scholarly journals Cultural sensitivity in brain death determination: a necessity in end-of-life decisions in Japan

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Yuri Terunuma ◽  
Bryan J. Mathis

Abstract Background In an increasingly globalized world, legal protocols related to health care that are both effective and culturally sensitive are paramount in providing excellent quality of care as well as protection for physicians tasked with decision making. Here, we analyze the current medicolegal status of brain death diagnosis with regard to end-of-life care in Japan, China, and South Korea from the perspectives of front-line health care workers. Main body Japan has legally wrestled with the concept of brain death for decades. An inability to declare brain death without consent from family coupled with cultural expectations of family involvement in medical care is mirrored in other Confucian-based cultures (China and South Korea) and may complicate care for patients from these countries when traveling or working overseas. Within Japan, China, and South Korea, medicolegal shortcomings in the diagnosis of brain death (and organ donation) act as a great source of stress for physicians and expose them to potential public and legal scorn. Here, we detail the medicolegal status of brain death diagnosis within Japan and compare it to China and South Korea to find common ground and elucidate the impact of legal ambiguity on health care workers. Conclusion The Confucian cultural foundation of multiple Asian countries raises common issues of family involvement with diagnosis and cultural considerations that must be met. Leveraging public education systems may increase awareness of brain death issues and lead to evolving laws that clarify such end-of-life issues while protecting physicians from sociocultural backlash.

2020 ◽  
Author(s):  
Gi Beom Kim ◽  
Oog-Jin Shon ◽  
Jeong Jin Park ◽  
Sun-Mi Lee ◽  
Gun Woo Lee

Abstract Background: This study aimed to investigate the cancellation rate and trend of orthopedic surgery at the main institution in Daegu, Korean epicenter of novel coronavirus disease 19 (COVID-19), and to analyze the psychologic status of the healthcare workers in the orthopedic division during the COVID-19 pandemic. Moreover, we sought to assess the outcomes of the preventive surgeries underwent in patients suspected to have COVID-19.Methods: Cancellation rates of elective surgeries over three months since the first confirmed COVID-19 case in South Korea on January 20, 2020 were investigated. Moreover, the number of elective surgeries conducted in the same period over the last two years was compared. Four different questionnaires were used to investigate psychologic impact among health care workers in the orthopedic department. The surveyed outcomes according to occupation and type of work were compared. Urgent preventive surgeries underwent in patients who could not wait for the results of the COVID-19 diagnosis were also investigated.Results: During the pandemic, spine and hip surgery had relatively lower cancellation rates, and elective surgeries were significantly reduced compared to the same period in the last two years. The surveyed outcomes of the psychological questionnaires were within the normal range and there were no significant differences between groups. After preventive surgeries, the virus did not spread to all medical staff involved.Conclusions: During the COVID-19 pandemic, the cancellation rate of orthopedic elective surgeries was significantly higher than in the same period of the previous year, and was different for each subdivision depending on the degree of pain or disability experienced by the patient. Health care workers in the orthopedic division did not seem to have significant psychological distress; rather, a decrease in workload appears to be a positive factor in their mental health. Preventive surgery performed in specialized facilities did not spread the virus to involved medical staff.


2019 ◽  
Vol 118 (7) ◽  
pp. 20-26
Author(s):  
S. JAYARAMAN ◽  
R. Sindhya ◽  
P. Vijiyalakshmi

this research aims to find out the intensity of Employee Engagement of the health care sector workers and the relationship between the Work life factors and Employee Engagement of Health care sector workers in Dindigul District. Primary data were used in this research, were collected from 298 Health care workers from Dindigul District. Questionnaire was the major tool used to gather the primary data from the selected sample respondents. For this purpose, a well structured questionnaire was constructed with the help of professionals and the practiced employees of various health care units in Dindigul District. The health care employees were chosen by simple random sampling method. The investigative measures of regression Path analysis, and simple percentage analysis were utilized to find the impact of work life related factors with the Employee Engagement. The maximum Health care workers were generally satisfied with their jobs. The analytical procedure of path analysis multiple regressions was utilized to determine the predicting strength among Work life factors and the employee engagement. This study provides an another view about the importance of Work life factors and Employee engagement for organizational effectiveness and performance .


Author(s):  
Hasan S. Alamri ◽  
Wesam F. Mousa ◽  
Abdullah Algarni ◽  
Shehata F. Megahid ◽  
Ali Al Bshabshe ◽  
...  

Objective: Little is known about the impact of Coronavirus (COVID-19) among the health care workers in Saudi Arabia. Therefore, the present study aimed to assess the psychological impact of COVID-19 among the health care workers. Methods: A cross-sectional survey was conducted from May till mid-July among 389 health care workers from government and private hospitals in Saudi Arabia. Data was collected using a pre-structured online questionnaire that measured adverse psychological outcomes, including the Patient Health Questionnaire-9 (PHQ-9) scale and the Generalized Anxiety Disorder 7-item (GAD-7) scale. The Pearson chi-square test was used to assess the distribution of depression and anxiety among health care workers. Results: A high level of anxiety was recorded among the health care workers, and 69.3% of health care workers below the age of 40 were found to have depression. There was a significant increase in depression among staff with chronic health problems (72.1% vs. 61.9%; p = 0.048). High anxiety levels were detected among young staff compared to others (68.7% vs. 43.8%; p = 0.001). Moreover, 82.1% of the female staff were anxious, as compared to 55.6% of the males (p = 0.001). Conclusions: We found increased prevalence of adverse psychological outcomes among the health care workers in Saudi Arabia during the outbreak of COVID-19. Therefore, there is a need for proper screening and development of corresponding preventive measures to decrease the adverse psychological outcomes.


2017 ◽  
Vol 21 (9) ◽  
pp. 1049-1055 ◽  
Author(s):  
M. J. Magee ◽  
L. Darchia ◽  
M. Kipiani ◽  
T. Chakhaia ◽  
R. R. Kempker ◽  
...  

2017 ◽  
Vol 17 (1) ◽  
Author(s):  
Ju Hyun Lee ◽  
Junhyeon Cho ◽  
Yung Jung Kim ◽  
Sang Hyuk Im ◽  
Eun Sun Jang ◽  
...  

2020 ◽  
Author(s):  
Denise van Hout ◽  
Paul Hutchinson ◽  
Marta Wanat ◽  
Caitlin Pilbeam ◽  
Herman Goossens ◽  
...  

ABSTRACTBackgroundWorking under pandemic conditions exposes health care workers (HCWs) to infection risk and psychological strain. Protecting the physical and psychological health of HCWs is a key priority. This study assessed the perceptions of European hospital HCWs of local infection prevention and control (IPC) procedures during the COVID-19 pandemic and the impact on their emotional wellbeing.MethodsWe performed two rounds of an international cross-sectional survey, between 31 March and 17 April 2020 via existing research networks (round 1), and between 14 May and 31 August 2020 via online convenience sampling (round 2). Main outcome measures were (1) behavioural determinants of HCW adherence with IPC procedures, (2) WHO-5 Well-Being Index, a validated scale of 0-100 reflecting emotional wellbeing. The WHO-5 was interpreted as a score below or above 50 points, a cut-off score used in previous literature to screen for depression.Results2,289 HCWs (round 1: n=190, round 2: n=2,099) from 40 countries in Europe participated. Mean age of respondents was 42 (±11) years, 66% were female, 47% and 39% were medical doctors and nurses, respectively. 74% (n=1699) of HCWs were directly treating patients with COVID-19, of which 32% (n=527) reported they were fearful of caring for these patients. HCWs reported high levels of concern about COVID-19 infection risk to themselves (71%) and their family (82%) as a result of their job. 40% of HCWs considered that getting infected with COVID-19 was not within their control. This was more common among junior than senior HCWs (46% versus 38%, P value <.01). Sufficient COVID-19-specific IPC training, confidence in PPE use and institutional trust were positively associated with the feeling that becoming infected with COVID-19 was within their control. Female HCWs were more likely than males to report a WHO-5 score below 50 points (aOR 1.5 (95% confidence interval (CI) 1.2-1.8).ConclusionsIn Europe, the COVID-19 pandemic has had a differential impact on those providing direct COVID-19 patient care, junior staff and women. Health facilities must be aware of these differential impacts, build trust and provide tailored support for this vital workforce during the current COVID-19 pandemic.


2010 ◽  
Vol 106 (2) ◽  
pp. 555-561 ◽  
Author(s):  
Li Wang ◽  
Jianxin Zhang ◽  
Mingjie Zhou ◽  
Zhanbiao Shi ◽  
Ping Liu

The symptoms of posttraumatic stress disorder and associated risk factors were investigated among health care workers in earthquake-affected areas in southwest China. 343 health care workers completed the Chinese version of the Impact of Event Scale–Revised 3 mo. after the Wenchuan Earthquake. The prevalence of probable PTSD was 19%. The significant risk factors identified for PTSD severity included being female, being bereaved, being injured, and higher intensity of initial fear. These findings suggest that PTSD is a common mental health problem among health care workers in earthquake-affected areas. The present information can be useful in directing, strengthening, and evaluating disaster-related mental health needs and interventions after an earthquake.


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