Enveloped Lives: Practicing Health and Care in Lithuania

Compassion or Corruption? Temporalities of Care and Nationhood in Papua New Guinean Nursing Education

Nurse educators in Papua New Guinea (PNG) must prepare students for often demoralizing working conditions. This article analyzes classroom and practical lessons in a PNG Highlands nursing college. A variety of pedagogical practices, including role plays and other simulation technologies, were used to socialize students to imagine patients' relatives while making clinical decisions, and to contemplate their own relatives and ancestors in reflecting on their moral commitments to health care. Such practices generate a mode of medical citizenship shaped by a regime of biocommunicability in which Christianity and education are thought to transform one's capacity to detach from the emotional appeals of kin. These pedagogies link the individual subjectivities of health workers to a persistent, though fragile, vision of the nation in which transgenerational, urban-rural kinship is a synecdoche for nationhood (and its deferral), despite professional counternarratives that cast these kinship ties as a slippery slope toward "corruption." [medical citizenship, temporalities of care, nursing simulation, nationhood, Papua New Guinea].

What does it mean to be the main caregiver to a terminally ill family member in Lithuania?: A qualitative study

Introduction

Family caregivers are a great resource for providing dignified end-of-life care for terminally ill patients. Framed from the perspective of role theory and the relational nature of providing and receiving care, study objectives were as follows: (1) to capture caregivers’ understanding of the process of taking on the role of main caregiver, (2) to conceptualize their understanding of the functions that they assume while being the main caregivers, and (3) to understand how they experienced the consequences they confronted.

Methods

The research team employed the methodological strategy of descriptive thematic analysis using a semi-structured interview guide. The sample consisting of 33 family caregivers was recruited using purposeful and snowball sampling strategies in 2020. Interview data was analyzed using content-driven inductive thematic analysis.

Results

The data analysis revealed four main themes that structure the process of becoming the main care giver of a terminally ill family member and the meaning of the caregiver role: (1) inaccessibility and mistrust of public care services for persons with terminal illness, (2) moral obligations and responsibilities of immediate family and friends, (3) cultural traditions, (4) the caregiver feels responsible for everything. The themes describe the social role of family caregiver in social context, address the process of taking on the role of caregiver and living with systemic corruption.

Conclusions

Recognition of caregiving experiences is essential in planning better systems, in direct practice and in confronting corruption. The study suggests the need for open communication, accessibility of quality services, and the recognition of caregivers as care-team members. The larger implication is that the increasing numbers of distressed caregivers and aging populations can be considered as public health populations, and thus addressable through public health methods.

I Know It When I See It: The Challenges of Addressing Corruption in Health Systems Comment on "We Need to Talk About Corruption in Health Systems"

In this commentary, I argue that corruption in health systems is a critical and legitimate area for research in order to strengthen health policy goals. This rationale is based partly on citizen demand for more accountable and transparent health systems, along with the fact that the poor and vulnerable suffer the most from the presence of corruption in health systems. What is more, there is a growing body of literature on the impact of corruption in the health system and best practices in terms of anti-corruption, transparency and accountability (ACTA) strategies and tactics within the health system. Still, we need to support ACTA integration into the health system by having a common definition of corruption that is meaningful for health systems and ensure that ACTA strategies and tactics are transparent themselves. The 2019 Consultation on a proposed Global Network on ACTA in Health Systems is promising for these efforts.

Can beliefs in justice predict corrupt behavior?

The belief in a just world has been found to be related to rule breaking behavior. However, research has yet to determine whether the same relation holds for corrupt behavior. The current study focused on identifying whether the belief in a just world is a factor that predicts bribery behavior. We hypothesized that people with a weaker belief in a just world would be more likely to report that they had given a bribe compared with people with a strong belief in a just world. A retrospective design was used to conduct a study in Lithuania. Belief in a just world was measured with two scales for assessing personal and general beliefs in a just world. We measured bribery behavior by asking participants (N = 316) to report how many times they had given a bribe during the past 5 years. The results showed that a personal belief in a just world predicted bribery behavior, whereas a general belief in a just world did not. We discuss implications for further studies.