Ethics of care in technology-mediated healthcare practices: A scoping review.

BACKGROUND: Introducing new technologies into healthcare practices may challenge professionals' traditional care cultures. The aim of this review was to map how the 'ethics of care' theoretical framework informs empirical studies of technology-mediated healthcare. METHOD: A scoping review was performed using eight electronic databases: CINAHL with full text, Academic Search Premier, MEDLINE, the Philosopher's Index, SocINDEX with Full Text, SCOPUS, APA PsycInfo and Web of Science. This was followed by citation tracking, and articles were assessed against the inclusion criteria. RESULTS: Of the 443 initial articles, 18 met the criteria and were included. We found that nine of the articles used the concept of 'ethics of care' (herein used interchangeably with the terms 'feminist ethics' or 'relational ethics') insubstantially. The remaining nine articles deployed care ethics (or its equivalent) substantially as an integrated theoretical framework and analytical tool. We found that several articles suggested an expansion of ethics of care to encompass technologies as part of contemporary care. Furthermore, ethics of care contributed to the empirical research by recognising both new relationships between patients and healthcare professionals as well as new ethical challenges. CONCLUSION: Ethics of care is sparsely used as a theoretical framework in empirical studies of technology-mediated healthcare practices. The use of ethics of care in technology-mediated care brings new dilemmas, relational tensions and vulnerabilities to the foreground. For ethics of care to be used more explicit in empirical studies, it is important that it is recognised by research community as an adequate, universal ethical theory.

CARING FUTURES: a study protocol for transdisciplinary qualitative research on technology-mediated care practices and theory development for ethics of care.

INTRODUCTION: The world's population is ageing. As older persons live longer and increase in number, society faces a greater disease burden and, in public welfare, a corresponding resource deficit. New technology is one solution to this deficit but there is scarce knowledge about ethical aspects of such innovations in care practices. In CARING FUTURES, we address this scarcity by interrogating how new technology in care can become ethically sound and, correspondingly, how ethics of care can become more technology aware. Our concern is to protect quality care for the future. METHODS AND ANALYSIS: CARING FUTURES advances transdisciplinarity through knowledge exchange around technology-mediated care and ethics of care, involving key stakeholders. We rely on established and innovative methods to generate experience-near and practice-near knowledge. Through this empirical research, we seek to expand understanding of technology-mediated care and to enrich ethics of care theory. ETHICS AND DISSEMINATION: Empirical studies have been approved or await approval by national ethics committees. CARING FUTURES is designed to create societal impact through Knowledge Transfer Events targeting stakeholders in health, care and welfare, and Educational Packages for students of care-providing knowledge-exchange forums for future academics and practitioners of care. The project's societal impact is also ensured in that participating researchers are also practitioners and/or educators of care personnel for the future. Project findings will be disseminated through scientific publications and conference presentations. Through communication in both traditional and digital media platforms, we engage in dialogues between researchers, user groups, policy makers and the wider public.

Trust building in a Norwegian municipal acute ward.

PURPOSE: Trust plays an important role in the organisation of healthcare services. In Norway, the establishment of mandatory municipal acute wards with 24 h inpatient services introduces a new unit into the healthcare system. This article discusses how this new health care service succeeds in building trust with patients and among healthcare workers. DESIGN/METHODOLOGY/APPROACH: The article is an in-depth case study of a single, exemplary inter-municipal acute ward. The study draws on interviews with COPD patients, the leader and doctors at the ward. The study also includes observations of daily work at the municipal acute ward. Moreover, administrators and healthcare workers at related healthcare institutions have been interviewed. Data were analysed using a qualitative method. FINDINGS: The study reveals that trust is built in complex relations and that it has both individual and systemic factors. The practices employed in the daily treatment and care of patients and in encounters between health care personnel and patients are important trust-building processes; however, these processes depend on structures and routines that promote efficient and adequate inter-organisational communication and patient-oriented procedures. PRACTICAL IMPLICATIONS: The study provides insight into how trust dynamics work on multiple organisational levels and how they depend on both individual and systemic factors. Additionally, the study may provide a picture of the importance of trust in organising healthcare services in the future. ORIGINALITY/VALUE: Lessons regarding trust building inspired by data from a case-study care institution can be applied in different care settings and countries.

Polish Honor and Norwegian Dignity: Life Satisfaction, Acculturation, and Self-Worth / El Honor Polaco, La Dignidad Noruega: Satisfacción de Vida, Aculturación y Autoestima

Abstract Locus of self-worth shifts from internal in cultures of dignity to external in cultures of honor. It remains yet unknown whether it can be modified, for example, under an influence of important life events, as migration to a culture of a distinct logic. Our study aimed to analyse relationships between the locus of self-worth and the acculturation strategies on life satisfaction. We collected data from 60 heterosexual Polish couples living in Poland, 120 Polish migrant couples in Norway, and 60 Norwegian couples living in Norway. Groups differed from each other in life satisfaction and in locus of self-worth, with Norwegians valuating the self the most internally and Poles in Poland the most externally. Our results on locus of self-worth show that Polish culture fits in the classification of culture of honor, while Norwegians represent culture of dignity. Moreover, a series of hierarchical linear regressions demonstrated that both locus of self-worth and acculturation strategy are significant predictors of participants' life satisfaction, with a moderating role of migrants' attachment to Polish culture and adaptation to Norwegian society.

Resumen En las culturas de dignidad, que ocurren principalmente en los estados del norte de los Estados Unidos, Canadá y el noroeste de Europa, la autoestima es inalienable y se valora internamente. Esto significa que la autoestima se basa en los logros, las decisiones y los valores del individuo (Aslani et al., 2016). En las culturas de dignidad, nadie puede privar a los individuos de su valor, ya que su ubicación está en lo más profundo de la persona. Por el contrario, en culturas de honor, el valor de una persona se basa en cualidades internas y externas. El honor puede ser quitado, si una persona rompe las reglas de conducta social. El locus de la autoestima cambia de lo interno en las culturas de dignidad, a lo externo en las culturas de honor. Aún no es claro si se puede modificar, por ejemplo, bajo la influencia de eventos importantes de la vida, como la migración a una cultura de una lógica distinta. Este estudio tuvo como objetivo analizar las relaciones entre el locus de autoestima y las estrategias de aculturación sobre la satisfacción con la vida. Se levantaron datos de 60 parejas heterosexuales polacas que viven en Polonia, 120 parejas polacas de inmigrantes en Noruega y 60 parejas noruegas que viven en Noruega. Los grupos diferían entre sí en la satisfacción con la vida y en el locus de la autoestima, los noruegos valoraban el yo más internamente y los polacos en Polonia más externamente. Los resultados en el locus de la autoestima muestran que la cultura polaca encaja en la clasificación de la cultura del honor, mientras que los noruegos representan la cultura de la dignidad. Además, una serie de regresiones lineales jerárquicas mostraron que tanto el locus de la autoestima como la estrategia de aculturación son predictores significativos de la satisfacción con la vida, con un papel moderador del apego de los migrantes a la cultura polaca y la adaptación a la sociedad noruega.