scholarly journals Ethics reflection groups for school nurses

2020 ◽  
pp. 096973302094037
Author(s):  
Anne Kari Tolo Heggestad ◽  
Reidun Førde ◽  
Morten Magelssen ◽  
Birgit Arnekleiv
Keyword(s):  
Medical Ethics ◽  
Healthcare Services ◽  
School Nurses ◽  
Ethical Challenges ◽  
Reflection Groups ◽  
Ethics Support ◽  
Written Information ◽  
Healthcare Experience ◽  
Group Interviews ◽  
Ethics Reflection

Background: School nurses have great responsibilities as the connecting link between school, children/adolescents, parents, and other healthcare services. Being in this middle position, and handling complex situations and problems related to children in school, may be demanding and also lead to ethical challenges. Clinical ethics support, such as ethics reflection groups, may be of help when dealing with ethical challenges. However, there is little research on experiences with ethics reflection groups among school nurses. Aim: The aim of this research was to explore how nurses in school healthcare experience their role, and how they experience participation in ethics reflection groups, using a model for systematic ethics reflection, the Centre for Medical Ethics model. Research design: The project had a qualitative design, using focus group interviews and thematic analysis. Ethical considerations: The study was evaluated by the Data Protection Official at the Norwegian Centre for Research Data (project no. 57373). The participants were given oral and written information about the study and signed a written consent. Participants and context: Twelve participants from school healthcare were recruited to the interviews. Findings: School nurses described their role as extremely challenging. How the school nurses experienced their role also influenced how they experienced participating in ethics reflection groups. The Centre for Medical Ethics model was experienced as both challenging and comprehensive. However, they also experienced that the model helped them to clarify their role and could also help them to find better solutions. Conclusion: The role as school nurse is complex and demanding, with several ethical challenges. Ethics reflection groups may be of great help when dealing with these challenges. However, it is of great importance that the methods used are adjusted to the professionals’ needs and context.

scholarly journals How to succeed with ethics reflection groups in community healthcare? Professionals’ perceptions

2018 ◽  
Vol 26 (4) ◽  
pp. 1243-1255 ◽  
Author(s):  
Heidi Karlsen ◽  
Lillian Lillemoen ◽  
Morten Magelssen ◽  
Reidun Førde ◽  
Reidar Pedersen ◽  
...  
Keyword(s):  
Organizational Support ◽  
Reflection Group ◽  
Healthcare Services ◽  
Healthcare Personnel ◽  
Success Factor ◽  
Ethical Challenges ◽  
Reflection Groups ◽  
Community Healthcare ◽  
Group Interviews ◽  
Ethics Reflection

Background: Healthcare personnel in the municipal healthcare systems experience many ethical challenges in their everyday work. In Norway, 243 municipalities participated in a national ethics project, aimed to increase ethical competence in municipal healthcare services. In this study, we wanted to map out what participants in ethics reflection groups experienced as promoters or as barriers to successful reflection. Objectives: To examine what the staff experience as promoters or as barriers to successful ethics reflection. Research design: The study has a qualitative design, where 56 participants in municipal healthcare participated in 10 different focus-group interviews. Ethical considerations: The data collection was based on the participants’ informed consent and approved by the Data Protection Official of the Norwegian Centre for Research Data. Results: The informants had different experiences from ethics reflection group. Nevertheless, we found that there were several factors that were consistently mentioned: competence, facilitator’s role, ethics reflection groups organizing, and organizational support were all experienced as promoters and as a significant effect on ethics reflection groups. The absence of such factors would constitute important barriers to successful ethics reflection. Discussion: The results are coincident with other studies, and indicate some conditions that may increase the possibility to succeed with ethics reflection groups. A systematic approach seems to be important, the systematics of the actual reflections, but also in the organization of ethics reflection group at the workplace. Community healthcare is characterized by organizational instabilities as many vacancies, high workloads, and lack of predictability. This can be a hinder for ethics reflection group. Conclusion: Both internal and external factors seem to influence the organization of ethics reflection group. The municipalities’ instabilities challenging this work, and perceived as a clear inhibitor for the development. The participants experienced that the facilitator is the most important success factor for establishing, carrying out, and to succeed with ethics reflection groups.

scholarly journals Hospital ethics reflection groups: a learning and development resource for clinical practice

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
H. Bruun ◽  
L. Huniche ◽  
E. Stenager ◽  
C. B. Mogensen ◽  
R. Pedersen
Keyword(s):  
Clinical Practice ◽  
General Hospital ◽  
Positive Impact ◽  
Reflection Group ◽  
Ethical Challenge ◽  
Ethical Challenges ◽  
Reflection Groups ◽  
Patient Admissions ◽  
The Impact ◽  
Ethics Reflection

Abstract Background An ethics reflection group (ERG) is one of a number of ethics support services developed to better handle ethical challenges in healthcare. The aim of this article is to evaluate the significance of ERGs in psychiatric and general hospital departments in Denmark. Methods This is a qualitative action research study, including systematic text condensation of 28 individual interviews and 4 focus groups with clinicians, ethics facilitators and ward managers. Short written descriptions of the ethical challenges presented in the ERGs also informed the analysis of significance. Results A recurring ethical challenge for clinicians, in a total of 63 cases described and assessed in 3 ethical reflection groups, is to strike a balance between respect for patient autonomy, paternalistic responsibility, professional responsibilities and institutional values. Both in psychiatric and general hospital departments, the study participants report a positive impact of ERG, which can be divided into three categories: 1) Significance for patients, 2) Significance for clinicians, and 3) Significance for ward managers. In wards characterized by short-time patient admissions, the cases assessed were retrospective and the beneficiaries of improved dialogue mainly future patients rather than the patients discussed in the specific ethical challenge presented. In wards with longer admissions, the patients concerned also benefitted from the dialogue in the ERG. Conclusion This study indicates a positive significance and impact of ERGs; constituting an interdisciplinary learning resource for clinicians, creating significance for themselves, the ward managers and the organization. By introducing specific examples, this study indicates that ERGs have significance for the patients discussed in the specific ethical challenge, but mostly indirectly through learning among clinicians and development of clinical practice. More research is needed to further investigate the impact of ERGs seen from the perspectives of patients and relatives.

Enhancing family nursing practice in schools: School nurses’ perspectives on illness beliefs and family nursing practice skills when caring for children with attention-deficit hyperactivity disorder or asthma – A cross-sectional study

2021 ◽  
pp. 205715852110096
Author(s):  
Erla Kolbrun Svavarsdottir ◽  
Gudny Bergthora Tryggvadottir ◽  
Margret Gisladottir ◽  
Ragnheidur Osk Erlendsdottir
Keyword(s):  
Nursing Practice ◽  
Healthcare Services ◽  
Cross Sectional Study ◽  
School Nurses ◽  
Illness Beliefs ◽  
Sectional Study ◽  
Cross Sectional ◽  
Hyperactivity Disorder ◽  
Family Nursing ◽  
Practice Skills

An increasing number of children attend schools with chronic illnesses/disorders that require managing and comprehensive healthcare from school nurses during the day. Collaboration between school nurses, the school-aged child with attention-deficit hyperactivity disorder (ADHD) or asthma, and their families is needed when coordinating/managing chronic health problems in the school setting. However, involving families in the assessment and care planning processes can be challenging. The aim of this study was to survey the illness beliefs of school nurses and their perceptions of their family nursing practice skills when offering healthcare services to children with ADHD or asthma in schools. A cross-sectional study was used for a sample of 82 school nurses. The manuscript was prepared following STROBE guidelines. Results indicated that the school nurses perceived themselves to be more confident and to have better knowledge and skill in family nursing practice when offering healthcare services to families of children with ADHD in comparison to asthma.

‘Who Ya Gonna Call …?’ Ethical and legal dilemmas in specialist children centres and district general hospitals

2021 ◽  
pp. 147775092110366
Author(s):  
Harika Avula ◽  
Mariana Dittborn ◽  
Joe Brierley
Keyword(s):  
Intensive Care ◽  
Clinical Ethics ◽  
Ethical Issues ◽  
General Setting ◽  
Daily Practice ◽  
Paediatric Intensive Care ◽  
Ethical Challenges ◽  
Legal Cases ◽  
Ethics Support ◽  
The Uk

The field of Paediatric Bioethics, or ethical issues applied to children's healthcare, is relatively new but has recently gained an increased professional and public profile. Clinical ethics support to health professionals and patients who face ethical challenges in clinical practice varies between and within institutions. Literature regarding services available to paediatricians is sparse in specialist tertiary centres and almost absent in general paediatrics. We performed a mixed-methods study using online surveys and focus groups to explore the experiences of ethical and legal dilemmas and the support structures available to (i) paediatric intensive care teams as a proxy for specialist children's centres and (ii) paediatricians working in the general setting in the UK. Our main findings illustrate the broad range of ethical and legal challenges experienced by both groups in daily practice. Ethics training and the availability of ethics support were variable in structure, processes, funding and availability, e.g., 70% of paediatric intensive care consultants reported access to formal ethics advice versus 20% general paediatricians. Overall, our findings suggest a need for ethics support and training in both settings. The broad experience reported of ethics support, where it existed, was good – though improvements were suggested. Many clinicians were concerned about their relationship with children and families experiencing a challenging ethical situation, partly as a result of high-profile recent legal cases in the media. Further research in this area would help collect a broader range of views to inform clinical ethics support's development to better support paediatric teams, children and their families.

scholarly journals How ethical challenges of covert observations can be met in practice

2021 ◽  
pp. 174701612110082
Author(s):  
Nicole Podschuweit
Keyword(s):  
Social Research ◽  
Role Playing ◽  
Great Distance ◽  
Point Of View ◽  
Ethical Challenges ◽  
Research Subjects ◽  
Written Information ◽  
Ethical Debate ◽  
The People ◽  
Almost All

This paper aims to bring into the ethical debate on covert research two aspects that are neglected to date: the perspective of the research subjects and the special responsibility of investigators towards their observers. Both aspects are falling behind, especially in quantitative social research. From a methodological point of view, quantitative forms of covert observation involve a great distance between the researcher and the research subjects. When human observers are involved, the focus is usually on the reliable application of the measuring instrument. Therefore, herein, a quantitative study is used as an example to show how the protection needs of both the observed persons and the observers can be met in practice. The study involved 40 student observers who covertly captured everyday conversations in real-world settings (e.g. in cafés or trains) by a highly standardised observation scheme. The study suggests that the anonymity of the research subjects and their trust in the observers are crucial for their subsequent consent. However, many participants showed only little or even no interest in the written information they were provided. Further, this study strongly emphasises how mentally stressful covert observations are to the observers. Almost all observers were worried in advance that the people they were observing would prematurely blow their cover and confront them. Role-playing and in-depth discussions in teams are good strategies to alleviate such and other fears and to prepare student assistants well for their demanding work in the field.

Providing Patient Centered Care for Adolescents with Chronic Conditions

2016 ◽  
Vol 6 (1) ◽  
pp. 22-29
Author(s):  
Nabeel Al-Yateem
Keyword(s):  
Young Adults ◽  
Healthcare Professionals ◽  
Transition Process ◽  
Healthcare Services ◽  
Adolescents And Young Adults ◽  
Study Phase ◽  
Patient Centered ◽  
Centered Care ◽  
Group Interviews ◽  
Depth Interviews

Background: It is well acknowledged that clear, structured healthcare services that are mutually developed between the patient and the healthcare professionals are likely to be of high quality, desirable, and effective. Such service should address the complexity of the illness-health experience in terms of the factors that influence it as well as the physical and psychosocial consequences on the patient. The required focus should be on treating the patient rather than just treating the disease.Objectives: To develop relevant and feasible care guidelines that may inform more competent and patient centered services for adolescents and young adults with chronic conditions.Methodology: A sequential exploratory mixed method design guided this study. The first qualitative phase employed in-depth interviews to explore the experiences of adolescents and young adults about the health services they were receiving. This was followed by focus group interviews with healthcare professionals to discuss the patients’ reported needs and to suggest interventions that would address them. Finally, a second quantitative phase was carried out through a survey to explore the views of a larger sample of service stakeholders about the relevance and feasibility of the suggested guidelines for clinical practice.Results: The in-depth interviews revealed four main themes, as follows: a current amorphous service, sharing knowledge, the need to be at the center of service, and easing the transition process to adulthood. The second study phase yielded 32 proposed guidelines that may contribute to more competent and patient centered health care.

scholarly journals The social management of medical ethics in sport: confidentiality in English professional football

2017 ◽  
Vol 54 (6) ◽  
pp. 649-665 ◽  
Author(s):  
Ivan Waddington ◽  
Andrea Scott-Bell ◽  
Dominic Malcolm
Keyword(s):  
Medical Ethics ◽  
Sports Medicine ◽  
Professional Autonomy ◽  
Professional Football ◽  
Ethical Challenges ◽  
Ethical Practice ◽  
Medical Work ◽  
Empirical Examination ◽  
Work Settings ◽  
Clinician Behaviour

This paper examines one of the major ethical challenges in the practice of sports medicine, confidentiality. Drawing on interview and questionnaire data with doctors and physiotherapists working in English professional football clubs, it explores the degree to which ethical compliance has improved since the publication of, and publicity surrounding, an earlier study of medical practice in professional football conducted by Waddington and Roderick. Thus, it provides an updated empirical examination of the management of medical ethics in sport. The data illustrate how the physical and social environmental constraints of sports medicine practice impinge upon the protection of athlete-patient confidentiality, how ethical codes and conflicting obligations converge to shape clinician behaviour in relation to lifestyle and injury issues, and the ethically problematic contractual constraints under which clinicians and athletes operate. It demonstrates that medical ethical practice continues to be very variable and draws on Freidson’s work on medical ‘work settings’ to argue that there is a need to augment existing confidentiality policies with more structurally oriented approaches to ensure both professional autonomy and medical ethical compliance in sport.

scholarly journals School Nurses Avoid Addressing Child Sexual Abuse

2016 ◽  
Vol 33 (2) ◽  
pp. 133-142 ◽  
Author(s):  
Lisbet Engh Kraft ◽  
GullBritt Rahm ◽  
Ulla-Britt Eriksson
Keyword(s):  
Sexual Abuse ◽  
Child Sexual Abuse ◽  
Sexually Abused ◽  
Secondary Analysis ◽  
Public Health Problem ◽  
School Nurses ◽  
Global Public Health ◽  
Abused Children ◽  
Group Interviews ◽  
The Individual

Child sexual abuse (CSA) is a global public health problem with major consequences for the individual child and society. An earlier Swedish study showed that the school nurses did not initially talk about nor mention CSA as one form of child abuse. For the child to receive adequate support, the disclosure is a precondition and is dependent on an available person prepared to listen. The aim of the study was to explore the ability of the school nurses to detect and support sexually abused children. It is a secondary analysis of focus group interviews with school nurses. Thematic analysis was performed. Results showed that the school nurses avoided addressing CSA due to arousal of strong emotions, ambivalence, and a complicated disclosure process. In order to detect CSA and support abused children, attentiveness of sexual abuse as a possible cause of physical and mental ill-health is crucial.

scholarly journals Identifying Motives for Implementing eHealth by using Activity Theory

2020 ◽  
Vol 12 (4) ◽  
pp. 1298 ◽  
Author(s):  
Ann Svensson
Keyword(s):  
Activity Theory ◽  
New Technology ◽  
Work Practice ◽  
Healthcare Services ◽  
Project Managers ◽  
Demographic Challenges ◽  
It Department ◽  
Professional Requirements ◽  
Group Interviews ◽  
Assistant Nurses

eHealth interventions are utilized as a solution to address the current demographic challenges in society, as the number of old people increases. Thus, working life, work practice, and professional requirements needed for providing healthcare services will be transformed. The aim of this paper is to explore contradictive motives regarding the professionals’ work practice when introducing innovative eHealth technologies in Scandinavian healthcare services at a municipal level. The study is based on two qualitative group interviews where nurses, assistant nurses, occupational and physiotherapists, as well as project managers participated. Two persons from an IT department were also interviewed. The interviews were analyzed by thematic analysis. The activity theory is used to explore the individuals’ different contradictive motives in this work practice. The work practice consists of a collaborative activity, where expansive learning is important in this transformation of work to obtain a sustainable society. The motives identified in this study are to 1) improve quality of life for the patients, 2) create attractive and interesting work for the employees, 3) save money for the municipality, 4) learn about new technology, and 5) use the municipality’s resources effectively.

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