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Ahlström G, Huang H, Luo Y, Bökberg C, Rasmussen BH, Persson EI, Xue L, Cai L, Tang P, Persson M, Huang J. Similarities and differences between China and Sweden regarding the core features of palliative care for people aged 60 or older: a systematic scoping review. BMC Palliat Care 2022; 21:35. [PMID: 35287635 PMCID: PMC8922883 DOI: 10.1186/s12904-022-00906-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 01/24/2022] [Indexed: 11/22/2022] Open
Abstract
Background Despite the increasing longevity of the world’s population, with an unprecedented rise in the number of people who need palliative care (PC), there has been sparse research regarding palliative care for older people, especially when it comes to comparison of PC between healthcare systems and cultures. The aim of this systematic scoping review was to identify the characteristics of the body of literature and to examine the knowledge gaps concerning PC research for older people (> 60 years) in two healthcare systems and cultures, mainland China and Sweden. Methods The guidelines PRISMA (Preferred Reporting Items for Systematic Reviews), and PICOS (Patient/population, Intervention, Comparison/control, and Outcome) were used. Empirical studies on patients 60 years or older, next of kin or staff participating in a palliative care intervention or setting were included. They were conducted in mainland China or in Sweden during 2007–2019, were published in English and were extracted from seven databases: Embase, PubMed, Scopus, Cinahl, PsycInfo, Academic Search Complete and Cochrane Library. Two independent researchers conducted the selection of studies, data extraction and methodological evaluation. Any disagreements were resolved in consultation with a third researcher. The analysis was manifest directed content analysis based on PICOS domains. Results Of the 15 studies, four were from mainland China and 11 from Sweden. Both countries included older patients with cancer but also other end-stage diseases such as heart failure and dementia. The studies differed in design, method and the content of the interventions. The study in China based on traditional Chinese medicine concerns traditional Chinese folk music. The six qualitative studies from Sweden were evaluations of five interventions. Conclusions Despite the high age of the participating patients, there was no focus on an ageing perspective concerning palliative care. To adapt to the changes taking place in most societies, future research should have increased focus on older persons’ need for palliative care and should take account of issues concerning research ethics, ethnicity and culture. Registered in Prospero CRD42020078685, available from. Supplementary Information The online version contains supplementary material available at 10.1186/s12904-022-00906-7.
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Affiliation(s)
- Gerd Ahlström
- Department of Health Sciences, Faculty of Medicine, Lund University, P.O. Box 157, SE-221 00, Lund, Sweden.
| | - Hongli Huang
- Hospital Management, the Third People's Hospital of Kunming, Kunming, Yunnan Province, China
| | - Yu Luo
- Hospice Care Department, the Third People's Hospital of Kunming, Kunming, Yunnan Province, China
| | - Christina Bökberg
- Department of Health Sciences, Faculty of Medicine, Lund University, P.O. Box 157, SE-221 00, Lund, Sweden
| | - Birgit H Rasmussen
- Department of Health Sciences, Faculty of Medicine, Lund University, P.O. Box 157, SE-221 00, Lund, Sweden.,The Institute for Palliative Care, Region Skane and Lund University, Lund, Sweden
| | - Eva I Persson
- Department of Health Sciences, Faculty of Medicine, Lund University, P.O. Box 157, SE-221 00, Lund, Sweden
| | - Lian Xue
- Hospice Care Department, the Third People's Hospital of Kunming, Kunming, Yunnan Province, China
| | - Le Cai
- School of Public Health, Kunming Medical University, Kunming, Yunnan Province, China
| | - Pingfen Tang
- School of Public Health, Kunming Medical University, Kunming, Yunnan Province, China
| | - Magnus Persson
- Department of Health Sciences, Faculty of Medicine, Lund University, P.O. Box 157, SE-221 00, Lund, Sweden
| | - Jingjing Huang
- The Medical Record Statistics Department, the Third People's Hospital of Kunming, Kunming, Yunnan Province, China
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Zahednezhad H, Shokrollahi N, Gheshlagh RG, Afshar PF. Does heavy mental workload affect moral sensitivity among critical care unit nursing professionals? a cross-sectional study. BMC Nurs 2021; 20:140. [PMID: 34376186 PMCID: PMC8353778 DOI: 10.1186/s12912-021-00662-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 07/14/2021] [Indexed: 11/10/2022] Open
Abstract
Background Moral sensitivity creates the basic attitude in providing effective ethical care to patients. Heavy mental workload is a major concern of critical care nursing professionals, which could adversely affect nursing staff and patients. The present study aimed to investigate the effects of mental workload and some demographic variables on the moral sensitivity of critical care nursing professionals. Methods This cross-sectional, descriptive-correlational study was performed on 181 nursing professionals working in the critical care units of Shahid Rajaei Cardiovascular Medical and Research Center in Tehran, Iran. Data were collected using a demographic questionnaire, the moral sensitivity questionnaire, and the NASA-task load index to assess mental workload. Data analysis was performed in SPSS version 22 using descriptive statistics, independent t-test, Pearson’s correlation-coefficient, and regression analysis. Results The results of regression analysis yielded no statistical significant relationship between heavy mental workload and moral sensitivity of the critical care nursing professionals, while clinical experience had a positive, significant association with moral sensitivity. Conclusions Although care nursing professionals experience a heavy mental workload in critical care units, it does not decrease their moral sensitivity. In addition, experienced nurses have higher moral sensitivity and lower mental workload. Therefore, it seems that nursing managers should pay special attention to the importance of employing experienced nurses along with younger nurses.
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Affiliation(s)
- Hosein Zahednezhad
- Department of Psychiatric Nursing and Management, School of Nursing & Midwifery, Shahid Beheshti University Of Medical sciences, Velenjak St, Shahid Chamran Highway, Tehran, Iran.
| | - Nasrin Shokrollahi
- Masters of Science in Critical Care Nursing, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tohid Square, Tehran, Iran
| | - Reza Ghanei Gheshlagh
- Spiritual Health Research Center, Research Institute for Health Development, Kurdistan University Of Medical sciences, Pasdaran Blvd., Sanandaj, Iran
| | - Pouya Farokhnezhad Afshar
- School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Shahid Hemmat Highway, 1449614535, Tehran, Iran
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Rainer J, Schneider JK, Lorenz RA. Ethical dilemmas in nursing: An integrative review. J Clin Nurs 2018; 27:3446-3461. [PMID: 29791762 DOI: 10.1111/jocn.14542] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2018] [Indexed: 11/27/2022]
Abstract
AIMS To identify themes and gaps in the literature to stimulate researchers to develop strategies to guide decision-making among clinical nurses faced with ethical dilemmas. BACKGROUND The concept of ethical dilemmas has been well explored in nursing because of the frequency of ethical dilemmas in practice and the toll these dilemmas can take on nurses. Although ethical dilemmas are prevalent in nursing practice, frequently leading to moral distress, there is little guidance in the literature to help nurses resolve them. DESIGN This study is an integrative review of published research from 2000 to 2017. METHODS The keywords ethics, ethical dilemmas and nurs* were searched in CINAHL, PubMed, OVID and SCOPUS. Exclusion criteria were sources not available in English, not in acute care, and without an available abstract. Seventy-two studies were screened; 35 were retained. Garrard's matrix was utilised to analyse and synthesise the studies. RESULTS Ethical dilemmas arose from end-of-life issues, conflict with physicians or families, patient privacy concerns and organisational constraints. Differences were found in study location, and yet international research confirms that ethical dilemmas are universally prevalent and must be addressed globally to protect patients and nurses. CONCLUSIONS This review offers an analysis of the available evidence regarding ethical dilemmas in acute care, identifying themes, limitations and gaps in the literature. The gaps in quantitative intervention work, US paucity of research, and lack of comparisons across practice settings/nursing roles must be addressed. Further exploration is warranted in the relationship between ethical dilemmas and moral distress, the significance patient physical appearance plays on nurse determination of futility, and strategies for pain management and honesty. RELEVANCE TO NURSING PRACTICE Understanding and addressing gaps in research is essential to develop strategies to help nurses resolve ethical dilemmas and to avoid moral distress and burnout.
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Dehghani A, Mosalanejad L, Dehghan-Nayeri N. Factors affecting professional ethics in nursing practice in Iran: a qualitative study. BMC Med Ethics 2015; 16:61. [PMID: 26354119 PMCID: PMC4565012 DOI: 10.1186/s12910-015-0048-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Accepted: 08/14/2015] [Indexed: 11/25/2022] Open
Abstract
Background Professional ethics refers to the use of logical and consistent communication, knowledge, clinical skills, emotions and values in nursing practice. This study aimed to explore and describe factors that affect professional ethics in nursing practice in Iran. Methods This qualitative study was conducted using conventional content analysis approach. Thirty nurses with at least 5 years of experience participated in the study; they were selected using purposive sampling. Data were collected through semi-structured interviews and analyzed using thematic analysis. Results After encoding and classifying the data, five major categories were identified: individual character and responsibility, communication challenges, organizational preconditions, support systems, educational and cultural development. Conclusions Awareness of professional ethics and its contributing factors could help nurses and healthcare professionals provide better services for patients. At the same time, such understanding would be valuable for educational administrators for effective planning and management.
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Affiliation(s)
- Ali Dehghani
- Mental Health Department, Nursing and Paramedical school, Jahrom University of Medical Sciences, Jahrom, Iran.
| | - Leili Mosalanejad
- Mental Health Department, Nursing and Paramedical school, Jahrom University of Medical Sciences, Jahrom, Iran.
| | - Nahid Dehghan-Nayeri
- Nursing Management Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
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Parandavar N, Rahmanian A, Badiyepeymaie Jahromi Z. A Study of the Relationship Between Nurses' Professional Self-Concept and Professional Ethics in Hospitals Affiliated to Jahrom University of Medical Sciences, Iran. Glob J Health Sci 2015; 8:82-8. [PMID: 26573035 PMCID: PMC4873582 DOI: 10.5539/gjhs.v8n4p82] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Accepted: 06/23/2015] [Indexed: 11/23/2022] Open
Abstract
Background: Commitment to ethics usually results in nurses’ better professional performance and advancement. Professional self-concept of nurses refers to their information and beliefs about their roles, values, and behaviors. The objective of this study is to analyze the relationship between nurses’ professional self-concept and professional ethics in hospitals affiliated to Jahrom University of Medical Sciences. Methods: This cross sectional-analytical study was conducted in 2014. The 270 participants were practicing nurses and head-nurses at the teaching hospitals of Peimanieh and Motahari in Jahrom University of Medical Science. Sampling was based on sencus method. Data was collected using Cowin's Nurses’ self-concept questionnaire (NSCQ) and the researcher-made questionnaire of professional ethics. Results: The average of the sample's professional self-concept score was 6.48±0.03 out of 8. The average of the sample's commitment to professional ethics score was 4.08±0.08 out of 5. Based on Pearson's correlation test, there is a significant relationship between professional ethics and professional self-concept (P=0.01, r=0.16). Conclusion: In view of the correlation between professional self-concept and professional ethics, it is recommended that nurses’ self-concept, which can boost their commitment to ethics, be given more consideration.
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