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https://www.readbyqxmd.com/read/28727521/ethical-guidance-for-disaster-response-specifically-around-crisis-standards-of-care-a-systematic-review
#1
Jonathon P Leider, Debra DeBruin, Nicole Reynolds, Angelica Koch, Judy Seaberg
BACKGROUND: Terrorism, disease outbreaks, and other natural disasters and mass casualty events have pushed health care and public health systems to identify and refine emergency preparedness protocols for disaster response. Ethical guidance, alongside legal and medical frameworks, are increasingly common components of disaster response plans. OBJECTIVES: To systematically review the prevalence and content of ethical guidance offered for disaster response, specifically around crisis standards of care (CSCs)...
July 20, 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28723309/moral-distress-as-experienced-by-hospital-social-workers-in-south-korea-and-australia
#2
Patricia Fronek, Lynne Briggs, Myung Hun Kim, Hye Bin Han, Quinn Val, Sungmin Kim, Donna McAuliffe
This exploratory, qualitative research explored the ethical problems faced by hospital social workers in South Korea and Australia, and what and who influenced their decision making using a focus group design. Although dilemmas of boundaries, confidentiality, self-determination, and other complex scenarios found in practice were identified, moral distress, a consequence of the unresolvable conflicts, dominated participants' narratives. This was particularly the case for the Korean social workers in this sample...
July 19, 2017: Social Work in Health Care
https://www.readbyqxmd.com/read/28718349/relationship-between-moral-distress-and-ethical-climate-with-job-satisfaction-in-nurses
#3
Sharareh Asgari, Vida Shafipour, Zohreh Taraghi, Jamshid Yazdani-Charati
BACKGROUND: Moral distress and ethical climate are important issues in the workplace that appear to affect people's quality of work life. OBJECTIVES: This study was conducted to determine the relationship of moral distress and ethical climate to job satisfaction in critical care nurses. MATERIALS AND METHODS: This descriptive-correlation study was conducted on 142 critical care nurses, selected from five social security hospitals in north Iran through census sampling...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28714452/predict-moral-distress-using-workplace-stress-stress-of-conscience-mediated-by-coping-using-roy-adaptation-model-a-path-analysis
#4
Muder Alkrisat
BACKGROUND: Moral distress can be predisposed when nurses are exposed to ambiguous moral situations. PURPOSE: Is to test a conceptual model based on Roy adaptation model (RAM) to examine the relationship among workplace stress, conscience stress, and moral distress mediated by coping. DESIGN: A correlational, cross sectional. RESULTS: Data were collected from 199 licensed nurses. The findings indicated that workplace stress was related negatively to coping processes (β = -...
December 1, 2016: Journal of Nursing Measurement
https://www.readbyqxmd.com/read/28668926/consequences-of-moral-distress-in-the-intensive-care-unit-a-qualitative-study
#5
Natalie J Henrich, Peter M Dodek, Emilie Gladstone, Lynn Alden, Sean P Keenan, Steven Reynolds, Patricia Rodney
BACKGROUND: Moral distress is common among personnel in the intensive care unit, but the consequences of this distress are not well characterized. OBJECTIVE: To examine the consequences of moral distress in personnel in community and tertiary intensive care units in Vancouver, Canada. METHODS: Data for this study were obtained from focus groups and analysis of transcripts by themes and sub-themes in 2 tertiary care intensive care units and 1 community intensive care unit...
July 2017: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/28664611/value-congruence-and-depressive-symptoms-among-critical-care-clinicians-the-mediating-role-of-moral-distress
#6
Giulia Lamiani, Paola Dordoni, Piergiorgio Argentero
Clinicians working in intensive care units are often exposed to several job stressors that can negatively affect their mental health. Literature has acknowledged the role of value congruence and job control in determining clinicians' psychological well-being and depressive symptoms. However, potential mediators of this association have been scarcely examined. This study aimed to test the mediating role of moral distress in the relationship between value congruence and job control, on the one hand, and depression, on the other hand...
June 30, 2017: Stress and Health: Journal of the International Society for the Investigation of Stress
https://www.readbyqxmd.com/read/28660801/seizing-the-moment-experiences-of-school-nurses-caring-for-students-with-overweight-and-obesity
#7
Shannon Baker Powell, Martha Keehner Engelke, Janice A Neil
School nurses are well positioned to assess, intervene, and evaluate efforts to positively impact students who are overweight or obese. The purpose of this qualitative, descriptive study was to explore the experiences of school nurses providing care to children living with overweight and obesity. Data were collected through face-to-face, tape-recorded, in-depth, open-ended interviews with 10 school nurses from rural areas of North Carolina working with minority and low-income children in the public school setting...
January 1, 2017: Journal of School Nursing: the Official Publication of the National Association of School Nurses
https://www.readbyqxmd.com/read/28659068/ethical-climate-in-nursing-environment
#8
Janika Koskenvuori, Olivia Numminen, Riitta Suhonen
BACKGROUND: In the past two decades, interest in the concept of ethical climate and in its research has increased in healthcare. Ethical climate is viewed as a type of organizational work climate, and defined as the shared perception of ethically correct behavior, and how ethical issues should be handled in the organization. Ethical climate as an important element of nursing environment has been the focus of several studies. However, scoping reviews of ethical climate research in nursing have not been conducted to guide further research in this area...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28659023/-powerlessness-or-doing-the-right-thing-moral-distress-among-nursing-home-staff-caring-for-residents-at-the-end-of-life-an-interpretive-descriptive-study
#9
Amanda Young, Katherine Froggatt, Sarah G Brearley
BACKGROUND: Caring for dying people can contribute to moral distress experienced by healthcare professionals. Moral distress can occur when this caring is restricted by organisational processes, resources or the provision of futile care. These factors apply to end of life care in nursing homes but research is lacking. AIM: To describe how nursing home staff experience moral distress when caring for residents during and at the end of life. METHODS: An interpretive descriptive design, using the critical incident technique in semi-structured interviews to collect data from nursing home staff...
February 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28654823/supporting-the-role-of-community-members-employed-as-research-staff-perspectives-of-community-researchers-working-in-addiction-research
#10
Gala True, Leslie B Alexander, Celia B Fisher
Community researchers are laypersons who conduct research activities in their own communities. In addiction and HIV research, community researchers are valued for their insider status and knowledge. At the same time, their presence on the research team raises concerns about coercion and confidentiality when community researchers and participants know each other personally, and the work of navigating between the worlds of research and community leads to moral distress and burnout for some community researchers...
June 20, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28644792/what-moral-distress-in-nursing-history-could-suggest-about-the-future-of-health-care
#11
Andrew Jameton
The concept of moral distress was defined in 1984 as (a) the psychological distress of (b) being in a situation in which one is constrained from acting (c) on what one knows to be right. A substantial literature on the subject has developed, primarily in nursing ethics. The aforementioned elements of distress are applied here to areas of clinical and organizational significance: (a) distress from causing intimate pain during care of the dying, (b) constraints stemming from proximate and background challenges of health care organizations, and (c) changing perspectives on therapeutic technologies derived from global environmental perspectives...
June 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28644791/culture-and-moral-distress-what-s-the-connection-and-why-does-it-matter
#12
Nancy Berlinger, Annalise Berlinger
Culture is learned behavior shared among members of a group and from generation to generation within that group. In health care work, references to "culture" may also function as code for ethical uncertainty or moral distress concerning patients, families, or populations. This paper analyzes how culture can be a factor in patient-care situations that produce moral distress. It discusses three common, problematic situations in which assumptions about culture may mask more complex problems concerning family dynamics, structural barriers to health care access, or implicit bias...
June 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28644790/strategies-for-promoting-high-quality-care-and-personal-resilience-in-palliative-care
#13
Katherine E Heinze, Heidi K Holtz, Cynda H Rushton
Palliative care (PC) clinicians are faced with ever-expanding pressures, which can make it difficult to fulfill their duties to self and others and lead to moral distress. Understanding the pressures that PC clinicians face and the resources that could be employed to ease their moral distress is crucial to maintaining a healthy PC workforce and to providing necessary PC services to patients. In this paper, we discuss recommendations related to two promising pathways for supporting PC clinicians in providing high-quality PC: (1) improving systemic PC delivery and (2) strategies to promote ethical practice environments and individual resilience...
June 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28644789/what-is-the-role-of-ethics-consultation-in-the-moral-habitability-of-health-care-environments
#14
Wendy Austin
Ethics consultation has traditionally focused on the provision of expert guidance to health care professionals when challenging quandaries arise in clinical cases. Its role, however, is expanding as demands on health care organizations are negatively impacting their moral habitability. A sign of this impact can be seen in the moral distress experienced by staff and administrators, such that some leave their positions and their organizations. Ethics consultation, more broadly conceived, can be a major asset in ensuring that ethical practice is meaningfully supported, that moral distress is mitigated, and that the organizational environment is morally habitable...
June 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28644788/initiatives-for-responding-to-medical-trainees-moral-distress-about-end-of-life-cases
#15
M Sara Rosenthal, Maria Clay
Moral distress frequently arises for medical trainees exposed to end-of-life cases. We review the small literature on best practices for reducing moral distress in such cases and propose two areas to target for moral distress reduction: medical education and organizational ethics programs. Students require training in end-of-life dialogues and truthful prognostication, which are not generally available without skilled mentors. But physician-mentors and teachers can suffer from lingering moral residue themselves, which can affect the teaching culture and student expectations...
June 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28644787/who-is-experiencing-what-kind-of-moral-distress-distinctions-for-moving-from-a-narrow-to-a-broad-definition-of-moral-distress
#16
Carina Fourie
Moral distress, according to Andrew Jameton's highly influential definition, occurs when a nurse knows the morally correct action to take but is constrained in some way from taking this action. The definition of moral distress has been broadened, first, to include morally challenging situations that give rise to distress but which are not necessarily linked to nurses feeling constrained, such as those associated with moral uncertainty. Second, moral distress has been broadened so that it is not confined to the experiences of nurses...
June 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28644786/antecedents-and-consequences-of-medical-students-moral-decision-making-during-professionalism-dilemmas
#17
Lynn Monrouxe, Malissa Shaw, Charlotte Rees
Medical students often experience professionalism dilemmas (which differ from ethical dilemmas) wherein students sometimes witness and/or participate in patient safety, dignity, and consent lapses. When faced with such dilemmas, students make moral decisions. If students' action (or inaction) runs counter to their perceived moral values-often due to organizational constraints or power hierarchies-they can suffer moral distress, burnout, or a desire to leave the profession. If moral transgressions are rationalized as being for the greater good, moral distress can decrease as dilemmas are experienced more frequently (habituation); if no learner benefit is seen, distress can increase with greater exposure to dilemmas (disturbance)...
June 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28644785/what-should-physicians-do-when-they-disagree-clinically-and-ethically-with-a-surrogate-s-wishes
#18
Terri Traudt, Joan Liaschenko
When patients' surrogates and physicians disagree about the appropriateness of aggressive treatment in intensive care units (ICUs), physicians can experience surrogates' demands as sources of moral distress. This article addresses the virtues and communication strategies needed to respond appropriately in such situations. Specifically, we offer a framework and language that rely on moral community to facilitate common ground and alleviate moral distress.
June 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28644784/how-should-physicians-respond-when-the-best-treatment-for-an-individual-patient-conflicts-with-practice-guidelines-about-the-use-of-a-limited-resource
#19
Edmund G Howe
The case presents a physician's ethical conflict, due to limited resources, between his obligations to meet the needs of a community and those of his patient. Elements of the decision-making process (and who should make the decision) are discussed, including the limitations of what ethical reasoning can offer and risks of arbitrary outcomes. Additionally, potential benefits to physicians and their patients of discussing these conflicts, including reducing the physician's moral distress, are noted. I argue that physicians' abilities to make "right" decisions in such situations are limited, and I suggest ways in which physicians can try to preserve their relationships with patients...
June 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28644783/how-should-integrity-preservation-and-professional-growth-be-balanced-during-trainees-professionalization
#20
Eli Weber, Sharon Gray
People can experience moral distress when they regard themselves as expected to pursue a course of action they believe to be morally wrong. However, beliefs that give rise to moral distress are sometimes underdeveloped. Experiences of moral distress are not uncommon for medical trainees, who are still in the process of forming their professional identities and whose identity-constituting beliefs might therefore be subject to ongoing revision. Thus, it is important for health professions training programs to incorporate case-based ethics education sessions into their structure to help identify and alleviate trainees' moral distress, provide ethics education, and create a "safe space" for trainees to talk openly about moral concerns related to clinical practice...
June 1, 2017: AMA Journal of Ethics
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