Nursing & health sciences
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Nursing & health sciences · Dec 2005
Comparative StudyAttitudes toward advance directives and the impact of prognostic information on the preference for cardiopulmonary resuscitation in medical inpatients in Chiang Mai University Hospital, Thailand.
Our previous study revealed that cardiopulmonary resuscitation (CPR) was performed in 65.7% of 411 terminally ill patients who died in a tertiary-care university hospital in northern Thailand. Advance directives (ADs) are needed to ensure that life-sustaining therapies are used more appropriately. To investigate inpatients' attitudes regarding ADs for CPR and the impact of providing prognostic information on treatment preferences for CPR, we interviewed a randomly selected group of 200 ambulatory medical inpatients in multiple sessions. ⋯ The majority preferred to have CPR when no information was provided on the chance of survival. However, this proportion decreased depending on the prognostic scenarios. Our investigation suggested that the preference of patients for CPR should be assessed individually and gradually, with adequate information given on the chance of survival.
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Nursing & health sciences · Dec 2005
Comparative StudyImplementing clinical guidelines for nutrition in a neurosurgical intensive care unit.
Patients in neurosurgical intensive care have individual needs concerning nutrition because of their conditions. An important therapeutic goal is to prevent the development of malnutrition as it contributes to an increase in mortality and enhances the risk of complications in these patients. The health-care team has a mutual responsibility for this, although it is a complex task and a correct assessment of patients' nutritional needs is vital. ⋯ Areas that focused on more practical aspects of nutritional support seemed to have a unified approach, whereas areas on nutritional assessment and routine nutrition orders demonstrated both a lack of knowledge and unclear role responsibilities. The results reveal how different professional groups in health care perceive the implementation of a clinical guideline. Some areas need further clarification, there needs to be continuing development of nutritional guidelines, and education of staff is needed in order to enhance the nutritional care of patients.
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Nursing & health sciences · Jun 2005
ReviewEssentials of research ethics for healthcare professionals.
Whether conducted in a university or the healthcare field, research with human subjects gives rise to a multitude of ethical questions for healthcare professionals. While engaging in ongoing professional development on how to conduct research ethically, both clinicians and scientists need to expand their knowledge to provide answers to the following questions: Which ethical theories serve as a foundation for ethical principles in research ethics? What ethical principles should a researcher respect when conducting research with human subjects? What does it mean to conduct research ethically? What ethical dilemmas are encountered by a researcher in conducting research? This paper provides a review of ethical theories, and the ethical basis of guidelines developed and used to guide human subject research. Ethical behaviors and the personal responsibility of the researcher conducting research with human subjects are discussed along with the ethical considerations in research designs and methods.
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Clinical nursing supervision enables supervisees to reflect on ethically difficult caring situations, thereby strengthening their professional identity, integrating nursing theory and practice, and leading to the development of ethical competence. The aim of this study was to develop an understanding of the core ethical issues of clinical nursing supervision, using previous research as well as philosophical analysis of the theories of three moral philosophers: Harald Ofstad, Richard Hare and Carol Gilligan. ⋯ The findings highlight four important values for the development of a basis for ethical decision-making. These values are caring, dignity, responsibility and virtue.
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Nursing & health sciences · Sep 2004
Multicenter Study Comparative StudyComparative study of perceptions of work environment and moral sensitivity among Japanese and Norwegian nurses.
The aim of the present study was to explore the relationship between work environment and moral sensitivity among Japanese (n = 138) and Norwegian nurses (n = 71), and to compare the results from a sociocultural perspective using a descriptive-correlational design. Data were analyzed using descriptive and inferential statistics. The results point to a significant relationship between work environment and moral sensitivity for both groups of nurses. ⋯ In addition, they ranked the factor 'values in action of patient care' as significant and 'relation to superior and colleagues' and 'job stress and anxiety' ranked significant to 'moral conflicts'. The Norwegian nurses were more independent, which was correlated with moderate significance with 'job stress and anxiety'. A significant correlation was found between 'physical and mental symptoms' and 'moral conflicts' among Norwegian nurses.