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Junger N, Hirsch O. Ethics of Nudging in the COVID-19 Crisis and the Necessary Return to the Principles of Shared Decision Making: A Critical Review. Cureus 2024; 16:e57960. [PMID: 38601812 PMCID: PMC11005480 DOI: 10.7759/cureus.57960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2024] [Indexed: 04/12/2024] Open
Abstract
Nudging, a controversial technique for modifying people's behavior in a predictable way, is claimed to preserve freedom of choice while simultaneously influencing it. Nudging had been largely confined to situations such as promoting healthy eating choices but has been employed in the coronavirus disease 2019 (COVID-19) crisis in a shift towards measures that involve significantly less choice, such as shoves and behavioral prods. Shared decision making (SDM), a method for direct involvement and autonomy, is an alternative approach to communicate risk. Predominantly peer-reviewed scientific publications from standard literature databases like PubMed, PsycInfo, and Psyndex were evaluated in a narrative review. The so-called fear nudges, as well as the dissemination of strongly emotionalizing or moralizing messages can lead to intense psycho-physical stress. The use of these nudges by specialized units during the COVID-19 pandemic generated a societal atmosphere of fear that precipitated a deterioration of the mental and physical health of the population. Major recommendations of the German COVID-19 Snapshot Monitoring (COSMO) study, which are based on elements of nudging and coercive measures, do not comply with ethical principles, basic psychological principles, or evidence-based data. SDM was misused in the COVID-19 crisis, which helped to achieve one-sided goals of governments. The emphasis on utilitarian thinking is criticized and the unethical behavior of decision makers is explained by both using the concept of moral disengagement and the maturity level of coping strategies. There should be a return to an open-ended, democratic, and pluralistic scientific debate without using nudges. It is therefore necessary to return to the origins of SDM.
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Affiliation(s)
- Nancy Junger
- Psychology, Independent Researcher, Tübingen, DEU
| | - Oliver Hirsch
- Psychology, FOM University of Applied Sciences, Siegen, DEU
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Breman RB, Waddell A, Watkins V. Shared Decision Making in Perinatal Care. J Obstet Gynecol Neonatal Nurs 2024; 53:96-100. [PMID: 38403272 DOI: 10.1016/j.jogn.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024] Open
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Hussain AK, Kakakhel MM, Ashraf MF, Shahab M, Ahmad F, Luqman F, Ahmad M, Mohammed Nour A, Varrassi G, Kinger S. Innovative Approaches to Safe Surgery: A Narrative Synthesis of Best Practices. Cureus 2023; 15:e49723. [PMID: 38161861 PMCID: PMC10757557 DOI: 10.7759/cureus.49723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 11/30/2023] [Indexed: 01/03/2024] Open
Abstract
By encompassing a wide range of best practices within the ever-changing realm of modern surgical care, this exhaustive narrative compendium attempts to unravel the complex tapestry of novel approaches to safe surgery. Within the context of a dynamic surgical environment, this research endeavors to illuminate and integrate state-of-the-art methods that collectively methodically improve patient safety. The narrative elucidates a diverse array of practices that seek to revolutionize the paradigm of safe surgery, emphasizing technological progress, patient-centric approaches, and global viewpoints. The combined effectiveness of these methods in fostering an all-encompassing culture of safety, improving surgical precision, and decreasing complications is revealed by the results obtained from their implementation. The recognition of the dynamic interplay among multiple components, including the active participation of patients, the integration of cutting-edge technologies, and the establishment of comprehensive quality improvement programs, is fundamental to this narrative. By their collective composition, these components support the notion that secure surgical practices are intricate and interrelated. The present synthesis functions as a fundamental resource for healthcare professionals, policymakers, and researchers, providing an enlightening examination of the current condition of secure surgical practices. By emphasizing the promotion of innovation, continuous development, and the utmost quality of patient care, it offers a strategic guide for navigating the complex terrain of safe surgery. In the ever-evolving landscape of surgical care, this narrative synthesis serves as a guiding principle for stakeholders striving to understand better and implement safe surgical procedures in various healthcare environments.
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Affiliation(s)
- Amer Kamal Hussain
- Urology, Sandwell and West Birmingham Hospitals National Health Service (NHS) Trust, Birmingham, GBR
| | - Muhammad Maaz Kakakhel
- Trauma and Orthopaedics, Liverpool University Hospitals National Health Service (NHS) Foundation Trust, Liverpool, GBR
| | | | | | - Fahad Ahmad
- Upper Gastrointestinal Surgery, University Hospitals Birmingham National Health Service (NHS) Foundation Trust, Birmingham, GBR
| | - Faizan Luqman
- Ophthalmology, Khyber Medical College, Peshawar, PAK
- Ophthalmology, Medical Teaching Institution (MTI) Khyber Teaching Hospital, Peshawar, PAK
| | - Mahmood Ahmad
- Trauma and Orthopaedics, Royal College of Surgeons, Dublin, IRL
| | - Ayman Mohammed Nour
- Urology, Sandwell and West Birmingham Hospitals National Health Service (NHS) Trust, Birmingham, GBR
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Jian H, Hao H, Haidan J, Haize P, Chuan L. Brownfield redevelopment evaluation based on structure-process-outcome theory and continuous ordered weighted averaging operator-topology method. Sci Rep 2023; 13:17530. [PMID: 37845278 PMCID: PMC10579277 DOI: 10.1038/s41598-023-44793-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 10/12/2023] [Indexed: 10/18/2023] Open
Abstract
As an important part of urban renewal, brownfield restoration and renovation are of great significance to the sustainable development of cities. The structure-process-outcome theory was introduced into this study to improve the rationality and scientific vigor of the redevelopment assessment process and to evaluate whether brownfield sites meet the conditions for redevelopment. Based on this theory, the relationship among structures, processes and outcomes can be well elucidated. Specifically, a good structure should contribute to an effective process, which will increase the possibility of a favorable outcome. The basic conditions, practice principles, and result orientation in the whole procedure of brownfield redevelopment were comprehensively analyzed. In addition, a more complete and reasonable three-level evaluation index system for brownfield redevelopment was established. In order to reduce the subjectivity in the evaluation process, an unbiased scientific brownfield redevelopment evaluation model was constructed using the continuous ordered weighted averaging operator-topology method. The evaluation decision system was applied to the renovation of a tract project in Chengdu, China. The results proved that the model could effectively and accurately evaluate the quality level of the brownfield redevelopment project, and the proposed recommendations can provide a basis for decision-making.
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Affiliation(s)
- He Jian
- College of Civil Engineering, Chongqing University of Arts and Sciences, Chongqing, 402160, China
| | - Hu Hao
- College of Civil Engineering, Chongqing University of Arts and Sciences, Chongqing, 402160, China
| | - Jiang Haidan
- College of Civil Engineering, Chongqing University of Arts and Sciences, Chongqing, 402160, China.
| | - Pan Haize
- School of Civil Engineering and Geomatics, Southwest Petroleum University, Chengdu, 610500, China
| | - Liu Chuan
- School of Civil Engineering and Geomatics, Southwest Petroleum University, Chengdu, 610500, China
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Zhang X, Buttery SC, Sterniczuk K, Brownrigg A, Kennington E, Quint JK. Patient Experiences of Communication with Healthcare Professionals on Their Healthcare Management around Chronic Respiratory Diseases. Healthcare (Basel) 2023; 11:2171. [PMID: 37570411 PMCID: PMC10418967 DOI: 10.3390/healthcare11152171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 07/19/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Communication is an important clinical tool for the prevention and control of diseases, to advise and inform patients and the public, providing them with essential knowledge regarding healthcare and disease management. This study explored the experience of communication between healthcare professionals (HCPs) and people with long-term lung conditions, from the patient perspective. METHODS This qualitative study analyzed the experience of people with chronic lung disease, recruited via Asthma & Lung UK (A&LUK) and COPD research databases. A&LUK invited people who had expressed a desire to be involved in research associated with their condition via their Expert Patient Panel and associated patients' groups. Two focus group interviews (12 participants) and one individual interview (1 participant) were conducted. Thematic analysis was used for data analysis. RESULTS Two main themes were identified and we named them 'involving communication' and 'communication needs to be improved. 'They included seven subthemes: community-led support increased the patients' social interaction with peers; allied-HCP-led support increased patients' satisfaction; disliking being repeatedly asked the same basic information; feeling communication was unengaging, lacking personal specifics and the use of medical terminology and jargon. CONCLUSIONS The study has identified what most matters in the process of communication with HCPs in people with long-term respiratory diseases of their healthcare management. The findings of the study can be used to improve the patient-healthcare professional relationship and facilitate a better communication flow in long-term healthcare management.
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Affiliation(s)
- Xiubin Zhang
- National Heart and Lung Institute, Imperial College London, London SW7 2BX, UK; (X.Z.); (S.C.B.)
| | - Sara C. Buttery
- National Heart and Lung Institute, Imperial College London, London SW7 2BX, UK; (X.Z.); (S.C.B.)
| | | | | | | | - Jennifer K. Quint
- National Heart and Lung Institute, Imperial College London, London SW7 2BX, UK; (X.Z.); (S.C.B.)
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