Six case studies on nursing home staff attitudes to patient autonomy have been analysed. The case studies are based on six polarities within autonomy, as developed by Collopy. In total, 189 professional caregivers, comprising the staff of 13 nursing homes in the county of Stockholm, Sweden, responded to questions based on the case studies. Results show that the attitudes within each professional category had a high level of internal correspondence. Nurses consistently supported patient preferences to the (...) highest degree, followed by assistant nurses and auxiliary staff. Nurses' aides ranked lowest in supporting patient preferences. In only one of the cases were background variables of significance. (shrink)

To ensure ethical employee behavior, companies often utilize several forms of mostly one-way communication such as codes of conduct. The extent to which these efforts, in addition to informing about the company stance on ethics, are able to positively influence behavior is disputed. In contrast, research on business ethics communication and behavior indicates a relatively clear, positive link between open workplace dialogue about ethical issues and ethical conduct. In this article, I therefore address the question: What influences employee attitudes (...) to talking openly about ethical issues? Answers are proposed on the basis of focus group interviews with staff at the Denmark and Brazil affiliates of the global healthcare company Novo Nordisk. It was found that interest in discussing ethical issues was influenced by two main factors: employee conceptualizations of business ethics and the level of inter-collegial trust, credibility, and confidence. In this article, by examining these phenomena, I aim at providing insight that can both inform scholars in these fields as well as help managers in their attempts to promote open workplace dialogue about ethical issues. (shrink)

Adherence to ethical principles in clinical research and practice is becoming topical issue in China, where the prevalence of mental illness is rising, but treatment facilities remain underdeveloped. This paper reports on a study aiming to understand the ethical knowledge and attitudes of Chinese mental health professionals in relation to the process of diagnosis and treatment, informed consent, and privacy protection in clinical trials.

The management of an infant after a decision to withdraw active treatment creates dilemmas. Both lingering death and active killing are undesirable, but palliative interventions can hasten death. We investigated what staff on our neonatal unit thought were the limits of acceptable practice and why. We administered a structured interview to elucidate their views, and asked them to justify their answers. The interviews were analysed quantitatively and qualitatively. A total of 25 participants (15 nurses and 10 doctors) were recruited. (...) 80% emphasized the importance of pain relief following withdrawal, 60% mentioned meeting parental needs at that time. 76% agreed that death can be a desired consequence of withdrawal, yet 52% felt that death should never be hastened. 96% felt that morphine is acceptable after withdrawal, and 72% would give a higher than normal dose if necessary. 56% would stop paralysis at extubation but not reverse it, while 24% would continue paralysis. 16% would consider a drug that ended life instantly in some cases. A wide variety of views emerged, but there were two main positions, a cautious majority, and a more proactive minority. Apparent contradictions within the majority position could be explained using the doctrine of double effect and the acts and omissions distinction. (shrink)

Objectives: After years of public discussion too little is still known about willingness to accept the idea of writing an advance directive among various groups of people in EU countries. We investigated knowledge about and willingness to accept such a directive in cancer patients, healthy controls, physicians, and nursing staff in Germany.Methods: Cancer patients, healthy controls, nursing staff, and physicians were surveyed by means of a structured questionnaire.Results: Only 18% and 19% of the patients and healthy controls respectively, (...) and 10% of the medical staff had written an advance directive. However, 50–81% of those surveyed indicated that they wished to write one. This intention was associated with deteriorating health . Only 29% of the healthy controls and 43% of the patients knew about the possibility of appointing a health care proxy. A majority in all groups believed that advance directives may influence the course of treatment , yet half of those surveyed in all groups fear that patients could be pressurised into writing an advance directive, and 38–65% thought that relatives could abuse such documents.Conclusions: Only a minority of the participants had written an advance directive and knew about the possibility of authorising a health care proxy. Deteriorating health was associated with increasing willingness to make a directive. Despite a majority belief that advance directives may influence treatment at the end of life, other factors limit their employment, such as fear of abuse. (shrink)

The aim of the article is to study the level of knowledge and declared behaviour towards the environment among academic teachers at one of the Polish universities. In the theorertical part the main assumptions of the grounded theory are presented. Next, research methodology is presented. The research was conducted in September 2017 among twenty academic teachers in the faculty of humanisties and natural sciences. As the result of the analyses of the data, two hypotheses were verified. They concerned knowledge and (...) attitudes. Academic teachers of the natural sciences presented broader natural knbowledge than the academic teachers of the humanities. The declared behaviour of respondents did not depend on the state of their knowledge. Both naturalists and humanists advocated for the need to protect environment and take action for the environment. As the result of the analysis two hypotheses were adopted. (shrink)

BackgroundFamily presence during adult cardiopulmonary resuscitation is still not widely implemented. Based on empirical evidence, various national and international professional organizations recommend allowing relatives to be present during resuscitation. However, healthcare providers worldwide are still reluctant to make it standard care.PurposeThis paper is a part of an ongoing cross-cultural study that aims to solicit attitudes of healthcare providers working in emergency departments towards family presence during cardiopulmonary resuscitation. This paper reports the qualitative data from surveying healthcare providers working in (...) an emergency department at a university-affiliated hospital in Singapore.MethodHealthcare workers were asked to fill out an online survey, including both quantitative and qualitative questions. Their attitudes were critically analyzed and compared with existing empirical data.ResultsMajority of healthcare workers believed that relatives should not be present during c... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Summaries and CommentsElizabeth C. Shaw, Staff*, and James ChamberlainBAGGINI, Julian. The Great Guide: What David Hume Can Teach Us about Being Human and Living Well. Princeton, N.J.: Princeton University Press, 2021. 319 pp. Cloth, $24.95; paper, $19.95Throughout this engaging and accessible book, Julian Baggini encourages his readers to treat the life and works of David Hume as a "model of how to live." Baggini presents summaries of Hume's (...) most famous philosophical arguments, along with biographical details about Hume's life, but always with the aim of learning from Hume about living well. He also discusses his own visits to several locations of importance to Hume.Over the course of The Great Guide, Baggini suggests many "Humean maxims and aphorisms" related to the good life. Some are drawn from Hume's own writings, such as the maxim that "the greatest part of mankind float betwixt vice and virtue." Others are arrived at by considering aspects of Hume's own life and character, including his failings. For example, after considering Hume's racism, Baggini clearly has his own admiration for Hume in mind when he suggests the maxim "never slavishly follow even the greatest minds, for they too have prejudices, weaknesses, and blind spots."Baggini begins by describing those parts of Edinburgh and southern Scotland that Hume would have known in his youth. He recounts the young Hume's rejection of religious belief and of the Stoic project of attempting to find happiness by making oneself independent of others. However, Baggini notes, Hume never rejected the racist views he expressed in his essay "Of National Characters." Baggini argues that, although we should condemn Hume's views, we should treat his possession of these views primarily as evidence of the extent to which we are all socially conditioned. In Baggini's view, Hume's empiricist commitments are such that, were he to be alive today, experience would lead him to reject racism. Baggini thus aims to excuse Hume, at least somewhat, without excusing his racism.In chapter 2, Baggini follows Hume to La Flèche, in France's Loire valley, where Hume wrote most of his Treatise of Human Nature. As well as providing an account of Hume's time there, Baggini summarizes Hume's arguments about miracles, reason, and causation. He approvingly [End Page 809] notes Hume's skeptical conclusions concerning miracles, which he takes to demonstrate Hume's insistence on philosophizing only about the world as it really is. Baggini treats Hume's conclusions about cause and effect as significantly less skeptical. Although he observes that some scholars deny this, Baggini understands Hume to assert that causation is a "real power." His is a clear and helpful introduction to Hume's arguments concerning cause and effect, but readers of the relevant passages might hope for a little more discussion of what certainly appear to be Hume's skeptical claims about causal powers.Chapter 3 examines Hume's arguments about free will and personal identity, via a discussion of the complex factors which shaped his identity as a man of letters. Baggini observes Hume's sociability and his satisfaction in his success. He also commends Hume's broad-minded approach to philosophy and his willingness to write a wide variety of essays and, eventually, historical works.In chapter 4, Baggini discusses Hume's relationship with Paris. Returning to the topic of Hume's broad understanding of philosophy, Baggini argues that many of Hume's greatest insights were psychological ones. By comparing Hume's views on religion with the fervent atheism of the French philosophes, Baggini admiringly stresses Hume's moderation and his denial of any knowledge about "the ultimate ground of being." Since Hume believed he knew no more about the origins of the universe than anyone else, Baggini argues, he was able to develop friendships with and respect for moderate religious thinkers, as many philosophes were not. However, Baggini also suggests that Hume's "conservative instincts" sometimes led him astray, as where he "broadly endorsed the patriarchal attitudes of his time."Chapter 5 begins with an account of the dispute between Hume and Jean-Jacques Rousseau, which then forms the background for a discussion... (shrink)

The use of coercion is morally problematic and requires an ongoing critical reflection. We wondered if not knowing or being uncertain whether coercion is morally right or justified (i.e. experiencing moral dou...

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:An Exposition of The Divine Names, The Book of Blessed Dionysius by Thomas AquinasMichael J. Rubin, Elizabeth C. Shaw, and Staff*AQUINAS, Thomas. An Exposition of The Divine Names, The Book of Blessed Dionysius. Translated and edited with an introduction by Michael A. Augros. Merrimack, N.H.: Thomas More College Press, 2021. xxv + 549 pp. Cloth, $65.00The profound influence that Pseudo-Dionysius had on Aquinas’s thought, especially in his (...) metaphysics of participation and his apophatic theology, has been known for some time now, thanks to the excellent work of such scholars as Fran O’Rourke. One would therefore think that Aquinas’s Exposition of the Divine Names (his only commentary on the works of Pseudo-Dionysius) would have been translated a lot sooner. This delay is assuredly due not just to the difficulty of translating this work but also to a certain embarrassment felt by Thomists over Aquinas’s sincere belief that the “Dionysius” who wrote the Divine Names was the Areopagite whose conversion at the teaching of St. Paul is mentioned in the Acts of the Apostles. That the author calling himself “Dionysius” was in fact a theologian writing in the fifth or sixth centuries has been well established by modern scholarship. Hence, Thomists may have felt tempted to discount or at least pass over the influence of this author on Aquinas since it is discomfiting to think that the Church’s greatest theologian accorded such authority to an imposter.Michael Augros tackles these concerns head-on in the excellent introduction to his new translation of the Divine Names commentary. First, Augros points out that in past centuries a pseudonym was usually not an act of forgery but, rather, a way of concealing the author’s identity, which an early Christian theologian might well decide to do either out of humility or out of a desire “to avoid provoking certain prejudices” in those who disagreed with him in contemporary theological disputes. Moreover, it is likely that the work was never intended for the general public (who could easily mistake the pseudonym as genuine) but, rather, was written for those “already initiated in a particular Neoplatonic school of Christian theology,” who would recognize the author as being “one of their own” but without knowing his precise identity. Finally, in taking the particular name of “Dionysius,” the author of the Divine Names was indicating his intention for the work: Just as the biblical Dionysius was a Greek philosopher who converted to Christianity, so the works of Pseudo-Dionysius [End Page 345] are an attempt to reconcile Greek philosophy with the Christian faith.It therefore seems likely, as Augros observes, that Aquinas would still have accorded a great deal of respect to the Divine Names even if he had learned the truth of the author’s identity. The work would not have had the same deuterocanonical authority for him that comes with being written by a direct disciple of St. Paul himself, but “the inherent cogency, coherence, and beauty” of Pseudo-Dionysius’s theology would have been the same. Hence, Pseudo-Dionysius would surely have earned from Aquinas the “docile attitude” appropriate “for a philosopher and theologian of the first order, such as Boethius.”That Aquinas was right to see the author of the Divine Names as a master philosopher and theologian becomes evident when one dives into the text itself, in which Aquinas sees a truly dazzling order, both externally and internally. According to Aquinas, the Divine Names discusses those truths about God of which there are intelligible likenesses in creatures, such as goodness or wisdom, whereas the truths about God of which there are sensible likenesses (for example, “when God is called a lion, or a rock”) are treated by Pseudo-Dionysius in The Symbolic Theology; meanwhile, in the lost or fictional work The Divine Characteristics, Dionysius claims to have treated those truths about God (such as the Trinity) that cannot be known through any likenesses in creatures.Aquinas finds a still more intricate order within the Divine Names itself. Since this work is dedicated to “the divine names by which the processions of God to creatures are manifested,” the plan of the work... (shrink)

The purposes of research were to describe the neonatal clinicians' personal views and attitudes on neonatal ethical decision-making, to identify factors that might affect these attitudes and to compare the attitudes between neonatal physicians and neonatal nurses in Taiwan. Research was a cross-sectional design and a questionnaire was used to reach different research purposes. A convenient sample was used to recruit 24 physicians and 80 neonatal nurses from four neonatal intensive care units in Taiwan. Most participants agreed (...) with suggesting a do not resuscitate (DNR) order to parents for dying neonates (86.5%). However, the majority agreed with talking to patients about DNR orders is difficult (76.9%). Most participants agree that review by the clinical ethics committee is needed before the recommendation of ‘DNR’ to parents (94.23%) and nurses were significantly more likely than physicians to agree to this (p=0.043). During the end-of-life care, most clinicians accepted to continue current treatment without adding others (70%) and withholding of emergency treatments (75%); however, active euthanasia, the administration of drug to end-of-life, was not considered acceptable by both physicians and nurses in this research (96%). Based on our research results, providing continuing educational training and a formal consulting service in moral courage for neonatal clinicians are needed. In Taiwan, neonatal physicians and nurses hold similar values and attitudes towards end-of-life decisions for neonates. In order to improve the clinicians' communication skills with parents about DNR options and to change clinicians' attitudes for providing enough pain-relief medicine to dying neonates, providing continuing educational training and a formal consulting service in moral courage are needed. (shrink)

Background The aim of the study is to assess the knowledge, attitudes and practices among healthcare professionals in Barbados in relation to healthcare ethics and law in an attempt to assist in guiding their professional conduct and aid in curriculum development. Methods A self-administered structured questionnaire about knowledge of healthcare ethics, law and the role of an Ethics Committee in the healthcare system was devised, tested and distributed to all levels of staff at the Queen Elizabeth Hospital in (...) Barbados (a tertiary care teaching hospital) during April and May 2003. Results The paper analyses 159 responses from doctors and nurses comprising junior doctors, consultants, staff nurses and sisters-in-charge. The frequency with which the respondents encountered ethical or legal problems varied widely from 'daily' to 'yearly'. 52% of senior medical staff and 20% of senior nursing staff knew little of the law pertinent to their work. 11% of the doctors did not know the contents of the Hippocratic Oath whilst a quarter of nurses did not know the Nurses Code. Nuremberg Code and Helsinki Code were known only to a few individuals. 29% of doctors and 37% of nurses had no knowledge of an existing hospital ethics committee. Physicians had a stronger opinion than nurses regarding practice of ethics such as adherence to patients' wishes, confidentiality, paternalism, consent for procedures and treating violent/non-compliant patients (p = 0.01) Conclusion The study highlights the need to identify professionals in the workforce who appear to be indifferent to ethical and legal issues, to devise means to sensitize them to these issues and appropriately training them. (shrink)

Objective To determine the knowledge and attitudes of healthcare personnel regarding the provision of non-beneficial futile care in the intensive care units at the major public hospitals in Trinidad and Tobago. Method Prospective data collection was done using a questionnaire administered to the medical and nursing staff of the intensive care units. The questionnaire was designed to capture the opinions regarding the futile care offered to terminally ill patients at the intensive care units. The responses were based on (...) a five-point Likert scale. The influence of factors such as age, gender, duration of work experience, religious belief, ethnicity, occupational category and educational status on the responses were analysed. Results A total of 274 completed responses were obtained from doctors and nurses. The frequency with which the respondents encountered ethical or legal problems in the intensive care unit varied widely from ‘daily’ to ‘yearly’. The majority felt that knowledge of ethics is important, and only 32% knew the legal issues pertaining to their work. Eighty percent of doctors and nurses had no knowledge of an existing Hospital Ethics Committee and its role in ethical dilemmas. Although 62% said their decisions regarding futile care will be influenced by their scientific knowledge, only 32% agreed to withdraw care. Eighty percent said that the government should pass appropriate laws regarding withdrawal of futile care. Conclusions Most healthcare providers in intensive care unit are not knowledgeable in the ethical and legal issues of non-beneficial futile care. There is a need to devise means to bring awareness and educate intensive care unit healthcare providers in this subject. (shrink)

The article attempts to provide a practical analysis of the psychological basis for the incentives of personality motivation in education managers. In particular, it highlights the results of an empirical study of motivational techniques for normative and value attitudes of education managers in terms of management. It justifies the opinion that leaders of the organizations with strong cooperation between staff and administration and united by a common desire for success, are dominated by the category “hope for success”. And (...) the leaders of such organizations where subordinates are in constant fear of dismissal and under sharp criticism regardless of their work quality, are dominated by the “fear of failure”. It emphasizes the idea that education managers should try to develop “hope for success”. This applies to both men and women, regardless of their work experience. It points out the need to practice methods of overcoming “blame and criticism caused by failure to succeed”. This is especially true for women with over 5 years work experience. It is also worth creating a sense of work efficiency with a positive hope and to overcome manifestations of immorality and injustice to subordinates. Considerable attention in scientific research is paid to the importance of the spiritual component in the personality of modern managers, which requires further study. (shrink)

The aim of this study was to reveal doctors' and nurses' attitudes to euthanasia in intensive care units and surgical, internal medicine and paediatric units in Turkey. A total of 205 doctors and 206 nurses working in several hospitals in Istanbul participated. Data were collected by questionnaire and analysed using SPSS v. 12.0. Significantly higher percentages of doctors (35.3%) and nurses (26.6%) working in intensive care units encountered euthanasia requests than those working in other units. Doctors and nurses caring (...) for terminally ill patients in intensive care units differed considerably in their attitudes to euthanasia and patient rights from other health care staff. Euthanasia should be investigated and put on the agenda for discussion in Turkey. (shrink)

Utilising science and technology to maximize human performance is often an essential feature of military activity. This can often be focused on mission success rather than just the welfare of the individuals involved. This tension has the potential to threaten the autonomy of soldiers and military physicians around the taking or administering of enhancement neurotechnologies (e.g., pills, neural implants, and neuroprostheses). The Hybrid Framework was proposed by academic researchers working in the U.S. context and comprises “rules” for military neuroenhancement (e.g., (...) ensuring transparency and maintaining dignity of the warfighter). Integrating traditional bioethical perspectives with the unique requirements of the military environment, it has been referenced by military/government agencies tasked with writing official ethical frameworks. Our two-part investigation explored the ethical dimensions of military neuroenhancements with military officers – those most likely to be making decisions in this area in the future. In three workshops, structured around the Hybrid Framework, we explored what they thought about the ethical issues of enhancement neurotechnologies. From these findings, we conducted a survey (N = 332) to probe the extent of rule endorsement. Results show high levels of endorsement for a warfighter’s decision-making autonomy, but lower support for the view that enhanced warfighters would pose a danger to society after service. By examining the endorsement of concrete decision-making guidelines, we provide an overview of how military officers might, in practice, resolve tensions between competing values or higher-level principles. Our results suggest that the military context demands a recontextualisation of the relationship between military and civilian ethics. (shrink)

Background: Admission to a nursing home does not necessarily diminish an older person’s desire for sexual expression and fulfillment. Given that nursing staff directly and indirectly influence the range of acceptable sexual expressions of nursing home residents, their knowledge and attitudes toward aged sexuality can have far-reaching effects on both the quality of care they provide to residents and the self-image and well-being of these residents. Research objectives: To investigate nursing staff’s knowledge and attitudes toward aged (...) sexuality, to determine whether certain sociodemographic factors of the nursing staff relate to their knowledge and attitudes toward later-life sexuality, and to examine the relationship between knowledge and attitudes. Research design: Descriptive cross-sectional survey study. Research participants and research context: The administered questionnaire collected sociodemographic data and data from an adapted, Dutch version of the Aging Sexual Knowledge and Attitudes Scale. Data were collected from November 2011 through April 2012. A total of 43 geographically dispersed nursing homes in Flanders, Belgium, participated. Out of a potential research sample of 2228 nursing staff respondents, 1166 participated. Ethical considerations: The study protocol was approved by the Ethics Committee of the Faculty of Medicine of the KU Leuven. Findings: Nursing staff appeared to be moderately knowledgeable about aged sexuality and displayed a rather positive attitude toward sexuality in older people. Significant relationships between various variables were found both at univariable and multivariable levels. Knowledge and attitudes proved to be positively related, indicating that a higher level of knowledge of aged sexuality is associated with a more positive attitude toward sexuality in later life. Discussion: Research findings are discussed within a broader international context. Conclusion: There is room for improvement for both nursing staff’s knowledge and attitudes toward aged sexuality. This might be aided by appropriate educational interventions. Our results identified different target groups of nursing home staff for these interventions. (shrink)

Background:Admission to a nursing home does not necessarily diminish an older person’s desire for sexual expression and fulfillment. Given that nursing staff directly and indirectly influence the range of acceptable sexual expressions of nursing home residents, their knowledge and attitudes toward aged sexuality can have far-reaching effects on both the quality of care they provide to residents and the self-image and well-being of these residents.Research objectives:To investigate nursing staff’s knowledge and attitudes toward aged sexuality, to determine (...) whether certain sociodemographic factors of the nursing staff relate to their knowledge and attitudes toward later-life sexuality, and to examine the relationship between knowledge and attitudes.Research design:Descriptive cross-sectional survey study.Research participants and research context:The administered questionnaire collected sociodemographic data and data from an adapted, Dutch version of the Aging Sexual Knowledge and Attitudes Scale. Data were collected from November 2011 through April 2012. A total of 43 geographically dispersed nursing homes in Flanders, Belgium, participated. Out of a potential research sample of 2228 nursing staff respondents, 1166 participated.Ethical considerations:The study protocol was approved by the Ethics Committee of the Faculty of Medicine of the KU Leuven.Findings:Nursing staff appeared to be moderately knowledgeable about aged sexuality and displayed a rather positive attitude toward sexuality in older people. Significant relationships between various variables were found both at univariable and multivariable levels. Knowledge and attitudes proved to be positively related, indicating that a higher level of knowledge of aged sexuality is associated with a more positive attitude toward sexuality in later life.Discussion:Research findings are discussed within a broader international context.Conclusion:There is room for improvement for both nursing staff’s knowledge and attitudes toward aged sexuality. This might be aided by appropriate educational interventions. Our results identified different target groups of nursing home staff for these interventions. (shrink)

The research reported in this article examined the influence of nurses’ attitudes, subjective norms and perceived behavioral control on maintaining patients’ privacy during hospitalization. The data were gathered from 109 nurses in six internal medicine wards at an Israeli hospital. The research was based on the theories of reasoned action and planned behavior. A positive and significant correlation was shown between nurses’ attitude to promoting and maintaining patient privacy and their planned behavior, while perceived behavioral control was the best (...) variable for predicting the nurses’ behavior. Better educated nurses believed that they had fewer resources and anticipated more obstacles in acting to promote and maintain patient privacy. This research adds a new dimension to what is already known about nurses’ attitudes to maintaining patients’ privacy, nurses’ planned behavior and their actual behavior. The practical implications of the findings are the identification of factors that influence the attitudes and behavior of nursing staff, which, in turn, will enable allocation of resources for solving difficulties and removing obstacles. The results will allow the formulation of educational programs to guide staff and also the application of policies based on both patient and nursing staff needs. (shrink)

ObjectivePatient involvement is used to describe the inclusion of patients as active participants in healthcare decision-making and research. This study aimed to investigate incoming year 1 medical (MBChB) students’ attitudes and opinions regarding patient involvement in this context.MethodsWe established a staff–student partnership to formulate the design of an online research survey, which included Likert scale questions and three short vignette scenarios designed to probe student attitudes towards patient involvement linked to existing legal precedent. Incoming year 1 medical (...) students (n=333) were invited to participate in the survey before formal teaching commenced.ResultsSurvey data (49 participants) indicate that students were broadly familiar with, and supportive of, patient involvement in medical treatment. There was least support for patient involvement in conducting (23.9%), contributing to (37.0%) or communicating research (32.6%), whereas there was unanimous support for patients choosing treatment from a selection of options (100%).ConclusionIncoming members of the medical profession demonstrate awareness of the need to actively involve patients in healthcare decision-making but are unfamiliar with the utility and value of such involvement in research. Further empirical studies are required to examine attitudes to patient involvement in healthcare. (shrink)

A self-designed questionnaire was given to 634 health professionals in a large teaching hospital in Hubei Province in mainland China, to clarify the participants’ attitude towards information disclosure to cancer patients. Statistic description was used to analyze the data. The item ‘inappropriate information about cancer easily leads to medical disputes’ scored highest at 3.86, while the scores of such items as ‘advantages of fully informing patients outweigh disadvantages’, ‘if their family members demand nondisclosure, you will find it difficult to cooperate (...) in good faith with patients’, and ‘telling white lies to patients disturbs you a lot’ were less than 3. The health care staff placed a high value on both the desire and priority of patients to know the truth, though most of them did not think that patients had received enough information about their disease. In order to improve cancer patients’ current state of knowledge, health professionals should learn more about informed consent, and special methods and guidelines compatible with Chinese culture are urgently required in China. (shrink)

Within the context of structural theories this paper examines what health professionals say about their clinical service structures. We firstly trace various conceptual perspectives on clinical service structures, discussing multiple theoretical axes. These theories question whether clinical service structures represent either superficial or more profound changes in hospitals. We secondly explore which view is supported though a content analysis of the free text responses of 111 health professionals (44 doctors, 45 nurses and 22 allied health practitioners) about their clinical service (...) structures in a questionnaire survey in two large hospitals that had implemented clinical service structures three years previously. Commentaries unfavourable toward clinical service structures were made by 47.7% of staff, favourable by 24.3%, mixed (both favourable and unfavourable) by 17.1% and non-evaluative statements were made by 10.8%. The most frequent criticisms were inefficient organisation of change (27%), poor management (24.3%), lack of cooperation between staff (15.9%) and failure to empower health practitioners (13.5%). All professions made more negative than positive evaluations of their clinical service structures but the ratio was highest for doctors and lowest for allied health. Ranking of nurses' and allied health staffs' specific evaluations were similar but both differed significantly from doctors.' Unfavourable or negative comments predominated, and change appears more superficial and less profound than advocates of structural contributions hope. Four types of belief systems about clinical service structures are apparent. Some study participants are disposed toward the status quo; others toward restructuring; yet others are team oriented; and a final group is tribally oriented. The implication of this paper for managers is that more work is needed if clinical service structures are to realise the promise of more multi-disciplinarity and less fragmentation across professional groups. For scholars, the implication is that marrying different theoretical frames with empirical data can serve to produce fresh perspectives and perhaps new insights. (shrink)

The purpose of this study was to develop the OL-IAT, an IAT tool that measures implicit attitudes toward organizational loyalty, and to verify its predictive validity. In total, 15 respondents were randomly selected from among the employees of P Company. The respondents were then asked open questions about the image they held of the target company. Based on their responses, a list of words was compiled for use on the OL-IAT. Evaluation categories, either like-dislike or positive-negative, were developed for (...) this test based on the approach-avoidance words proposed by Ostafin and Palfai. The OL-IAT was then administered to 127 employees of Company P, and self-reporting measures were also devised to measure explicit attitudes. A survey of whether the implicit attitude toward organizational loyalty was consistent with the explicit attitude showed that there was no significant correlation, and the attitude inconsistency was evident in the responses. When differences in rank were accounted for, organizational loyalty attitudes were consistent at the manager level, and organizational participation attitudes were consistent at the manager and general staff levels. This study will aid in the development of effective measures of organizational loyalty and accelerate interventions to increase it, which in turn will positively impact long-term organizational growth. (shrink)

The abundance of information technology and electronic resources for academic materials has contributed to the attention given to research on plagiarism from various perspectives. Among the issues that have attracted researchers’ attention are perceptions of plagiarism and attitudes toward plagiarism. This article presents a critical review of studies that have been conducted to examine staff’s and students’ perceptions of and attitudes toward plagiarism. It also presents a review of studies that have focused on factors contributing to plagiarism. (...) Our review of studies reveals that most of the studies on perceptions of plagiarism and attitudes toward plagiarism lack an in-depth analysis of the relationship between the perceptions of plagiarism and other contextual, sociocultural and institutional variables, or the relationship between attitudes toward plagiarism and students’ perceptions of various forms of plagiarism. Although our review shows that various factors can contribute to plagiarism, there is no taxonomy that can account for all these factors. Some suggestions for future research are provided in this review article. (shrink)

Mass testing is one COVID-19 pandemic response strategy. The effect of population-wide testing programs is influenced by public attitudes toward COVID-19 viral tests. However, the public’s attitudes toward mass testing and related factors in mainland China are not adequately understood. This study focuses on pandemic responses during the first wave of the Delta variant outbreak in southern China and explores how residents responded to population-wide mass COVID-19 testing programs. The research relies on data collected from short videos recording (...) residents’ experiences of being in lockdown, media reports, and semi-structured interviews. Thematic analysis was used to analyze the data, and four themes emerged: public attitudes toward mass testing, the technology of viral tests, policy and governance, and cultural practices. The study finds that residents actively participated in mass testing campaigns as mass viral tests are associated with hope and trust. The Reverse Transcription–Polymerase Chain Reaction (RT-PCR), negative test results, lockdown policies, waiting times, medical staff, and media representations are all actors that assemble and mobilize hope and trust. The research reveals some critical factors influencing people’s attitudes toward mass testing policies in response to COVID-19 and provides practical suggestions for public health professionals in rolling out effective population-wide mass COVID-19 testing. (shrink)

Lesbian, gay, bisexual, trans and/or queer (LGBTQ) people experience profound health and social care inequalities. Research suggests that staff with negative attitudes towards LGBTQ people, are more likely to hold strong, traditional, religious beliefs. This article reports on a single case study with a newly qualified UK nurse who has since left the National Health Service. This is based on a single interview taken from a larger dataset derived from a funded scoping research study exploring religious freedoms, sexual (...) orientation and gender identity rights in older age care spaces. The interviewee described a toxic nursing culture on a hospital ward for older people. She recounted various incidents involving homophobic and transphobic practice and LGBTQ microaggressions which reportedly impacted the quality of nursing care. The findings are considered in relation to standards for anti-oppressive practice in nursing care, and how nursing students and staff can be supported in addressing practice relating to equality and diversity issues, specifically LGBTQ issues. They confirm the direct significance of addressing the needs and circumstances of LGBTQ people in nursing curricula and ongoing professional practice, and the need to further research, evaluate and progress translation of learning into improved quality care for diverse populations. (shrink)

University staff play an important role in the development of a more sustainable world. Their attitudes towards pro-environmental behavior and environmental values likely have an influence on ethics, the current society and future generations. Therefore, this study aims to measure and interpret the ecological worldview among university staff using the validated New Environmental Paradigm (NEP) survey. The mean NEP-score was 3.68. This overall value is of the same magnitude as many samples from diverse geographical areas with representatives (...) and students, but it is considerably lower than for environmentalists. The facet Balance of nature reported the highest score whereas Limits to growth the lowest score. Women had higher mean score, mainly explained by the higher score in the facet Human domination over nature. There is a potential for improving the ecological world-view scores of University staff, who are an unstudied and important group. Values in higher education may influence sustainable development, environmental ethics and society. (shrink)

Background: Neonatal nurse practitioners have become the frontline staff exposed to a myriad of ethical issues that arise in the day-to-day environment of the neonatal intensive care unit. However, ethics competency at the time of graduation and after years of practice has not been described. Research aim: To examine the ethics knowledge base of neonatal nurse practitioners as this knowledge relates to decision making in the neonatal intensive care unit and to determine whether this knowledge is reflected in (...) class='Hi'>attitudes toward ethical dilemmas in the neonatal intensive care unit. Research design: This was a prospective cohort study that examined decision making at the threshold of viability, life-sustaining therapies for sick neonates, and a ranking of the five most impactful ethical issues. Participants and research context: All 47 neonatal nurse practitioners who had an active license in the State of Mississippi were contacted via e-mail. Surveys were completed online using Survey Monkey software. Ethical considerations: The study was approved by the University of Mississippi Medical Center Institutional Review Board (IRB; #2015-0189). Findings: Of the neonatal nurse practitioners who completed the survey, 87.5% stated that their religious practices affected their ethical decision making and 76% felt that decisions regarding life-sustaining treatment for a neonate should not involve consultation with the hospital’s legal team or risk management. Only 11% indicated that the consent process involved patient understanding of possible procedures. Participating in the continuation or escalation of care for infants at the threshold of viability was the top ethical issue encountered by neonatal nurse practitioners. Discussion: Our findings reflect deficiencies in the neonatal nurse practitioner knowledge base concerning ethical decision making, informed consent/permission, and the continuation/escalation of care. Conclusion: In addition to continuing education highlighting ethics concepts, exploring the influence of religion in making decisions and knowing the most prominent dilemmas faced by neonatal nurse practitioners in the neonatal intensive care unit may lead to insights into potential solutions. (shrink)

Recently, several states in the US have made it more difficult to receive nonmedical exemptions to school vaccine mandates in the hope of better orienting parents towards vaccination. However, little is known about how public-facing school staff implement and enforce mandate policies, including why or how often they steer parents towards nonmedical exemptions. This study focused on Michigan, which has recently added an additional burden for families seeking nonmedical exemptions. We used an anonymous online survey to assess Michigan public-school (...) employees (n = 157) about their knowledge, attitudes, and behaviors regarding Michigan's school enrollment vaccine mandate policy. Our main conclusions are that frontline school staff are generally knowledgeable about vaccines and immunization policy, but are at best ambivalent about their role in immunization governance, believing that other agents should be responsible for ensuring that children are vaccinated. Furthermore, some respondents indicated low vaccine confidence, which was associated with increased ambivalence about, or opposition to, their role in immunization governance. As more jurisdictions within and beyond the US consider introducing or tightening childhood vaccine mandates, it is increasingly important to understand how these policies can be improved by attending to the attitudes and roles of relevant frontline actors. (shrink)

Background: Publication of ethically uncertain research occurs despite well-published guidelines set forth in documents such as the Declaration of Helsinki. Such guidelines exist to aide editorial staff in making decisions regarding ethical acceptability of manuscripts submitted for publication, yet examples of ethically suspect and uncertain publication exist. Our objective was to survey journal editors regarding practices and attitudes surrounding such dilemmas. Methods: The Editor-in-chief of each of the 103 English-language journals from the 2005 Abridged Index Medicus list publishing (...) original research were asked to complete a survey sent to them by email between September-December 2007. Results: A response rate of 33% (n = 34) was obtained from the survey. 18% (n = 6) of respondents had published ethically uncertain or suspect research within the last 10 years. 85% (n = 29) of respondents stated they would always reject ethically uncertain articles submitted for publication on ethical grounds alone. 12% (n = 4) of respondents stated they would approach each submission on a case-by-case basis. 3% (n = 1) stated they would be likely to publish such research, but only with accompanying editorial. Only 38% (n = 13) give reviewers explicit instruction to reject submissions on ethical grounds if found wanting. Conclusions: Editorial compliance with the Declaration of Helsinki in rejecting research that is conducted unethically was difficult to ascertain because of a poor response rate despite multiple attempts using different modalities. Of those who did respond, the majority do reject ethically suspect research but few explicitly advise reviewers to do so. In this study editors did not take advantage of the opportunity to describe their support for the rejection of the publication of unethical research. (shrink)

Differences in perception and potential disagreements between parents and professionals regarding the attitude for resuscitation at the limit of viability are common. This study evaluated in healthcare professionals whether the decision to resuscitate at the limit of viability are influenced by the way information on incurred risks is given or received. This is a prospective randomized controlled study. This study evaluated the attitude of healthcare professionals by testing the effect of information given through graphic fact sheets formulated either optimistically or (...) pessimistically. The written educational fact sheet included three graphical presentations of survival and complication/morbidity by gestational age. The questionnaire was submitted over a period of 4 months to 5 and 6-year medical students from the Geneva University as well as physicians and nurses of the neonatal unit at the University Hospitals of Geneva. Our sample included 102 healthcare professionals. Forty-nine responders were students, 32 paediatricians and 21 nurses in NICU. The received risk tended to be more severe in both groups compared to the graphically presented facts and current guidelines, although optimistic representation favoured the perception of “survival without disability” at 23 to 25 weeks. Therapeutic attitudes did not differ between groups, but healthcare professionals with children were more restrained and students more aggressive at very low gestational ages. Written information on mortality and morbidity given to healthcare professionals in graphic form encourages them to overestimate the risk. However, perception in healthcare staff may not be directly transferable to parental perception during counselling as the later are usually naïve to the data received. This parental information are always communicated in ways that subtly shape the decisions that follow. (shrink)

Background: Through education, individuals acquire knowledge, skill and attitudes that facilitate professional socialization; it involves intellectual, emotional and psychomotor skill development. Teachers are role models for behaviour modification and value development. Objective: To examine students’ perceptions of faculty members’ ethical and unethical attitudes during interactions in undergraduate nursing. Research design: This descriptive study consisted of two phases. In Phase I, we developed an instrument, which was administered to nursing students to assess validity and reliability. Exploratory factor analysis yielded (...) 32 items. Cronbach’s α was 0.83, and test–retest reliability was good. In Phase II, a 32-item version of the instrument was administered to nursing students from another university. Participants and research context: Participants included 219 nursing students from one university in Phase I and 196 from another university in Phase II. The study was conducted at the universities attended by the participants. Ethical considerations: Ethical approval was granted by the institutions involved, and all participants provided informed consent. Findings: In Phase I, the instrument demonstrated good psychometric properties for measuring nursing students’ perceptions of faculty members’ ethical and unethical behaviours. In Phase II, students considered certain professional and personal qualities, including respecting confidentiality and students’ private lives and assuming an impartial stance during interactions in the classroom, examinations, or clinical practice, ethical. They considered using obscene examples or unprofessional speech during teaching, selling textbooks in class, using university facilities for personal interests, engaging in romantic relationships with students, and humiliating students in front of patients or staff in clinical settings unethical. Conclusion: Results of this study suggest that nurse educators should be aware of their critical role in the teaching–learning process, and they must scrutinize their attitudes towards students from an ethical point of view. (shrink)

The notion of “agent bookkeeping” was proposed when the “Accounting Law of the People’s Republic of China” was updated in 1993. Since their business is specialized in serving small and micro-enterprises, this has created the industry characteristic of generally small in the size of company and low in the salary of employees in Chinese agent bookkeeping companies. Such characteristic results in a series of problems including negative work attitude of employees in the development process, which seriously limit the development of (...) Chinese agent bookkeeping companies. However, issues occurred in the development of agent bookkeeping, such as negative employee attitudes, which severely hampered the growth of Chinese agent bookkeeping companies. Therefore, a model of three dimensions of work attitude has been set up in this paper to demonstrate the working attitude of the staff of the agent bookkeeping companies in China’s Guangdong-Hong Kong-Macao Greater Bay Area, including emotional dimension, behavioral dimension, and cognitive dimension which consists of eight factors: work environment, career satisfaction, interpersonal relationship, role engagement, work vitality, responsibility attitude, emotional identity, and retention attitude. The result indicates that female employees outnumber male ones in agent bookkeeping companies, most employees have a low sense of belonging to the company, limited career development affects employees’ enthusiasm for work, work attitudes are influenced by mediocre work performance among employees with a graduate degree or higher. (shrink)

Dysfunctional customer behavior is common in service settings. For frontline employees, negative encounters can cause short-term despondency or have profound, long-term psychological effects that often result in both direct and indirect costs to service firms. Existing research has explored the influence of dysfunctional customer behavior on employee emotions, but it has not fully investigated the psychological mechanism through which customer misbehavior transforms into employee responses. To maintain service quality and employee well-being, it is important to understand the impact of customer (...) misconduct on employee emotions and its effect on subsequent service behavior. To assess the process through which dysfunctional customer behavior manifests as negative emotions in frontline service employees, and the influence of negative employee emotions on their prosocial service behavior, we surveyed 185 frontline banking service employees. We sought information on service employee experiences, attitudes, and feelings regarding dysfunctional customer behaviors, the perceived level of supervisor support, and employee prosocial service behavior intentions. Structural equation modeling and hierarchical linear modeling were used for statistical analysis and hypothesis verification. Results indicate that dysfunctional customer behavior has a positive relationship with bank service employee negative emotions and a negative influence on employee prosocial service behavior. The study found that negative emotions fully mediated the relationship between dysfunctional customer behavior and prosocial service behavior. The moderating role that perceived supervisor support plays on the relationships between dysfunctional customer behavior and negative emotion was also investigated. The results show that perceived supervisor support moderates the relationship between dysfunctional customer behavior and negative employee emotions. Finally, the study provides bank managers with effective strategies to assist frontline employees to manage and deter dysfunctional customer behavior, and presents employees with internal recovery strategies when encountering dysfunctional customer behavior. (shrink)

Drawing on a survey of nursing staff of nursing homes in a Midwestern state in the United States, the study examines how the relationships between employee—organization value congruence and job attitudes vary between nonprofit and for-profit organizational types. Statistical comparison of the levels of employee value congruence and job attitudes does not suggest significant difference between the two types of employees. Although value congruence is found positively associated with nursing home employees' job satisfaction and organizational commitment, and (...) negatively associated with intent to quit, consistent with prior research, the difference in the magnitude of the relationships between the two types of employees is not found. These findings suggest inconsistency with conventional wisdom of profiling employee value according to organizational ownership type. (shrink)

Academic integrity is becoming increasingly important to managing academic institutions. Accordingly there are efforts to uniformly assess campus attitudes to such issues as cheating in assessments along with the policies and procedures in place to address them. This paper seeks to summarize and understand the attitude of the students and academic staff at an Australian university towards academic integrity, as reflected in the results of a campus-wide survey, using both qualitative and quantitative analysis. The main finding of the (...) quantitative results was the disconnect between academic staff and students belief’s about academic honesty and the reactions of students and academics to dishonest behaviour. Four key themes of academic honesty were identified through qualitative analysis, being those of cheating, student, solutions to cheating and general concerns. (shrink)

Spirituality and spiritual care have long been kept separate from patient care in mental health, primarily because it has been associated with psycho-pathology. Nursing has provided limited spiritual care competency training for staff in mental health due to fears that psychoses may be activated or exacerbated if religion and spirituality are addressed. However, spirituality is broader than simply religion, including more existential issues such as providing non-judgmental presence, attentive listening, respect, and kindness. Unfortunately, healthcare personnel working in mental health (...) institutions are not well prepared to address spiritual concerns or resources of their patients. Therefore, a mixed-method pilot study was conducted using a self-assessment survey tool to examine spiritual care competencies of mental health staff in Norway and to understand the perspectives of mental health staff in the Scandinavian context. Five questions and comments related to survey items provided rich qualitative data. While only a small pilot with 24 participants, this study revealed a need for spiritual care educational materials targeted specifically for those who work in mental health, materials that address the approach of improving attitudes, enhancing skills, and increasing knowledge related to spirituality and spiritual care of patients. (shrink)

Service providers working for a service organization are asked to express such positive emotions as joy, pleasure, and politeness required at the organizational level rather than their natural emotions they are experiencing at the moment. They cannot express their emotion they are actually going through and accordingly, their level of emotional labor and emotional dissonance influence on their job commitment and trust toward their organization. This study thus set out to investigate the effects of leading variables of emotional labor on (...) the level of emotional labor and the impact of emotional labor on organizational trust and organizational commitment with a subject group of college administrative staffs. Three underlying factors such as job stress, intimacy, and professionalism were identified as the determinants of emotional labor. Conceptual background about job stress, intimacy, emotional labor, and organizational effectiveness as the core variables of the study was investigated. Based on the conceptual background and our research questions, 5 research hypotheses and the proposed research model regarding the effects of emotional labor on organizational commitment and trust were developed. We also tried to include the moderating effects of work environment and gender of service providers on the research model. Unlike many different studies on emotional labor from the traditional perspective of service, this study also offers a practical implication by expanding and applying it to the field of college administrative service, which is an area where service providers are in the different working environment from the traditional company work environment. Finally, the managerial implications and the limitations of the study were also discussed. (shrink)

A challenge of performing research in the paediatric emergency and acute care setting is obtaining valid prospective informed consent from parents. The ethical issues are complex, and it is important to consider the perspective of participants, health care workers and researchers on research without prospective informed consent while planning this type of research. We performed a systematic review according to PRISMA guidelines, of empirical evidence relating to the process, experiences and acceptability of alternatives to prospective informed consent, in the paediatric (...) emergency or acute care setting. Major medical databases and grey sources were searched and results were screened and assessed against eligibility criteria by 2 authors, and full text articles of relevant studies obtained. Data were extracted onto data collection forms and imported into data management software for analysis. Thirteen studies were included in the review consisting of nine full text articles and four abstracts. Given the heterogeneity of the methods, results could not be quantitatively combined for meta-analysis, and qualitative results are presented in narrative form, according to themes identified from the data. Major themes include capacity of parents to provide informed consent, feasibility of informed consent, support for alternatives to informed consent, process issues, modified consent process, child death, and community consultation. Our review demonstrated that children, their families, and health care staff recognise the requirement for research without prior consent, and are generally supportive of enrolling children in such research with the provisions of limiting risk, and informing parents as soon as possible. Australian data and perspectives of children are lacking and represent important knowledge gaps. (shrink)

Due to the spread of COVID-19, a key challenge was to reduce potential staff shortages in the healthcare sector. Besides recruiting retired healthcare workers, medical students were considered to support this task. Commitment of medical students in Germany during the COVID-19 pandemic was evaluated using an online survey, with particular focus on their burdens and anxieties. This survey was distributed to students within a 2-week period in April and May 2020. Ultimately, 1241 participants were included in the analysis. During (...) the pandemic, 67.9% of the participants reported that they had volunteered. Furthermore, 88.9% stated that they were against compulsory recruitment in this context. Students who volunteered had a significantly lower anxiety index than non-committed students. Additionally, students were more concerned about infecting other patients and relatives than themselves. Higher levels of anxiety were related to lower levels of commitment. A mandatory assignment during the pandemic was rejected by the students and does not seem to be necessary due to the large number of volunteers. (shrink)

This descriptive study was undertaken to identify the degree of ethical sensitivity of staff nurses and to analyze the differences in ethical sensitivity in terms of both general and ethics-related characteristics. Participants were 236 staff nurses working in general hospitals in Korea. Ethical sensitivity was measured by means of an instrument developed by the researchers. The results showed that the mean score for the degree of ethical sensitivity was 0.71 out of a possible maximum score of 1 (range (...) 0.30 to 0.97). For general characteristics, there was a significant difference in ethical sensitivity according to age (F (df 2233)-3.99, P-0.02). For characteristics related to ethics, there was a significant difference in ethical sensitivity according to attitude towards the nursing profession (F (df 4231)-2.94, P-0.03). It is therefore recommended that a training program reflecting these variables be developed to enhance staff nurses’ ethical sensitivity. (shrink)

Feeding difficulties in older patients who are suffering from dementia present problems with balancing conflicting ethical principles. They have been considered by several writers in recent years, and the views of nursing and care staff have been studied in different contexts. The present study used focus groups to explore the way in which nursing and care staff in a National Health Service trust deal with conflict between ethical principles in this area. Three focus groups were convened, one each (...) from the staff of three wards caring for patients with dementia. Case histories were discussed and transcripts analysed. It emerged that staff were aware of making fine judgements of utility concerning the spectrum of feeding methods available. Informants gave some weight to the principle of autonomy, but sought to balance that against their commitment to care. In explaining their perspectives, informants gave more weight to personal attitudes and trust culture than to professional ethics. (shrink)

The new National Institutes of Health (NIH) Policy on the Use of a Single Institutional Review Board (sIRB) for Multi-Site Research was adopted primarily to simplify and speed the review of complex multisite clinical trials. However, speeding review requires overcoming a number of obstacles. Perhaps the most substantial obstacle is the time and effort needed to develop reliance agreements among the participating sites. We conducted 102 semistructured interviews with sIRB personnel, including directors, chairs, reviewers, and staff, from 20 IRBs (...) that acted as sIRBs for multisite research, including 6 commercial/independent sIRBs, and 10 university-based academic and 4 federal sIRBs. Almost without exception, the interviewees agreed that reliance agreements were complex, difficult to develop, and time-consuming. A major problem for relying sites was that different agreements specified different responsibilities for the relying sites. Attitudes differed about whether these problems will be resolved as IRB staff and managers become more experienced with sIRBs. However it is clear that the process of developing reliance agreements must be simplified. Federal assistance in standardizing at least some sections of reliance agreements might reduce the difficulties involved. (shrink)

Background: Breastfeeding is recognized as the optimal approach to provide essential nutrients and promote the health of infants. Aim: This study aims to assess the nurses’ knowledge in the obstetric unit regarding breastfeeding practices in KFGH. Methods: A descriptive research approach, utilizing a questionnaire to evaluate nurses’ knowledge of breastfeeding best practices was used in this study among nurses who are working at KFGH. Results: Of the total 64 nurses, and majority (39.5%) of them are aged from 26 to 30 (...) years. Most of them (98.4%) were female and 45.3% worked in the Obstetrics and Gynecology department, also, the majority (73.4%) held a Bachelor of Nursing degree. The results showed the attitude among nurses toward the breastfeeding management level was moderate with a mean score of 1.72 while the practice among nurses toward the breastfeeding management level was high with a mean score of 2.66, also, the knowledge among nurses toward the breastfeeding management level was high with mean score 2.36. The results showed there was a significant difference in the attitude level according to nationality (P-value = 0.007), but there was no significant difference according to the other demographic characteristics (age, marital status, department, education, experience, position, Course in obstetrics and Gynecology, and self-experience about breastfeeding). Conclusion: This study's findings gave insights into the current knowledge level of nurses in the obstetric unit regarding breastfeeding practices in KFGH and may contribute to the development of targeted interventions and educational programs to improve breastfeeding support and promotion in the hospital setting. (shrink)

BackgroundPatients’ satisfaction arises from their appraisal of experience in hospital services and measuring patients’ satisfaction in hospital has become a global phenomenon. To improve on patients’ satisfaction, radiographers have to imbibe the right ethical attitude in their conduct while discharging duties to patients during radiological examination. The objective of this study is to understand from the patients’ perspective the ethical conduct of radiographers and radiology nurses that constitute factors in patient satisfaction during routine radiological examination. The rationale of the study (...) is to use the findings to improve radiological service delivery and improve on patient satisfaction.MethodsThis is a cross-sectional descriptive study in which 300 respondents in two hospitals were surveyed to ascertain their satisfaction with the ethical conduct of radiographers and services provided by radiology nurses in the department. The data was analyzed using descriptive statistics at 95 % confidence interval for mean scores and Z-values.ResultsThree hundred patients responded to the survey which comprised of 145 patients from the public hospital and 155 patients from the private hospital. Radiographers fell short in some ethical/professional conduct as in informed consent before treatment ; radiographers’ not explaining his/her experience, expectation, knowledge and equipment procedure. However, they did well in some aspects including observation of professional boundaries with patients during treatment and equity in treatment for the patients during the radiological examination. Some services provided by staff members in the department also fell short of patients’ expectation and satisfaction including explanation of what to expect during the exam, whereas they did well in their level of courtesy to patients. There was a significant difference in the satisfaction level experienced by patients at both hospitals in favour of the private hospital.ConclusionsThere is an urgent need for improved ethical/professional conduct of radiographers and general service delivery in the radiology departments of the hospitals where this investigation was carried out to enhance patient satisfaction. Government has to improve the curricular of service providers in radiology service in the university to include ethical/professional conduct and patient/provider relationship. (shrink)

The academic standing of the staff working in vocational higher education must be judged as unsatisfactory according to two possible criteria: the traditional criteria, which are derived from the universities operating within the previous unitary higher education system; and the criteria outlined by the bill of the Law of Higher Education Institutions. The latter derive from the same historical institutional pattern.There are many reasons to conclude that, academically, in most fields of study, the new institutions do not reach the (...) level of the old ones. However, the mission of the new sector—the second-rank academic institutions in the eyes of the traditional academic community—is at least debatable, if not mistaken. The public university sector appears to be in deep crisis, with academics so attached to the Humboldtian university that they ignore the claims for social relevance in education.8 This is further complicated by deepening financial hardship.Using traditional criteria, it is possible that Estonia will be left with two socially irrelevant higher education sectors, instead of one functioning sector. It is also possible that the second sector, which does not fit these criteria, will be eliminated. However, the fault does not lie wholly with the dominance of traditional university attitudes. It also lies in a lack of vision on the part of the new institutions. As children of the proletariat society, they fail to recognise their vocational orientation as a benefit, and instead try to hide it. They are developing theoretically overloaded four- to five-year study programmes. None of these institutions has solved the problem of balancing the requirement of employing 50 per cent faculty full time and maintaining a satisfactory academic level. The need to demonstrate that part-time employees may actually benefit the vocational sector has not yet been understood.9As long as the sector continues to accept the rules forced upon it by the old universities, it probably has no useful role in Estonia. Its institutions, especially the public institutions, cannot compete with the traditional universities in academic fields. The universities, on the other hand, are beginning to understand that the policy they proclaimed some years ago, which was based on the clear distinction between two sectors on the German pattern, does not work in a small country with very limited resources, and an inheritance from the previous regime of a large university sector with an enrolment rate of more than 20 per cent of the age group. The universities have agreed to offer their own non-degree courses at diploma level, and now seriously threaten the small new institutions. From the financial point of view, the universities' expressed desire to swallow the small vocational institutions is beneficial since the small institutions have no clearly distinct role of their own.The private vocational higher education institutions do not conceal the fact that, according to their own vision, they have little place in the vocational sector. Some of them would like an official status equal to that of the universities, the right to offer graduate and postgraduate courses as well as diploma courses, and the registration of their diplomas and certificates on an equal basis with the public universities in the Register of Diplomas and Certificates at the Ministry of Culture and Education. In other words, they are interested in becoming fully accredited universities. This increases competition for students and—given the Estonian mechanism of public financing of higher education based on the number of students admitted provided by the Ministry of Culture and Education10—there will be less money for public universities. Here lies the origin of the principle that the universities are established by parliament and the vocational higher education institutions by executive action by the government.The existence of the new sector is seriously threatened. The current pattern of postgraduate studies has blocked the preparation of a sufficient number of research-degree holders, even at master's level.11 The new institutions cannot train their own faculty. The recent experience of Concordia International University—which depends greatly on staff with bachelor's and master's degrees from the United States, who form some 80 per cent of the faculty—demonstrates that the participation of first- or even second-rank Western academics in Estonian higher education can never be very high. If the system cannot accept experienced local staff for legal appointments in the vocational sector, unless they have a research degree, these institutions will not survive for long. Society will be back to the position where there are a large number of underpaid or unemployed academics, but a shortage of qualified individuals who could be self-employed and capable of running small and medium-size enterprises. (shrink)

We have examined healthcare staff attitudes of toward a blogging cancer patient who publishes critical posts about her treatment and their possible effect on patient-staff relationships and treatment decisions. We used two versions of a questionnaire containing a vignette based on a modified real case involving a 39-year-old cancer patient who complained on her blog about how she was encountered and the treatment she received. Initially she was not offered a new, and expensive treatment, which might have (...) influenced her perception of further encounters. In one version of the vignette, the team decides to put extra effort into both encounters and offers the expensive new cancer treatment. In the other version, the team decides to follow the clinic’s routine to the letter. Subsequently, blog postings became either positive or negative in tone. We also divided participants into value-neutral and value-influenced groups by asking how their trust in healthcare would be affected if the team’s suggestion were followed. A total of 56 % of the respondents faced with a team decision to ‘do something-extra’ in encounters would act in accordance with this ambition. Concerning treatment, 32 % would follow the team’s decision to offer a new and expensive treatment. A large majority of those who received the “follow-routine” version agreed to do so in encountering [94 % ]. Similar proportions were found regarding treatment [86 % ]. A total of 83 % of the value-neutral participants who received the “do-something-extra” version stated that they would act as the team suggested regarding encounters, while 57 % would do so in regard to treatment. Among the value-influenced participants who received the “do-something-extra” version, 45 % stated that they would make an extra effort to accommodate the patient and her needs, while the proportion for treatment was 22 %. Among those who had received the “follow-routine” version, a large majority agreed, and no difference was indicated between the value-neutral and the value-influenced participants. The present study indicates that healthcare staff is indeed influenced by reading a patient’s critical blog entries, largely regarding encounters, but also concerning treatment is concerned. Value-neutral healthcare personnel seem to exhibit a pragmatic attitude and be more inclined to heed and respond to a patient whose criticism may well be warranted. The study also indicates that healthcare staff is partly positive or negative to future blogging patients depending on how the issue has been framed. For future research we suggest as a bold hypothesis that the phrase “clinical routine” might conceal power aspects masquerading as adopted ethical principles. (shrink)