission for Case Manager Certification, acknowledges "case managers may often confront ethical dilemmas" (Code 1996, Rev. 2015). PRIMARY PRACTICE SETTINGS: The Code and expectations that professional case managers, particularly those who are board certified, will uphold ethical and legal practice apply to case managers in every practice setting across the full continuum of health care...
January 2018: Professional Case Management
https://www.readbyqxmd.com/read/29160962/recognizing-and-dealing-with-moral-distress
#18
Beth Ulrich
No abstract text is available yet for this article.
July 2017: Nephrology Nursing Journal: Journal of the American Nephrology Nurses' Association
https://www.readbyqxmd.com/read/29095938/challenges-to-code-status-discussions-for-pediatric-patients
#19
Katherine E Kruse, Jason Batten, Melissa L Constantine, Saraswati Kache, David Magnus
OBJECTIVES: In the context of serious or life-limiting illness, pediatric patients and their families are faced with difficult decisions surrounding appropriate resuscitation efforts in the event of a cardiopulmonary arrest. Code status orders are one way to inform end-of-life medical decision making. The objectives of this study are to evaluate the extent to which pediatric providers have knowledge of code status options and explore the association of provider role with (1) knowledge of code status options, (2) perception of timing of code status discussions, (3) perception of family receptivity to code status discussions, and (4) comfort carrying out code status discussions...
2017: PloS One
https://www.readbyqxmd.com/read/29079608/vulnerability-survival-and-shame-in-nina-raine-s-tiger-country
#20
Deborah Bowman
Shame in healthcare remains relatively underexplored, yet it is commonplace and its impact is significant. This paper explores shame in healthcare using Nina Raine's 2011 play Tiger Country Three manifestations of shame are explored, namely (1) shame in relation to professional identity and survival in the clinical workplace; (2) shame and illness as experienced by both patients and doctors; and (3) the systemic and organisational influences on shame within healthcare systems. I suggest that the theatre is particularly well-placed to elucidate shame, and that Tiger Country demonstrates the prevalence and impact of shame on clinical work...
December 2017: Medical Humanities
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