Moral distress among health care workers in the intensive care unit; a systematic review and meta-analysis

2021 ◽  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Health Care Providers ◽  
Moral Distress ◽  
Meta Analysis ◽  
Significant Heterogeneity ◽  
Care Providers ◽  
Distress Scale

Background: The effect of moral distress among healthcare providers is significant on disease morbidity, especially within the intensive care unit (ICU). In this systematic review and meta-analysis, we aimed to gather all evidence regarding moral distress frequency and severity/intensity among ICU health care providers. Methods: We conducted a systematic search to gather all relevant studies from six databases, followed by a manual search of references. Fourteen studies consisting of 5905 participants were included in the final moral distress scale analyses. Results: Overall, there was moderate moral distress severity/intensity among all participants (Mean = 27.79; 95% confidence interval (CI) = 7.40–64.18). On further stratification of the results according to countries, Canada (Mean = 91.99; 95% CI = 80.10–105.65) and USA (Mean = 52.54; 95% CI = 44.78–61.64) showed the highest distress scores, followed by Iran (Mean = 21.20; 95% CI = 7.21–62.30) and Italy (Mean = 3.42; 95% CI = 3.15–3.72). Studies conducted in high income-earning countries reported more severity/intensity (Mean = 22.65; 95% CI = 6.58–78.02) compared to those in the upper-middle income-earning ones (Mean = 18.89; 95% CI = 2.80–127.34). There was significant heterogeneity among the included studies, which could not be explained by the difference in scales, country of the participants, or the female proportion. Moreover, there was a moderate frequency of moral distress (Mean = 46.83; 95% CI = 8.34–262.87), which was found to be much higher (Mean = 87.94; 95% CI = 83.55–92.57), in performing analysis. Conclusion: Moral distress is a major problem in the ICU setting, in terms of both severity/intensity and frequency. Future large-scale studies are required, through a unified framework, to develop appropriate interventions to address ICU-related moral distress.

Visitation in the Pediatric Intensive Care Unit: Controversy and Compromise

1994 ◽  
Vol 5 (3) ◽  
pp. 289-295 ◽  
Author(s):  
Nancy E. Page ◽  
Nancy M. Boeing
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Health Care Providers ◽  
Pediatric Intensive Care ◽  
Care Providers ◽  
The Family ◽  
Centered Care ◽  
Family Centered

Much controversy has arisen in the last few decades regarding parental and family visitation in the intensive care setting. The greatest needs of parents while their child is in an intensive care unit include: to be near their child, to receive honest information, and to believe their child is receiving the best care possible. The barriers that exist to the implementation of open visitation mostly are staff attitudes and misconceptions of parental needs. Open visitation has been found in some studies to make the health-care providers’ job easier, decrease parental anxiety, and increase a child’s cooperativeness with procedures. To provide family-centered care in the pediatric intensive care unit, the family must be involved in their child’s care from the day of admission. As health-care providers, the goal is to empower the family to be able to advocate and care for their child throughout and beyond the life crisis of a pediatric intensive care unit admission

Mothers’ Stories about Their Experiences in the Neonatal Intensive Care Unit

2000 ◽  
Vol 19 (3) ◽  
pp. 13-21 ◽  
Author(s):  
Diane Holditch-Davis ◽  
Margaret Shandor Miles
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Health Care Providers ◽  
Neonatal Intensive Care ◽  
Family Factors ◽  
Parental Role ◽  
Parental Distress ◽  
Care Providers

The purpose of this article is to let mothers tell the stories of their neonatal intensive care unit (NICU) experiences and to determine how well these experiences fit the Preterm Parental Distress Model. Interviews were conducted with 31 mothers when their infants were six months of age corrected for prematurity and were analyzed using the conceptual model as a framework. The analysis verified the presence in the data of the six major sources of stress indicated in the Preterm Parental Distress Model: (1) pre-existing and concurrent personal and family factors, (2) prenatal and perinatal experiences, (3) infant illness, treatments, and appearance in the NICU, (4) concerns about the infant’s outcomes, (5) loss of the parental role, and (6) health care providers. The study indicates that health care providers, and especially nurses, can have a major role in reducing parental distress by maintaining ongoing communication with parents and providing competent care for their infants.

scholarly journals Non-adherence to inhaled medications among adult asthmatic patients in Ethiopia: a systematic review and meta-analysis

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Woldu Aberhe ◽  
Abrha Hailay ◽  
Kidane Zereabruk ◽  
Guesh Mebrahtom ◽  
Teklehaimanot Haile
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Care Providers ◽  
Meta Analysis ◽  
Cochrane Review ◽  
World Health ◽  
Care Providers ◽  
Asthmatic Patients ◽  
Inconsistency Index ◽  
National Prevalence

Abstract Background Medication non-adherence is one of a common problem in asthma management and it is the main factor for uncontrolled asthma. It can result in poor asthma control, which leads to decreased quality of life, increase hospital admission, increased health care utilization, lost productivity, and mortality. To date, there have been no studies and protocols that estimated the pooled national prevalence of non-adherence to inhaled anti-asthmatic medications in Ethiopia. Therefore, the primary purpose of this systematic review and meta-analysis is to determine the pooled national prevalence of non-adherence to inhaled medications among asthmatic patients in Ethiopia. Methods Different database searching engines including PubMed, Scopus, Google Scholar, Africa journal online, World Health Organization afro library, and Cochrane review were systematically searched by using keywords such as “prevalence, non-adherence to inhaled medications, inhaled corticosteroids, and asthmatic patients” and their combinations. Six published observational studies that report the prevalence of non-adherence to inhaled medications were finally selected. The Preferred Reporting Items for Systematic Review and Meta-Analysis guideline was followed. Heterogeneity across the included studies was evaluated by the inconsistency index (I2). The random-effect model was fitted to estimate the pooled prevalence of non-adherence to inhale anti-asthmatic medications. All statistical analysis was done using R version 3.5.3 and R Studio version 1.2.5033 software for windows. Results The pooled national prevalence of non-adherence to inhaled medications among asthmatic patients was 29.95% (95% CI, 19.1, 40.8%). The result of this meta-analysis using the random-effects model revealed that there is high heterogeneity across the included studies. The result of subgroup analysis indicates that one out of three in the Oromia region and one out of five in the Amhara region asthmatic patients was non-adherent to their inhaled anti-asthmatic medications. Conclusion the prevalence of non-adherence to inhaled anti-asthmatic medications was high. Thus, our finding suggests that one out of four asthmatic patients were non-adherent to inhaled medications. The ministry of health, health policymakers, clinicians, and other health care providers should pay attention to strengthening the adherence levels to inhaled anti-asthmatic medications, and country-based interventions should be developed to reduce the burden of non-adherence to inhaled anti-asthmatic medications.

Are health care providers who work with cancer drugs at an increased risk for toxic events? A systematic review and meta analysis of the literature

2005 ◽  
Vol 23 (16_suppl) ◽  
pp. 6082-6082 ◽  
Author(s):  
G. Dranitsaris ◽  
M. Johnston ◽  
S. Poirier ◽  
T. Trudi Schueller ◽  
T. Savage ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Care Providers ◽  
Meta Analysis ◽  
Care Providers ◽  
Cancer Drugs ◽  
Increased Risk

Loyalty and Hope: Keys to Parenting in the NICU

2003 ◽  
Vol 22 (4) ◽  
pp. 39-45 ◽  
Author(s):  
Margo Charchuk ◽  
Christy Simpson
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Neonatal Intensive Care ◽  
Care Providers ◽  
Medical Needs

When a newborn is admitted to a neonatal intensive care unit the parents may experience a variety of emotions, including a heightened sense of loyalty to their child. While health care providers are working to meet the medical needs of their patients, parents need to find ways to fulfill this sense of loyalty and to express it via hope. Through sharing the experience of having a child in the NICU, I examine hope and loyalty as critical features of parents’ NICU experience, explaining why these emotions need to be acknowledged and encouraged by health care professionals.

Newborn in Neonatal Intensive Care Unit: Parental Concerns

2020 ◽  
Vol 34 (4) ◽  
pp. 196-198
Author(s):  
Pardeep Dhingra
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Health Care Providers ◽  
Neonatal Intensive Care ◽  
Depression Scale ◽  
Parental Satisfaction ◽  
Anxiety And Depression ◽  
Care Providers

Background: Having a newborn baby admitted in the neonatal intensive care unit (NICU) can be a stressful experience for the parents. Objectives: This study was planned to know the following: 1. The concerns of parents whose babies were admitted in NICU 2. Parental satisfaction level about the services provided 3. Assessment of parents for their understanding and knowledge at discharge Study Design: Semiqualitative interview. Participants: Parents of 100 (56 M, 44 F) neonates. Intervention: We subjected them to a semiqualitative interview on the day of discharge of their newborn infant. Questionnaire consisted of parent’s understanding regarding NICU and health care providers, their perspective about the possible cause of illness in their baby along with competence and communication skills of health care providers. Parental satisfaction about the services was assessed by the short assessment of patient satisfaction (SAPS). They were assessed for their anxiety and depression levels by hospital anxiety and depression scale (HADS). They were assessed for their knowledge about care of baby at home after discharge by patient knowledge questionnaire (PKQ). Results: Parents of 44% babies had no prior idea about NICU and why babies need to be admitted. In total, 48% mothers and 36% fathers had clinically significant anxiety levels as assessed by HADS. Many parents complained about lack of communication about their babies illness, its cause, duration of treatment, and prognosis. Both parents scored the caregivers on borderline scores on the SAPS. At discharge only 13% knew the correct dose and duration of medicines prescribed. PKQ scores varied from 5 to 20. Almost all parents emphasized the need for more space, resting place for mothers, and better communication by doctors. Conclusions: This study reveals a significant communication gap between health care providers and parents. Concerns of parents have to be addressed to have their full participation in newborn care.

scholarly journals Current Knowledge, Attitudes, and Practice among Health Care Providers in OSCC Awareness: Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (9) ◽  
pp. 4506
Author(s):  
Noemi Coppola ◽  
Michele Davide Mignogna ◽  
Immacolata Rivieccio ◽  
Andrea Blasi ◽  
Maria Eleonora Bizzoca ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Care Providers ◽  
Current Knowledge ◽  
Meta Analysis ◽  
Sun Exposure ◽  
Care Providers ◽  
Screening Programs ◽  
Dental Practitioners ◽  
Significant Difference

OSCC remain a global health problem. Lack of awareness leads to inadequate watchfulness regarding early signs/symptoms despite the ease of visual oral inspection. What clinicians know and feel, and how they behave on OSCC is crucial to understand the feasibility and effectiveness of screening programs. The aim of this systematic review was to assess knowledge, attitudes, and practice (KAP) regarding OSCC among health care providers (HCPs). Therefore, a systematic review was conducted with SPIDER and PICO as major tools. A meta-analysis was structured through common items in two comparison groups of medical and dental practitioners. Descriptive statistics and a Mantel–Haenszel test were used to validate data. Sixty-six studies were selected for systematic review, eight of which are useful for meta-analysis. A statistically significant difference was recorded between dentists and medical practitioners for questions regarding: Alcohol (p < 0.001); Elderly (p < 0.012); Sun exposure (p < 0.0001); Erythroplakia (p < 0.019); Red patch (p < 0.010); White patch (p < 0.020); Tobacco consultation (p < 0.0001); Intraoral examination (p < 0.0001) and Up-to-date knowledge (p < 0.002). Overall, the incidence of OSCC screening is low. Most HCPs feel the need to increase KAP. Data confirmed gaps in KAP, highlighting the need for a more efficient pre- and post-graduation training, necessary to increase competence worldwide.

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