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Nadolny S, Bruns F, Nowak A, Schildmann J. Moral competency of students at a german medical school - A longitudinal survey. BMC MEDICAL EDUCATION 2024; 24:691. [PMID: 38918781 PMCID: PMC11201357 DOI: 10.1186/s12909-024-05674-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 06/19/2024] [Indexed: 06/27/2024]
Abstract
BACKGROUND Medical students and doctors face various challenges in clinical practice. Some of these challenges are related to ethical issues. Therefore, teaching ethics respectively building moral competences has become an integral part of the medical curriculum in Germany and many other countries. To date, there is little evidence on moral competence of medical students. METHODS Self-administered survey among medical students from one German medical school in the first (cohort 1) and fifth semester (cohort 2) in the winter term 2019/20 (T0). Both cohorts received the same questionnaire one year later in winter term 2020/21 (T1). Assessment was performed with Lind's Moral Competence Test. We performed convenience sampling. We analyzed the data with descriptive statistics and C-Scores as a measure of moral competence (higher scores = higher competence, ≥ 30 points = high competence). RESULTS A total of 613 students participated in the study (response rate 67.5%, n = 288 with data on both time points). 69.6% of the participants were female, the mean age was 21.3 years. Mean C-Score for both cohorts for T0 (first and fifth semester) is 32.5 ± 18.0 and for T1 (third and seventh semester) is 30.4 ± 17.9. Overall, 6.6% (T0) and 6.7% (T1) of respondents showed some but very low moral competence. 3.3% (T0) and 3.0% (T1) showed no moral competence. Additionally, students without prior experience in the healthcare system scored 3.0 points higher. CONCLUSIONS Improvement of assessment of moral competence as well effective interventions are particular needed for supporting those students which have been identified to demonstrate little moral competences.
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Affiliation(s)
- Stephan Nadolny
- Institute for History and Ethics of Medicine, Interdisciplinary Center for Health Sciences, Martin Luther University Halle-Wittenberg, 06112, Magdeburger Str. 8, Halle, Germany.
- Institute for Educational and Health-Care Research in the Health Sector, Hochschule Bielefeld - University of Applied Sciences and Arts, Bielefeld, Germany.
| | - Florian Bruns
- Institute for History and Ethics of Medicine, Interdisciplinary Center for Health Sciences, Martin Luther University Halle-Wittenberg, 06112, Magdeburger Str. 8, Halle, Germany
- Institute for the History of Medicine, Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Andre Nowak
- Institute for History and Ethics of Medicine, Interdisciplinary Center for Health Sciences, Martin Luther University Halle-Wittenberg, 06112, Magdeburger Str. 8, Halle, Germany
- Clinical Ethics and Ethics Committee, University Hospital Schleswig-Holstein, Lübeck/Kiel, Germany
| | - Jan Schildmann
- Institute for History and Ethics of Medicine, Interdisciplinary Center for Health Sciences, Martin Luther University Halle-Wittenberg, 06112, Magdeburger Str. 8, Halle, Germany
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Nazari AM, Borhani F, Zare-Kaseb A, Zafarnia N. The relationship between nurses' moral competency and missed nursing care: a descriptive-correlational study. BMC Nurs 2024; 23:388. [PMID: 38844989 PMCID: PMC11155051 DOI: 10.1186/s12912-024-02058-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Accepted: 06/03/2024] [Indexed: 06/10/2024] Open
Abstract
BACKGROUND When any aspect of patient care is overlooked or delayed, it is known as Missed Nursing Care (MNC), leading to adverse events such as medication errors, infections, increased mortality rates, and poor prognosis. Moral competence is crucial for clinical nurses as it guarantees high-quality patient care in nursing practice. Thus, this study aimed to investigate the correlation between moral competencies and MNC among nurses. METHODS This study was conducted with a descriptive-correlational design. The participants in the study were nurses who were currently enrolled at Shahid Beheshti University of Medical Sciences. In order to recruit nurses for the study, a convenience sampling method was implemented. The study tools were completed by a total of two hundred nurses. Research tools included a demographic questionnaire, the Moral Competence of Clinical Nurses Questionnaire, and the Kalisch and Williams Missed Nursing Care (MISSCARE) survey. ETHICAL CONSIDERATION This study was approved by the Medical Ethics and Law Research Center of Shahid Beheshti University of Medical Sciences. RESULTS The mean scores of moral competencies and MNC were 151.83 ± 12.60 and 42.71 ± 9.38, respectively. In other words, descriptive statistics showed that the moral competence score was more than 75%, and the MNC score was less than 50%. Also, there was a significant negative correlation between the total scores of moral competencies and MNC (r = -0.38, p < 0.001), indicating that more moral competence was correlated with lower levels of MNC. CONCLUSION The study revealed a negative correlation between nurses' moral competence and MNC, suggesting that enhancing moral competence could reduce MNC. To reduce MNC occurrences, hospitals, and organizations should prioritize moral competency, according to our research.
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Affiliation(s)
- Amir Mohamad Nazari
- Student Research Committee, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fariba Borhani
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Akbar Zare-Kaseb
- Student Research Committee, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Niloofar Zafarnia
- Educational Development Center, Kerman University of Medical Sciences, Kerman, Iran
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Wiisak J, Stolt M, Igoumenidis M, Chiappinotto S, Gastmans C, Keogh B, Mertens E, Palese A, Papastavrou E, Mc Cabe C, Suhonen R. Factors contributing to the promotion of moral competence in nursing. Nurs Ethics 2024:9697330241235305. [PMID: 38504620 DOI: 10.1177/09697330241235305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
Ethics is a foundational competency in healthcare inherent in everyday nursing practice. Therefore, the promotion of qualified nurses' and nursing students' moral competence is essential to ensure ethically high-quality and sustainable healthcare. The aim of this integrative literature review is to identify the factors contributing to the promotion of qualified nurses' and nursing students' moral competence. The review has been registered in PROSPERO (CRD42023386947) and reported according to the PRISMA guideline. Focusing on qualified nurses' and nursing students' moral competence, a literature search was undertaken in January 2023 in six scientific databases: CINAHL, Cochrane Library, PsycINFO, PubMed Medline, Scopus and Web of Science. Empirical studies written in English without time limitation were eligible for inclusion. A total of 29 full texts were retrieved and included out of 5233 citations. Quality appraisal was employed using Joanna Briggs Institute checklists and the Mixed Method Appraisal Tool. Data were analysed using inductive content analysis. Research about the factors contributing to the promotion of qualified nurses' and nursing students' moral competence is limited and mainly explored using descriptive research designs. The contributing factors were identified as comprising two main categories: (1) human factors, consisting of four categories: individual, social, managerial and professional factors, and ten sub-categories; and (2) structural factors, consisting of four categories: educational, environmental, organisational and societal factors, and eight sub-categories. This review provides knowledge about the factors contributing to the promotion of qualified nurses' and nursing students' moral competence for the use of researchers, nurse educators, managers, organisations and policymakers. More research about the contributing factors is needed using complex intervention, implementation and multiple methods designs to ensure ethically sustainable healthcare.
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Affiliation(s)
| | - Minna Stolt
- University of Turku; Wellbeing Services County of Satakunta
| | | | | | | | | | | | | | | | | | - Riitta Suhonen
- University of Turku; Turku University Hospital; Wellbeing Services County of Southwest Finland
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Yu Q, Huang C, Yan J, Yue L, Tian Y, Yang J, Li X, Li Y, Qin Y. Ethical climate, moral resilience, and ethical competence of head nurses. Nurs Ethics 2024:9697330241230526. [PMID: 38317573 DOI: 10.1177/09697330241230526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
BACKGROUND The ethical competence of head nurses plays a pivotal role in nursing ethics. Ethical climate is a prerequisite for ethical competence, and moral resilience can positively influence an individual's ethical competence. However, few studies have focused on the relationship between ethical climate, moral resilience, and ethical competence among them. OBJECTIVES To investigate the relationship between ethical climate, moral resilience, and ethical competence, and examine the mediating role of moral resilience between ethical climate and ethical competence among head nurses. DESIGN A quantitative, cross-sectional study. METHODS A total of 309 Chinese head nurses completed an online survey, including ethical climate questionnaire, Rushton moral resilience scale, and ethical competence questionnaire. Inferential statistical analysis includes Pearson's correlation and a structural equation model. ETHICAL CONSIDERATIONS This study received ethical approval from the Institutional Review Board of Xiangya Nursing School of Central South University (No. E2023146). RESULTS Head nurses' ethical climate score positively impacted ethical competence (r = 0.208, p < .001), and ethical climate could affect ethical competence through the mediating role of moral resilience. CONCLUSION This study emphasized the value of ethical climate in moral resilience of head nurses, ultimately leading to an enhancement in their ethical competence.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Yuelan Qin
- The First Affiliated Hospital of Hunan Normal University
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Mirhosseini S, Aghayan SS, Basirinezhad MH, Ebrahimi H. Health Care Providers' Attitudes Toward Do-Not-Resuscitate Order in COVID-19 Patients: An Ethical Dilemma in Iran. OMEGA-JOURNAL OF DEATH AND DYING 2024; 88:908-918. [PMID: 35042392 PMCID: PMC8792911 DOI: 10.1177/00302228211057992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This study aimed to investigate the health care providers' attitudes toward the Do-Not-Resuscitate order (DNR) in COVID-19 patients. This study was conducted on 332 health care providers (HCPs) at the COVID-19 referral hospital in Shahroud, Iran by convenience sampling method. The study tools included a demographic information form and the DNR attitude questionnaire. Significance level was considered 0.05 for all tests. The mean scores of attitudes toward DNR order, the procedure of DNR, some aspects of passive euthanasia, and religious and cultural factors were 25.27 ± 2.78, 40.61 ± 5.99, 11.26 ± 2.51, and 6.12 ± 1.27, respectively. The death of relatives due to COVID-19 and female gender were associated with high and low scores of attitudes toward DNR order, respectively. Extended working hours and more work experience were correlated with high scores of DNR procedure. The history of COVID-19 increased the mean score of attitudes toward some aspects of passive euthanasia. In addition, an increase in following COVID-19 news decreased the score of religious and cultural factors affecting DNR order. Despite the legal ban on implementation of the DNR in Iran, the attitude of Iranian HCPs toward this was positive in COVID-19 patients.
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Affiliation(s)
- Seyedmohammad Mirhosseini
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Psychiatric Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Shahrokh Aghayan
- Department of Clinical Sciences, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mohammad Hasan Basirinezhad
- Department of Epidemiology and Biostatistics, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hossein Ebrahimi
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
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Vierula J, Karihtala T, Ervaala N, Naamanka K, Haavisto E, Talman K. Applicants' success in the ethics entrance exam: A cross-sectional study. Nurs Ethics 2023:9697330231204999. [PMID: 37899712 DOI: 10.1177/09697330231204999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
BACKGROUND Student selection is the first step in recruiting future social and healthcare professionals. Ethically competent professionals are needed in social and healthcare. It is important to select applicants who have the best possible abilities to develop their ethical competence in the future. Values-based recruitment has been used to inform the recruitment and selection of higher education applicants. However, objective and valid tests in student selection are needed. AIM To assess social and healthcare applicants' success and related factors in the ethics section of the universities of applied sciences digital entrance examination (UAS Exam) to undergraduate degree programmes. RESEARCH DESIGN A cross-sectional design was used. PARTICIPANTS AND RESEARCH CONTEXT Social and healthcare applicants needed to identify ethical situations in the ethics section of a national digital entrance examination (UAS Exam) in autumn 2019 (between 29 October and 1 November) in 20 Finnish universities of applied sciences. ETHICAL CONSIDERATIONS The process for the responsible conduct of research was followed in the study. Ethics committee approval was obtained from the Human Sciences Ethics Committee in the Satakunta region (27 September 2019). Approval to undertake the study was obtained from the participating universities of applied sciences. Participation to the study was voluntary and based on informed consent. RESULTS The applicants' (n = 8971) mean scores were 7.1/20 (standard deviation 6.5), and 22.7% of the applicants failed the ethics section. Age, previous education, and place of birth (own/parent) explained the applicants' success in the ethics section (total score and failed exam results). CONCLUSION(S) Applicants' success in the ethics section varied indicating that future students may have a different basis to develop their ethical competence. This may impact on (new) students' learning, especially in practical studies.
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Affiliation(s)
| | | | - Niina Ervaala
- South-Eastern Finland University of Applied Sciences
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Erkkilä P, Koskenranta M, Kuivila H, Oikarainen A, Kamau S, Kaarlela V, Immonen K, Koskimäki M, Mikkonen K. Ethical and cultural competence of social- and health care educators from educational institutions - Cross-sectional study. Scand J Caring Sci 2023; 37:642-653. [PMID: 36710666 DOI: 10.1111/scs.13145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 10/14/2022] [Accepted: 01/05/2023] [Indexed: 01/31/2023]
Abstract
BACKGROUND The international mobility has increased cultural diversity in social- and health care. As such, ethical and cultural competence is an essential skill among educators. They are promoting the ethical and cultural competence and professional growth of students with diverse backgrounds and, therefore, must be ethically and culturally competent. AIM The aim of the study was to identify distinct ethical and cultural competence profiles of social- and health care educators and explore the associated factors. RESEARCH DESIGN A descriptive cross-sectional survey design was used to collect quantitative observational data in 2020-2021. Competence profiles were identified by K-means clustering based on answers to an instrument focussing on educators' ethical and cultural competence. PARTICIPANTS AND RESEARCH CONTEXT Participants (N = 1179, n = 243) were social- and health care educators based at 10 universities of applied sciences and 10 vocational colleges in Finland. ETHICAL CONSIDERATIONS The research adhered to good scientific practice. A research permit was received from each educational institution that participated in the study. The privacy of the participants was protected throughout the study. RESULTS The analysis identified three profiles of educators (A, B, C) based on self-assessed ethical and cultural competence. Profile A educators demonstrated high scores across all three competence areas. Profile B educators had high scores for ethical knowledge and intermediate scores for other competence areas. Profile C educators demonstrated intermediate scores across all three competence areas. An educator's pedagogical education was found to significantly influence which profile they belonged to. CONCLUSIONS The educators generally evaluated their ethical and cultural competence highly. Educators understand the importance of professional ethics in their work, but they need additional support in developing ethics skills in their daily work. Among all educators, there is a need for developing international and culturally diverse collaboration.
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Affiliation(s)
- Päivi Erkkilä
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland
| | - Miro Koskenranta
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland
| | - Heli Kuivila
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland
| | - Ashlee Oikarainen
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland
| | - Suleiman Kamau
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland
- Department of Social services and Health Care, Jyvaskylä University of Applied Sciences, Jyväskylä, Finland
| | - Veera Kaarlela
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland
| | - Kati Immonen
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland
| | - Minna Koskimäki
- Faculty of Social Sciences, Nursing Science/Health Sciences, Tampere University, Tampere, Finland
- Faculty of Social Sciences (SOC) FI-33014, Tampere University, Tampere, Finland
| | - Kristina Mikkonen
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
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Mármol-López MI, Marques-Sule E, Naamanka K, Arnal-Gómez A, Cortés-Amador S, Durante Á, Tejada-Garrido CI, Navas-Echazarreta N, Juárez-Vela R, Gea V. Physiotherapists' ethical behavior in professional practice: a qualitative study. Front Med (Lausanne) 2023; 10:1158434. [PMID: 37529240 PMCID: PMC10390221 DOI: 10.3389/fmed.2023.1158434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 06/26/2023] [Indexed: 08/03/2023] Open
Abstract
Background In health professions, ethics is considered a fundamental competence. The increase in clinical autonomy in the field of physiotherapy is associated with an increase in ethical situations in their clinical practice. Objective To explore the ethics of the clinical relationship between physiotherapists and patients, the ethics training received by physiotherapists, and if in the clinical context, physiotherapists identify the necessary attitudes and apply the ethical recommendations of the profession for the ethical situations they experience. Methods A qualitative exploratory and descriptive study was performed with physiotherapists. Data were collected through semi-structured interviews. The data were analyzed using content analysis, as proposed by Krippendorf. The study protocol was approved by the University of Valencia Ethics Committee of Human Research. Results This study included 15 physiotherapists (66.66% women, average age = 42.2 years), which was sufficient to reach data saturation. We identified four categories: (i) Ethics of the clinical relationship (ethical values, principles, and norms; type of clinical relationship), (ii) Ethics training received (during the physiotherapy studies; current training of students; low importance of ethics in the curriculum), (iii) Necessary attitudes for professional ethical practice (main attitudes were identified: personal attitudes and professional attitudes); (iv) Experiences from professional practice (general; public sector vs. private sector). Conclusion The ethics of the clinical relationship between physiotherapists and patients is determined by the attitudes of the practitioner, which are the result of his or her values and previous experiences; and are very centered on ethics of indication (founded mainly on the principles of Beneficence and Non-Maleficence). It is necessary to improve the ethical training received by physiotherapists, which is poorly focused on professional attitudes.
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Affiliation(s)
- María Isabel Mármol-López
- Research Group GREIACC, Health Research Institute La Fe (IISLaFe), Nursing School La Fe, Adscript Centre, University of Valencia, Valencia, Spain
| | - Elena Marques-Sule
- Physiotherapy in Motion, Department of Physiotherapy, Multispeciality Research Group (PTinMOTION), University of Valencia, Valencia, Spain
| | - Kati Naamanka
- Department of Nursing Science/Turku University of Applied Sciences, University of Turku, Turku, Finland
| | - Anna Arnal-Gómez
- Physiotherapy in Motion, Department of Physiotherapy, Multispeciality Research Group (PTinMOTION), University of Valencia, Valencia, Spain
| | - Sara Cortés-Amador
- Physiotherapy in Motion, Department of Physiotherapy, Multispeciality Research Group (PTinMOTION), University of Valencia, Valencia, Spain
| | - Ángela Durante
- Department of Nursing, GRUPAC, Universidad de La Rioja, La Rioja, Spain
- Comprehensive Health Care Research Group (INCUiSA) Biomedical Research Center of La Rioja, La Rioja, Spain
| | - Clara Isabel Tejada-Garrido
- Department of Nursing, GRUPAC, Universidad de La Rioja, La Rioja, Spain
- Comprehensive Health Care Research Group (INCUiSA) Biomedical Research Center of La Rioja, La Rioja, Spain
| | - Noelia Navas-Echazarreta
- Department of Nursing, GRUPAC, Universidad de La Rioja, La Rioja, Spain
- Comprehensive Health Care Research Group (INCUiSA) Biomedical Research Center of La Rioja, La Rioja, Spain
| | - Raúl Juárez-Vela
- Department of Nursing, GRUPAC, Universidad de La Rioja, La Rioja, Spain
- Comprehensive Health Care Research Group (INCUiSA) Biomedical Research Center of La Rioja, La Rioja, Spain
| | - Vicente Gea
- Faculty of Health Sciences, Research Group Community Health and Care (SALCOM), Valencia International University, Valencia, Spain
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Abstract
BACKGROUND Moral courage is a recognized virtue. In the context of the COVID-19 pandemic, the master's students of nursing (MSNs) in China have shown tenacious moral courage. OBJECTIVE This study elaborates on the moral courage of Chinese MSNs through their experiences of volunteering during the pandemic. RESEARCH DESIGN Descriptive qualitative, interview-based. PARTICIPANTS AND RESEARCH CONTEXT Participants were nursing postgraduate students who participated in the prevention and control of the COVID-19 pandemic selected by purposeful sampling. The sample size was determined by data saturation, which was reached with 10 participants. Data were analyzed using a deductive method of content analysis. Because of the isolation policy, telephone interviews were adopted. ETHICAL CONSIDERATIONS After obtaining the approval of the ethical institution of the author's school (No. 138, 30 August 2021), verbal consent was obtained before the interview with the participants. All data were processed anonymously and confidentially. In addition, we recruited participants through MSNs' counselors, and obtained their phone numbers with their permission. RESULTS Data analysis resulted in 15 subcategories that were subsequently grouped into 3 major categories including proceed without hesitation, the outcome of practicing moral courage, and develop and maintain moral courage. CONCLUSION This qualitative study is based on the special background of the COVID-19 pandemic, and the MSNs in China have shown tenacious moral courage in the work of epidemic prevention and control. Five factors led them to take action without hesitation, and six possible outcomes followed. Lastly, this study provides some suggestions for nurses and nursing students to enhance their moral courage. To better develop and support moral courage in the future, it is necessary to use different methods and multidisciplinary approaches to study moral courage.
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Affiliation(s)
- Mingtao Huang
- School of Health Management, Fujian Medical University, China; Research Centre for Medical Humanities, Fujian Medical University, China
| | - Wenhong Dong
- School of Health Management, Fujian Medical University, China; Research Centre for Medical Humanities, Fujian Medical University, China
| | - Qianqian Zhao
- School of Health Management, Fujian Medical University, China; Research Centre for Medical Humanities, Fujian Medical University, China
| | - Nan Mo
- School of Marxism, Fujian Medical University, China; Research Centre for Medical Humanities, Fujian Medical University, China
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Blomqvist H, Bergdahl E, Hemberg J. Ethical sensitivity and compassion in home care: Leaders' views. Nurs Ethics 2023; 30:180-196. [PMID: 36241186 PMCID: PMC10014894 DOI: 10.1177/09697330221122965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND With an increasing older population, the pressure on home care resources is growing, which makes it important to ensure the maintenance of quality care. It is known that compassion and ethical sensitivity can improve the quality of care, but little is known about care leaders' perceptions on ethical sensitivity and compassion in home care and how it is associated with staff competence and thus quality of care. AIM The aim of the study was to explore home care leaders' perceptions of ethical sensitivity and compassion associated with care quality in home care. RESEARCH DESIGN, PARTICIPANTS, AND RESEARCH CONTEXT A hermeneutical approach with a qualitative explorative design was used. The data consists of texts from 10 in-depth interviews with home care leaders. Content analysis was used as a method. ETHICAL CONSIDERATIONS The study was conducted following the ethical guidelines of the Declaration of Helsinki and the Finnish Advisory Board of Research Ethics. Research ethics permission was applied for from a Research Ethics Board. FINDINGS One overall theme and four subthemes were found. The overall theme was: "Compassion provides deeper meaning and ethical sensitivity provides means for knowing how to act". DISCUSSION If nurses fail to be sensitive and compassionate with patients, good and high qualitative home care cannot be achieved. Ethical sensitivity and compassion can be seen as resources in home care but the organization and the care leaders need to provide the support for these to develop. CONCLUSION This study provides an understanding of the meaning of ethical sensitivity and compassion as sources of strength and their link to quality of care in a home care context. Further studies could focus on how to build compassion and ethical sensitivity into home-based care and how to ensure adequate support for healthcare professionals' compassion and ethical sensitivity.
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Affiliation(s)
- Heidi Blomqvist
- Faculty of Education and Welfare Studies, Department of Caring Sciences, 1040Åbo Akademi University, Finland
| | | | - Jessica Hemberg
- Faculty of Education and Welfare Studies, Department of Caring Sciences, 1040Åbo Akademi University, Finland
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Firoozehchian F, Zareiyan A, Geranmayeh M, Behboodi Moghadam Z. Domains of competence in midwifery students: a basis for developing a competence assessment tool for iranian undergraduate midwifery students. BMC MEDICAL EDUCATION 2022; 22:704. [PMID: 36199088 PMCID: PMC9533548 DOI: 10.1186/s12909-022-03759-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 09/02/2022] [Accepted: 09/22/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Current study was conducted with the aim of explaining domains of clinical competence in undergraduate midwifery students so that it addresses the challenges in midwifery curriculum and improving clinical assessment methods in Iranian undergraduate midwifery students. METHODS Qualitative approach and conventional content analysis were used in the design of the present study. The research setting included midwifery and nursing schools and hospitals and health centers affiliated to Tehran and Guilan universities of medical sciences in Iran. The target population consisted of undergraduate midwifery students in the fourth to eighth semesters of school, midwives working in hospitals and health centers, midwifery faculty members, and obstetricians. The participants were selected through purposive maximum variation sampling, which continued until data saturation. After in-depth semi-structured interviews, the content of the interviews was analyzed according to the steps proposed by Zhang & Wildemuth. RESULTS Twenty-four people participated in this study, including seven midwifery students, seven midwives, nine midwifery and reproductive and sexual health faculty members, and one obstetrician. The participants were aged 20-56 years and their mean age was 39.75 years. Their level of education varied from midwifery student to PhD. The mean work experience of the participants was 13.62 years and the mean duration of the interviews was 48 min. The analysis of the data obtained from the experiences of the participants led to the formation of the four categories of ethical and professional function in midwifery, holistic midwifery care, effective interaction, and personal and professional development, along with ten subcategories. CONCLUSION The findings of the present study showed that clinical competence in midwifery students involves different domains that correspond well overall to the general definitions of clinical competence in different sources. These findings can be used as a basis for the design and psychometric assessment of a clinical competence assessment tool for undergraduate midwifery students.
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Affiliation(s)
- Firoozeh Firoozehchian
- Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Armin Zareiyan
- Department of Public Health, Department of Health in Disaster & Emergencies, Nursing Faculty, Aja University of Medical Sciences, Tehran, Iran
| | - Mehrnaz Geranmayeh
- Department of Reproductive Health and Midwifery, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Behboodi Moghadam
- Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
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Arnal-Gómez A, Muñoz-Gómez E, Espí-López GV, Juárez-Vela R, Tolsada-Velasco C, Marques-Sule E. Professional values and perception of knowledge regarding professional ethics in physical therapy students: A STROBE compliant cross-sectional study. Medicine (Baltimore) 2022; 101:e30181. [PMID: 36107566 PMCID: PMC9439820 DOI: 10.1097/md.0000000000030181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Undergraduate students start the acquisition of a professional identity, and begin to achieve professional values and consciousness of an ethical behavior as future health professionals. The aim of this study was describe professional values and perception of knowledge regarding professional ethics of physical therapy students. A cross-sectional study was performed. A total of 351 students participated in the study. Professional values and perception of knowledge regarding professional ethics were assessed. Ethical approval was obtained from the University Ethics Review Board. The most important value was equity, while the least one was abnegation. The second educational year showed higher scores in importance of scientific quality (P = .010 vs first year), the third year in respect for life (P = .041 vs first year, respectively), and the fourth year in respect to patient's autonomy (P = .033 vs first year). First-year students showed lower scores in perception of knowledge regarding professional ethics (P < .001 vs second, third, and fourth year), while second-year students had higher scores (P < .001 vs first and third; P = .006 vs fourth year) and no differences between third- and fourth-year students were found. Those professional values highly considered by the students were mainly shared professional values, with equity ranked highest and abnegation lowest. Furthermore, second-year students had a well-established perception of knowledge regarding professional ethics, showing significant higher scores when compared to the rest of the educational years. This is the first cross-sectional study that describes these variables among physical therapy students and it is a starting point for future. Physical therapy educators might want to take into account these findings when teaching and guiding students in developing awareness for their professional values and perception of knowledge regarding professional ethics.
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Affiliation(s)
| | | | - Gemma Victoria Espí-López
- Department of Physiotherapy, University of Valencia, Spain
- *Correspondence: Gemma Victoria Espí-López, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Gascó Oliag Street, 5, 46010 Valencia, Spain (e-mail: )
| | - Raúl Juárez-Vela
- Department of Nursing, University of La Rioja, Spain
- Hospital La Paz Institute for Health Research (IdiPAZ), Spain
| | | | - Elena Marques-Sule
- Department of Physiotherapy, University of Valencia, Spain
- Physiotherapy in Motion, Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Spain
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Cortés-Amador S, Arnal-Gómez A, Marques-Sule E, Hernández-Guillén D, Tolsada-Velasco C, Espí-López GV. Development of Advanced Competencies in Physiotherapy: Impact of a Single-Blinded Controlled Trial on Ethics Competence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10590. [PMID: 36078306 PMCID: PMC9518481 DOI: 10.3390/ijerph191710590] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/17/2022] [Accepted: 08/19/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Innovation in the training of future physiotherapy professionals through the use of collaborative learning could be an effective method for developing advanced competencies such as professional ethics. This study aimed at comparing the effects of cooperative learning and individual learning on the knowledge of professional ethics, the perception of knowledge regarding professional ethics, the teaching quality assessment and satisfaction in future physiotherapy professionals. METHODS A prospective, assessor-blinded, controlled trial was performed. A 12-week program was carried out with future physiotherapy professionals. The cooperative learning group was based on group activities, while the individual learning group performed the same activities with an individual approach. Knowledge, perception of knowledge regarding professional ethics, teaching quality and satisfaction were assessed. RESULTS A total of 216 participants completed the study (cooperative group n = 106; individual group n = 110). The cooperative learning group showed higher knowledge and perception of knowledge regarding professional ethics compared to the individual learning group (p < 0.001 and p < 0.001, respectively). Additionally, the cooperative learning group reported higher scores in the teaching materials, attitude towards future professionals and the teacher's global score. CONCLUSIONS Cooperative learning showed a positive impact on developing advanced competencies such as knowledge and perception of knowledge regarding professional ethics. Both methodologies showed adequate results in the assessment of teaching quality and satisfaction.
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Affiliation(s)
- Sara Cortés-Amador
- Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, 46010 Valencia, Spain
- UBIC Research Group, Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
| | - Anna Arnal-Gómez
- Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, 46010 Valencia, Spain
- Physiotherapy in Motion, Multispeciality Research Group (PTin MOTION), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
| | - Elena Marques-Sule
- Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, 46010 Valencia, Spain
- Physiotherapy in Motion, Multispeciality Research Group (PTin MOTION), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
| | - David Hernández-Guillén
- Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, 46010 Valencia, Spain
- Group of Physiotherapy in the Aging Process: Social and Health Care Strategies (PT_AGE), Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, 46010 Valencia, Spain
| | - Catalina Tolsada-Velasco
- Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, 46010 Valencia, Spain
| | - Gemma V. Espí-López
- Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, 46010 Valencia, Spain
- Exercise Intervention for Health (EXINH), Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, 46010 Valencia, Spain
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Martin D, Mörch CM, Figoli E. The notion of moral competence in the scientific literature: a critical review of a thin concept. ETHICS & BEHAVIOR 2022. [DOI: 10.1080/10508422.2022.2067163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Dominic Martin
- Organization and Human Resources Department, School of Management Sciences, Université du Québec à Montréal
| | | | - Emmanuelle Figoli
- Organization and Human Resources Department, School of Management Sciences, Université du Québec à Montréal
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Katayama H, Muramatsu T, Aoki Y, Nagashima E. Psychometric evaluation of the Ethical Caring Competency Scale in nursing. BMC Nurs 2022; 21:103. [PMID: 35505338 PMCID: PMC9066827 DOI: 10.1186/s12912-022-00886-2] [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: 10/10/2021] [Accepted: 04/28/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND An ethical competence list for nurses could guide educators and managers in the field of health care to both support the development of ethical conduct and improve the assessment of ethical competence in health care. AIM This study aimed to verify the reliability and validity of the Ethical Caring Competency Scale (ECCS) and to obtain suggestions for its use as an evaluation form in rubric format among a sample of Japanese nurses. RESEARCH DESIGN This research employed a descriptive and cross-sectional design. PARTICIPANTS AND RESEARCH CONTEXT A self-administered questionnaire was distributed to 1157 nurses working in two hospitals in Japan. The contents of the survey were demographic data, a draft of the ECCS consisting of 22 competencies from four core competencies, questions regarding experience in learning about medical/nursing ethics, and the Work Motivation Measurement Scale for Nurses. Three levels of difficulty for the 22 items were established using relative comparisons of the mean scores within the four core competencies. Three groups, namely, an expert group, a middle group, and a beginner group, were categorized according to the quartiles of the total ECCS score. ETHICAL CONSIDERATIONS This study was approved by the Clinical Research Ethics Committee of Hamamatsu University School of Medicine (Decision no. 18-267). The ethical principles of voluntary participation, anonymity, and confidentiality were considered. FINDINGS A total of 962 valid responses were analyzed. The ECCS scores for the three levels of difficulty were significantly different from each other. Stability was confirmed by the test-retest of the total ECCS scores (r = .900, p < .0001). The total ECCS scores for the three groups showed significant differences in all pairs. The Cronbach's α coefficient ranged from .72 to .89 for each core competency, and internal consistency was confirmed. CONCLUSION The reliability and validity of the ECCS as a scale were statistically verified, and we were able to obtain suggestions for its application as a form of evaluation in rubric format.
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Affiliation(s)
- Harumi Katayama
- Department of Fundamental Nursing, Hamamatsu University School of Medicine 1-20-1 Handayama, Higashi-ku, Hamamatsu city, Shizuoka, 431-3192, Japan.
| | - Taeko Muramatsu
- Department of Fundamental Nursing, Hamamatsu University School of Medicine 1-20-1 Handayama, Higashi-ku, Hamamatsu city, Shizuoka, 431-3192, Japan
| | - Yoshimi Aoki
- Department of Fundamental Nursing, Hamamatsu University School of Medicine 1-20-1 Handayama, Higashi-ku, Hamamatsu city, Shizuoka, 431-3192, Japan
| | - Eri Nagashima
- Department of Fundamental Nursing, Hamamatsu University School of Medicine 1-20-1 Handayama, Higashi-ku, Hamamatsu city, Shizuoka, 431-3192, Japan
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Heggestad AKT, Konow-Lund AS, Christiansen B, Nortvedt P. A vulnerable journey towards professional empathy and moral courage. Nurs Ethics 2022; 29:927-937. [PMID: 35225056 PMCID: PMC9289973 DOI: 10.1177/09697330221074013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Background: Empathy and moral courage are important virtues in nursing and nursing ethics. Hence, it is of great importance that nursing students and nurses develop their ability to empathize and their willingness to demonstrate moral courage. Research aim: The aim of this article is to explore third-year undergraduate nursing students’ perceptions and experiences in developing empathy and moral courage. Research design: This study employed a longitudinal qualitative design based on individual interviews. Participants and research context: Seven undergraduate nursing students were interviewed during or immediately following their final clinical placement. Ethical considerations: The Norwegian Social Science Data Services (NSD) approved the study. Participants were informed that their participation was voluntary and were assured confidentiality. They were informed that they could withdraw from the study at any time, without providing reasons. Findings: Affective empathy seemed to be strong among third-year undergraduate nursing students. However, they tried to handle the situations in a ‘professional’ way, and to balance their emotions. At the same time, they expressed how difficult it can be to show moral courage when confronted with poor patient care. In addition, they spoke about a lack of role models during clinical practice and supervision. Conclusions: Undergraduate nursing students are in a vulnerable position throughout their journey to become professional and to develop empathy and moral courage. The professional socialisation and forming of professional empathy and moral courage among nursing students, may be seen as a complex interaction of formal and hidden curriculum, where role models play an important role. We argue that the main theme ‘Vulnerable students – a journey towards professional empathy and moral courage’ may cover the longitudinal project as a whole. This vulnerability is something both teachers and supervisors should be aware of when following up with students in their clinical placements.
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Affiliation(s)
- Anne Kari Tolo Heggestad
- Faculty of Health Studies, VID Specialized University, Oslo and Centre for Medical Ethics, University of Oslo, Norway
| | | | - Bjørg Christiansen
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Per Nortvedt
- Centre for Medical Ethics, University of Oslo, Oslo
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Koskinen C, Kaldestad K, Rossavik BD, Ree Jensen A, Bjerga G. Multi-professional ethical competence in healthcare - an ethical practice model. Nurs Ethics 2022; 29:1003-1013. [PMID: 35212250 PMCID: PMC9289975 DOI: 10.1177/09697330211062986] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Introduction The starting point is that ethical competence is the basis for ethical healthcare practices and quality of care. Simultaneously, there is a need for research and development from a holistic multi-professional perspective. Aim The aim is to create a proposed model for multi-professional ethical competence grounded in clarified meanings and dimensions of ethical competence studied from a multi-professional healthcare perspective. The research questions are, what is ethical competence from a multi-professional healthcare perspective and what strengthens a multi-professional ethical healthcare practice? Research design The research has a qualitative approach and hermeneutic application research design. Two groups with six participants from clinical practice and two scientific researchers in each group met four times for dialogue. Thematic analysis was used as an analysis method. Ethical considerations The research is approved by the Declaration of Helsinki, the General Data Protection Regulations, and ethical permission was asked from the Norwegian Centre for Research Data (NSD). Results The proposed model for multi-professional ethical competence encompasses a three-dimensional ethical value base that is underpinned by: Ethical attitude – a personal desire to do good; Ethical basis – the best for the patient as a common goal and Ethical culture – common goals and values in the organization. Multi-professional ethical competence is strengthened by: Reflection – to see with new wondering eyes; Time for talk – interdisciplinary teamwork and Leadership – an ethical role model and support. Discussion Ethical competence has a strong link to the core of caring ethics and a deeper personal value base and attitude. Ethical competence involves the whole culture and is seen as a shared value base and a responsibility to do the best for the patient as a multi-professional team and organization. Ethical competence becomes active in healthcare practice by opening up for meaningful multi-professional talks and reflections.
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Affiliation(s)
- Camilla Koskinen
- Faculty of Health Sciences, Department of Caring and Ethics,56627University of Stavanger, Stavanger, Norway
| | - Kari Kaldestad
- Faculty of Health Sciences, Department of Caring and Ethics,56627University of Stavanger, Stavanger, Norway
| | | | - Anne Ree Jensen
- Department of Surgery,60496Stavanger University Hospital, Stavanger, Norway
| | - Grethe Bjerga
- Faculty of Health Sciences, Department of Caring and Ethics,56627University of Stavanger, Stavanger, Norway
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Naamanka K, Suhonen R, Tolvanen A, Leino-Kilpi H. Ethical competence - exploring situations in physiotherapy practice. Physiother Theory Pract 2022; 39:1237-1248. [DOI: 10.1080/09593985.2022.2039817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Kati Naamanka
- Department of Nursing Science/Turku University of Applied Sciences, University of Turku, Turku, Finland
| | - Riitta Suhonen
- Department of Nursing Science/Turku University of Applied Sciences, University of Turku, Turku, Finland
| | - Anna Tolvanen
- Department of Nursing Science/Turku University of Applied Sciences, University of Turku, Turku, Finland
| | - Helena Leino-Kilpi
- Department of Nursing Science/Turku University of Applied Sciences, University of Turku, Turku, Finland
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Lu X, Huang H, Khoshnood K, Koniak-Griffin D, Wang H, Yang M. Ethical Decision-making of Health Professionals Caring for People Living with HIV/AIDS in Hunan, China: A Qualitative Study. INQUIRY: THE JOURNAL OF HEALTH CARE ORGANIZATION, PROVISION, AND FINANCING 2022; 59:469580221127789. [DOI: 10.1177/00469580221127789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Numerous ethical issues surged the moment acquired immunodeficiency syndrome (AIDS) was discovered. As advocates of people living with HIV/AIDS (PLWHA), health professionals encounter many ethical dilemmas in clinical practice. However, it remains unclear how health professionals solve these issues. The descriptive qualitative research was conducted through semi-structured interviews with 22 health professionals from May to August 2018. Three themes emerged from data analyses of the interviews: (1) real ethical dilemma experienced by health professionals, (2) factors influencing ethical judgment, (3) ethical motivations. About two-thirds of participants failed to recall ethical dilemmas experienced in their clinical practice. Emotions, gender, occupation, and difficulty balancing different roles may influence the ethical judgments of health professionals. In the ethical decision-making (EDM) process, most participants took other people’s interests into consideration and conformed to law and professional codes of conduct. However, the fear of medical disputes (conflicts with families and others) was experienced by many participants, influencing their ethical behaviors.
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Affiliation(s)
- Xiaoxiao Lu
- Xiang Ya Nursing School of Central South University, Changsha, Hunan, China
| | - Hangyu Huang
- Xiang Ya Nursing School of Central South University, Changsha, Hunan, China
| | | | | | - Honghong Wang
- Xiang Ya Nursing School of Central South University, Changsha, Hunan, China
| | - Min Yang
- Xiang Ya Nursing School of Central South University, Changsha, Hunan, China
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Megregian M, Low LK, Emeis C, de Vries R, Nieuwenhuijze M. Midwifery students' expectations of and experiences with ethics education: A qualitative study. NURSE EDUCATION TODAY 2021; 105:105035. [PMID: 34242906 DOI: 10.1016/j.nedt.2021.105035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 06/08/2021] [Accepted: 06/23/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Instruction in ethics is an essential component of midwifery education. However, the evidence for how midwifery students experience ethics instruction in the classroom and via clinical experience is limited. OBJECTIVE This study explores midwifery students' perceptions of ethics education and their opinions about essential components of ethics education. DESIGN This was a qualitative descriptive thematic study, exploring student midwives' experiences of ethics education in their midwifery programs. We conducted focus group interviews with students from three midwifery programs in the United States (U.S.). SETTING Graduate midwifery educational programs in the United States. PARTICIPANTS Thirty-nine students from three graduate midwifery programs participated in four focus group discussions. RESULTS Thematic analysis identified three primary themes and associated subthemes: 1) current experience and identified needs, 2) the preceptor dilemma, with subthemes the critical role of modeling ethics and powerlessness within interprofessional conflicts, and 3) complicated relationships: advocacy, autonomy and choice. Students relied primarily upon clinical preceptors rather than classroom discussion as a significant source of learning ethics content and ethical behavior. Students called for explicit identification of ethics learning when it occurs, particularly midwifery-specific content, as well as increased opportunities for reflection and integration of their experiences. CONCLUSION This study shows the need for intentional inclusion of midwifery-specific ethics content into the overall midwifery education program content, in both classroom and clinical experiences. Midwifery programs should integrate ethics content in their curricula in a way that complements other midwifery content. This study also demonstrates the key role of clinical preceptors in student ethics learning.
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Affiliation(s)
- Michele Megregian
- School of Nursing, Oregon Health & Science University, 3455 US Veterans Hospital Rd, Portland, OR 97239, United States of America.
| | - Lisa Kane Low
- School of Nursing and Department of Women's Studies and Department of Obstetrics and Gynecology, University of Michigan, 400 North Ingalls Suite 3160, Ann Arbor, MI 48103, United States of America.
| | - Cathy Emeis
- School of Nursing, Oregon Health & Science University, 3455 US Veterans Hospital Rd, Portland, OR 97239, United States of America.
| | - Raymond de Vries
- CAPHRI, School of Public Health and Primary Care Maastricht, Zuyd University, Universiteitssingel 60, 622ER Maastricht, the Netherlands; Center for Bioethics and Social Sciences in Medicine, University of Michigan Medical School, 2800 Plymouth Rd, Ann Arbor, MI 48109, United States of America.
| | - Marianne Nieuwenhuijze
- Research Centre for Midwifery Science, Zuyd University, Universiteitssingel 60, 6229 ER Maastricht, the Netherlands.
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Expert nurses' coping strategies in ethically challenging situations: a qualitative study. BMC Nurs 2021; 20:183. [PMID: 34587956 PMCID: PMC8479722 DOI: 10.1186/s12912-021-00709-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 09/22/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Nurses frequently encounter ethically challenging situations in everyday practice. In these situations, nurses often know an appropriate course of action to take but are unable to do so. Many studies have examined the ethically challenging situations faced by nurses, but how nurses cope with these situations is not well understood. Therefore, this study aims to explore the coping strategies used or adopted in ethically challenging situations by expert nurses in South Korea. METHODS Participants were recruited via purposive sampling. Small group interviews were conducted with 26 expert registered nurses in a general hospital in South Korea. The data were analyzed using Giorgi's descriptive phenomenological method. RESULTS The essential theme of nurses' experience of coping with ethically challenging situations was "being faithful to the nature of caring." This essential theme comprised three themes: self-monitoring of ethical insensitivity, maintaining honesty, and actively acting as an advocate. CONCLUSIONS The findings of this study suggest that the coping strategies of expert nurses are mostly consistent with the attributes of ethical competence as previously defined in healthcare, and expert nurses can address ethically challenging situations in an effective and ethical manner by faithfully adhering to the spirit of caring. System-wide early counseling and interventions should be considered for nurses who have experienced ethical difficulties.
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Guenna Holmgren A, Juth N, Lindblad A, von Vogelsang AC. Nurses' experiences of using restraint in neurosurgical care - A qualitative interview study. J Clin Nurs 2021; 31:2259-2270. [PMID: 34514650 DOI: 10.1111/jocn.16044] [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: 06/11/2021] [Revised: 08/18/2021] [Accepted: 08/24/2021] [Indexed: 11/28/2022]
Abstract
AIM AND OBJECTIVES To describe nurses' experiences of using restraint in neurosurgical care. BACKGROUND Despite reports of negative consequences, and conflicts with key values in healthcare, restraint measures are still practised in somatic healthcare worldwide. When using restraint, basic principles of nursing collide, creating dilemmas known to be perceived as difficult for many nurses. Patients in neurosurgical care are at high risk of being subjected to restraint, but research on nurses' experiences of using restraint in neurosurgical care are scarce. DESIGN A qualitative, descriptive design guided by a naturalistic inquiry was used. METHODS Semi-structured interviews with 15 nurses working in three neurosurgical departments in Sweden were analysed with inductive qualitative content analysis. COREQ reporting guidelines were used as reporting checklist. RESULTS The analysis resulted in one overarching theme, The struggling professional, and two categories. The category Internal struggle describes nurses' conflicting emotions and internal struggle when engaging in restraint. The category The struggle in clinical practice, describes how nurses struggle with handling restraint in clinical practice, and how the use of restraint is based on individual assessment rather than guidelines. CONCLUSION Nurses' experience restraint in neurosurgical care as a multi-layered struggle, ranging from inner doubts to practical issues. In order to enhance patient safety, there is a need for policies and guidelines regarding the use of restraint, as well as structured discussions and reflections for nurses engaged in the practice. RELEVANCE TO CLINICAL PRACTICE The results highlight the importance of clear guidelines, openness, support and teamwork for nurses working with patients at risk to be subjected to restraint, in order to create a safer care for patients as well as healthcare personnel. When developing guidelines and policies concerning restraint in somatic care, both practical issues such as the decision-making process, and the emotional effect on nurses should be considered.
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Affiliation(s)
- Amina Guenna Holmgren
- Stockholm Centre for Healthcare Ethics (CHE), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden.,Department of Neurosurgery, Heart, Vascular and Neuro Theme, Karolinska University Hospital, Stockholm, Sweden
| | - Niklas Juth
- Stockholm Centre for Healthcare Ethics (CHE), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
| | - Anna Lindblad
- Stockholm Centre for Healthcare Ethics (CHE), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
| | - Ann-Christin von Vogelsang
- Department of Neurosurgery, Heart, Vascular and Neuro Theme, Karolinska University Hospital, Stockholm, Sweden.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Honkavuo L. Midwifery students' experiences of support for ethical competence. Nurs Ethics 2021; 29:145-156. [PMID: 34448430 PMCID: PMC8866738 DOI: 10.1177/0969733021999773] [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] [Indexed: 11/24/2022]
Abstract
Background: Midwifery students are confronted with several ethical dilemmas and challenging
situations during clinical midwifery care practice. Since ethical competence of
midwifery students is under development, it is important to support the students’
learning progress of ethical issues from diverse viewpoints. Objective: From the perspective of didactics of caring science and the context of midwifery
students, to explore how midwifery students’ experience supports for ethical competence
in midwifery education and investigate how ethically challenging situations have been
carried out during clinical midwifery care practice. Design: Qualitative, explorative and descriptive design with inductive nature. Methods: Focus group interviews with nine Swedish midwifery students. Hans-Georg Gadamer’s
philosophical hermeneutics was applied to guide the interpretation. Ethical considerations: Ethical principles and scientific guidelines were followed. Informed consent was
obtained from the participants. Confidentiality was respected and quotations
anonymised. Results: Receiving support when ethically challenging situations occur in clinical midwifery
practice is important and necessary. One main theme, such as support is a human and
caring factor in the midwifery students’ Bildung process on ethical competence, and four
subthemes, such as supporting through trust and responsibility; supporting through
dignity and respect; supporting through truthfulness and justice; and supporting through
dialogue and reflection, were created from the hermeneutical interpretation. Discussion: Teaching ethics should be carefully planned, consistent and continue throughout the
midwifery education. There is dispersion in the pedagogy of ethical situations, the
methods and perceptions associated with it, and in obtaining possible support for
students. Developing well-experienced methods could benefit the support of midwifery
students’ ethical competence when they experience ethically challenging situations in
midwifery care practice.
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Physiotherapy Students' Experiences about Ethical Situations Encountered in Clinical Practices. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168489. [PMID: 34444233 PMCID: PMC8391809 DOI: 10.3390/ijerph18168489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 08/06/2021] [Accepted: 08/07/2021] [Indexed: 11/17/2022]
Abstract
(1) Background: It is important to explore the ethical situations that physiotherapy students encountered in their clinical practices. (2) Methods: Qualitative, explorative, descriptive study. The participants included third-year physiotherapy students. They had to write five narratives about ethical situations encountered in their clinical practices. Krippendorff’s method for qualitative content analysis was used to cluster units within the data to identify emergent themes. The study protocol was approved by the authors’ University Ethic Committee of Human Research (H1515588244257). (3) Result: 280 narratives were reported by 64 students (23.34 ± 4.20 years, 59% women). Eight categories were identified from the qualitative analysis of the data: (a) professional responsibility, (b) professional competence, (c), beneficence, (d) equality and justice, (e) autonomy, (f) confidentiality, (g) respect for privacy, and (h) sincerity. All participants were informed and provided written informed consent. (4) Conclusions: Ethical principles were frequently violated in physiotherapy. Experiences of physiotherapy students must be examined to tailor educational interventions prior to their initiation into practice. Ethics education is needed in workplaces and should be increased in basic education. Facilitating the ethical awareness of future physiotherapists is a challenge for university teachers who provide ethical competence training.
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Maluwa VM, Maluwa AO, Mwalabu G, Msiska G. Assessment of ethical competence among clinical nurses in health facilities. Nurs Ethics 2021; 29:181-193. [PMID: 34346258 DOI: 10.1177/09697330211010259] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Ethical competence in nursing practice helps clinical nurses to think critically, analyse issues, make ethical decisions, solve ethical problems and behave ethically in their daily work. Thus, ethical competence contributes to the promotion of high-quality care. However, studies on ethical competence in Malawi are scanty. OBJECTIVES The aim of this study was to explore ethical competence among clinical nurses in selected hospitals in Malawi. METHODOLOGY A cross-sectional survey was conducted in four selected hospitals in Malawi with a sample of 271 clinical nurses. Data were collected using self-administered questionnaires, which included a Moral Competence Scale for Home Care Nurses. Descriptive statistics and logistic regression were computed for the dataset using STATA version 12.0. ETHICAL CONSIDERATION The study protocol complied with all ethical requirements and was approved by the College of Medicine Research Ethics Committee under the University of Malawi. RESULTS The clinical nurses in Malawi are ethically competent. However, there is a significantly high number (p < 0.05) of nurses 57% (n = 135) with low ethical competence. There was no significant association between respondents' demographic variables and level of ethical competence (p > 0.05). Three determinants of high ethical competence level (strong will, judgement skills and recognition of discrepancy of intention) were identified through a reduced model after stepwise logistic regression analysis. Furthermore, results show that indicators of ethical competence include caring, confidentiality and observance of nurses dressing code. The study has also confirmed that the Moral Competence Scale for Home Care Nurses is a reliable tool to assess ethical competence in low-resource settings. CONCLUSION The majority of nurses who completed the survey had low ethical competence. However, clinical nurses with high ethical competence level are required to competently manage complex ethical challenges in health facilities. Strategies for enhancing ethical competence such as continuing ethics education, establishment of ethics committees and provision of supportive supervision are recommended to enable nurses in Malawi attain a high level of ethical competence.
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Numminen O, Konings K, Claerhout R, Gastmans C, Katajisto J, Leino-Kilpi H, de Casterlé BD. Validation of the Dutch-language version of Nurses' Moral Courage Scale. Nurs Ethics 2021; 28:809-822. [PMID: 33427057 PMCID: PMC8366187 DOI: 10.1177/0969733020981754] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Moral courage as a part of nurses' moral competence has gained increasing interest as a means to strengthen nurses acting on their moral decisions and offering alleviation to their moral distress. To measure and assess nurses' moral courage, the development of culturally and internationally validated instruments is needed. OBJECTIVE The objective of this study was to validate the Dutch-language version of the four-component Nurses' Moral Courage Scale originally developed and validated in Finnish data. RESEARCH DESIGN This methodological study used non-experimental, cross-sectional exploratory design. PARTICIPANTS AND RESEARCH CONTEXT A total of 559 nurses from two hospitals in Flanders, Belgium, completed the Dutch-language version of the Nurses' Moral Courage Scale. ETHICAL CONSIDERATIONS Good scientific inquiry guidelines were followed throughout the study. Permission to translate the Nurses' Moral Courage Scale was obtained from the copyright holder, and the ethical approval and permissions to conduct the study were obtained from the participating university and hospitals, respectively. FINDINGS The four-component 21-item, Dutch-language version of the Nurses' Moral Courage Scale proved to be valid and reliable as the original Finnish Nurses' Moral Courage Scale. The scale's internal consistency reliability was high (0.91) corresponding with the original Nurses' Moral Courage Scale validation study (0.93). The principal component analysis confirmed the four-component structure of the original Nurses' Moral Courage Scale to be valid also in the Belgian data explaining 58.1% of the variance. Confirmatory factor analysis based on goodness-of-fit indices provided evidence of the scale's construct validity. The use of a comparable sample of Belgian nurses working in speciality care settings as in the Finnish study supported the stability of the structure. DISCUSSION AND CONCLUSION The Dutch-language version of the Nurses' Moral Courage Scale is a reliable and valid instrument to measure nurses' self-assessed moral courage in speciality care nursing environments. Further validation studies in other countries, languages and nurse samples representing different healthcare environments would provide additional evidence of the scale's validity and initiatives for its further development.
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Essential components of midwifery ethics education: results of a Delphi study. Midwifery 2021; 96:102946. [PMID: 33610063 DOI: 10.1016/j.midw.2021.102946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 12/18/2020] [Accepted: 02/07/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Ethical dilemmas are an inevitable part of a midwife's experience in clinical care. Midwifery educational programs have an obligation to provide students the opportunities to acquire the skills and knowledge to recognize and negotiate ethical dilemmas. Implementation of strategies for imparting ethical competencies and clinical ethics decision-making skills in formal midwifery curricula have been challenging and inconsistent. The purpose of this study was to gather information and opinions from midwifery educators and clinical preceptors about the essential components of ethics education for midwifery students in the United States (U.S.), aiming for consensus on key content, competencies, learning outcomes, and teaching strategies. DESIGN This is an online Delphi study conducted in three rounds. Round 1 consisted of open-ended questions to explore and identify key content, competencies, learning outcomes, and teaching strategies for midwifery ethics education. In Rounds 2 and 3, experts rated statements on a 1 to 7 Likert scale, with positive consensus defined as 70% or more of the experts scoring ≥6. PARTICIPANTS The panel included midwifery educators (midwifery program directors, faculty, and clinical preceptors) from the United States. FINDINGS Of the 12 statements on key content of ethics education, midwives emphasized that content promoting an understanding of shared decision-making is essential for inclusion. Of the statements regarding competencies, learning outcomes, and teaching strategies, 20 of 21 statements met consensus, including those related to shared decision-making and ethical decision-making, as well as attributes such as compassion and courage. Midwives did not agree that an essential teaching strategy includes a validated assessment tool for evaluating students on any component of ethics learning (knowledge, skills, behaviour). KEY CONCLUSIONS This Delphi study reveals what midwifery educators consider essential components of ethics education for midwifery students, with a particular focus on the professional attributes of shared decision-making. IMPLICATIONS FOR PRACTICE Initial insights about optimal ways to incorporate the essential ethics education components into midwifery program curricula are provided, and more research is needed.
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Spekkink A, Jacobs G. The development of moral sensitivity of nursing students: A scoping review. Nurs Ethics 2020; 28:791-808. [PMID: 33325340 DOI: 10.1177/0969733020972450] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Moral sensitivity is known to be the starting point for moral competence and even is a core concept in the curricula for bachelor's-level nursing students in the Netherlands. While the development of moral sensitivity in nursing is commonly agreed to be important, there is no clear understanding of how to develop moral sensitivity through nursing education and what components of nursing education contribute to moral sensitivity. Studies on educational interventions could build knowledge about what works in developing moral sensitivity and how to achieve this outcome. Therefore, the aim of this study is to explore if and how educational interventions contribute to the development of moral sensitivity in nursing students. A scoping review was conducted. Four electronic databases were searched: CINAHL, PubMed, MEDLINE and SpringerLink. Articles that were not about formal or initial nursing education and that had no link to moral development or moral sensitivity were excluded. After the final selection on educational interventions, 10 articles out of the initial 964 resources were included in the review. Three different but related dimensions of moral sensitivity emerged from the literature: (1) raising moral awareness, (2) providing the ability to frame and name ethical issues and (3) improving moral reasoning ability. Half of the studies used quantitative measures to evaluate the educational intervention, in particular the Moral Sensitivity Questionnaire; the other half used diverse qualitative evaluation methods. None of the studies presented teaching methods that included all three dimensions of moral sensitivity. Moral awareness of self appears to be more loosely connected to the other two dimensions, which raises the question of whether it can be seen as a prerequisite for them. To encompass all dimensions of moral sensitivity, a mix of quantitative and qualitative measures seems most appropriate to study that topic.
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Affiliation(s)
| | - Gaby Jacobs
- 36513University of Humanistic Studies, The Netherlands
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Zakaria NS, Subarimaniam N, Wan Jaafar WM, Mohd Ayub AF, Saripan MI. Conceptualization and initial measurement of counseling ethics competency: the influence of spirituality and self-efficacy. EUROPEAN JOURNAL OF TRAINING AND DEVELOPMENT 2020. [DOI: 10.1108/ejtd-02-2020-0016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Purpose
This paper aims to contribute to the existing conceptualizations of counseling ethics competency and to develop a counseling ethics competency scale. This paper also argues that spirituality and self-efficacy influence counseling ethics competency.
Design/methodology/approach
A series of studies were performed to develop hypotheses and a conceptual framework to determine the relationships among spirituality, self-efficacy and counseling ethics competency. To measure registered counselors’ counseling ethics competency, a document analysis of the Counselors Code of Ethics was conducted and pretested on the basis of a pilot test prior to the empirical development of the scale.
Findings
A conceptual framework was developed to operationalize the theory and to present the influence of spirituality and self-efficacy on counseling ethics competency. The counseling ethics competency scale was found reliable and valid to measure the registered counselors’ competency in the eight components of the Counselors Code of Ethics.
Practical implications
The scale and framework can be used as tools to identify competencies where registered counselors are lacking and to pinpoint skills on which counselors need to improve. This research also will provide insights for counselor educators to be innovative in teaching and learning ethics within the scope of counselor education training programs.
Originality/value
There is no specific scale available to measure counseling ethics competency among registered counselors in Malaysia. Thus, this research unveils the importance of measuring counseling ethics competency in molding effective and ethical Malaysian counselors, and subsequently pinpointing factors that can improve counseling ethics competency.
Recommendations
We recommend to assess the scale using EFA, followed by CFA to determine and confirm the factor structure of the scale items. In terms of the field, future scope may not just focus on the traits, characters and skills building but also place more emphasis on ethics comprehension toward best practices of ethics application and internalization on becoming self-sufficient counselors.
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Falkenström E, Höglund AT. "There is total silence here" Ethical competence and inter-organizational learning in healthcare governance. J Health Organ Manag 2020; 34:53-70. [PMID: 32141269 DOI: 10.1108/jhom-05-2019-0130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this paper is to analyse ethical competence related to healthcare governance and management tasks at the county/regional level in Sweden. The paper also discusses conditions that support or constrain the development and application of such competence. DESIGN/METHODOLOGY/APPROACH The study is based on original qualitative data from 13 interviews and 6 meeting observations. Three key groups of actors were included: politicians, civil servants and CEOs in publicly financed health-provider organizations. An abductive analysis was carried out by a stepwise method guided by thematic research questions. FINDINGS The informants viewed themselves as having a high degree of ethical responsibility for healthcare practice. However, they did not integrate ethical reflection and dialogue into their work decisions (e.g. regarding budgets, reforms and care agreements). The current organization, control systems and underlying business principles, along with the individuals' understanding of their own and others' roles, tended to constrain the development and use of ethical competence. PRACTICAL IMPLICATIONS Qualities of an appropriate ethical competence related to healthcare governance and management, and conditions to develop and use such competence, are suggested. ORIGINALITY/VALUE Hardly any empirical research has examined ethical competence related to healthcare governance and management tasks. The paper integrates ethics and theories on learning in organizations and contributes knowledge about ethical competence and the conditions necessary to develop and practise ethical competence in an organizational and inter-organizational context.
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Affiliation(s)
| | - Anna T Höglund
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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Manninen K, Björling G, Kuznecova J, Lakanmaa RL. Ethical Coffee Room: An international collaboration in learning ethics digitally. Nurs Ethics 2020; 27:969733020934145. [PMID: 32666868 DOI: 10.1177/0969733020934145] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Ethics is a fundamental part of health care professionals' competence and one of the major quality factors in good nursing care. Research shows challenges in learning and applying ethics. Ethical Coffee Room is an electronic platform, where the students, nurses and teachers discuss anonymously ethical issues during students' clinical practice. ECR offers 1 credit (27 working hours) for the students. This work included reading theoretical material, contributions for discussion of ethical dilemmas and reflection of one's own learning. Every user - student, nurse supervisor or teacher - could choose her or his own pseudonym. AIM The aim of this study was to describe how nursing students experience learning ethics with digital learning activity during clinical practice, how usable the Ethical Coffee Room platform is and how this learning activity should be developed further. RESEARCH DESIGN, PARTICIPANTS AND CONTEXT The study employed a qualitative descriptive design and was an EU project between Finland, Sweden and Latvia. In total, 34 second-year nursing students participated in the study. The data collection methods were semi-structured interviews and written comments in the discussion forum Ethical Coffee Room. The data were analysed using content analysis. ETHICAL CONSIDERATIONS Ethical approval and research permission were obtained from each partner organization, according to their national standards. FINDINGS The results are presented under three themes: positive learning experiences of Ethical Coffee Room, challenges in learning during Ethical Coffee Room and practical suggestions for future development of Ethical Coffee Room. The results showed that the Ethical Coffee Room was experienced as a novel type of learning activity and an interesting way to learn ethics. DISCUSSION AND CONCLUSION Ethical Coffee Room seems to be a promising learning activity enhancing students' ethical competence in clinical practice. However, active participation of the mentor nurses and teachers is essential. Therefore, mentor nurses and teachers need in-depth knowledge of ethical theories and concepts and how to apply them in clinical context.
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Affiliation(s)
- Katri Manninen
- The Swedish Red Cross University College, Sweden; Karolinska Institutet and Karolinska University Hospital, Sweden
| | - Gunilla Björling
- Karolinska Institutet, Sweden; The Swedish Red Cross University College, Sweden
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Hemberg J, Hemberg H. Ethical competence in a profession: Healthcare professionals' views. Nurs Open 2020; 7:1249-1259. [PMID: 32587745 PMCID: PMC7308671 DOI: 10.1002/nop2.501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 03/02/2020] [Accepted: 03/27/2020] [Indexed: 11/24/2022] Open
Abstract
Aim Ethical competence is a crucial component for enabling good quality care but there is insufficient qualitative research on healthcare professionals' views on ethical competence. The aim of this study was to investigate healthcare professionals' views on ethical competence in a student healthcare context. Design A qualitative design and a hermeneutical approach were used. Methods The material consists of texts from interviews with healthcare professionals (N = 10) in a student healthcare context. The method was inspired by content analysis. Results One main theme and four subthemes emerged. The main theme was as follows: safeguarding the vulnerability of the other. The subthemes were as follows: using sensitivity to establish a trustful relationship, acting in an objective and flexible manner, using a reflective process in decision-making, and maintaining confidentiality and honesty. Future research should focus on investigating ethical competence from various perspectives in student health care, for example the student perspective or observational studies.
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Affiliation(s)
- Jessica Hemberg
- Department of Caring SciencesFaculty of Education and Welfare StudiesÅbo Akademi UniversityVaasaFinland
| | - Håkan Hemberg
- Department of Public AdministrationFaculty of Social Sciences, Business and EconomicsÅbo Akademi UniversityTurkuFinland
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Koskinen C, Koskinen M, Koivula M, Korpi H, Koskimäki M, Lähteenmäki ML, Mikkonen K, Saaranen T, Salminen L, Sjögren T, Sormunen M, Wallin O, Kääriäinen M. Health and social care educators' ethical competence. Nurs Ethics 2020; 27:1115-1126. [PMID: 32495718 DOI: 10.1177/0969733019871678] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND AND PURPOSE Educators' ethical competence is of crucial importance for developing students' ethical thinking. Previous studies describe educators' ethical codes and principles. This article aims to widen the understanding of health- and social care educators' ethical competence in relation to core values and ethos. THEORETICAL BACKGROUND AND KEY CONCEPTS The study is based on the didactics of caring science and theoretically links the concepts ethos and competence. METHODS Data material was collected from nine educational units for healthcare and social service in Finland. In total 16 semi-structured focus group interviews with 48 participants were conducted. The interviews were analysed with a thematic analysis according to Braun and Clarke. ETHICAL CONSIDERATIONS The study is approved by the Declaration of Helsinki, the legislation regarding personal data and the General Data Protection Regulation. The study received ethical permission from the University of Jyväskylä. Informed consent was obtained from all the educational units and participants in the study. FINDINGS The findings are presented based on three general patterns, an ethical basic motive, an ethical bearing and ethical actions. Subthemes are Humane view of students as unique individuals with individual learning, Bearing of tactfulness and firmness, Bearing of perceptiveness and accessibility, Bearing of satisfaction and joy over student learning, Valuing bearing towards each oneself and colleagues, Ability to interact and flexibility, Collegiality and a supportive work community and Educators as role models and inspirators. CONCLUSION Educators' personal and professional ethos is crucial to student learning, personal growth and ethical reasoning. Therefore, it is important to further develop educators' training regarding ethical competence.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Outi Wallin
- Tampere University of Applied Sciences, Finland
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Kulju K, Suhonen R, Puukka P, Tolvanen A, Leino-Kilpi H. Self-evaluated ethical competence of a practicing physiotherapist: a national study in Finland. BMC Med Ethics 2020; 21:43. [PMID: 32471504 PMCID: PMC7257238 DOI: 10.1186/s12910-020-00469-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 04/01/2020] [Indexed: 11/22/2022] Open
Abstract
Background Patients have the right to equal, respectful treatment. Nowadays, one third of patient complaints concern health care staff’s behavior towards patients. Ethically safe care requires ethical competence, which has been addressed as a core competence in physiotherapy. It has been defined in terms of character strength, ethical awareness, moral judgment skills in decision-making, and willingness to do good. The purpose of this study was to analyze the ethical competence of practicing physiotherapists. Method A self-evaluation instrument (Physiotherapist’s Ethical Competence Evaluation Tool) based on an analysis of a concept “ethical competence” was constructed in 2016 and physiotherapists (n = 839), working in public health services or private practice responded to the questionnaire. Results Based on the results, most of the physiotherapists evaluated themselves highly ethically competent in all areas of ethical competence, subscales being Strength, Awareness, Skills and Will. Willingness to do good was evaluated as highest, while character strength, including the strength to support ethical processes and speak on behalf of the patient, was evaluated the lowest. Physiotherapists most commonly consult a colleague when encountering an ethical problem. Other methods for problem solving are not very familiar, neither are the international or national ethical codes of conduct. Conclusions This was the first attempt to assess all aspects of ethical competence empirically in a clinical environment in physiotherapy, using a novel self-evaluation instrument. Even if physiotherapists evaluate themselves as competent in ethics, further exploration is needed for ethical awareness. Also the patients’ viewpoints about ethically competent care should be considered, to better ensure ethical safety of the patient.
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Affiliation(s)
- Kati Kulju
- Department of Nursing Science, University of Turku, FI-20014, Turku, Finland.
| | - Riitta Suhonen
- Department of Nursing Science/ Turku University Hospital and City of Turku, Welfare Division, University of Turku, Turku, Finland
| | - Pauli Puukka
- National Institute for Health and Welfare, Turku, Finland
| | - Anna Tolvanen
- Department of Nursing Science, University of Turku, FI-20014, Turku, Finland
| | - Helena Leino-Kilpi
- Department of Nursing Science, Turku University Hospital, University of Turku, Turku, Finland
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The concept of competence: a thematic review and discussion. EUROPEAN JOURNAL OF TRAINING AND DEVELOPMENT 2020. [DOI: 10.1108/ejtd-10-2019-0171] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
This paper follows three objectives. The paper aims to demonstrate a synoptic view of the historical evolution of competence, significant growth and changes in conversation. The second objective is to investigate the meaning and definitional usage of competence and competency. The third objective is to present a synoptic view of different dimensions of competence.
Design/methodology/approach
This paper reviews the selected literature spanning from 1959 to date from various databases using the following keywords: competence, competency, employee competence, employee competency, competency management and competency-based management. A total of 170 studies were selected in the first wave. In the second wave, a detailed assessment was made, as suggested by Tranfield Denyer and Smart, to ascertain the relevance of the articles. In this way, only 63 studies were selected for the review. This study also considers other relevant literature.
Findings
The historical evolution demonstrates that competence scholarship has focused on use of the concept in different fields and contexts, theoretical frameworks for competence development and strategic relevance of competence-based (demand-based) human resource management. Results also suggest that the term competency and competence are interchangeably usable. Finally, the review summarizes a total of 16 dimensions of competence, studied in various contexts and classifies them into hard and soft competence and further dividing them into knowledge, skill and self-actualization-related competence.
Research limitations/implications
This paper discusses various research implications for human resource development scholars and professionals.
Originality/value
This paper is a unique attempt to review the literature on three themes of employee competence.
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Kleemola E, Leino-Kilpi H, Numminen O. Care situations demanding moral courage: Content analysis of nurses’ experiences. Nurs Ethics 2020; 27:714-725. [DOI: 10.1177/0969733019897780] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Nurses encounter complex ethical dilemmas in everyday nursing care. It is important for nurses to have moral courage to act in these situations which threaten patients’ safety or their good care. However, there is lack of research of moral courage. Purpose: This study describes nurses’ experiences of care situations demanding moral courage and their actions in these situations. Method: A qualitative descriptive research design was applied. The data were collected with an open-ended question in the questionnaire used in validation of the Nurses’ Moral Courage Scale. The sample consisted of 286 nurses from four different clinical fields in a major university hospital in Finland, providing a total of 611 answers. Data were analyzed using inductive content analysis. Ethical considerations: The study followed the commonly recognized principles of good scientific practice. The use of data was authorized by the developer of the instrument, the data collector, and the participating hospital. Ethical approval was obtained from the university ethics committee. Findings: Nurses acted morally courageously in most situations but sometimes they failed to do so. Although situations demanding moral courage varied, they could be categorized into seven main domains relating to colleagues, physicians, patients, relatives, nurses themselves, managers, and organizations. Nurses acted in the situations in different ways. The main acts in solving the situations were verbal communication or immediate action, such as interrupting of action. Conclusion: Care situations demanding moral courage focus on good and safe patient care and the patient’s good is at the center of attention. The situations are mostly related to the activities of other healthcare professionals. Findings may be applied in developing ethical nursing care through basic and continuing nursing education. Research is needed on the moral courage of physicians and managers, as well as on patients’ and their relatives’ experiences of care situations demanding moral courage.
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Kuivila HM, Mikkonen K, Sjögren T, Koivula M, Koskimäki M, Männistö M, Lukkarila P, Kääriäinen M. Health science student teachers' perceptions of teacher competence: A qualitative study. NURSE EDUCATION TODAY 2020; 84:104210. [PMID: 31683137 DOI: 10.1016/j.nedt.2019.104210] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 06/30/2019] [Accepted: 09/06/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Health science teacher competence is multifaceted and continuously changing according to national and international healthcare standards. Organizational restructuring and emphasis on cost effectiveness is changing the scope of health science teachers' practical work and their role in healthcare (worldwide). AIM This study aimed to describe student teachers' perceptions of the competencies needed to work as an educator in the healthcare field. Objective of study was to gain new knowledge which can be used in the development of teacher education programs in nursing science and to define a broader definition of the health science educators. METHODS A qualitative study was conducted. Data were collected from 23 Finnish students completing a master's degree in teaching in the healthcare context using focus group interviews. The data were analyzed by inductive content analysis. RESULTS The student teachers identified eight main categories of teacher competence: leadership and management competence; evidence-based practice competence; subject competence; ethical competence; pedagogical competence; collaboration competence; internationalization competence; and continuous professional development competence. CONCLUSION This study identified essential teacher competencies that can be evaluated among students to develop health science teacher curricula. The findings can be used in follow-up studies or comparative research to investigate competence differences between novice and experienced teachers.
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Affiliation(s)
- Heli-Maria Kuivila
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland.
| | - Kristina Mikkonen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland.
| | - Tuulikki Sjögren
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
| | - Meeri Koivula
- Faculty of Social Sciences, University of Tampere, Tampere, Finland.
| | - Minna Koskimäki
- Faculty of Social Sciences, University of Tampere, Tampere, Finland.
| | - Merja Männistö
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland; Health Care and Nursing, Oulu University of Applied Sciences, Oulu, Finland.
| | | | - Maria Kääriäinen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; The Finnish Centre for Evidence-Based Health Care: A Joanna Briggs Institute Centre of Excellence, Helsinki, Finland.
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Rodger D, Stewart-Lord A. Students' perceptions of debating as a learning strategy: A qualitative study. Nurse Educ Pract 2019; 42:102681. [PMID: 31805450 DOI: 10.1016/j.nepr.2019.102681] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 11/08/2019] [Accepted: 11/22/2019] [Indexed: 10/25/2022]
Abstract
Debate has been shown to develop critical thinking skills, enhance communication, and encourage teamwork in a range of different disciplines, including nursing. The objective of this study was to explore students' perceptions of the educational value of debate. A semi-structured focus group was conducted with 13 undergraduate Operating Department Practice students following a debate on the opt-out system of organ donation. Transcripts were analysed thematically, identifying three main themes that described the students' perceptions of the debate. These were: (1) openness to diverse viewpoints; (2) developing non-technical skills, and (3) encouraging deep learning. The analysis showed participants perceived debate to be a valuable educational method that enhanced their learning. Engaging in debate encouraged students to critically reflect on their prior beliefs about organ donation-in some cases leading them to reconsider their original position. The findings from this study suggest that debate can be a valuable pedagogical tool to incorporate into healthcare education. Future research should consider the use of debate to develop non-technical skills that have utility in healthcare.
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Affiliation(s)
- Daniel Rodger
- Allied Health Sciences, School of Health and Social Care, London South Bank University, 103 Borough Road, London, SE1 0AA, UK.
| | - Adéle Stewart-Lord
- Allied Health Sciences, School of Health and Social Care, London South Bank University, 103 Borough Road, London, SE1 0AA, UK
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Lehmeyer S, Riedel A. Ethikkompetenzerwerb im Handlungsfeld – Voraussetzungen und Impulse für die professionelle Pflegepraxis. Ethik Med 2019. [DOI: 10.1007/s00481-019-00554-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Mikkonen K, Koskinen M, Koskinen C, Koivula M, Koskimäki M, Lähteenmäki ML, Mäki-Hakola H, Wallin O, Sjögren T, Salminen L, Sormunen M, Saaranen T, Kuivila HM, Kääriäinen M. Qualitative study of social and healthcare educators' perceptions of their competence in education. HEALTH & SOCIAL CARE IN THE COMMUNITY 2019; 27:1555-1563. [PMID: 31456309 DOI: 10.1111/hsc.12827] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 06/21/2019] [Accepted: 07/22/2019] [Indexed: 06/10/2023]
Abstract
Competent educators are needed to ensure that social and healthcare professionals are effective and highly competent. However, there is too little evidence-based knowledge of current and required enhancements of educators' competences in this field. The aim of this study was to describe social and healthcare educators' perceptions of their competence in education. The study had a qualitative design, based on interviews with educators and rooted in critical realism. Forty-eight participants were recruited from seven universities of applied sciences and two vocational colleges in Finland, with the assistance of contact persons nominated by the institutions. The inclusion criterion for participation was employment by an educational institution as a part-time or full-time, social and/or healthcare educator. Data were collected in the period February-April 2018. The participants were interviewed in 16 focus groups with two to five participants per group. The acquired data were subjected to inductive content analysis, which yielded 506 open codes, 48 sub-categories, nine categories and one main category. The educators' competence was defined as a multidimensional construct, including categories of educators' competences in practicing as an educator, subject, ethics, pedagogy, management and organisation, innovation and development, collaboration, handling cultural and linguistic diversity, and continuous professional development. Educators recognised the need for developing competence in innovation to meet rapid changes in a competitive and increasingly global sociopolitical environment. Enhancement of adaptability to rapid changes was recognised as a necessity. The findings have social value in identifying requirements to improve social and healthcare educators' competence by helping educational leadership to improve educational standards, construct a continuous education framework and create national and/or international curricula for teacher education degree programs to enhance the quality of education. We also suggest that educational leadership needs to establish, maintain and strengthen collaborative strategies to provide effective, adaptable support systems, involving educators and students, in their working practices.
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Affiliation(s)
- Kristina Mikkonen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
| | - Monika Koskinen
- Faculty of Education and Welfare Studies, Åbo Akademi University, Turku, Finland
| | - Camilla Koskinen
- Faculty of Education and Welfare Studies, Åbo Akademi University, Turku, Finland
| | - Meeri Koivula
- Faculty of Social Sciences, University of Tampere, Tampere, Finland
| | - Minna Koskimäki
- Faculty of Social Sciences, University of Tampere, Tampere, Finland
| | | | - Hanne Mäki-Hakola
- Pedagogical R&D, Tampere University of Applied Sciences, Tampere, Finland
| | - Outi Wallin
- Degree Programme in Social Services, Tampere University of Applied Sciences, Tampere, Finland
| | - Tuulikki Sjögren
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Leena Salminen
- Faculty of Medicine, Department of Nursing Science, University of Turku, Turku, Finland
| | - Marjorita Sormunen
- Faculty of Health Sciences, Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Terhi Saaranen
- Faculty of Health Sciences, Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Heli-Maria Kuivila
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
| | - Maria Kääriäinen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- The Finnish Centre for Evidence-Based Health Care: A Joanna Briggs Institute Centre of Excellence, Helsinki, Finland
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Ethikkompetenzen vertiefen und verdichten – Welche Rolle kann die Ethik-Leitlinienentwicklung als exemplarische Methode der Ethikdidaktik in der hochschulischen Pflegeausbildung spielen? Ethik Med 2019. [DOI: 10.1007/s00481-019-00544-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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42
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Anderberg P, Björling G, Stjernberg L, Bohman D. Analyzing Nursing Students' Relation to Electronic Health and Technology as Individuals and Students and in Their Future Career (the eNursEd Study): Protocol for a Longitudinal Study. JMIR Res Protoc 2019; 8:e14643. [PMID: 31573945 PMCID: PMC6774236 DOI: 10.2196/14643] [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: 05/12/2019] [Revised: 06/29/2019] [Accepted: 07/30/2019] [Indexed: 11/29/2022] Open
Abstract
Background The nursing profession has undergone several changes in the past decades, and new challenges are to come in the future; patients are now cared for in their home, hospitals are more specialized, and primary care will have a key role. Health informatics is essential in all core competencies in nursing. From an educational perspective, it is of great importance that students are prepared for the new demands and needs of the patients. From a societal point of view, the society, health care included, is facing several challenges related to technological developments and digitization. Preparation for the next decade of nursing education and practice must be done, without the advantage of certainty. A training for not-yet-existing technologies where educators should not be limited by present practice paradigms is desirable. This study presents the design, method, and protocol for a study that investigates undergraduate nursing students’ internet use, knowledge about electronic health (eHealth), and attitudes to technology and how experiences of eHealth are handled during the education in a multicenter study. Objective The primary aim of this research project is to describe the design of a longitudinal study and a qualitative substudy consisting of the following aspects that explore students’ knowledge about and relation to technology and eHealth: (1) what pre-existing knowledge and interest of this area the nursing students have and (2) how (and if) is it present in their education, (3) how do the students perceive this knowledge in their future career role, and (4) to what extent is the education capable of managing this knowledge? Methods The study consists of two parts: a longitudinal study and a qualitative substudy. Students from the BSc in Nursing program from the Blekinge Institute of Technology, Karlskrona, Sweden, and from the Swedish Red Cross University College, Stockholm/Huddinge, Sweden, were included in this study. Results The study is ongoing. Data analysis is currently underway, and the first results are expected to be published in 2019. Conclusions This study presents the design of a longitudinal study and a qualitative substudy. The eHealth in Nursing Education eNursEd study will answer several important questions about nursing students’ attitudes toward and use of information and communications technology in their private life, their education, and their emerging profession. Knowledge from this study will be used to compare different nursing programs and students’ knowledge about and relation to technology and eHealth. Results will also be communicated back to nursing educators to improve the teaching of eHealth, health informatics, and technology. International Registered Report Identifier (IRRID) DERR1-10.2196/14643
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Affiliation(s)
- Peter Anderberg
- Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden
| | - Gunilla Björling
- Department of Health Sciences, The Swedish Red Cross University College, Huddinge, Sweden.,Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Louise Stjernberg
- Department of Health Sciences, The Swedish Red Cross University College, Huddinge, Sweden.,Unit of Quality & Development, Region of Blekinge, Karlskrona, Sweden
| | - Doris Bohman
- Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden
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Kruijtbosch M, Göttgens-Jansen W, Floor-Schreudering A, van Leeuwen E, Bouvy ML. Moral reasoning among Dutch community pharmacists: testing the applicability of the Australian Professional Ethics in Pharmacy test. Int J Clin Pharm 2019; 41:1323-1331. [PMID: 31254151 PMCID: PMC6800840 DOI: 10.1007/s11096-019-00869-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 06/20/2019] [Indexed: 10/26/2022]
Abstract
Background Moral reasoning competency is essential in healthcare practice, especially in situations of moral dilemmas when a professional has to choose a morally justifiable action among several suboptimal action options. The Australian Professional Ethics in Pharmacy test (PEP test) measures moral reasoning among pharmacists. In Australia three levels of moral reasoning (schemas) were measured (1) business orientation (2) rules and regulations, and (3) patient rights (i.e. most advanced schema). Objective To test the applicability of the PEP test to pharmacists working in the Netherlands. Setting Dutch community pharmacy. Methods The PEP test consists of 36 statements (items) accompanying 3 moral dilemma scenarios. It was translated into Dutch and completed by 390 pharmacists. Principle component analysis (PCA) was used to investigate construct validity and Cronbach's Alpha was used to indicate internal consistency of the Dutch version of the PEP test. The eligible grouped statements and perceived possible moral reasoning schemas were compared to the Australian findings. Main outcome measure Moral reasoning schemas. Results The PCA analysis resulted in 3 components (i.e. possible moral reasoning schemas) that together accounted 27% variance in the data. The statements that represented the moral reasoning schemas 'business orientation' and 'rules and regulations' were somewhat similar when comparing these with the statements that represented these schemas in the PEP test study. The most advanced moral reasoning schema identified in Dutch pharmacists contained different statements compared to the statements that represented that schema among Australian pharmacists. This schema was labelled 'professional ethics'. Conclusion The PEP test needs further adaptation to the Dutch pharmacy practice context: especially the statements that should reflect the most advanced moral reasoning schema, need more accurate representations of professional pharmacy ethics that guide pharmacists in the Netherlands. Moral reasoning tests for a specific professional setting or country should be developed and adapted by experts who share the same professional values and practice as the respondents.
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Affiliation(s)
- M Kruijtbosch
- SIR Institute for Pharmacy Practice and Policy, Theda Mansholtstraat 5b, 2331 JE, Leiden, The Netherlands. .,Division of Pharmacoepidemiology and Clinical Pharmacology, Department of Pharmaceutical Sciences, Utrecht University, P.O. Box 80082, 3508 TB, Utrecht, The Netherlands.
| | - W Göttgens-Jansen
- Department of Primary and Community Care, Radboud Institute for Health Sciences (RIHS), Radboud University Medical Center, P.O. Box 9101, 120, ELG, 6500 HB, Nijmegen, The Netherlands
| | - A Floor-Schreudering
- SIR Institute for Pharmacy Practice and Policy, Theda Mansholtstraat 5b, 2331 JE, Leiden, The Netherlands.,Division of Pharmacoepidemiology and Clinical Pharmacology, Department of Pharmaceutical Sciences, Utrecht University, P.O. Box 80082, 3508 TB, Utrecht, The Netherlands
| | - E van Leeuwen
- Department of Primary and Community Care, Radboud Institute for Health Sciences (RIHS), Radboud University Medical Center, P.O. Box 9101, 120, ELG, 6500 HB, Nijmegen, The Netherlands
| | - M L Bouvy
- Division of Pharmacoepidemiology and Clinical Pharmacology, Department of Pharmaceutical Sciences, Utrecht University, P.O. Box 80082, 3508 TB, Utrecht, The Netherlands
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Yamaguchi Y, Greiner C, Ryuno H, Fukuda A. Dementia nursing competency in acute care settings: A concept analysis. Int J Nurs Pract 2019; 25:e12732. [DOI: 10.1111/ijn.12732] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 02/03/2019] [Accepted: 03/05/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Yuko Yamaguchi
- Department of Gerontological Nursing, Graduate School of Health SciencesKobe University Kobe Japan
| | - Chieko Greiner
- Department of Gerontological Nursing, Graduate School of Health SciencesKobe University Kobe Japan
| | - Hirochika Ryuno
- Department of Gerontological Nursing, Graduate School of Health SciencesKobe University Kobe Japan
| | - Atsuko Fukuda
- Department of Adult Nursing, Graduate School of Health SciencesKobe University Kobe Japan
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Shek DTL, Zhu X. Reciprocal Relationships Between Moral Competence and Externalizing Behavior in Junior Secondary Students: A Longitudinal Study in Hong Kong. Front Psychol 2019; 10:528. [PMID: 30894835 PMCID: PMC6414454 DOI: 10.3389/fpsyg.2019.00528] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 02/22/2019] [Indexed: 11/13/2022] Open
Abstract
Defining moral competence using a virtue approach, this longitudinal study examined the prospective relationships between moral competence and externalizing behavior indexed by delinquency and intention to engage in problem behavior in a large and representative sample of Hong Kong Chinese adolescents. Starting from the 2009-2010 academic year, Grade 7 students in 28 randomly selected secondary schools in Hong Kong were invited to join a longitudinal study, which surveyed participating students annually during the high school years. The current study used data collected in the first 3 years (Wave 1 to Wave 3) across junior secondary school stage (Grades 7-9) with a sample of 3,328 students (Age = 12.59 ± 0.74 years and 52.1% boys at Wave 1). Cross-lagged panel path analyses were conducted to compare four models involving different hypothesized patterns of relationships between moral competence and externalizing behavior. Results revealed that the reciprocal effects model best fit the data, supporting reciprocal causal relationships between moral competence and externalizing behavior measures. Specifically, a higher level of moral competence significantly predicted a lower level of delinquency and problem behavioral intention over time. At the same time, a higher level of externalizing behavior also significantly predicted a lower level of moral competence 1 year later. As the magnitudes of the significant findings were not high, replications in different Chinese communities are needed. Nevertheless, the present findings provide important theoretical insights on how moral competence and externalizing behavior in adolescents are associated with each other. Practically speaking, the findings suggest that it is promising to reduce adolescent externalizing behavior by promoting their virtues through moral education programs, and guiding adolescents to behave in a good manner would help promote the development of their virtues.
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Affiliation(s)
- Daniel T L Shek
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Xiaoqin Zhu
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
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46
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Riedel A, Giese C. Ethikkompetenzentwicklung in der (zukünftigen) pflegeberuflichen Qualifizierung – Konkretion und Stufung als Grundlegung für curriculare Entwicklungen. Ethik Med 2019. [DOI: 10.1007/s00481-018-00515-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Koskenvuori J, Stolt M, Suhonen R, Leino‐Kilpi H. Healthcare professionals' ethical competence: A scoping review. Nurs Open 2019; 6:5-17. [PMID: 30534390 PMCID: PMC6279725 DOI: 10.1002/nop2.173] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 05/29/2018] [Indexed: 12/22/2022] Open
Abstract
AIM The aim of this study was to examine the extent and nature of the available research literature on healthcare professionals' ethical competence and to summarize the research findings in this field. DESIGN A scoping review guided by Arksey and O'Malleys methodological framework was conducted. METHODS Six databases including Pubmed/Medline, CINAHL, Web of Science Core Collection, PsycInfo, Philosophers' Index, and Scopus were searched systematically. Of 1,476 nonduplicate citations, 17 matched the inclusion criteria. RESULTS Findings revealed that healthcare professionals' ethical competence is a limited but topical research area. The focus areas of the studies were conceptualization, measuring, and realization of the ethical competence. The studies provided varying definitions and constructions for ethical competence and a few instruments to measure ethical competence were identified. Research in this area seems to be in a transition phase from theorization to empirical measurement. Methodologically, the research was rather heterogeneous and mainly focused on nurses.
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Affiliation(s)
| | - Minna Stolt
- Department of Nursing ScienceUniversity of TurkuFinland
| | - Riitta Suhonen
- Department of Nursing ScienceUniversity of TurkuFinland
- Turku University HospitalFinland
- City of Turku, Welfare DivisionFinland
| | - Helena Leino‐Kilpi
- Department of Nursing ScienceUniversity of TurkuFinland
- Turku University HospitalFinland
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Mikkonen K, Ojala T, Sjögren T, Piirainen A, Koskinen C, Koskinen M, Koivula M, Sormunen M, Saaranen T, Salminen L, Koskimäki M, Ruotsalainen H, Lähteenmäki ML, Wallin O, Mäki-Hakola H, Kääriäinen M. Competence areas of health science teachers - A systematic review of quantitative studies. NURSE EDUCATION TODAY 2018; 70:77-86. [PMID: 30170152 DOI: 10.1016/j.nedt.2018.08.017] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 07/16/2018] [Accepted: 08/13/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND In the face of rapid digitalisation and ever-higher educational requirements for healthcare professionals, it is important that health science teachers possess the relevant core competences. The education of health science teachers varies internationally and there is no consensus about the minimum qualifications and experience they require. OBJECTIVE The aim of this systematic review was to describe the health science teachers' competences and the factors related to it. DESIGN Systematic review of original quantitative studies. DATA SOURCES Four databases were selected from which to retrieve original studies: Cinahl (Ebsco), PubMed, Medic, Eri (ProQuest). REVIEW METHODS The systematic review used PICOS inclusion criteria. Original peer-reviewed quantitative studies published between 1/2007 and 1/2018 were identified. Screening was conducted by two researchers separately reading the 1885 titles, 600 abstracts, and 63 full-texts that were identified, and then agreed between them. Critical appraisal was performed using the JBI MAStARI evaluation tool. The data was extracted and then analysed narratively. RESULTS The core competences of health science teachers include areas of knowledge, skills and attitudes. Health science teachers evaluate their own competence as high. Only in relation to entrepreneurship and leadership knowledge was evaluated to be average. The most common factors influencing competence were teachers' title/position, healthcare experience, research activities, age, academic degree and for which type of organisation they work. CONCLUSION It is important to identify the core competencies required by health science teachers in order to train highly competent healthcare professionals. Based on the findings of this systematic review we suggest that teachers should be encouraged to gain university education and actively participate in research, and that younger teachers should have opportunities to practice the relevant teaching skills to build competence.
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Affiliation(s)
- Kristina Mikkonen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland.
| | - Tapio Ojala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Tuulikki Sjögren
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Arja Piirainen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Camilla Koskinen
- Faculty of Education and Welfare Studies, Åbo Akademi University, Turku, Finland
| | - Monika Koskinen
- Faculty of Education and Welfare Studies, Åbo Akademi University, Turku, Finland
| | - Meeri Koivula
- Faculty of Social Sciences, University of Tampere, Tampere, Finland
| | - Marjorita Sormunen
- Faculty of Health Sciences, Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Terhi Saaranen
- Faculty of Health Sciences, Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Leena Salminen
- Faculty of Medicine, Department of Nursing Science, University of Turku, Turku, Finland
| | - Minna Koskimäki
- Faculty of Social Sciences, University of Tampere, Tampere, Finland
| | - Heidi Ruotsalainen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
| | | | - Outi Wallin
- Degree Programme in Social Services, Tampere University of Applied Sciences, Tampere, Finland
| | - Hanne Mäki-Hakola
- Teacher Training Programme, Tampere University of Applied Sciences, Tampere, Finland
| | - Maria Kääriäinen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; The Finnish Centre for Evidence-Based Health Care: A Joanna Briggs Institute Centre of Excellence, Finland
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Numminen O, Katajisto J, Leino-Kilpi H. Development and validation of Nurses' Moral Courage Scale. Nurs Ethics 2018; 26:2438-2455. [PMID: 30185132 DOI: 10.1177/0969733018791325] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Moral courage is required at all levels of nursing. However, there is a need for development of instruments to measure nurses' moral courage. OBJECTIVES The objective of this study is to develop a scale to measure nurses' self-assessed moral courage, to evaluate the scale's psychometric properties, and to briefly describe the current level of nurses' self-assessed moral courage and associated socio-demographic factors. RESEARCH DESIGN In this methodological study, non-experimental, cross-sectional exploratory design was applied. The data were collected using Nurses' Moral Courage Scale and analysed statistically. PARTICIPANTS AND RESEARCH CONTEXT The data were collected from a convenience sample of 482 nurses from four different clinical fields in a major university hospital in Finland for the final testing of the scale. The pilot comprised a convenience sample of 129 nurses. ETHICAL CONSIDERATIONS The study followed good scientific inquiry guidelines. Ethical approval was obtained from the university ethics committee and permission to conduct the study from the participating hospital. FINDINGS Psychometric evaluation showed that the 4-sub-scale, 21-item Nurses' Moral Courage Scale demonstrates good reliability and validity at its current state of development showing a good level of internal consistency for a new scale, the internal consistency values ranging from 0.73 to 0.82 for sub-scales and 0.93 for the total scale, thus well exceeding the recommended Cronbach's alpha value of >0.7. Principal component analysis and confirmatory factor analysis supported the theoretical construct of Nurses' Moral Courage Scale. Face validity and expert panel assessments markedly contributed to the relevance of items in establishing content validity. DISCUSSION AND CONCLUSION Nurses' Moral Courage Scale provides a new generic instrument intended for measuring nurses' self-assessed moral courage. Recognizing the importance of moral courage as a part of nurses' moral competence and its assessment offers possibilities to develop interventions and educational programs for enhancement of moral courage. Research should focus on further validation measures of Nurses' Moral Courage Scale in international contexts.
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Oelhafen S, Cignacco E. Moral distress and moral competences in midwifery: A latent variable approach. J Health Psychol 2018; 25:2340-2351. [PMID: 30173571 DOI: 10.1177/1359105318794842] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Like other health professionals, midwives need moral competences in order to cope effectively with ethical issues and to prevent moral distress and negative consequences such as fatigue or impaired quality of care. In this study, we developed and conducted a survey with 280 midwives or midwifery students assessing the burden associated with ethical issues, moral competences, and negative consequences of moral distress. Results show that ethical issues associated with asymmetries of power and authority most often lead to the experience of distress. The results are critically discussed in the context of the conceptualization and operationalization of moral distress.
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Affiliation(s)
| | - Eva Cignacco
- Bern University of Applied Sciences, Switzerland
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