scholarly journals Quality dementia care: Prerequisites and relational ethics among multicultural healthcare providers

2017 ◽  
Vol 26 (2) ◽  
pp. 504-514 ◽  
Author(s):  
Gerd Sylvi Sellevold ◽  
Veslemøy Egede-Nissen ◽  
Rita Jakobsen ◽  
Venke Sørlie
Keyword(s):  
Quality Care ◽  
Healthcare Providers ◽  
Working Environment ◽  
Working Relationships ◽  
Ethical Challenges ◽  
Participatory Action ◽  
Action Research Project ◽  
Science Data ◽  
Data Services ◽  
People With Dementia

Background: Many nursing homes appear as multicultural workplaces where the majority of healthcare providers have an ethnic minority background. This environment creates challenges linked to communication, interaction and cultural differences. Furthermore, the healthcare providers have varied experiences and understanding of what quality care of patients with dementia involves. Purpose: The aim of this study is to illuminate multi-ethnic healthcare providers’ lived experiences of their own working relationship, and its importance to quality care for people with dementia. Research design: The study is part of a greater participatory action research project: ‘Hospice values in the care for persons with dementia’. The data material consists of extensive notes from seminars, project meetings and dialogue-based teaching. The text material was subjected to phenomenological-hermeneutical interpretation. Participants and research context: Participants in the project were healthcare providers working in a nursing home unit. The participants came from 15 different countries, had different formal qualifications, varied backgrounds and ethnic origins. Ethical considerations: The study is approved by the Norwegian Regional Ethics Committee and the Norwegian Social Science Data Services. Findings: The results show that good working relationships, characterized by understanding each other’s vulnerability and willingness to learn from each other through shared experiences, are prerequisites for quality care. The healthcare providers further described ethical challenges as uncertainty and different understandings. Discussion: The results are discussed in the light of Lögstrup’s relational philosophy of ethics and the concepts of vulnerability, ethic responsibility, trust and openness of speech. Conclusion: The prerequisite for quality care for persons with dementia in a multicultural working environment is to create arenas for open discussions between the healthcare providers. Leadership is of great importance.

Quality care for persons experiencing dementia

2013 ◽  
Vol 20 (3) ◽  
pp. 263-272 ◽  
Author(s):  
Gerd S Sellevold ◽  
Veslemøy Egede-Nissen ◽  
Rita Jakobsen ◽  
Venke Sørlie
Keyword(s):  
Nursing Homes ◽  
Quality Care ◽  
Healthcare Providers ◽  
Ethical Challenges ◽  
Narrative Interviews ◽  
Provide Quality Care ◽  
The Relationship

The degree of success in creating quality care for people suffering from dementia is limited despite extensive research. This article describes healthcare providers’ experience with the ethical challenges and possibilities in the relationship with patients suffering from dementia and its impact on quality care. The material is based on qualitative, in-depth individual narrative interviews with 12 professional healthcare providers from two different nursing homes. The transcribed interview texts were subjected to a phenomenological–hermeneutical interpretation. To provide quality care to patients with dementia, the healthcare providers emphasized the importance of sensing and understanding the patients’ emotional and bodily expressions through sentient attentiveness and recognition of the patient as a person. They also described reciprocity of expressions in the relationship where the patient recognized them both as persons and healthcare providers. The analyses of the findings are, inter alia, discussed in light of Løgstrup’s relational philosophy of ethics.

Ethics and quality care in nursing homes: Relatives’ experiences

2017 ◽  
Vol 26 (3) ◽  
pp. 767-777 ◽  
Author(s):  
Rita Jakobsen ◽  
Gerd Sylvi Sellevold ◽  
Veslemøy Egede-Nissen ◽  
Venke Sørlie
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Nursing Staff ◽  
Quality Care ◽  
Science Data ◽  
Data Services ◽  
Nursing Home Patients ◽  
Positive Experiences ◽  
Close Relatives

Background: A total of 71,000 people in Norway suffer from some form of dementia in 2013, of whom approximately 30,000 are in nursing homes. Several studies focus on the experiences of those who have close relatives and who are staying in a nursing home. Results show that a greater focus on cooperation between nursing staff and relatives is a central prerequisite for an increased level of care. Benefits of developing systematic collaboration practices include relief for nursing staff, less stress, and greater mutual understanding. Going through studies focusing on the experiences of nursing home patients’ relatives, negative experiences are in the majority. In this study, relatives are invited to share positive experiences regarding the care of their loved ones; a slightly different perspective, in other words. Aim: The aim of the study is to investigate relatives of persons with dementia’s experiences with quality care in nursing homes. Method: The study is a part of a larger project called Hospice values in the care for persons with dementia and is based on a qualitative design where data are generated through narrative interviews. The chosen method of analysis is the phenomenological–hermeneutical method for the study of lived experiences. Participants and research context: Participants in the project were eight relatives of persons with dementia who were living in nursing homes, long-term residences. The sampling was targeted, enrolment happened through collective invitation. All relatives interested were included. Ethical considerations: The Norwegian Regional Ethics Committee and the Norwegian Social Science Data Services approve the study. Findings: Findings show that relatives have certain expectations as to how their loved ones ought to be met and looked after at the nursing home. The results show that in those cases where the expectations were met, the relatives’ experiences were associated with engagement, inclusion and a good atmosphere. When the expectations were not met, the relatives experienced powerlessness, distrust and guilt. Discussion: The results are discussed considering the concepts of trust, power and asymmetry. Conclusion: When asked about experiences with quality care, the relatives spoke both of expectations met and of expectations not met. Results in this study are important knowledge for developing units where performing quality care is the overall aim.

scholarly journals Mitigating Burnout in an Oncological Unit: A Scoping Review

2021 ◽  
Vol 9 ◽  
Author(s):  
Rasheed Omobolaji Alabi ◽  
Päivi Hietanen ◽  
Mohammed Elmusrati ◽  
Omar Youssef ◽  
Alhadi Almangush ◽  
...  
Keyword(s):  
Job Satisfaction ◽  
Scoping Review ◽  
Positive Impact ◽  
Quality Care ◽  
Healthcare Providers ◽  
Training Group ◽  
Well Being ◽  
Working Environment ◽  
Clinical Practices ◽  
Patients With Cancer

Objectives: The purpose of this study was to provide a scoping review on how to address and mitigate burnout in the profession of clinical oncology. Also, it examines how artificial intelligence (AI) can mitigate burnout in oncology.Methods: We searched Ovid Medline, PubMed, Scopus, and Web of Science, for articles that examine how to address burnout in oncology.Results: A total of 17 studies were found to examine how burnout in oncology can be mitigated. These interventions were either targeted at individuals (oncologists) or organizations where the oncologists work. The organizational interventions include educational (psychosocial and mindfulness-based course), art therapies and entertainment, team-based training, group meetings, motivational package and reward, effective leadership and policy change, and staff support. The individual interventions include equipping the oncologists with adequate training that include—communication skills, well-being and stress management, burnout education, financial independence, relaxation, self-efficacy, resilience, hobby adoption, and work-life balance for the oncologists. Similarly, AI is thought to be poised to offer the potential to mitigate burnout in oncology by enhancing the productivity and performance of the oncologists, reduce the workload and provide job satisfaction, and foster teamwork between the caregivers of patients with cancer.Discussion: Burnout is common among oncologists and can be elicited from different types of situations encountered in the process of caring for patients with cancer. Therefore, for these interventions to achieve the touted benefits, combinatorial strategies that combine other interventions may be viable for mitigating burnout in oncology. With the potential of AI to mitigate burnout, it is important for healthcare providers to facilitate its use in daily clinical practices.Conclusion: These combinatorial interventions can ensure job satisfaction, a supportive working environment, job retention for oncologists, and improved patient care. These interventions could be integrated systematically into routine cancer care for a positive impact on quality care, patient satisfaction, the overall success of the oncological ward, and the health organizations at large.

Ethical challenges in everyday work with adults with learning disabilities

2014 ◽  
Vol 22 (4) ◽  
pp. 417-427 ◽  
Author(s):  
Betty-Ann Solvoll ◽  
Elisabeth OC Hall ◽  
Berit Støre Brinchmann
Keyword(s):  
Learning Disabilities ◽  
Research Question ◽  
Healthcare Providers ◽  
Shared Responsibility ◽  
Ethical Challenges ◽  
Science Data ◽  
Group Discussions ◽  
Daily Work ◽  
Community Institution ◽  
Adults With Learning Disabilities

Background: Healthcare providers caring for learning-disabled individuals in institutions face challenges of what is right or wrong in their daily work. Serving this group, it is of utmost importance for the healthcare staff to raise awareness and to understand how ethical values are at stake. Research question: What ethical challenges are discussed among healthcare providers working with adults with learning disabilities? Research design: The study had a qualitative and investigative design. Participants and research context: The study was conducted in a community institution for adults with learning disabilities. Participants were healthcare providers joining regular focused group discussions. Two groups participated and each group consisted of six participants. The conversations were taped and transcribed. Ethical considerations: The study was reported to Norwegian Social Science Data Services and was approved by the regional ethics committee. Findings: Findings are presented in four themes: (a) feeling squeezed between conflicting actions, (b) being the client’s spokesman, (c) searching shared responsibility, and (d) expecting immediate and fixed solutions. The healthcare providers wanted to be the clients’ advocates. They felt obliged to speak up for the clients, however, seeking for someone with whom to share the heavily experienced responsibility. Data likewise revealed that the group discussions created expectations among the healthcare providers; they expected smart and final solutions to the problems they discussed. Discussion: The discussion focuses on everyday ethical challenges, the meaning of being in-between and share responsibility, and the meaning of ethical sensitivity. Conclusion: Ethical challenges can be demanding for the staff; they might feel squeezed in-between contradictory attitudes or feel alone in decision-making. Frequent conversations about ethical challenges do not solve the ethical problems here-and-now, but they do visualize them. This also visualizes the staff’s need for support.

Moral distress in acute psychiatric nursing: Multifaceted dilemmas and demands

2019 ◽  
Vol 27 (5) ◽  
pp. 1315-1326 ◽  
Author(s):  
Trine-Lise Jansen ◽  
Marit Helene Hem ◽  
Lars Johan Dambolt ◽  
Ingrid Hanssen
Keyword(s):  
Psychiatric Care ◽  
Moral Distress ◽  
Quality Care ◽  
Moral Dilemmas ◽  
Ethical Awareness ◽  
Science Data ◽  
Data Services ◽  
Definition Of ◽  
Acute Psychiatric Care

Background In this article, the sources and features of moral distress as experienced by acute psychiatric care nurses are explored. Research design A qualitative design with 16 individual in-depth interviews was chosen. Braun and Clarke’s six analytic phases were used. Ethical considerations Approval was obtained from the Norwegian Social Science Data Services. Participation was confidential and voluntary. Findings Based on findings, a somewhat wider definition of moral distress is introduced where nurses experiencing being morally constrained, facing moral dilemmas or moral doubt are included. Coercive administration of medicines, coercion that might be avoided and resistance to the use of coercion are all morally stressful situations. Insufficient resources, mentally poorer patients and quicker discharges lead to superficial treatment. Few staff on evening shifts/weekends make nurses worry when follow-up of the most ill patients, often suicidal, in need of seclusion or with heightened risk of violence, must be done by untrained personnel. Provision of good care when exposed to violence is morally challenging. Feelings of inadequacy, being squeezed between ideals and clinical reality, and failing the patients create moral distress. Moral distress causes bad conscience and feelings of guilt, frustration, anger, sadness, inadequacy, mental tiredness, emotional numbness and being fragmented. Others feel emotionally ‘flat’, cold and empty, and develop high blood pressure and problems sleeping. Even so, some nurses find that moral stress hones their ethical awareness. Conclusion Moral distress in acute psychiatric care may be caused by multiple reasons and cause a variety of reactions. Multifaceted ethical dilemmas, incompatible demands and proximity to patients’ suffering make nurses exposed to moral distress. Moral distress may lead to reduced quality care, which again may lead to bad conscience and cause moral distress. It is particularly problematic if moral distress results in nurses distancing and disconnecting themselves from the patients and their inner selves.

Power, Truth and Justice in Youth Participatory Action Research: Ethical Questions

2004 ◽  
Vol 26 (2) ◽  
pp. 61-66 ◽  
Author(s):  
Ivor Pritchard
Keyword(s):  
Action Research ◽  
Participatory Action Research ◽  
Ethical Issues ◽  
Youth Participatory Action Research ◽  
Ethical Challenges ◽  
Research Subjects ◽  
Participatory Action ◽  
Action Research Project ◽  
To Come ◽  
The Right

What difference does it make, ethically speaking, to be part of an action research project involving youth? How are participants supposed to act towards one another? How are they supposed to act toward others- research subjects, peers, adults in positions of authority, community members- who they encounter in the course of their projects? Youth Participatory Action Research (Youth PAR), as reflected in this volume's various projects, raises ethical issues that deserve its supporters' attention. Action researchers who are serious about both achieving their objectives and doing the right thing in the process are bound to come across certain kinds of ethical challenges in their activity. This essay will try to illuminate some common and troubling challenges.

Ethics support in community care makes a difference for practice

2016 ◽  
Vol 25 (2) ◽  
pp. 165-173 ◽  
Author(s):  
Morten Magelssen ◽  
Elisabeth Gjerberg ◽  
Lillian Lillemoen ◽  
Reidun Førde ◽  
Reidar Pedersen
Keyword(s):  
Large Scale ◽  
Response Rate ◽  
Ethical Challenges ◽  
Next Of Kin ◽  
Science Data ◽  
Data Services ◽  
Care Services ◽  
Ethics Support ◽  
Community Sector

Background: Through the Norwegian ethics project, ethics activities have been implemented in the health and care sector in more than 200 municipalities. Objectives: To study outcomes of the ethics activities and examine which factors promote and inhibit significance and sustainability of the activities. Research design: Two online questionnaires about the municipal ethics activities. Participants and research context: A total of 137 municipal contact persons for the ethics project answered the first survey (55% response rate), whereas 217 ethics facilitators responded to the second survey (33% response rate). Ethical considerations: Based on informed consent, the study was approved by the Data Protection Official of the Norwegian Social Science Data Services. Findings: Around half of the respondents found the ethics project to have been highly significant for daily professional practice. Outcomes include better handling of ethical challenges, better employee cooperation, better service quality, and better relations to patients and next of kin. Factors associated with sustainability and/or significance of the activities were sufficient support from stakeholders, sufficient available time, and ethics facilitators having sufficient knowledge and skills in ethics and access to supervision. Discussion: This study shows that ethics initiatives can be both sustainable and significant for practice. There is a need to create regional or national structures for follow-up and develop more comprehensive ethics training for ethics facilitators. Conclusion: It is both possible and potentially important to implement clinical ethics support activities in community health and care services systematically on a large scale. Future ethics initiatives in the community sector should be designed in light of documented promoting and inhibiting factors.

Current Practices and Challenges of Medical Services on Health Care System of Mandalay General Hospital

2019 ◽  
Vol 31 (2) ◽  
pp. 131
Keyword(s):  
Health Care ◽  
General Hospital ◽  
Health Care Providers ◽  
Quality Care ◽  
Healthcare Providers ◽  
Medical Services ◽  
Tertiary Level ◽  
Care Providers ◽  
Level Hospital ◽  
Care System

In Myanmar, the main challenge to provide quality healthcare by Universal Health Care approach is documented as low health services coverage with substantial wealth-based inequality. To achieve the effective health care system, strong medical care system is essential. Understanding on challenges and needs in provision of medical services among patients and health care providers is critical to provide quality care with desirable outcomes. The aim of the study was to explore the patients’ and health care providers’ perceptions on the challenges in provision of medical services at the Mandalay General Hospital. This was a qualitative study conducted at the tertiary level hospital (Mandalay General Hospital). The data was collected by using focus group discussions and in-depth interviews with hospitalized patients or attendants, healthcare providers such as medical doctors, nurses, laboratory scientists and hospital administrators in March 2017. The qualitative data was analyzed using themes by themes matrix analysis. Most patients were satisfied with the care provided by the doctors because they believed that they received quality care. However, some patients complained about long waiting time for elective operation, congested conditions in the ward, burden for investigations outside the hospital for urgent needs and impolite manners of general workers. Healthcare providers reported that they had heavy workload due to limited human and financial resources in the hospital, poor compliances with hospital rules and regulation among patients and attendants, and inefficient referral practices from other health facilities. Other challenges experienced by healthcare providers were lack of ongoing training to improve knowledge and skills, limited health infrastructure and inadequate medicinal supplies. The findings highlighted the areas needed to be improved to provide quality health care at the tertiary level hospital. The challenges and problems encountered in this hospital can be improved by allocating adequate financial and human resources. The systematic referral system and hospital management guidelines are needed to reduce workload of health staff.

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