Exploring moral problems and moral competences in midwifery: A qualitative study

2018 ◽  
Vol 26 (5) ◽  
pp. 1373-1386 ◽  
Author(s):  
Stephan Oelhafen ◽  
Settimio Monteverde ◽  
Eva Cignacco
Keyword(s):  
Moral Distress ◽  
Professional Competence ◽  
Ethical Issues ◽  
Structured Interviews ◽  
Interprofessional Communication ◽  
Daily Work ◽  
Midwifery Practice ◽  
Moral Problems ◽  
Moral Competences ◽  
Ethics Courses

Background: Most undergraduate midwifery curricula comprise ethics courses to strengthen the moral competences of future midwives. By contrast, surprisingly little is known about the specific moral competences considered to be relevant for midwifery practice. Describing these competences not only depends on generic assumptions about the moral nature of midwifery practice but also reflects which issues practitioners themselves classify as moral. Objective: The goal of this study was to gain insight into the ethical issues midwives encounter in their daily work, the key competences and resources they consider indispensable to understand and deal with them, and to assess phenomena linked to moral distress. Methods: We conducted individual semi-structured interviews with eight midwives and two other health professionals, varying in terms of years of experience and work setting. Interview transcripts were analyzed in an interdisciplinary research group, following thematic analysis. Ethical considerations: This study was not subject to approval according to the Swiss Law on Research with Humans. Participants were informed about the study goals and gave written informed consent prior to participation. Results: External constraints limiting the midwife’s and the patient’s autonomy and resulting interpersonal conflicts were found to be the most relevant ethical issues encountered in clinical practice and were most often associated with moral distress. These conflicts often arise in the context of medical interventions midwives consider as not appropriate and situations in which less experienced midwives in particular observe a lack of both interprofessional communication and trust in their professional competence. Ethical issues related to late abortions or prenatal diagnostics and selective abortions were also frequently addressed, but many midwives involved had learned to cope with them. Discussion: In the light of the ethical issues and factors contributing to phenomena of moral distress, an empirically grounded profile of moral competences is drafted. Curricular implications in the light of possible adaptations within undergraduate midwifery education are critically discussed.

Moral distress and moral competences in midwifery: A latent variable approach

2018 ◽  
Vol 25 (13-14) ◽  
pp. 2340-2351 ◽  
Author(s):  
Stephan Oelhafen ◽  
Eva Cignacco
Keyword(s):  
Health Professionals ◽  
Latent Variable ◽  
Moral Distress ◽  
Ethical Issues ◽  
Negative Consequences ◽  
Variable Approach ◽  
Moral Competences ◽  
Latent Variable Approach ◽  
Impaired Quality

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.

Ethical Issues in Private Practice: A Phenomenological Investigation of Music Therapy Business Owners

2021 ◽  
Author(s):  
Kyle Wilhelm ◽  
Lindsey Wilhelm
Keyword(s):  
Music Therapy ◽  
Private Practice ◽  
Phenomenological Study ◽  
Ethical Issues ◽  
Ethical Dilemmas ◽  
The United States ◽  
Business Owners ◽  
Snowball Sampling ◽  
Structured Interviews ◽  
Music Therapists

Abstract As a music therapy private practice is both a business and a healthcare service, it should adhere to ethical standards from both disciplines. However, this topic has rarely been examined in the music therapy literature. The purpose of this phenomenological study was to explore ethical dilemmas experienced by music therapy business owners (MTBOs) in their private practice and how MTBOs avoid or address ethical dilemmas. Utilizing convenience and snowball sampling techniques, 21 MTBOs in the United States were interviewed using semi-structured interviews. To answer the two areas of inquiry, we identified three themes and 12 subthemes: (1) Ethical issues related to client welfare, (2) Ethical issues related to business relationships and operation, and (3) Strategies to address or avoid ethical dilemmas. MTBOs also shared how they ensure ethical behavior in themselves, with their employees or independent contractors, and when interacting with professionals outside the private practice. These findings provide a better understanding of MTBOs’ lived experiences of ethics in their private practice and may benefit other music therapists who are in private practice or are wanting to go into private practice. Limitations and recommendations for further research are provided.

scholarly journals Doctors’ maintenance of professional competence: a qualitative study informed by the theory of planned behaviour

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anél Wiese ◽  
Emer Galvin ◽  
Janet O’Farrell ◽  
Jantze Cotter ◽  
Deirdre Bennett
Keyword(s):  
Qualitative Study ◽  
Theory Of Planned Behaviour ◽  
Professional Competence ◽  
Age Groups ◽  
Structured Interviews ◽  
Negative Attitudes ◽  
Planned Behaviour ◽  
Targeted Interventions ◽  
Research Findings ◽  
Meaningful Engagement

Abstract Background Medical regulators worldwide have implemented programmes of maintenance of professional competence (MPC) to ensure that doctors, throughout their careers, are up to date and fit to practice. The introduction of MPC required doctors to adopt a range of new behaviours. Despite high enrolment rates on these programmes, it remains uncertain whether doctors engage in the process because they perceive benefits like improvements in their practice and professional development or if they solely meet the requirements to retain medical registration. In this study, we aimed to explore the relationship between doctors’ beliefs, intention and behaviour regarding MPC through the lens of the Theory of Planned Behaviour (TPB) to make explicit the factors that drive meaningful engagement with the process. Methods We conducted a qualitative study using semi-structured interviews. From a pool of 1258 potential participants, we purposively selected doctors from multiple specialities, age groups, and locations across Ireland. We used thematic analysis, and the TPB informed the analytic coding process. Results Forty-one doctors participated in the study. The data analysis revealed doctors’ intention and behaviour and the factors that shape their engagement with MPC. We found that attitudes and beliefs about the benefits and impact of MPC mediated the nature of doctors’ engagement with the process. Some participants perceived positive changes in practice and other gains from participating in MPC, which facilitated committed engagement with the process. Others believed MPC was unfair, unnecessary, and lacking any benefit, which negatively influenced their intention and behaviour, and that was demonstrated by formalistic engagement with the process. Although participants with positive and negative attitudes shared perceptions about barriers to participation, such perceptions did not over-ride strongly positive beliefs about the benefits of MPC. While the requirements of the regulator strongly motivated doctors to participate in MPC, beliefs about patient expectations appear to have had less impact on intention and behaviour. Conclusions The findings of this study broaden our understanding of the determinants of doctors’ intention and behaviour regarding MPC, which offers a basis for designing targeted interventions. While the barriers to engagement with MPC resonate with previous research findings, our findings challenge critical assumptions about enhancing doctors’ engagement with the process. Overall, our results suggest that focused policy initiatives aimed at strengthening the factors that underpin the intention and behaviour related to committed engagement with MPC are warranted.

Ethical Considerations In ICU Preparations For Viral Epidemics

2021 ◽  
Vol 66 (Special Issue) ◽  
pp. 142-143
Author(s):  
Cristina Petrișor ◽  
◽  
Sebastian Tranca ◽  
◽  
Keyword(s):  
Clinical Picture ◽  
Health Care Professionals ◽  
Administrative Support ◽  
Moral Distress ◽  
Ethical Issues ◽  
Ventilatory Support ◽  
H1n1 Influenza ◽  
Modern World ◽  
Medical Systems ◽  
Infected People

"Intensive Care Units (ICUs) admit patients with the most severe forms of the diseases, viral ARDS included. Since the 2009 H1N1 influenza outbreak, ICU preparations and triage have been recommended. The novel COVID-19 clinical picture resembles influenza in terms of organ dysfunction which may start with hypoxemic breathing insufficiency and ultimately, a possibility of evolution towards multiple organ failure. Its current clinical picture is not new for intensivists. However, there are several important differences as far as we know now: there is overall human susceptibility to become infected and nobody can be specifically protected by vaccination. This fact led to large numbers of infected people all over the world, overwhelming medical systems. Almost 10% of COVID-19 infections would be qualified for ICU admittance and ventilatory support. The main ethical issues in ICUs, in time of viral epidemics are: lack of free ICU beds, free ventilator machines, pressures on providing aggressive treatments for people with low chances of survival, dealing with terminally ill patients, high degrees of burnout in the medical team, reporting errors and inadequate behavior of other medical staff, lack of adequate protective equipment, as well as lack of administrative support. All these facts lead to moral distress and high burnout incidences. Administrative preparations, prioritization and triage are important aspects to consider. In conclusion, we all see that the modern world is not prepared enough to face such challenges and from these situations we, all (health care professionals, providers, population and authorities) should learn important personal and professional lessons. "

A Retrospective Comparison of American Women’s Spontaneous Conceptions and Gestational Surrogate Pregnancies

2021 ◽  
Author(s):  
Jennifer Lahl ◽  
Kallie Fell ◽  
Kate Bassett ◽  
Frances Broghammer ◽  
Maggie Eastman ◽  
...  
Keyword(s):  
Ethical Issues ◽  
Demographic Data ◽  
Health Issues ◽  
Structured Interviews ◽  
Survey Tool ◽  
Level Data ◽  
Retrospective Comparison ◽  
Caucasian Women ◽  
Future Work

Abstract Purpose: To evaluate the retrospective pregnancy experiences of American women by comparing spontaneous pregnancies with gestational surrogate pregnancies. Methods: Data were collected via structured interviews following an approved survey tool utilizing an online video platform. In total, 97 interviews were conducted. Results: Demographic data was collected on age, ethnicity, primary language, country of birth, education, and income level. Data revealed that a woman was more likely to have a pregnancy that was high-risk during a surrogate pregnancy than a non-surrogate pregnancy, independent of maternal age or gravidity (OR 7.22, p<0.001). A surrogate pregnancy had 4 times higher odds of resulting in a c-section (p<0.001) as well as delivering at an earlier gestational age (p<0.001). Further, women were more likely to experience adverse effects, including postpartum depression, following delivery of a surrogate child than their own biological child (p<0.001). Finally, the rate of new post-surrogacy chronic health issues for non-Caucasian women was significantly higher than for Caucasians (p<0.001). Women reported using the payment they received for their surrogacy for basic needs. Almost half of the women reported using the money to pay bills or get out of debt.Conclusions: These results are among the first of their kind. This study reveals that surrogate health disparities exist and that there may be long-term complications after a surrogate pregnancy. This raises important social, economic, and ethical issues related to surrogacy which must be further explored. Future work will build on this study and help elucidate the circumstances and consequences surrounding this complex issue.

scholarly journals How to Support Child Healthcare Nurses in Sweden to Promote Healthy Lifestyle Behaviors from the Start of Life

Children ◽  
2021 ◽  
Vol 8 (8) ◽  
pp. 696
Author(s):  
Matilda Ersson ◽  
Maria Henström ◽  
Gerd Almquist-Tangen ◽  
Kylie D. Hesketh ◽  
Christine Delisle Nyström
Keyword(s):  
Healthy Lifestyle ◽  
Lifestyle Behaviors ◽  
Structured Interviews ◽  
Daily Work ◽  
Openness To Change ◽  
Sensitive Topics ◽  
Healthy Lifestyle Behaviors ◽  
Need For Support ◽  
Child Healthcare ◽  
Facilitators And Barriers

Child healthcare (CHC) nurses have a key role in promoting and supporting healthy lifestyle behaviors from a young age. Thus, this study aims to investigate the perspectives of CHC nurses regarding discussing food introduction, physical activity/active play, and screen time with parents; explore facilitators and barriers influencing the discussion of healthy lifestyle behaviors with parents; and explore the perspectives of CHC nurses regarding a complementary program to promote healthy lifestyle behaviors from the start of life. A total of fifteen nurses participated in semi-structured interviews, which were recorded, transcribed verbatim, and analyzed using thematic analysis. There were four themes that were generated: parental needs; facilitators and barriers; parental groups; and future working methods. This study found that CHC nurses have seen an increase in the need for support among today’s parents. Time, the need to tailor information, and confidence to address sensitive topics were perceived as the largest barriers during daily work for the nurses. Furthermore, large variations in parental groups were found. Finally, the CHC nurses displayed a willingness and openness to change and develop current working methods using digital solutions. These solutions could possibly ease the workload and at the same time, support parents to create healthy lifestyle behaviors from the start of their child’s life.

scholarly journals QUALITATIVE INVESTIGATION OF COACHES’ PERSPECTIVES ON MORAL EDUCATION IN SPORT

2017 ◽  
Vol 4 (107) ◽  
pp. 46-56 ◽  
Author(s):  
Saulius Šukys ◽  
Živilė Dargenė ◽  
Diana Karanauskienė
Keyword(s):  
Moral Education ◽  
Thematic Analysis ◽  
Personal Development ◽  
Career Planning ◽  
Professional Knowledge ◽  
Primary Data ◽  
Structured Interviews ◽  
Football Coaches ◽  
Moral Behaviour ◽  
Moral Competences

Background. Moral behaviour and moral education of young athletes still remain an important issue in sports context. This study was designed to examine coaches’ perspectives on moral education in sport. Methods. In this study, aiming at establishing the perspectives of coaches on the moral education of athletes in sports activities, qualitative research was selected. Primary data were collected via semi-structured interviews with nine basketball and football coaches of different experience and age. The data were analysed applying thematic analysis. Results. Thematic analysis indicated that coaches identified goals of athletes’ education as the development of athletes’ personality, motivation, the development of sports excellence and the encouragement to achieve victory. Coaches defined moral education as the development of the authority of an athlete, fair play, compliance with rules, and integrity. The most common means coaches used for moral education were explanation, discussion, lectures, meetings, personal examples, case analyses. Such means are important for athlete’s personal development, pursuit of results, and career planning. The qualities of good coach were professional knowledge, authority, competences of creating motivational climate, and also moral competences. Conclusion. A central finding of the study is that coaches define moral education in sport through the education of moral values and the goals set by coaches related not only to the sports results, but also to the development of the personality of athletes. Personal role of coaches in moral education encompassing professional knowledge and moral competences of athletes is of great importance.

scholarly journals Remoção de órgãos sólidos para transplante: protocolo para a enfermagem

2019 ◽  
Vol 13 ◽  
Author(s):  
Edna Andréa Pereira de Carvalho ◽  
Shirlei Moreira da Costa Faria ◽  
Natália Ribeiro Ramos ◽  
Karla Rona da Silva
Keyword(s):  
Nursing Care ◽  
Professional Competence ◽  
Descriptive Study ◽  
Quality And Safety ◽  
Clinical Protocols ◽  
Structured Interviews ◽  
Validity Index ◽  
Organ Removal ◽  
Qualitative Descriptive ◽  
Adults And Children

Objetivos: elaborar um instrumento na modalidade de protocolo que permita a uniformidade das ações de Enfermagem em remoção de órgãos sólidos para transplantes. Método: trata-se de estudo qualitativo, descritivo, com foco na construção de um instrumento tecnológico do tipo protocolo, respeitando-se as seguintes etapas: revisão integrativa; coleta de dados por meio de entrevistas semiestruturadas; apreciação dos dados por meio da Análise de Conteúdo; elaboração da proposta de protocolo e utilização do Índice de Validade do Conteúdo para a validação.  Resultados esperados: espera-se disponibilizar, para os centros transplantadores, um protocolo que auxilie o enfermeiro na sistematização das ações de Enfermagem em cirurgias de remoção de órgãos para transplantes, contribuindo para a qualidade e segurança da assistência prestada a adultos e crianças submetidos a transplantes. Descritores: Protocolos Clínicos; Cuidados de Enfermagem; Transplante de Órgãos; Aloenxerto; Competência Profissional; Fluxo de Trabalho. ABSTRACT Objectives: to elaborate an instrument in the protocol modality that allows uniformity of Nursing actions in the removal of solid organs for transplants. Method: this is a qualitative, descriptive study, focusing on the construction of a protocol-type technological instrument, respecting the following steps: integrative review; data collection through semi-structured interviews; data appreciation through Content Analysis; elaboration of the protocol proposal and use of the Content Validity Index for validation. Expected results: It is expected to make available to transplantation centers a protocol that assists nurses in the systematization of Nursing actions in transplantation organ removal surgeries, contributing to the quality and safety of care provided to adults and children undergoing transplantation. Descriptors: Clinical Protocols; Nursing Care; Organ Transplantation; Allografts; Professional Competence; Workflow.RESUMEN Objetivos: elaborar un instrumento en la modalidad de protocolo que permita la uniformidad de las acciones de enfermería en la extracción de órganos sólidos para trasplante. Método: se trata de un estudio cualitativo, descriptivo, centrado en la construcción de un instrumento tecnológico de tipo protocolo, respetando los siguientes pasos: revisión integradora; recopilación de datos a través de entrevistas semiestructuradas; apreciación de datos a través del Análisis de Contenido; elaboración de la propuesta de protocolo y uso del índice de validez de contenido para la validación. Resultados esperados: se espera que se ponga a disposición para los centros de trasplante, un protocolo que ayude el enfermero en la sistematización de las acciones de Enfermería en cirugías de extracción de órganos de trasplante, contribuyendo para la calidad y seguridad de la atención prestada en adultos y niños sometidos a trasplantes. Descriptores: Protocolos Clínicos; Atención de Enfermería; Transplante de Órganos; Aloinjertos; Competencia Profesional; Flujo de Trabajo. 

Professional expertise for radiation therapists in Africa

2007 ◽  
Vol 6 (03) ◽  
pp. 125-131 ◽  
Author(s):  
P. C. Engel-Hills
Keyword(s):  
Reflective Practice ◽  
Role Models ◽  
Professional Competence ◽  
Education Institution ◽  
Professional Expertise ◽  
Structured Interviews ◽  
Clinical Role ◽  
Text Data ◽  
Applicable Knowledge ◽  
South African Higher Education

AbstractThe radiation therapist (RTT) is a practitioner who must learn to take responsibility as an autonomous professional within a collaborative multi-professional team. A case study of international students on fellowship studies to a South African Higher Education Institution was used as the lens to explore the development of professional expertise in RTTs. Documents and semi-structured interviews generated textual data that was semantically analysed. The findings are presented as a discussion of the themes that emerged from the text data; (1) autonomy in a team, (2) collaboration facilitates learning, (3) the need for professional competence, (4) reflective practice and (5) participatory learning. The paper offers the interpretation of professional competence as a practitioner who has applicable knowledge, clinical and generic competence as well as appropriate behaviour and attitudes. It is proposed that a collaborative, integrated curriculum meets the need for the education of RTTs on the African continent. In such an environment optimised learning is facilitated by access to good clinical role models, the development of skills toward reflective practice and student participation in the learning environment.

scholarly journals ‘By the way….how’s your sex life?’ – A descriptive study reporting primary health care registered nurses engagement with youth about sexual health

2017 ◽  
Vol 9 (1) ◽  
pp. 22 ◽  
Author(s):  
Rhiannon Martel ◽  
Ruth Crawford ◽  
Helen Riden
Keyword(s):  
Health Care ◽  
New Zealand ◽  
Sexual Health ◽  
Registered Nurses ◽  
Online Survey ◽  
Ethical Issues ◽  
Descriptive Study ◽  
Health Providers ◽  
Cultural Issues ◽  
Structured Interviews

ABSTRACT INTRODUCTION Youth rates of sexually transmitted infections in New Zealand are among the highest in the Organisation for Economic Cooperation and Development. Registered nurses employed in primary healthcare settings (PHC RNs) may lack confidence engaging with youth about their sexual health. AIM To identify what facilitates PHC RNs to discuss sexual health with youth. METHODS This descriptive study was undertaken in two phases. In phase one, 23 PHC RNs completed an online survey. Phase two followed up the survey with semi-structured interviews with seven PHC RNs. RESULTS Most PHC RNs are female, aged between 40 and 60 years old and identify with New Zealand or other European ethnicity. Participants identified specific educational needs relating to youth sexual health that are not being met: legal and ethical issues (65%); cultural issues (65%); youth sexual (44%) and psychological (52%) development; and working with gay, lesbian, bisexual or transsexual youth (48%). Lack of time was cited as a barrier to engaging with youth about sexual health by 30% of the participants. Ongoing support practices such as regular debriefing, reflections of practice and case reviews with colleagues (74%); support from other sexual health providers (87%); and access to educational materials about youth sexual health aimed at health professionals (100%) were perceived to be useful to increase confidence in discussing sexual health with youth. DISCUSSION The PHC RNs lacked knowledge and confidence engaging with youth about sexual health. PHC RNs need resourcing to provide culturally safe, effective sexual health care to youth.

Sign in / Sign up

Export Citation Format

Share Document