The patients have a story to tell: Informed consent for people who use illicit opiates

2020 ◽  
Vol 27 (3) ◽  
pp. 666-672
Author(s):  
Jane McCall ◽  
J Craig Phillips ◽  
Andrew Estafan ◽  
Vera Caine
Keyword(s):  
Cognitive Impairment ◽  
Informed Consent ◽  
Social Workers ◽  
Thematic Analysis ◽  
Descriptive Study ◽  
Ethical Considerations ◽  
Opiate Use ◽  
Ethical Approval ◽  
The University ◽  
Written Informed Consent

Background: There is a significant discourse in the literature that opines that people who use illicit opiates are unable to provide informed consent due to withdrawal symptoms and cognitive impairment as a result of opiate use. Aims: This paper discusses the issues related to informed consent for this population. Ethical considerations: Ethical approval was obtained from both the local REB and the university. Written informed consent was obtained from all participants. Method: This was a qualitative interpretive descriptive study. 22 participants were interviewed, including 18 nurses, 2 social workers and 2 clinic support workers. The findings were analyzed using thematic analysis, which is a way of systematically reducing the complexity of the information to arrive at generalized explanations. Results: The staff at the clinic were overwhelming clear in their judgment that people who use opiates can and should be able to participate in research and that their drug use is not a barrier to informed consent. Conclusions: It is important to involve people who use opiates in research. Protectionist concerns about this population may be overstated. Such concerns do not promote the interests of research participants. People who use heroin need to be able to tell their story.

scholarly journals Compassion fatigue as bruises in the soul: A qualitative study on nurses

2021 ◽  
pp. 096973302110032
Author(s):  
Tove Gustafsson ◽  
Jessica Hemberg
Keyword(s):  
Content Analysis ◽  
Informed Consent ◽  
Compassion Fatigue ◽  
Ethics Committee ◽  
Private Person ◽  
The Gift ◽  
Ethical Approval ◽  
Life Itself ◽  
The University ◽  
Written Informed Consent

Background: Nurses who are constantly being exposed to patients’ suffering can lead to compassion fatigue. There is a gap in the latest research regarding nurses’ experiences of compassion fatigue. Little is known about how compassion fatigue affects the nurse as a person, and indications of how it affects the profession are scarce. Aim: The aim of this study was to explore compassion fatigue experienced by nurses and how it affects them as persons and professionals. Research design, participants, and research context: A qualitative explorative approach was used. The data consisted of texts from interviews with seven nurses in various nursing contexts. Content analysis was used. Ethical consideration: Ethical approval was sought and granted from an ethics committee at the university where the researchers were based, and written, informed consent was obtained from all the participants. Findings: Five themes were discovered: Compassion as an empathic gift and compassion fatigue as a result of compassion overload, Compassion fatigue as exhausting the nurse as a professional and private person, Compassion fatigue as a crisis with potentially valuable insights, Compassion fatigue can be handled by self-care and focus on self, and Compassion fatigue is affected by life itself and multifaceted factors. Discussion: Compassion stress and overload can lead to compassion fatigue. Compassion fatigue affects the nurse’s ability to compassion, and the caring is no longer experienced in the same way; the nurses experienced it as being deprived of the gift of compassion. Compassion fatigue implicates a crisis with potentially valuable insights. Conclusion: Compassion fatigue can be symbolized as bruises in the soul, hurtful, but with time it can fade away, although it leaves a sense of caution within the nurse, which can affect the suffering patient.

scholarly journals Medical terminology circulation and interactional organisation in interpreter-mediated medical encounters

2021 ◽  
Vol 11 ◽  
Author(s):  
Sara Pittarello
Keyword(s):  
Informed Consent ◽  
Active Participation ◽  
Point Of View ◽  
Personal Interest ◽  
Medical Terminology ◽  
Institutional Talk ◽  
Italian Hospital ◽  
Ethical Approval ◽  
Medical Interpreters ◽  
Written Informed Consent

Two medical encounters taking place in a Northern Italian hospital are analysed in this paper from a qualitative point of view, based on the author’s previous research. The aim is to reveal the strategies adopted by medical interpreters, in these two specific cases, to translate medical terminology and promote/exclude interlocutors’ active participation. This latter aspect is influenced by the way the interaction is socially and linguistically organised and, in particular, by how interlocutors’ utterances are translated. The prevalence of dyadic or triadic sequences and especially the shifts between such communication exchanges are pivotal in fostering or hindering interlocutors’ participation. Furthermore, medical interactions, as a form of institutional talk, enshrine specific expectations, which are mainly of a cognitive nature but may also be affective, as in the two encounters observed. By conveying such expectations and expressions of personal interest, interpreters have proved to contribute to the fair distribution of active participation among primary interlocutors. Hospital ethical approval and subjects’ written informed consent have been obtained.

scholarly journals A review of informed consent and how it has evolved to protect vulnerable participants in emergency care research

2020 ◽  
Vol 5 (2) ◽  
pp. 73-79
Author(s):  
Rajpal Nandra ◽  
Alan F. Brockie ◽  
Faisal Hussain
Keyword(s):  
Informed Consent ◽  
Emergency Care ◽  
Ethics Committees ◽  
Moral Obligations ◽  
Ethical Considerations ◽  
Vulnerable Patients ◽  
Ethical Approval ◽  
Life Threatening ◽  
Time Critical

A vulnerable participant in research lacks capacity to consent or may be exposed to coercion to participate. Capacity may be temporarily impaired due to loss of consciousness, hypoxia, pain and the consumption of alcohol or elicit substances. To advance emergency care, providing life-threatening measures in life-threatening circumstances, vulnerable patients are recruited into research studies. The urgent need for time-critical treatment conflicts with routine informed consent procedures. This article reviews ethical considerations and moral obligations to safeguard these participants and preserve their autonomy. A particular focus is given to research methodology to waive consent, and the role of ethics committees, research audits, research nurses and community engagement. Research on the acutely unwell patient who lacks capacity is possible with well-designed research trials that are led by investigators who are sufficiently trained, engage the community, gain ethical approval to waive consent and continuously audit practice. Cite this article: EFORT Open Rev 2020;5:73-79. DOI: 10.1302/2058-5241.5.180051

scholarly journals Death and dying in the formation process of nurses from the perspective of nursing professors

2014 ◽  
Vol 23 (2) ◽  
pp. 400-407 ◽  
Author(s):  
Danieli Bandeira ◽  
Silvana Bastos Cogo ◽  
Leila Mariza Hildebrandt ◽  
Marcio Rossato Badke
Keyword(s):  
Thematic Analysis ◽  
Formation Process ◽  
Death And Dying ◽  
Descriptive Study ◽  
Structured Interviews ◽  
Undergraduate Nursing ◽  
The University ◽  
Nursing Course

This qualitative and descriptive study aimed to identify how nursing course professors approach death and dying in the university and what the implications are on the formation process. Ten professors of the undergraduate nursing course were intentionally selected and underwent semi-structured interviews, which were recorded. The thematic analysis of the data revealed that the presence of the fact caused insecurity in the interviewees and portrayed the lack of preparation in the undergraduate course, which could indicate a certain difficulty working with this theme. Furthermore, the interviewees highlighted the importance of working with death and dying. It is essential to understand the university to be a transforming agent of reflective subjects and a promoter of conditions for the student to experience the aspects involved in the care when faced with death.

Five years of ECT: the relationship between consent status and treatment experiences

2010 ◽  
Vol 27 (3) ◽  
pp. 117-122 ◽  
Author(s):  
Susanna Enriquez ◽  
Sheila Tighe ◽  
Noreen Fitzgibbon ◽  
Seamus Ó Flaithbheartaigh ◽  
David Meagher
Keyword(s):  
Mental Health ◽  
Cognitive Impairment ◽  
Informed Consent ◽  
Mental Health Services ◽  
Health Services ◽  
Response Rate ◽  
Electrode Placement ◽  
Severe Illness ◽  
Patient Consent ◽  
Written Informed Consent

AbstractObjectives:ECT has received limited systematic study in the Irish setting. Amendments to the Mental Health Act (2001) propose limiting the use of ECT to patients who can provide written informed consent. We report on the use of ECT in Limerick specifically addressing the issue of patient consent and how it relates to response rate.Method:Since 2003, the use of ECT within Limerick Mental Health Services has been monitored by a data gathering process that includes the documentation of mood disturbance before and after the procedure.Results:In the five years between 2003 and 2007, 153 courses of ECT were given to 126 different patients (frequency 16.7/100,000; Female:Male = 2:1). The principal indication for ECT was depressive illness (95%). Bilateral electrode application was the preferred mode comprising 83% of use. A total of 60% experienced at least a 50% reduction in MADRS score over the course of ECT with 78% experiencing a reduction of 10 points or more on the MADRS. Higher response rate was linked to use of bilateral ECT (p = 0.007; 95% CI 1.3-13.6). A total of 14% of patients were unable to provide written informed consent and these patients had more severe depression at outset (p = 0.007; 95% CI 1.8-11.1) and a trend towards greater reduction in MADRS scores during ECT (p = 0.08). The commonest adverse incident associated with ECT was cognitive impairment (33 patients). The risk of cognitive problems was not related to age, ECT dose, number of treatments, severity of depressive symptoms, treatment response, or consent status.Conclusions:Frequency of use, response and adverse effect rates for ECT in Limerick Mental Health Services are similar to other centres. Cognitive impairment was the most frequent adverse event. The choice of electrode placement for ECT requires further consideration. Restricting ECT to patients that can provide written informed consent would prevent its use in many patients with severe illness who experience significant response to treatment.

scholarly journals Reporting of ethical considerations in clinical trials in Chinese nursing journals

2017 ◽  
Vol 26 (4) ◽  
pp. 973-983 ◽  
Author(s):  
Yanni Wu ◽  
Michelle Howarth ◽  
Chunlan Zhou ◽  
Xue Ji ◽  
Jiexia Ou ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Informed Consent ◽  
Human Subjects ◽  
Journal Citation Report ◽  
Mainland China ◽  
Ethical Guidelines ◽  
Ethical Considerations ◽  
Research Papers ◽  
Technology Journal ◽  
Ethical Approval

Background: It is acknowledged that publishers now require all primary research papers to demonstrate that they have obtained ethical approval for their research. Objectives: To assess the rate of reporting of ethical approval in clinical trials in core nursing journals in mainland China. Research design: A retrospective observational study. Participants: All clinical trials published in all of the 12 core nursing periodicals from 2016 edition China Science and Technology Journal Citation Report (core version) between 2013 and 2016 were retrieved by hand to explicate rate of reporting ethical approval and informed consent. Ethical considerations: The study did not require approval from the research ethics committee as it did not involve human subjects or records. Results: In total, 40,278 papers were published in 12 nursing periodicals between 2013 and 2016. Out of these, 9488 (23.6%) focused on clinical trials. Informed consent obtained from patients or the legally authorized representative was reported in 51.8% of clinical trials. Notably, only 27.4% of clinical trials reported that they had obtained written consent. Furthermore, 25.9% of clinical trials described ethical approval; however, the rate of reporting informed consent and ethical approval in these 12 nursing journals in China during 4 years from 2013 to 2016 improved markedly, with 38.1%, 44.0%, 59.0% and 66.6%, respectively ( p < 0.001), and 17.6%, 21.9%, 28.6% and 35.8%, respectively ( p < 0.001). In addition, both reporting informed consent and reporting written informed consent had a positive significant correlation with the reporting ethical approval ( p < 0.05 or < 0.01). Conclusion: Chinese scientific nursing journals have improved the rate of reporting informed consent and ethical approval in clinical trials during the last 4 years. However, it should be noted that nearly half of clinical trials still did not report either ethical approval or whether informed consent was obtained. Efforts from editors, researchers, sponsors and authors are needed to ensure the transparency of ethical scrutiny and adherence to ethical guidelines in publishing clinical trials in Chinese nursing journals.

Nurses’ attitudes towards euthanasia in conflict with professional ethical guidelines

2016 ◽  
Vol 24 (1) ◽  
pp. 70-86 ◽  
Author(s):  
Anja Terkamo-Moisio ◽  
Tarja Kvist ◽  
Mari Kangasniemi ◽  
Teuvo Laitila ◽  
Olli-Pekka Ryynänen ◽  
...  
Keyword(s):  
Ethical Guidelines ◽  
Ethical Considerations ◽  
Cross Sectional ◽  
Web Based ◽  
Ethical Approval ◽  
Research Questions ◽  
The Moment ◽  
The Right ◽  
The University

Background: Despite the significant role of nurses in end-of-life care, their attitudes towards euthanasia are under-represented both in the current literature and the controversial debate that is ongoing in several countries. Research questions: What are the attitudes towards euthanasia among Finnish nurses? Which characteristics are associated with those attitudes? Research design: Cross-sectional web-based survey. Participants and research context: A total of 1003 nurses recruited via the members’ bulletin of the Finnish Nurses Association and social media. Ethical considerations: Ethical approval was obtained from the Committee on Research Ethics of the university to which the authors were affiliated. Findings: The majority (74.3%) of the participants would accept euthanasia as part of Finnish healthcare, and 61.8% considered that Finland would benefit from a law permitting euthanasia. Most of the nurses (89.9%) thought that a person must have the right to decide on his or her own death; 77.4% of them considered it likely that they would themselves make a request for euthanasia in certain situations. Discussion: The value of self-determination and the ability to choose the moment and manner of one’s death are emphasized in the nurses’ attitudes towards euthanasia. Conclusion: A continuous dialogue about euthanasia and nurses’ shared values is crucial due to the conflict between nurses’ attitudes and current ethical guidelines on nursing.

Conhecimento, atitudes e crenças de mulheres ribeirinhas frente à concepção e contracepção

2009 ◽  
Vol 3 (4) ◽  
pp. 972
Author(s):  
Raquel Faria Da Silva ◽  
Leila Rangel Da Silva
Keyword(s):  
Qualitative Research ◽  
Thematic Analysis ◽  
Descriptive Study ◽  
Family Conflicts ◽  
Women Health ◽  
Knowledge And Attitudes ◽  
Nursing Culture ◽  
Popular Knowledge ◽  
Ethics In Research ◽  
The University

Objective: to describe the knowledge and attitudes of the riverside women from Vila Nova Maringá, Amazonas, regards to conception and contraception. Methods: this is about an exploratory and descriptive study, from qualitative boarding, in the Vila Nova Maringá riverside community, in Maués city, Amazonas, from July to August 2008. Participated of these study 15 riverside women above eighteen old years. Data were collected through interviews with semi-structured script. After transcribing the data, was chosen the content analysis (thematic analysis), giving support to the qualitative research of the interviewees’ speech. The study has been approved by the Committee of Ethics in Research of the São Francisco de Assis College of the University Federal of Rio de Janeiro (54/2008). Results: still the women suggested ideal age to be a mother is between eighteen and twenty years old, the majority experienced the pregnancy in the adolescence, with family conflicts. Concerning to conception and contraception the women majority know and act influenced by the simply popular knowledge. Conclusion: to take care of these women is necessary associate the popular knowledge to scientific knowledge, enabling the women to exercise the justice to sexuality exercise released of the procreation. Descriptors: nursing, culture, reproduction, women health.           

scholarly journals Transforming Shame in the Pandemic: An International Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Claude-Hélène Mayer ◽  
Elisabeth Vanderheiden
Keyword(s):  
Thematic Analysis ◽  
Cultural Context ◽  
International Study ◽  
The Self ◽  
Cultural Norms ◽  
Snowball Sampling ◽  
Ethical Considerations ◽  
International Perspectives ◽  
Ethical Approval ◽  
The Individual

Shame is an unconscious, somehow unattended and neglected emotion and occurs when individual and socio-cultural norms are violated. It often impacts negatively on the self and others across cultures. During the Covid-19 crises, shame has become an important emotion with a powerful effect, depending on how it is experienced within the socio-cultural context. This article explores shame in international perspectives in the context of Covid-19 and addresses the question how shame is transformed from an existential positive psychology (PP2.0) perspective. The study uses a qualitative research paradigm and explores shame and its transformation during Covid-19. Purposeful and snowball sampling was used. The sample consisted of 24 individuals (16 female, 8 male), of 13 different nationalities. Data were collected from written interviews and analyzed through thematic analysis. Ethical considerations were followed; ethical approval was given by a university. Findings show that participants become very worried, anxious, scared, sad, and shocked when they or individuals in their close relationships contracted Covid-19. Shame plays an important role during the Covid-19 pandemic. However, the meaning and experience of shame during Covid-19 is strongly dependent on the socio-cultural background of the individual who is experiencing the disease. Individuals use different strategies and mechanisms to deal with and transform shame in the context of Covid-19.

scholarly journals Patients’ satisfaction with ophthalmic counselling services in a tertiary hospital in Calabar, South-South Nigeria

2020 ◽  
Vol 54 (2) ◽  
pp. 76-81
Author(s):  
Bassey Etim ◽  
Affiong Ibanga ◽  
Martha-Mary Udoh ◽  
Elizabeth Nkanga ◽  
Utam Utam ◽  
...  
Keyword(s):  
Social Workers ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Teaching Hospitals ◽  
Cross Sectional ◽  
Patients Satisfaction ◽  
Counselling Services ◽  
Resource Limited ◽  
Ethical Approval ◽  
The University

Objective: To assess the level of satisfaction of patients who access the Ophthalmic counselling services anchored by trained social workers of the University of Calabar Teaching Hospital, Calabar, NigeriaMethods: A cross-sectional study of serial consenting participants was done. Ethical approval was obtained from the University of Calabar Teaching hospitals’ ethics committee. Data was obtained using a semi-structured intervieweradministeredquestionnaire. Data were collated and analyzed using the SPSS for Windows (version 20, SPSS inc. Chicago, IL, USA). Modified Likert scale (very satisfied, satisfied and not satisfied) was used to rate the satisfaction level.Results: A total of 120 respondents met the inclusion criteria and were enrolled into the study. Majority of the respondents (60%) were male with an overall mean age of 45.32± 1.82. Over a quarter (28.3%) of the respondents were in the age bracket of 41-50. Glaucoma (48.3%) was the most common eye condition of the respondents. Seventy-five percent of the respondents were satisfied with the average time spent for the counselling services while 76.7% were satisfied with the overall ophthalmic counselling services they received with 46.7% believing that the service was provided by a social worker.Conclusion: Majority of the Patients were satisfied with the Ophthalmic counselling services mainly anchored by social workers. Training and retraining of allied support staff to render ophthalmic counselling services in order to ease the workload of the Ophthalmologist should be encouraged in resource-limited settings.Keywords: Patients satisfaction, ophthalmic counselling service, NigeriaFunding: None declared

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