Next of kin’s experiences of registered nurses’ leadership close to older adults in municipal home care in Sweden: an interview study

Background Next of kin to older adults over 65 years in municipal home care are concerned whether their older adults’ needs are being met. In municipal home care, the registered nurses’ leadership is important and complex, entailing multi-artist skills involving the older adults and their next of kin. Yet, little is known about next of kin’s experiences of registered nurses’ leadership. Thus, the aim of this study was to explore next of kin’s experiences of registered nurses’ leadership close to older adults in municipal home care. Methods Individual telephone interviews were conducted with next of kin (n = 11) of older adults from April to September 2020 in two municipalities in western Sweden. Data were analysed using qualitative content analysis. Results The results are presented with the theme, registered nurses do what they can, including two categories, interaction and competence, and the subcategories, relationship, communication, availability, responsibility, team leadership and cooperation. Registered nurses’ leadership was experienced as a balancing act between their commitments and what they were able to achieve. Conclusions Next of kin’s experiences of registered nurses’ leadership can contribute knowledge that will strengthen and prepare registered nurses for their leadership roles. This knowledge can support the development of policies for organisational preconditions that ensure quality and safe care to older adults in municipal home care.

What are the ethical conflicts faced by Mexican internists?

Background No studies have been conducted in Mexico to ascertain what ethical problems doctors working at hospitals deal with. This article aims to describe the ethical conflicts most commonly identified by Mexican internists and the importance they attribute to each of these conflicts. Methods Voluntary survey to the members of the Internal Medicine Association of Mexico. Results Responses were submitted by 347 internists. Half of those face ethical conflicts almost always or frequently. The most commonplace and relevant conflicts are those resulting from the clinical relationship (communication, confidentiality, informed consent, assessment of mental capacity, decisions involving incapacitated patients, and conflicts with family members), and secondly those problems related with the end of life (palliative care, withholding or withdrawing treatment, and “No CPR orders”). To resolve conflicts they seek support through protocols, Institutional Ethics Committees (IECs), and consultations with colleagues and, occasionally, with bioethics experts. Protocols and IECs are the tools most in demand among them. Conclusions 1) the most frequent and relevant conflicts are those caused by the clinical relationship, above all those due to doctor–patient communication, and secondly those due to problems which arise at the end of life; 2) though nearly all of them have doubts about how to resolve conflicts, the vast majority are satisfied with the way in which they do so; 3) to deal with conflicts, they seek support mainly in protocols, IECs, and consultation with colleagues; and 4) in order to resolve them better, what they most demand are protocols and IECs, but also bioethics consultants.

Family Resilience during COVID-19 Pandemic: A Literature Review

Introduction: The COVID-19 pandemic has spread rapidly in many countries. This pandemic has led to short-term as well as long-term psychosocial and mental health implications for all family members. The magnitude of family resilience is determined by many vulnerability factors like developmental age, educational status, preexisting mental health condition, being economically underprivileged or being quarantined due to infection or fear of infection. Methods: PubMed, SCOPUS, MEDLINE, Google Scholar, Cochrane, and ProQuest were searched from the inception of the pandemic to December 31, 2020. Articles were screened for inclusion by Authors. Results: After exclusion, there were eight studies included in the analysis with 165,515 participants. The literature review demonstrated that pandemic has caused mental health problems such as anxiety, stress, and depression. Creating daily practices of gratitude is important to build family wellbeing. It is essential to have good and healthy communication and to find positive activities to do together among family members which can build a sense of togetherness, trust, cohesion, and happiness. Conclusion: In conclusion, the pandemic has caused unpredictable and uncertain impacts that can pose a threat to the wellbeing of the families. Pandemic has caused mental health problems such as anxiety, stress, and depression. A healthy relationship, communication, faith-based practices, a positive mindset, and building social support are adaptive coping to respond to the crisis and adversity together.

Adverse Childhood Experiences, Intimate Partner Violence, and Communication Quality in a College-Aged Sample

Previous adverse childhood experiences (ACEs) research focused on the future effects of intimate partner violence (IPV) among adult men, as well as victimization patterns. Continuing evidence is needed informing how ACEs, communication, and IPV may emerge within the intimate partnerships of 18–24 year olds. The present study addresses a literature gap by investigating ACEs in relation to relationship communication quality and IPV, considering not only victimization but also perpetration. An online survey was distributed through social media outlets targeting college-aged adults ( n = 228). Men were more likely to perpetrate and be victimized by IPV than women in the sample. However, both sexes had moderate associations between ACES and victimization as well as perpetration of physical, emotional, sexual, and cyber abuse. Poor communication quality was associated with ACEs and most forms of abuse experienced in the last year. Continued investigation of this topic is warranted to understand mechanisms for effective treatment and skill development.

Improved couple satisfaction and communication with marriage and relationship programs: are there gender differences?—a systematic review and meta-analysis

Background The aspects of marriage and relationship and their effect on couples’ satisfaction are essential and critical aspects to be explored in this globalized and contemporary world. Since there are no reported meta-analysis and systematic reviews conducted in the last two decades in this area, we aimed to investigate the effect of marriage and relationship programs (MRP) on couples’ relationship satisfaction (CRS) and couples’ relationship communication (CRC) and also to determine the gender differences if any. Method In this systematic review and meta-analysis, the randomized clinical trials (RCTs) published between 2000 and July 26, 2019, were retrieved from several online electronic databases such as Medline, Embase, ProQuest, and Cochrane Library. Inclusion and exclusion criteria were developed using the PICO (Population, Intervention, Comparison, Outcome) framework of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). The mean differences (MDs) and 95% confidence intervals (CIs) were calculated. The reported summary statistics were calculated as random effects models based on the heterogeneity between the studies model. Funnel plots and the Egger regression test was used to confirm the presence of any publication bias. Results Of the total 12 intervention studies included, five (5) are education/communication skills programs, three (3) enrichment programs, and four (4) therapy programs. The impact of these programs was investigated on CRS and CRC. Therapy programs had a larger effect than other programs (pooled MD: 0.53 (95% CI = 0.35 to 0.71, I2 = 71.5% p = 0.0001) and had a larger effect size on wives (pooled MD: 0.53 (95% CI 0.25 to 0.80, I2 = 74.1% p = 0.0001) than husbands RS (pooled MD: 0.26 (95% CI 0.25 to 0.76, I2 = 72.4% p = 0.0001). In RC (relationship communication) area, the Enhancement programs showed the small to large effect on CRC (pooled MD: 1.31 (95% CI = 0.13 to 2.50, I2 = 94.7% p = 0.0001)) and educational programs showed small to medium effect (pooled MD: 0.32 (95% CI = 0.13 to 0.50, I2 = 74.5% p = 0.0001) on women and no effect on men. Conclusion Due to the high effect of the therapy programs on CRS and enhancement program on CRC in the current meta-analysis, the priority of their utilizations in interventions, especially by psychologists and mental health professionals, should be emphasized. Therefore, mental health planning in communities to develop MRP and care for couples’ health should be given special attention to men’s health. Due to the high heterogeneity of the results and with scanty literature in this specific domain, we are uncertain about their actual effect. However, well-designed RCTs with a larger sample size would be beneficial in closely examining the effect of MRPs on CRS and CRC.

Race talk: How racial worldview impacts discussions in interracial relationships

Using a mixed-method approach, this study investigates how individuals believe race impacts their interracial relationship. Two-hundred and three individuals representing diverse racial-gender compositions of relationships responded to a series of measures to assess their Racial Worldview—a collective of notions about racial/ethnic identity, intergroup relations, and recognition of racist hegemony—before indicating the ways in which race or racial issues affect their romantic partnership. Results revealed four distinct types of Racial Worldview through K-means cluster and four broad themes of influences on relationship communication and functioning. Cross-tabs analyses indicated that Racial Worldview and participants perceptions of the impact of race were related with statistically significant differences between those who acknowledge racism and valued group differences reaching different conclusions than those who do not. The results add to existing research by drawing attention to the heterogeneity of thought and understanding within interracial relationships. The promise of using Racial Worldview in future research is discussed.

The Challenges of Ethical Behaviors for Drug Supply in the Iran Pharmacies by Principles-Based Approach

Background: Pharmacists as the trustee of pharmacy services must adhere to ethical principles and evaluate their professionalism. Pharmacists may sometimes show different unethical behaviors in their interactions, so it is essential to understand these behaviors. The present study aimed to determine the challenges of ethical behaviors based on a principles-based approach in the area of drug supply in pharmacies.Methods: This qualitative content analysis was conducted in Kerman in 2018. Several key players in the field of medication supply were selected using snowball sampling to be interviewed. An effort was made to select samples with maximum variation. Exclusion criteria include having less than 3 years of experience in pharmacy and supervision, not willing to participate in the interview, and canceling the interview 3 times. The participants in this study consisted of pharmacy technicians (n=5), patients (n=6), pharmacists (n=8), inspectors of insurance companies (n=4), and inspectors of food and drug administration (n=3). Data were analyzed using directed content analysis by Maxqda software version 10 (VERBI Software, Berlin, Germany). The principles of the “Beauchamp and Childress Ethics” theory including autonomy, beneficence, non-maleficence, and justice were selected as the main principles. Results: After data analysis, 8 main categories and 26 subcategories were obtained. The main categories include patient privacy, patient independence, communication principles, patient-centered services, drug supplier, patient harm avoidance, supervision, and distributive, procedural, and interactive justice. The subcategories include increasing patient awareness, culturizing prescription, and rational drug use, confidentiality and privacy, and pharmacist-patient relationship/communication, which were the biggest ethical challenges in the area of drug supply at pharmacies. Conclusions: According to the Principles-based approach, two principles of autonomy and beneficence had the greatest challenges. The policymakers in the health care system should emphasize patient independence, patient privacy, and patient-centered services. The results of this study can be used as a tool to introduce ethical challenges to policymakers and develop educational contents, the charter of professional ethics in pharmacies, and measures of pharmacy accreditation.