scholarly journals Lebanese Doctors Facing the SARS-CoV-2 Pandemic: Practical and Ethical Issues

2020 ◽  
Author(s):  
Nicole Gebara ◽  
Georges Dabar ◽  
Roland Eid ◽  
Fady Ghassan Haddad ◽  
Hampig Raphael Kourie ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Medical Practice ◽  
Ethical Issues ◽  
Well Being ◽  
Ethical Principles ◽  
Neutral Position ◽  
Care Providers ◽  
Ethical Considerations ◽  
Cross Sectional

Abstract Background In the light of the COVID-19 pandemic, the role of health care providers is essential to maintain the functioning of the health care system. Physicians accept a primary ethical duty to place the well-being and health of their patients above their own welfares. However, does the duty to patient well-being have any limit? Two ethical concerns are debated: public health’s ethical principles and medical ethics values. We aimed in this study to assess Lebanese physicians’ attitudes, practice and ethical considerations when treating their patients during the COVID-19 pandemic. Materials and methods It’s a cross-sectional study conducted in March 2019 among a random sample of Lebanese physicians, using a questionnaire based mainly on a five-point Likert numerical scale to make the answers more reliable and valid. The questionnaire focused on the medical practice during the pandemic and the ethical considerations in public health and in medical practice. It also evaluates the physicians’ point of view toward the management of the pandemic in Lebanon. Results A total of 318 physicians responded, with a mean age of 40 years. Five doctors of the total were affected by the COVID-19 infection (1.6%). 51.4% of medical specialists considered themselves to be at a higher risk of contracting the infection, while 52.3% of surgeons stated that they were at a lower risk. Doctors expressed a neutral position regarding the prioritization of patients during treatment and the disconnection of patients with poor prognosis from ventilators to treat other patients. The majority of doctors disagreed regarding the respect of the patient’s autonomy in refusing COVID-19 treatment with a mean score of 1.7/5. Finally, doctors expressed a neutral opinion regarding the ability of the country to manage such a pandemic with a mean score of 3.1/5. Conclusion Although physicians recognize that they are at high risk of contracting COVID-19, they assume their responsibilities and their duty to treat, and they were neutral against any prioritization in treatment approach. However, applying the four ethical principles (autonomy, beneficence, non-maleficence and justice) may become challenging. Hence, more medical and ethical recommendations are required to guide physicians during this pandemic.

scholarly journals Lebanese Doctors Facing the SARS-CoV-2 Pandemic: Practical and Ethical Issues

2020 ◽  
Author(s):  
Nicole Gebara ◽  
Georges Dabar ◽  
Roland Eid ◽  
Fady Ghassan Haddad ◽  
Hampig Raphael Kourie ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Medical Practice ◽  
Ethical Issues ◽  
Well Being ◽  
Cross Sectional Study ◽  
Ethical Principles ◽  
Care Providers ◽  
Ethical Considerations ◽  
Cross Sectional

Abstract Background: In the light of the COVID-19 pandemic, the role of health care providers is essential to maintain the functioning of the health care system. Physicians accept a primary ethical duty to place the wellbeing and health of their patients above their own welfares. However, does the duty to patient well-being have any limit? Two ethical concerns are debated: public health’s ethical principles and medical ethics values. We aimed in this study to assess Lebanese physicians’ attitudes, practice and ethical considerations when treating their patients during the COVID-19 pandemic.Materials and methods: It’s a cross-sectional study conducted in March 2020 among a random sample of Lebanese physicians, using a questionnaire based mainly on a five-point Likert numerical scale to make the answers more reliable and valid. The questionnaire focused on the medical practice during the pandemic and the ethical considerations in public health and in medical practice. It also evaluates the physicians’ point of view toward the management of the pandemic in Lebanon. Results: A total of 318 physicians responded, with a mean age of 40 years. Five doctors of the total were affected by the COVID-19 infection (1.6%). 51.4% of medical specialists considered themselves to be at a higher risk of contracting the infection, while 52.3% of surgeons stated that they were at a lower risk. Doctors were neutral regarding treating patients according to any priority and discontinuing the ventilation of any patient with bad prognosis. The majority of doctors disagreed regarding the respect of the patient’s autonomy in refusing COVID-19 treatment with a mean score of 1.7/5. Finally, doctors expressed a neutral opinion regarding the ability of the country to manage such a pandemic with a mean score of 3.1/5. Conclusion: Although physicians recognize that they are at high risk of contracting COVID-19, they assume their responsibilities and their duty to treat, and they were neutral against any prioritization in treatment approach. However, applying the four ethical principles (autonomy, beneficence, non-maleficence and justice) may become challenging. Hence, more medical and ethical recommendations are required to guide physicians during this pandemic.

scholarly journals Risk Perception and Worries among Health Care Workers in the COVID-19 Pandemic: Findings from an Italian Survey

Healthcare ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 535
Author(s):  
Mariangela Valentina Puci ◽  
Guido Nosari ◽  
Federica Loi ◽  
Giulia Virginia Puci ◽  
Cristina Montomoli ◽  
...  
Keyword(s):  
Health Care ◽  
Risk Perception ◽  
Health Care Providers ◽  
Health Care Workers ◽  
Health Care Professionals ◽  
Sleep Disturbances ◽  
Well Being ◽  
Care Providers ◽  
Cross Sectional ◽  
Care Workers

The ongoing pandemic scenario, due to the coronavirus disease 2019 (COVID-19), has had a considerable impact on public health all over the world. Italy was one of the most affected countries, as the first European full-blown outbreak occurred there. The exposure of the Italian health care workers to COVID-19 may be an important risk factor for psychological distress. The aim of this cross-sectional study was to describe worries and risk perception of being infected among Italian Health Care Workers (HCWs) during the first wave of the pandemic. In total, 2078 HCWs participated in a web survey (78.8% were females). The highest percentage of respondents were physicians (40.75%) and nurses (32.15%), followed by medical (18.00%), health care support (4.50%) and administrative (4.60%) staff. In a score range between 0 (not worried) and 4 (very worried), our results showed that participants declared that they were worried about the Coronavirus infection with a median score of 3 (IQR 2-3) and for 59.19% the risk perception of being infected was very high. In addition, HCWs reported they suffered from sleep disturbances (63.43%). From the analysis of the psychological aspect, a possible divergence emerged between the perceived need for psychological support (83.85%) and the relative lack of this service among health care providers emerged (9.38%). Our findings highlight the importance of psychological and psychiatric support services not only during the COVID-19 pandemic, but also in other emerging infectious diseases (EIDs) scenarios. These services may be useful for health authorities and policymakers to ensure the psychological well-being of health care professionals and to promote precautionary behaviors among them.

scholarly journals Orvosok kiégettségének összefüggése az egészséggel, életérzéssel, alváskörülményekkel

2016 ◽  
Vol 157 (16) ◽  
pp. 623-630
Author(s):  
Anikó Németh
Keyword(s):  
Health Care ◽  
Life Satisfaction ◽  
Health Care Providers ◽  
Sleep Disturbances ◽  
Protective Factor ◽  
Well Being ◽  
Care Providers ◽  
Chi Square ◽  
Cross Sectional ◽  
Psychosomatic Symptoms

Introduction: Burnout is common among health care providers and doctors. Aim: The correlations between burnout and health, psychosomatic symptoms, life satisfaction and sleep were investigated. Method: An online quantitative cross-sectional questionnaire was administered to 186 doctors. Burnout was assessed by the means of the 21-item questionnaire of Pines and Aronson (1981). Data were analysed with chi-square probe, Mann-Whitney test, correlational analysis and linear regression. Results: Level of burnout correlated negatively with age (p = 0.040; r = –0.151), years spent in the health care system (p = 0.027; r = –0.162) and positive well-being (p<0.001, r = –0.670), while there was a negative correlation with negative well-being (p<0.001; r = 0.585) and life satisfaction (p<0.001; r = –0.532). Doctors with burnout reported worse health (p<0.001), more frequent psychosomatic symptoms (p<0.001), tumours (p = 0.007), allergies (p = 0.030), psychiatric disorders (p = 0.025) and sleep disturbances. Conclusions: One-third of the doctors were affected by burnout in the present study. Higher age and having more children served as a protective factor. Orv. Hetil., 2016, 157(16), 623–630.

Dual loyalty, medical ethics, and health care in offshore asylum-seeker detention

2019 ◽  
pp. 260-272 ◽  
Author(s):  
Deborah Zion
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Asylum Seekers ◽  
Ethical Issues ◽  
Care Providers ◽  
Ethical Considerations ◽  
Dual Loyalty ◽  
Christmas Island ◽  
Care Workers ◽  
Refugees And Asylum Seekers

This chapter examines the ethical issues related to the practice of health care in an environment where human rights are absent, specifically relating to the conditions for refugees and asylum seekers who arrive by sea in Australian territory. The ethical considerations of working within the offshore detention environment are discussed. Health-care workers in these harsh environments often have divided loyalties, when duties to their patients conflict with duties to their employer or to the state. The author draws on published accounts and interviews with health-care providers who have worked on Manus Island and Nauru and Christmas Island, the sites used by Australia for offshore detention of asylum seekers.

scholarly journals Perceptions of Healthcare Professionals on Covid-19 in Lesotho: a Cross-sectional Survey

2021 ◽  
Author(s):  
Isabel Nyangu ◽  
Maseabata Ramathebane
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Healthcare Professionals ◽  
Survey Design ◽  
Well Being ◽  
Health Care Facilities ◽  
Care Providers ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Care Facilities

Abstract BackgroundHealth care professionals at the frontline of the Covid-19 pandemic require continued support to ensure not only their well-being, but enhanced care for those infected by the disease.AimThe aim of this study was to assess the perceptions of health care providers regarding the Covid-19 pandemic in Lesotho. MethodologyA quantitative cross-sectional survey design was used to collect data from a sample of 190 health care workers who were conveniently sampled from a total of 25 health care facilities (12 hospitals and 13 health center clinics). The sample included nurses, doctors, pharmacists, laboratory scientists/ technicians, dentists, counsellors, and administrative assistants. A total of 255 structured questionnaires were distributed and 190 of them were returned completed (75% response rate). Data were collected in September 2021 and analyzed using SPSS (vs23). Permission to conduct this study was granted by the relevant authorities. Informed written consent was given by the participants in writing before they could take part in this study.ResultsThe level of education was found to be associated with positive perceptions of the respondents on the Covid-19 pandemic. Respondents generally had positive views about the Covid-19 pandemic. Their views were positive as they understood that Covid-19 can affect anyone including themselves and is not a disease for any particular race. They were also aware that they could contract Covid-19, even despite pre-existing conditions. Respondents perceived that there was a positive prognosis after contracting Covid-19 if necessary precautions were taken. They had positive perceptions as they knew that the virus was affecting many people worldwide, including the elderly, and were willing to take the test and did not mind having to pay for it if asked to do so. Even though the Covid-19 test was viewed not to take too much time, respondents felt that it is rather painful and uncomfortable. The test providers were perceived as friendly and not rude, and respondents did not have any preferred gender for the test providers. Respondents were also willing to discuss issues on Covid-19 with families and friends. Majority of the respondents lived close to health care facilities.ConclusionsThis study concludes that health care providers at the frontline were mostly nurses. Positive perceptions about the Covid-19 pandemic in Lesotho were found as respondents were knowledgeable, and were willing to test for the disease. Test providers were viewed as pleasant and health care facilities were accessible. This shows positive progress towards fighting the pandemic in Lesotho.RecommendationsSupport for frontline healthcare professionals remains crucial to ensure effective service delivery. More education can be provided to improve the general views about the Covid-19 to improve uptake of services not only amongst healthcare professionals but the general public as well.

Development of an Outcome Measure of Observable Signs of Health and Well-Being in Infants With Orofacial Clefts

2020 ◽  
Vol 57 (11) ◽  
pp. 1266-1279
Author(s):  
Carrie L. Heike ◽  
Meredith Albert ◽  
Cassandra L. Aspinall ◽  
Suzel Bautista ◽  
Claudia Crilly Bellucci ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Cleft Lip ◽  
Outcome Measure ◽  
Psychometric Testing ◽  
Well Being ◽  
Care Providers ◽  
Cross Sectional ◽  
Health And Well Being

Objective: To develop an outcomes instrument that assesses observations that can be reliably reported by caregivers and can be used to assess health of infants with a cleft lip or cleft lip and cleft palate (CL±P) and impacts of treatments. Design: Cross-sectional, mixed methods study. Setting: Caregivers and health-care providers were recruited from 3 academic craniofacial centers and national advertisements. Most interviews were conducted by telephone, and surveys were completed online. Participants: Caregivers had a child less than 3 years of age with CL±P and spoke either English or Spanish. Health-care providers were members of a cleft team. Caregivers (n = 492) and health-care professionals (n = 75) participated in at least one component of this study. Main Outcome Measure(s): Caregivers and health-care providers participated in tasks related to instrument development: concept elicitation for items within relevant health domains, prioritization of items, and item review. Results: We identified 295 observations of infant well-being across 9 health areas. Research staff and specialists evaluated items for clarity, specificity to CL±P, and responsiveness to treatment. Caregivers and health-care providers rated the resulting list of 104 observations and developed the final instrument of 65 items. Conclusions: In this phase of development of the Infant with Clefts Observation Outcomes (iCOO) instrument, items were developed to collect caregiver observations about indicators of children’s health and well-being across multiple domains allowing for psychometric testing, sensitivity to changes associated with treatment, and documentation of the effects of treatment.

scholarly journals Examining the ethical challenges in managing elder abuse: a systematic review

2019 ◽  
Author(s):  
Afsaneh Saghafi ◽  
Fatemeh Bahramnezhad ◽  
Afsaneh Poormollamirza ◽  
Ali Dadgari ◽  
Elham Navab
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Ethical Issues ◽  
Elder Abuse ◽  
Scientific Information ◽  
Ethical Principles ◽  
Care Providers ◽  
Ethical Challenges ◽  
Common Definition ◽  
Study Results

Elder abuse is an increasingly intangible phenomenon that has created numerous ethical issues for care teams and caregivers. Although different studies have concentrated on various ethical issues regarding abuse, no study has arrived at a comprehensive conclusion. Therefore, the present study aimed to determine the existing ethical challenges in this context. For this purpose, two researchers familiar with systematic search approach examined national and international journals on PubMed, Excerpta Medica Database (EMBASE), Scientific Information Database (SID) and similar databases between January and February 2017. They were able to find 116 articles that met the inclusion and exclusion criteria, and finally selected 15 articles based on the predesigned questions. The findings were classified in five subtitles as follow: 1) the common definition of elder abuse, 2) a comprehensive legislation on elder abuse, 3) comprehensive ethical principles about elder abuse, 4) ethical considerations regarding patients without competency, and 5) reporting and sharing information about elder abuse. The study results revealed no common definition and no legislation about elder abuse, and also showed that health care providers’ observance of ethical principles depends on the ethical and legal conditions of the community. Nowadays, elder abuse is a serious problem in many countries. Cultural and religious differences are the reasons for lack of a common definition and legislations, which comprises the biggest obstacle to protecting the rights of elderly people. It is clear that ethical principles should be respected as far as a person has competency. Furthermore, localization of clinical guidelines related to this issue leads to proper functioning of health care providers, especially nurses as the first line of treatment

scholarly journals Impact of COVID-19 on medical practice: A nationwide survey of dermatologists and health care providers in Iraq

2020 ◽  
Author(s):  
Mohammed Shanshal ◽  
Hayder Saad Ahmed ◽  
Hayder Asfoor ◽  
Raad Ibrahim Salih ◽  
Shehab Ahmed Ali ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Medical Practice ◽  
Nationwide Survey ◽  
Care Providers

scholarly journals Ethical Considerations on Pediatric Genetic Testing Results in Electronic Health Records

2020 ◽  
Vol 11 (05) ◽  
pp. 755-763
Author(s):  
Shibani Kanungo ◽  
Jayne Barr ◽  
Parker Crutchfield ◽  
Casey Fealko ◽  
Neelkamal Soares
Keyword(s):  
Genetic Testing ◽  
Best Practices ◽  
Health Care Providers ◽  
Genetic Information ◽  
Ethical Issues ◽  
Interdisciplinary Approach ◽  
Care Providers ◽  
Ethical Considerations ◽  
Electronic Health ◽  
Genetic Results

Abstract Background Advances in technology and access to expanded genetic testing have resulted in more children and adolescents receiving genetic testing for diagnostic and prognostic purposes. With increased adoption of the electronic health record (EHR), genetic testing is increasingly resulted in the EHR. However, this leads to challenges in both storage and disclosure of genetic results, particularly when parental results are combined with child genetic results. Privacy and Ethical Considerations Accidental disclosure and erroneous documentation of genetic results can occur due to the nature of their presentation in the EHR and documentation processes by clinicians. Genetic information is both sensitive and identifying, and requires a considered approach to both timing and extent of disclosure to families and access to clinicians. Methods This article uses an interdisciplinary approach to explore ethical issues surrounding privacy, confidentiality of genetic data, and access to genetic results by health care providers and family members, and provides suggestions in a stakeholder format for best practices on this topic for clinicians and informaticians. Suggestions are made for clinicians on documenting and accessing genetic information in the EHR, and on collaborating with genetics specialists and disclosure of genetic results to families. Additional considerations for families including ethics around results of adolescents and special scenarios for blended families and foster minors are also provided. Finally, administrators and informaticians are provided best practices on both institutional processes and EHR architecture, including security and access control, with emphasis on the minimum necessary paradigm and parent/patient engagement and control of the use and disclosure of data. Conclusion The authors hope that these best practices energize specialty societies to craft practice guidelines on genetic information management in the EHR with interdisciplinary input that addresses all stakeholder needs.

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