Caregivers blinded by the care: A qualitative study of physical restraint in pediatric care

Background: The phenomenon of forceful physical restraint in pediatric care is an ethical issue because it confronts professionals with the dilemma of using force for the child’s best interest. This is a paradox. The perspective of healthcare professional working in pediatric wards needs further in-depth investigations. Purpose: To explore the perspectives and behaviors of healthcare professionals toward forceful physical restraint in pediatric care. Methods: This qualitative ethnographic study used focus groups with purposeful sampling. Thirty volunteer healthcare professionals (nurses, hospital aids, physiotherapists, and health educators) were recruited in five pediatric facilities in four hospitals around Paris, France, from March to June 2013. The data were processed using NVIVO software (QSR International Ltd. 1999–2013). The data analysis followed a qualitative methodological process. Ethical Considerations: The research was conducted in compliance with the Declaration of Helsinki. Written informed consent was collected systematically from participants. Findings: This study provides elements to help understand why restraint remains common despite its contradiction with the duty to protect the child and the child’s rights. All participants considered the use of forceful physical restraint to be a frequent difficulty in pediatrics. Greater interest in the child’s health was systematically used to justify the use of force, with little consideration for contradictory or ethical aspects. Raising the issue of forceful restraint always triggered discomfort, unease and an outpour of emotions among healthcare professionals. The findings have highlighted a form of hierarchy of duties that give priority to the execution of the technical procedure and legitimize the use of restraint. Professionals seemed to temporarily suspend their ability to empathize in order to apply restraint to carry out a technical procedure. This observation has allowed us to suggest the concept of “transient empathic blindness.” Conclusion: Using physical restraint during pediatric care was considered a common problem by participants. This practice must be questioned, and professionals must have access to training to find alternatives to strong restraint. Conceptualizing this phenomenon with the concept of “transient empathic blindness” could help professionals understand what happens in their minds when using forceful restraint.

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Experiences of Hearing Parents Following the Diagnosis of Their Child's Hearing Loss

SOUTHERN AFRICAN JOURNAL OF SOCIAL WORK AND SOCIAL DEVELOPMENT ◽

10.25159/2415-5829/2468 ◽

2018 ◽

Vol 30 (2) ◽

Cited By ~ 2

Author(s):

Ronel Sanet Davids ◽

Mariana De Jager

Keyword(s):

South Africa ◽

Hearing Loss ◽

Thematic Analysis ◽

Qualitative Methodology ◽

Cape Town ◽

Best Interest ◽

Ethical Considerations ◽

Hearing Parents ◽

Phenomenological Design ◽

Depth Interviews

An estimated 90 per cent of children with a hearing loss are born to hearing parents. Most parents are unprepared for the diagnosis, leaving them shocked, confused, sad and bewildered. This article reports on a study aimed at exploring and describing the experiences of hearing parents regarding their child’s hearing loss. The study was conducted in Cape Town, South Africa. The study applied a qualitative methodology with a phenomenological design. Purposive sampling was implemented and data were collected by means of unstructured in-depth interviews. Data were analysed using thematic analysis. Ethical considerations were adhered to. The main findings of the study indicated that hearing parents experience a myriad of emotions when their child is diagnosed with a hearing loss. This study advocates for various stakeholders in the helping profession to collaborate in the best interest of hearing parents and a child with hearing loss. Furthermore, these findings serve as guidelines for professionals working with these families.

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Care for delirium superimposed on dementia at an early stage

Tijdschrift voor Gerontologie en Geriatrie ◽

10.36613/tgg.1875-6832/2020.04.02 ◽

2020 ◽

Keyword(s):

Behavioral Problems ◽

Healthcare Professionals ◽

Early Stage ◽

Good Care ◽

Structured Interviews ◽

Ethical Considerations ◽

Appropriate Care ◽

Adequate Care ◽

Insight Into ◽

Delirium Superimposed On Dementia

Delirium is a common serious complication in dementia that is associated with poor prognosis and a high burden on caregivers and healthcare professionals. Appropriate care is therefore important at an early stage for patients with delirium superimposed on dementia To gain insight into the care of six patients with delirium superimposed on dementia, 19 semi-structured interviews were conducted focused on the experiences of caregivers and professionals. The interviews revealed four themes that appeared to play a role: 1. experiences with and views on behavioral problems of these patients, 2. recognition and diagnosis of delirium in dementia, 3. views on good care and 4. organizational aspects. Knowledge gaps about delirium in dementia, as well as ethical considerations, play an important role in organizing timely and adequate care for patients with delirium superimposed on dementia.

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Discharge Plan to Promote Patient Safety and Shared Decision Making by a Multidisciplinary Team of Healthcare Professionals in a Respiratory Unit

Nursing Reports ◽

10.3390/nursrep11030056 ◽

2021 ◽

Vol 11 (3) ◽

pp. 590-599

Author(s):

Daniel A. Nnate ◽

David Barber ◽

Ukachukwu O. Abaraogu

Keyword(s):

Healthcare Professionals ◽

Health Condition ◽

Social Needs ◽

Chronic Obstructive ◽

Best Interest ◽

Obstructive Pulmonary Disease ◽

Discharge Plan ◽

Health And Social Care ◽

Multidisciplinary Working ◽

Prolonged Hospital

Patients with chronic obstructive pulmonary disease (COPD) often require frequent hospitalization due to worsening symptoms. Preventing prolonged hospital stays and readmission becomes a challenge for healthcare professionals treating patients with COPD. Although the integration of health and social care supports greater collaboration and enhanced patient care, organizational structure and poor leadership may hinder the implementation of patient-oriented goals. This paper presents a case of a 64-year-old chronic smoker with severe COPD who was to be discharged on long-term oxygen therapy (LTOT). It also highlights the healthcare decisions made to ensure the patient’s safety at home and further provides a long-lasting solution to the existing medical and social needs. The goal was accomplished through a discharge plan that reflects multidisciplinary working, efficient leadership, and change management using Havelock’s theory. While COPD is characterized by frequent exacerbation and hospital readmission, it was emphasized that most failed discharges could be attributed to bureaucratic organizational workflow which might not be in the patient’s best interest. It was further demonstrated that healthcare professionals are likely to miss the window of opportunity to apply innovative and long-lasting solutions to the patient’s health condition in an attempt to remedy the immediate symptoms of COPD.

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Ethical challenges when using coercion in mental healthcare: A systematic literature review

Nursing Ethics ◽

10.1177/0969733016629770 ◽

2016 ◽

Vol 25 (1) ◽

pp. 92-110 ◽

Cited By ~ 29

Author(s):

Marit Helene Hem ◽

Elisabeth Gjerberg ◽

Tonje Lossius Husum ◽

Reidar Pedersen

Keyword(s):

Patient Autonomy ◽

Moral Distress ◽

Mental Healthcare ◽

Healthcare Personnel ◽

Ethical Challenge ◽

Ethical Challenges ◽

Best Interest ◽

Ethical Considerations ◽

Search Terms ◽

Healthcare It

Background: To better understand the kinds of ethical challenges that emerge when using coercion in mental healthcare, and the importance of these ethical challenges, this article presents a systematic review of scientific literature. Methods: A systematic search in the databases MEDLINE, PsychInfo, Cinahl, Sociological Abstracts and Web of Knowledge was carried out. The search terms derived from the population, intervention, comparison/setting and outcome. A total of 22 studies were included. Ethical considerations: The review is conducted according to the Vancouver Protocol. Results: There are few studies that study ethical challenges when using coercion in an explicit way. However, promoting the patient’s best interest is the most important justification for coercion. Patient autonomy is a fundamental challenge facing any use of coercion, and some kind of autonomy infringement is a key aspect of the concept of coercion. The concepts of coercion and autonomy and the relations between them are very complex. When coercion is used, a primary ethical challenge is to assess the balance between promoting good (beneficence) and inflicting harm (maleficence). In the included studies, findings explicitly related to justice are few. Some studies focus on moral distress experienced by the healthcare professionals using coercion. Conclusion: There is a lack of literature explicitly addressing ethical challenges related to the use of coercion in mental healthcare. It is essential for healthcare personnel to develop a strong awareness of which ethical challenges they face in connection with the use of coercion, as well as challenges related to justice. How to address ethical challenges in ways that prevent illegitimate paternalism and strengthen beneficent treatment and care and trust in connection with the use of coercion is a ‘clinical must’. By developing a more refined and rich language describing ethical challenges, clinicians may be better equipped to prevent coercion and the accompanying moral distress.

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Professional and community satisfaction with the Brazilian family health strategy

Revista de Saúde Pública ◽

10.1590/s0034-8910.2013047003868 ◽

2013 ◽

Vol 47 (2) ◽

pp. 403-413 ◽

Cited By ~ 8

Author(s):

Lilian G Perez ◽

Juliet D Sheridan ◽

Andrea Y Nicholls ◽

Katherine E Mues ◽

Priscila S Saleme ◽

...

Keyword(s):

Health Care ◽

Community Health ◽

Health Care Professionals ◽

Healthcare Professionals ◽

Family Health ◽

Pediatric Care ◽

Southeastern Brazil ◽

Health Strategy ◽

The Family ◽

Family Health Strategy

OBJECTIVE: To analyze the strengths and limitations of the Family Health Strategy from the perspective of health care professionals and the community. METHODS: Between June-August 2009, in the city of Vespasiano, Minas Gerais State, Southeastern Brazil, a questionnaire was used to evaluate the Family Health Strategy (ESF) with 77 healthcare professionals and 293 caregivers of children under five. Health care professional training, community access to health care, communication with patients and delivery of health education and pediatric care were the main points of interest in the evaluation. Logistic regression analysis was used to obtain odds ratios and 95% confidence intervals as well as to assess the statistical significance of the variables studied. RESULTS: The majority of health care professionals reported their program training was insufficient in quantity, content and method of delivery. Caregivers and professionals identified similar weaknesses (services not accessible to the community, lack of healthcare professionals, poor training for professionals) and strengths (community health worker-patient communications, provision of educational information, and pediatric care). Recommendations for improvement included: more doctors and specialists, more and better training, and scheduling improvements. Caregiver satisfaction with the ESF was found to be related to perceived benefits such as community health agent household visits (OR 5.8, 95%CI 2.8;12.1), good professional-patient relationships (OR 4.8, 95%CI 2.5;9.3), and family-focused health (OR 4.1, 95%CI 1.6;10.2); and perceived problems such as lack of personnel (OR 0.3, 95%CI 0.2;0.6), difficulty with access (OR 0.2, 95%CI 0.1;0.4), and poor quality of care (OR 0.3, 95%CI 0.1;0.6). Overall, 62% of caregivers reported being generally satisfied with the ESF services. CONCLUSIONS: Identifying the limitations and strengths of the Family Health Strategy from the healthcare professional and caregiver perspective may serve to advance primary community healthcare in Brazil.

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Participant Photography as a Research Tool: Ethical Issues and Practical Implementation

Sociological Methods & Research ◽

10.1177/0049124117701480 ◽

2017 ◽

Vol 48 (2) ◽

pp. 369-399

Author(s):

Leeanne O’Hara ◽

Kathryn Higgins

Keyword(s):

Northern Ireland ◽

Young People ◽

Ethical Issues ◽

Social Research ◽

Ethnographic Study ◽

Practical Implementation ◽

Participatory Methods ◽

Ethical Considerations ◽

Children And Young People ◽

Research Drug

Participatory methods for engaging children and young people in research are becoming more popular and innovative in social research. One example of this is the inclusion of participant photography. Drawing on an ethnographic study conducted in Northern Ireland, this article explores the application of participant photography to research drug use and antisocial behavior among youth. Findings highlight issues surrounding implementation when in the field, building on the existing knowledge base and focusing on recruitment, continuous engagement, image presentation, and analysis. This is followed by an overview of ethical considerations including specific issues relating to researcher and participant safety.

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Reinforcing and Reproducing Stereotypes? Ethical Considerations When Doing Research on Stereotypes and Stereotyped Reasoning

Societies ◽

10.3390/soc9040079 ◽

2019 ◽

Vol 9 (4) ◽

pp. 79 ◽

Cited By ~ 1

Author(s):

Mathilde Cecchini

Keyword(s):

Research Ethics ◽

Ethical Issue ◽

Ethical Issues ◽

Ethnographic Study ◽

Seventh Graders ◽

Ethical Considerations ◽

Social Scientists ◽

Potential Harm ◽

Or Groups ◽

Practical Guidelines

Many social scientists are interested in studying stereotypes and stereotyped reasoning. This interest often comes from a wish to contribute to creating a more just and equal society. However, when we as scholars study stereotypes and stereotyped reasoning, we risk reproducing and maybe even reinforcing these processes, and thereby harming individuals or groups of individuals. The debates of this ethical issue mainly take the form of general discussions of research ethics and of weighing the aim of the research against potential harm to participants. While these reflections are extremely important, there is a need for discussing how this ethical issue can be handled in practice. The aim of this article is to develop a set of practical guidelines for managing this ethical issue, based on the examination of ethically delicate moments experienced during an ethnographic study of the construction of health and risk identities among seventh-graders in Denmark. Three guiding principles are proposed: Develop an ethical sensibility in order to identify ethically delicate moments; consider ethics as well as methods when constructing and posing questions; more specifically, briefings and debriefings can be used to address ethical issues; and, finally, make participants reflect upon their opinions and answers.

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“What is essential is invisible to the eye”

Spiritual Care ◽

10.1515/spircare-2017-0031 ◽

2018 ◽

Vol 7 (4) ◽

pp. 341-352

Author(s):

Beate Mayr ◽

Eckhard Frick ◽

Niels Christian Hvidt ◽

Thomas Breidenbach ◽

Nicole Erbe ◽

...

Keyword(s):

Organ Donation ◽

Healthcare Professionals ◽

Ethical Considerations ◽

Clinical Procedure ◽

Entire Process

AbstractOrgan donation and transplantation (ODT) is a complex multi-professional clinical procedure. Healthcare professionals’ attitudes and concerns towards the procedure influence the entire process. A 3-hour interview with ODT staff (13 participants) was performed in order to explore ODT professionals’ spiritual attitudes and concerns. The interview was recorded and transcribed verbatim. All (sub)themes were directly derived from the data. The discussants expressed the following issues: (1) ethical considerations and barriers in ODT; (2) individual beliefs about death and afterlife; (3) dealings with patients, relatives and close ones; (4) lack of support for ODT staff; and (5) spiritual facilitators. The interview provided a list of themes that either explicitly or implicitly demonstrate spiritual attitudes and concerns which may influence procedures in ODT. The themes and subthemes formed the basis to design a questionnaire in order to initiate a more detailed investigation of a larger group of professionals.

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