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"Moral distress"

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https://www.readbyqxmd.com/read/28532556/ethical-challenges-in-the-provision-of-dialysis-in-resource-constrained-environments
#1
REVIEW
Valerie A Luyckx, Ingrid Miljeteig, Addisu M Ejigu, M Rafique Moosa
The number of patients requiring dialysis by 2030 is projected to double worldwide, with the largest increase expected in low- and middle-income countries (LMICs). Dialysis is seldom considered a high priority by health care funders, consequently, few LMICs develop policies regarding dialysis allocation. Dialysis facilities may exist, but access remains highly inequitable in LMICs. High out-of-pocket payments make dialysis unsustainable and plunge many families into poverty. Patients, families, and clinicians suffer significant emotional and moral distress from daily life-and-death decisions imposed by dialysis...
May 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28489312/blowing-the-whistle-moral-distress-and-advocacy-for-preterm-infants-and-their-families
#2
EDITORIAL
Annie Janvier, Trisha Prentice, John Lantos
No abstract text is available yet for this article.
June 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28481130/perception-of-futile-care-and-caring-behaviors-of-nurses-in-intensive-care-units
#3
Somaye Rostami, Ravanbakhsh Esmaeali, Hedayat Jafari, Jamshid Yazdani Cherati
OBJECTIVES: Futile medical care is considered as the care or treatment that does not benefit the patient. Staff of intensive care units experience moral distress when they perceive the futility of care. Therefore, this study aimed to determine the relationship between perceptions of nurses regarding futile medical care and their caring behaviors toward patients in the final stages of life admitted to intensive care units. METHOD: This correlation, analytical study was conducted with 181 nursing staff of the intensive care units of health centers affiliated to Mazandaran University of Medical Sciences, Mazandaran, Iran...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28476218/-bioethics-in-end-of-life-decisions-in-neonatology-unresolved-issues
#4
Juan Arnaez, Juan Carlos Tejedor, Sonia Caserío, María Teresa Montes, María Teresa Moral, Javier González de Dios, Alfredo García-Alix
This document is the result of previous work carried out by different expert groups and submitted to multidisciplinary debate at a Conference about controversial, deficient, or new aspects in the field of neonatal palliative care, such as: 1) the deliberative decision-making process, 2) hospital and domiciliary palliative care, 3) donation after controlled cardiac death, and 4) moral stress in professionals. The most relevant conclusions were: the need to instruct professionals in bioethics and in the deliberative method to facilitate thorough and reasonable decision-making; the lack of development in the field of perinatal palliative care and domiciliary palliative care in hospitals that attend newborns; the need to provide neonatal units with resources that help train professionals in communication skills and in the management of moral distress, as well as delineate operational procedure and guidelines for neonatal organ donation...
May 2, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28473795/self-rated-health-and-sick-leave-among-nurses-and-physicians-the-role-of-regret-and-coping-strategies-in-difficult-care-related-situations
#5
Stéphane Cullati, Boris Cheval, Ralph E Schmidt, Thomas Agoritsas, Pierre Chopard, Delphine S Courvoisier
Moral distress - such as feeling strong regret over difficult patient situations - is common among nurses and physicians. Regret intensity, as well as the coping strategies used to manage regrets, may also influence the health and sickness absence of healthcare professionals. The objective of this study was to determine if the experience of regret related to difficult care-related situations is associated with poor health and sick leave and if coping strategies mediate these associations. Two cross-sectional surveys were conducted in Switzerland (Geneva, 2011 and Zurich, 2014)...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/28464757/nurses-contributions-to-the-resolution-of-ethical-dilemmas-in-practice
#6
Nichola Ann Barlow, Janet Hargreaves, Warren P Gillibrand
BACKGROUND: Complex and expensive treatment options have increased the frequency and emphasis of ethical decision-making in healthcare. In order to meet these challenges effectively, we need to identify how nurses contribute the resolution of these dilemmas. AIMS: To identify the values, beliefs and contextual influences that inform decision-making. To identify the contribution made by nurses in achieving the resolution of ethical dilemmas in practice. DESIGN: An interpretive exploratory study was undertaken, 11 registered acute care nurses working in a district general hospital in England were interviewed, using semi-structured interviews...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28436928/moral-distress-conscious-and-unconscious-feelings
#7
William J Winslade
In analyzing moral distress, perhaps greater attention should be given to the possible implicit sources of feelings of distress, as well as explicit sources.
2017: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/28436927/looking-at-the-positive-side-of-moral-distress-why-it-s-a-problem
#8
Elizabeth G Epstein, Ashley R Hurst
Moral distress, is, at its core, an organizational problem. It is experienced on a personal level, but its causes originate within the system itself. In this commentary, we argue that moral distress is not inherently good, that effective interventions must address the external sources of moral distress, and that while there is a place for resilience in the healthcare professions, it cannot be an effective antidote to moral distress.
2017: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/28436926/using-moral-distress-for-organizational-improvement
#9
James E Sabin
Moral distress is a major problem for nurses, other clinicians, and the health system itself. But if properly understood and responded to, it is also a promising guide for healthcare improvement. When individuals experience moral distress or burnout, their reports must be seen as crucial data requiring careful attention to the individuals and to the organization. Distress and burnout will often point to important opportunities for system improvements, which may in turn reduce the experience of distress. For this potential virtuous cycle to happen, individuals must be able to articulate their concerns without fear of retribution, and organizational leaders must be able to listen in an undefensive, improvement-oriented manner...
2017: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/28436925/focus-more-on-causes-and-less-on-symptoms-of-moral-distress
#10
Tessy A Thomas, Laurence B McCullough
In this commentary on Carse and Rushton's call for reorientation of moral distress, we state agreement with the authors that the discourse of moral distress should refocus on the moral components of integrity. We then explain how our philosophical taxonomy of moral distress, mentioned by the authors, appeals to moral integrity. In this process, we clarify our taxonomy's appeal to Aristotle's concept of akrasia. We conclude by offering support of Carse and Rushton's challenge to organizations to strengthen moral integrity by fostering resilience...
2017: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/28436924/harnessing-the-promise-of-moral-distress-a-call-for-re-orientation
#11
Alisa Carse, Cynda Hylton Rushton
Despite over three decades of research into the sources and costs of what has become an "epidemic" of moral distress among healthcare professionals, spanning many clinical disciplines and roles, there has been little significant progress in effectively addressing moral distress. We believe the persistent sense of frustration, helplessness, and despair still dominating the clinical moral distress narrative signals a need for re-orientation in the way moral distress is understood and worked with. Most fundamentally, moral distress reveals moral investment and energy...
2017: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/28436923/fourteen-important-concepts-regarding-moral-distress
#12
Edmund G Howe
I suggest that we may want to strive, over time, to change our present professional-cultural view, from one that sees an expression of moral distress as a threat, to a professional-cultural view that welcomes these challenges. Such an effort to better medicine would not only include dissenting clinicians, but patients (and their loved ones) as well.
2017: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/28434608/a-concept-analysis-of-moral-resilience
#13
Peter D Young, Cynda Hylton Rushton
BACKGROUND: Nurses experience moral distress, which has led to emotional distress, frustration, anger, and nurse attrition. Overcoming moral distress has become a significant focus in nursing research. PURPOSE: The continued focus on moral distress has not produced sustainable solutions within the nursing profession. Since positive language may alter the outcomes of morally distressing situations, we look to better understand one such positive phrase, moral resilience...
March 16, 2017: Nursing Outlook
https://www.readbyqxmd.com/read/28426307/how-california-prepared-for-implementation-of-physician-assisted-death-a-primer
#14
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...
June 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28425313/moral-distress-among-school-nurses
#15
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
#16
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
#17
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/28344714/moral-distress-and-burnout-in-internal-medicine-residents
#18
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
#19
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/28319986/perceived-ethics-dilemmas-among-pioneer-accountable-care-organizations
#20
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
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