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1.
Cogn Psychol ; 152: 101671, 2024 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-39079256

RESUMO

Research has shown that infants represent legitimate leadership and predict continued obedience to authority, but which cues they use to do so remains unknown. Across eight pre-registered experiments varying the cue provided, we tested if Norwegian 21-month-olds (N=128) expected three protagonists to obey a character even in her absence. We assessed whether bowing for the character, receiving a tribute from or conferring a benefit to the protagonists, imposing a cost on them (forcefully taking a resource or hitting them), or relative physical size were used as cues to generate the expectation of continued obedience that marks legitimate leadership. Whereas bowing sufficed in generating such an expectation, we found positive Bayesian evidence that all the other cues did not. Norwegian infants unlikely have witnessed bowing in their everyday life. Hence, bowing/prostration as cue for continued obedience may form part of an early-developing capacity to represent leadership built by evolution.

2.
BMC Pregnancy Childbirth ; 24(1): 370, 2024 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-38750412

RESUMO

OBJECTIVE: To ascertain and explore the views of women and their partners, giving birth in the Czech Republic, of the level of respectful or disrespectful care provided during pregnancy and early labour. DESIGN: Ethical approval was granted for a descriptive, online anonymous survey of 65 questions, with quantitative and qualitative responses. SETTING: The Czech Republic.The survey was completed by 8,767 women and 69 partners in 2018. MEASUREMENTS AND FINDINGS: Descriptive statistics and thematic analysis were used to present results. The majority of women were aged 26-35 years. Most had birthed in one of 93 hospitals, with 1.5% home births. Almost 40% never had an abdominal examination.in pregnancy. Quantitative data analysis revealed that less than half were given information on place of birth, or how to keep labour normal or non-interventionist. Almost 60% did not get information on positions for birth. Most (68%) commenced labour naturally, 25% had labour induced, 40% of them before term, and 7% had an elective caesarean section; 55% stated they had not been given any choice in the decision. Over half of those who had a membrane sweep said permission had not been sought. Half (54%) only had 'checking' visits from the midwife in labour. KEY CONCLUSIONS: Findings reveal a lack of information-giving, discussion and shared decision-making from healthcare professionals during pregnancy and early labour. Some practices were non-evidenced-based, and interventions were sometimes made without consent. IMPLICATIONS FOR PRACTICE: The examples of disrespectful care described in this study caused women distress during childbirth, which may result in an increased fear of childbirth or an increase in free-birthing.


Assuntos
Respeito , Humanos , Feminino , Gravidez , Adulto , República Tcheca , Inquéritos e Questionários , Trabalho de Parto/psicologia , Adulto Jovem , Relações Profissional-Paciente , Gestantes/psicologia , Parto Obstétrico/psicologia , Atitude do Pessoal de Saúde
3.
BMC Med Ethics ; 25(1): 39, 2024 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-38539213

RESUMO

BACKGROUND: Respect is essential to providing high quality healthcare, particularly for groups that are historically marginalized and stigmatized. While ethical principles taught to health professionals focus on patient autonomy as the object of respect for persons, limited studies explore patients' views of respect. The purpose of this study was to explore the perspectives of a multiculturally diverse group of low-income women living with HIV (WLH) regarding their experience of respect from their medical physicians. METHODS: We analyzed 57 semi-structured interviews conducted at HIV case management sites in South Florida as part of a larger qualitative study that explored practices facilitating retention and adherence in care. Women were eligible to participate if they identified as African American (n = 28), Hispanic/Latina (n = 22), or Haitian (n = 7). They were asked to describe instances when they were treated with respect by their medical physicians. Interviews were conducted by a fluent research interviewer in either English, Spanish, or Haitian Creole, depending on participant's language preference. Transcripts were translated, back-translated and reviewed in entirety for any statements or comments about "respect." After independent coding by 3 investigators, we used a consensual thematic analysis approach to determine themes. RESULTS: Results from this study grouped into two overarching classifications: respect manifested in physicians' orientation towards the patient (i.e., interpersonal behaviors in interactions) and respect in medical professionalism (i.e., clinic procedures and practices). Four main themes emerged regarding respect in provider's orientation towards the patient: being treated as a person, treated as an equal, treated without blame or prejudice, and treated with concern/emotional support. Two main themes emerged regarding respect as evidenced in medical professionalism: physician availability and considerations of privacy. CONCLUSIONS: Findings suggest a more robust conception of what 'respect for persons' entails in medical ethics for a diverse group of low-income women living with HIV. Findings have implications for broadening areas of focus of future bioethics education, training, and research to include components of interpersonal relationship development, communication, and clinic procedures. We suggest these areas of training may increase respectful medical care experiences and potentially serve to influence persistent and known social and structural determinants of health through provider interactions and health care delivery.


Assuntos
Infecções por HIV , Médicos , Humanos , Feminino , Haiti , Atenção à Saúde , Pesquisa Qualitativa , Médicos/psicologia , Infecções por HIV/terapia
4.
Cult Health Sex ; : 1-14, 2024 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-38215003

RESUMO

Family honour, protecting and upholding the family name, is central to familism. Yet, it has been somewhat neglected by scholarship on Latin American and Latino families. Familism involves prioritising the family over the individual. Likewise, the family of origin holds particular significance, offering material, social and emotional support, and shaping one's identity, honour and sense of belonging. Heteronormativity and patriarchy portray queer individuals as the causes of family shame. This study examined how family honour, as a component of familism, operates within kin dynamics, specifically focusing on same-sex cohabitation, as this living arrangement serves as a tangible expression of a non-normative sexual orientation. A life course perspective was used to study 24 cases of cohabiting lesbian, gay and bi/pansexual individuals in Chile. The results show the enduring significance of families in providing support, sociability, identity, and a sense of belonging. Nevertheless, it reveals notable instances of family rejection towards queer kin. In Chile, both families of origin and queer individuals employ subtle strategies to conceal their queerness, guided by notions of 'respect' associated with family honour and decency. These strategies involve unspoken agreements to maintain family bonds through discreet displays of queer behaviour without explicit acknowledgement of sexual identity.

5.
J Adv Nurs ; 2024 Feb 06.
Artigo em Inglês | MEDLINE | ID: mdl-38318983

RESUMO

AIMS: Globally, the nursing shortage is a growing concern. Much of the research on retention of nurses focuses on the experience of those who left positions. In this study, we set out to listen to critical care nurses (CCRNs) who have chosen to remain in their positions to understand the factors retaining them in critical care. DESIGN: This interpretive descriptive study was guided by the following research question: 'what factors influence CCRN's decision to continue to work in critical care?' METHODS: Digitally recorded interviews and a focus group were conducted between July 2022 and January 2023 using a semi-structured, strengths-based interview guide with CCRNs from three critical care units at a tertiary hospital in a city in a central Canadian province. Transcribed interviews were analysed using open, axial and selective coding and constant comparative analysis. RESULTS: Twenty-two CCRNs participated in interviews and three in a focus group. The theme of Respect, demonstrated through the interconnected concepts of Working to Full Scope, Team, Rotations and Compensation was identified. Working to Full Scope was described as providing nursing care aligned with how each nurse envisions what nursing is. Being part of a Team led by strong nurse leaders that provides opportunities and supports the sharing of their perspectives was also found. Respect was also found to be demonstrated through Rotations that recognize that work is one part of these nurses' lives. Compensation that reflects the increased education, knowledge and skills required in critical care was the final concept of Respect. CONCLUSION: Organizations should focus their efforts across the identified concepts to demonstrate Respect for CCRNs and retain them. IMPLICATIONS FOR PRACTICE: The findings of this study provide ways to support the retention of CCRNs. IMPACT: This research will have an impact on nursing leaders by providing tangible ways to retain CCRNs. REPORTING METHOD: Reporting of this work was guided by the Standards for Reporting Qualitative Research. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

6.
Nurs Outlook ; 72(5): 102238, 2024 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-39029447

RESUMO

Nursing leaders have recognized the need for consistent mechanisms to promote and sustain nursing professionalism. Peer-to-peer feedback and peer review are widely effective for nurse professionalism and self-regulation, patient care outcomes, and retention. Unprofessional behavior has been noted as widespread in health care and the effects on patients, clinicians, and organizations have been well-documented. Approximately 10% of the registered nurses in the United States belong to a collective bargaining unit (CBU) or union. This article will describe how a peer feedback program to address unprofessional behavior was implemented in a Magnet nursing practice with CBU representation.

7.
Health Care Anal ; 32(2): 126-140, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38159128

RESUMO

In health care, the provision of pertinent information to patients is not just a moral imperative but also a legal obligation, often articulated through the lens of obtaining informed consent. Codes of medical ethics and many national laws mandate the disclosure of basic information about diagnosis, prognosis, and treatment alternatives. However, within publicly funded health care systems, other kinds of information might also be important to patients, such as insights into the health care priorities that underlie treatment offers made. While conventional perspectives do not take this as an obligatory part of the information to be shared with patients, perhaps through viewing it as clinically "non-actionable," we advocate for a paradigm shift. Our proposition diverges from the traditional emphasis on actionability. We contend that honoring patients as equal moral agents necessitates, among other principles, a commitment to honesty. Withholding specific categories of information pertinent to patients' comprehension of their situation is inherently incompatible with this principle. In this article, we advocate for a recalibration of the burden of proof. Rather than requiring special justifications for adding to the standard set of information items, we suggest that physicians should be able to justify excluding relevant facts about the patient's situation and the underlying considerations shaping health care professionals' choices. This perspective prioritizes transparency and empowers patients with a comprehensive understanding, aligning with the ethos of respect for the patient as person.


Assuntos
Prioridades em Saúde , Disseminação de Informação , Humanos , Disseminação de Informação/ética , Consentimento Livre e Esclarecido/legislação & jurisprudência , Consentimento Livre e Esclarecido/ética , Revelação
8.
Artigo em Inglês | MEDLINE | ID: mdl-38175334

RESUMO

A plethora of studies has exhibited the effectiveness of using measurement-based care feedback systems within mental health services to improve treatment outcomes; however, patient gender/race and patient-therapist matching on gender and race remain relatively unexplored as predictors/moderators in feedback studies. We conducted predictor/moderator analyses focusing on the relation of gender, race/ethnicity, and patient-therapist gender and race/ethnicity matching on two outcomes: patient self-reported levels of (1) functioning and (2) trust/respect within the therapeutic relationship. We used data from a randomized controlled trial studying the effectiveness of a feedback system comparing patient-reported levels of trust and respect towards their provider (together with symptom feedback) in comparison to symptom only feedback. We found that men improved in functioning more than women when their therapists received trust/respect feedback compared to symptom only feedback (F[1, 902] = 9.79, p = .002, d = 0.21). We also found that dyads matched on race/ethnicity but not gender, and those matched on gender but not race/ethnicity, improved in functioning over time more than dyads mismatched on both gender and race/ethnicity and those matched on both gender and race/ethnicity (F[1, 897] = 8.63, p = .0034, d = 0.20). On trust/respect outcomes, we found a gender difference over time (F[1, 759] = 6.61, p = .01, d = 0.19), a gender matching difference by feedback condition interaction (F[1, 757] = 5.25, p = .02, d = 0.17), and a racial/ethnic matching difference on trust/respect scores over time (F[1, 785] = 3.89, p = .049, d = 0.14). Male patients showed an initial decrease followed by a steady increase in trust/respect over time while female patients showed an initial increase followed by a steady decrease. Gender-matched therapeutic dyads showed higher levels of trust/respect compared to mismatched dyads when therapists received symptom only feedback, but this difference was not apparent when trust/respect feedback was provided. Dyads mismatched on race/ethnicity improved steadily in trust/respect over time, but matched dyads decreased in trust/respect after an initial increase. Future research should focus on the use of feedback systems to enhance outcomes for patients with specific gender and racial/ethnic identities.

9.
Entropy (Basel) ; 26(1)2024 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-38248173

RESUMO

This paper introduces the notion of multi-sensitivity with respect to a vector within the context of non-autonomous dynamical systems on uniform spaces and provides insightful results regarding N-sensitivity and strongly multi-sensitivity, along with their behaviors under various conditions. The main results established are as follows: (1) For a k-periodic nonautonomous dynamical system on a Hausdorff uniform space (S,U), the system (S,fk∘⋯∘f1) exhibits N-sensitivity (or strongly multi-sensitivity) if and only if the system (S,f1,∞) displays N-sensitivity (or strongly multi-sensitivity). (2) Consider a finitely generated family of surjective maps on uniform space (S,U). If the system (S,f1,∞) is N-sensitive, then the system (S,fk,∞) is also N-sensitive. When the family f1,∞ is feebly open, the converse statement holds true as well. (3) Within a finitely generated family on uniform space (S,U), N-sensitivity (and strongly multi-sensitivity) persists under iteration. (4) We present a sufficient condition under which an nonautonomous dynamical system on infinite Hausdorff uniform space demonstrates N-sensitivity.

10.
Mult Scler ; 29(1): 8-10, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36448322

RESUMO

Addressing a person in the context of their disease must be done respectfully. As a person with multiple sclerosis (MS), my preference is to be referred to as such. Some people with MS refer to themselves as MSers, MS warriors, MS sufferers, and that's fine. A person with MS can refer to themselves in the context of their disease in the manner they choose. People without MS should use terminology most respectful and acceptable to the broadest of the minority. Academics sometimes use persons with MS to refer to an infinite number of people. Not only is this incorrect but use of persons has broadly fallen out of favour in recent decades. In this personal viewpoint I discuss these issues from a lived experience perspective.


Assuntos
Esclerose Múltipla , Autoimagem , Humanos , Esclerose Múltipla/psicologia
11.
BMC Pregnancy Childbirth ; 23(1): 444, 2023 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-37316792

RESUMO

BACKGROUND: Disrespect and abuse violates women's basic human rights and autonomy and can traumatize women who are already in a vulnerable position during childbirth and deter them from utilizing skilled care for future childbirth. This study explored women's perspectives on the acceptability of disrespect and abuse during facility-based childbirth in Ethiopia. METHODS: A qualitative descriptive design using five focus group discussions and fifteen in-depth, semi-structured, interviews was conducted with women between October 2019 to January 2020 in north Showa zone of Oromia region, central Ethiopia. Using purposive sampling, women who had given birth at public health facilities of North Showa zone during the twelve months preceding data collection were recruited, regardless of birth outcome. Inductive thematic analysis using Open Code software was used to explore the perspectives of participants. RESULTS: While women reject disrespectful and abusive acts during childbirth generally, they may consider some disrespectful acts as acceptable and or necessary under certain circumstances. Four emerging themes were identified. (1) Disrespect and abuse is not acceptable, (2) Disrespectful and abusive actions are acceptable only if intended to save lives, (3) Disrespectful and abusive actions are an accepted part of everyday practice to prevent complications and adverse outcomes, (4) Disrespectful and abusive actions are necessary to discipline disobedient women. CONCLUSION: Women's perceptions of disrespectful and abusive acts of care providers is deeply rooted within the context of violence in Ethiopia and the societal hierarchies that have systematically disempowered women. Given the pervasiveness of disrespect and abusive actions during childbirth, policymakers, clinical managers and care providers must take these essential contextual and societal norms into account and devise comprehensive clinical interventions that addresses the root causes.


Assuntos
Atitude do Pessoal de Saúde , Parto Obstétrico , Abuso Emocional , Parto , Relações Profissional-Paciente , Feminino , Humanos , Gravidez , Etiópia , Grupos Focais , Parto/psicologia , Pesquisa Qualitativa , Abuso Emocional/psicologia , Serviços de Saúde Materna/ética , Características Culturais
12.
BMC Med Ethics ; 24(1): 73, 2023 09 21.
Artigo em Inglês | MEDLINE | ID: mdl-37735658

RESUMO

BACKGROUND: Standard interpretations of the ethical principle of respect for persons have not incorporated the views and values of patients, especially patients from groups underrepresented in research. This limits the ability of research ethics scholarship, guidance, and oversight to support inclusive, patient-centered research. This study aimed to identify the practical approaches that patients in community-based settings value most for conveying respect in genomics research. METHODS: We conducted a 3-round, web-based survey using the modified Delphi technique to identify areas of agreement among English-speaking patients at primary care clinics in Washington State and Idaho who had a personal or family history of cancer. In Round 1, respondents rated the importance of 17 items, identified in prior qualitative work, for feeling respected. In Round 2, respondents re-rated each item after reviewing overall group ratings. In Round 3, respondents ranked a subset of the 8 most highly rated items. We calculated each item's mean and median rankings in Round 3 to identify which approaches were most important for feeling respected in research. RESULTS: Forty-one patients consented to the survey, 21 (51%) completed Round 1, and 18 (86% of Round 1) completed each of Rounds 2 and 3. Two sets of rankings were excluded from analysis as speed of response suggested they had not completed the Round 3 ranking task. Respondents prioritized provision of study information to support decision-making (mean ranking 2.6 out of 8; median ranking 1.5) and interactions with research staff characterized by kindness, patience, and a lack of judgment (mean ranking 2.8; median ranking 2) as the most important approaches for conveying respect. CONCLUSIONS: Informed consent and interpersonal interactions are key ways that research participants experience respect. These can be supported by other approaches to respecting participants, especially when consent and/or direct interactions are infeasible. Future work should continue to engage with patients in community-based settings to identify best practices for research without consent and examine unique perspectives across clinical and demographic groups in different types of research.


Assuntos
Emoções , Ética em Pesquisa , Humanos , Técnica Delphi , Genômica , Consentimento Livre e Esclarecido
13.
Public Health ; 225: 72-78, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37922589

RESUMO

OBJECTIVES: This study aimed to explore occupational stress, perceived respect, and the need for psychological counselling among nurses in China. STUDY DESIGN: This was a nationwide cross-sectional study. METHODS: Chinese nurses from 311 cities were randomly selected through a simple random sampling method. Occupational stress, perceived respect, and psychological counselling need were assessed using an online questionnaire validated by experts. The underlying associated factors were analysed using multiple logistic regression analyses. RESULTS: We collected and analysed 51,406 valid online questionnaires. Family factors and low income were the most commonly cited sources of occupational stress, and 91.9% and 80.0% of nurses, respectively, perceived that individuals in society and patients did not give adequate respect. Furthermore, 75.5% and 79.7%, respectively, believed they were not respected by clinical managers and doctors. As a result, 64.7% nurses believed they had a moderate or high need for psychological counselling. However, 80.7% indicated that receiving adequate respect could decrease the need for stress-related psychological counselling. Indeed, multiple logistic regression analyses showed that lower respect perceived by nurses was associated with higher need for psychological counselling, particularly regarding criticism that nurses perceived from nursing managers (a little: odds ratio [OR], 1.597; 95% confidence interval [CI], 1.176-2.170; P = 0.003; moderately: OR, 1.433; 95% CI, 1.180-1.741; P < 0.001) and the difficulty of receiving respect from patients and their families (a little: OR, 1.389; 95% CI, 1.044-1.850; P = 0.024). CONCLUSIONS: Nurses in China perceive high levels of occupational stress and low levels of respect and often seek psychological counselling.


Assuntos
Enfermeiras e Enfermeiros , Estresse Ocupacional , Humanos , China/epidemiologia , Estudos Transversais , População do Leste Asiático , Enfermeiras e Enfermeiros/psicologia , Enfermeiras e Enfermeiros/estatística & dados numéricos , Estresse Ocupacional/epidemiologia , Estresse Ocupacional/terapia , Estresse Psicológico/epidemiologia , Estresse Psicológico/terapia , Inquéritos e Questionários , Aconselhamento
14.
J Clin Nurs ; 32(7-8): 1286-1302, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35322497

RESUMO

AIMS AND OBJECTIVES: The aim of this study was to explore older adults' perspectives about dignity and dignified nursing care during acute hospitalisation in Ghana. BACKGROUND: Maintaining hospitalised older adults' dignity is an essential component of nursing care and one of the most important determinants of wellbeing. To date, no study has been published on older adults' perspectives of dignified nursing care in the African context. STUDY DESIGN: A qualitative descriptive research design. METHODS: Twenty hospitalised older adults were purposively selected from the medical and surgical wards of a teaching hospital in Ghana. Data were gathered through semi-structured interviews between April and August, 2021, and analysed using reflexive thematic analysis techniques. The SRQR checklist was used to document reporting of the study. RESULTS: The following four themes were identified: Effective nurse-patient communication, Maintaining patients' privacy, Respectful and compassionate care provision and Providing quality and safe care. Dignity was preserved when patients were treated with respect and compassion, provided privacy, and had close family members involved in physical care. Identified barriers to dignity included inadequate information about their health condition, poor communication by the nurses, lack of autonomy, poorly designed healthcare infrastructure and inadequate privacy. CONCLUSIONS: Several enablers and barriers to dignified nursing care have been identified that have been discussed in previous studies. The unique factors identified in the Ghanaian context were family members' involvement in physical care influenced by cultural and religious beliefs, environmental barriers to privacy and dignity and inadequate involvement in decision making. RELEVANCE TO CLINICAL PRACTICE: Nurses must treat older patients with respect, educate them about the health condition, involve them in care decisions, and identify their preferences regarding provision of hygiene needs, particularly in consideration of religious and cultural beliefs, including involvement of family members. Future planning of healthcare infrastructure needs to consider the importance of private cubicles with disability-accessible ensuite bathrooms for patients' comfort and privacy.


Assuntos
Enfermagem , Respeito , Idoso , Humanos , População Negra , Lista de Checagem , Gana , Hospitais de Ensino , Comunicação
15.
J Med Philos ; 48(3): 225-242, 2023 05 16.
Artigo em Inglês | MEDLINE | ID: mdl-37061804

RESUMO

Several recent papers have suggested that the pro-life view entails a radical, implausible thesis: that miscarriage is the biggest public health crisis in the history of our species and requires radical diversion of funds to combat. In this paper, I clarify the extent of the problem, showing that the number of miscarriages about which we can do anything morally significant is plausibly much lower than previously thought, then describing some of the work already being done on this topic. I then briefly survey a range of reasons why abortion might be thought more serious and more worthy of prevention than miscarriage. Finally, I lay out my central argument: that reflection on the wrongness of killing reveals that the norms for ending life and failing to save life are different, in such a way that could justify the prioritization of anti-abortion advocacy over anti-miscarriage efforts. Such an account can also respond to similar problems posed to the pro-lifer, such as the question of whom to save in a "burning lab" type scenario.


Assuntos
Aborto Induzido , Aborto Espontâneo , Gravidez , Feminino , Humanos , Valor da Vida
16.
J Med Philos ; 48(1): 33-49, 2023 02 17.
Artigo em Inglês | MEDLINE | ID: mdl-36592336

RESUMO

Patient safety is a central aspect of healthcare quality, focusing on preventable, iatrogenic harm. Harm, in this context, is typically assumed to mean physical injury to patients, often caused by technical error. However, some contributions to the patient safety literature have argued that disrespectful behavior towards patients can cause harm, even when it does not lead to physical injury. This paper investigates the nature of such dignitary harms and explores whether they should be included within the scope of patient safety as a field of practice. We argue that dignitary harms in health care are-at least sometimes-preventable, iatrogenic harms. While we caution against including dignitary harms within the scope of patient safety just because they are relevantly similar to other iatrogenic harms, we suggest that thinking about dignitary harms can help to elucidate the value of patient safety, and to illuminate the evolving relationship between safety and quality.


Assuntos
Segurança do Paciente , Qualidade da Assistência à Saúde , Humanos , Doença Iatrogênica/prevenção & controle
17.
Int J Aging Hum Dev ; 96(3): 335-349, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-35404172

RESUMO

Erikson's theory of psychosocial development defines generativity as the drive to benefit future generations and leave a legacy. Generativity has been shown to predict life satisfaction, but generative concern and action can be impacted by factors such as perceived respect from younger generations. This study utilized caregiving grandparents aged 40 and older to assess the extent to which perceived respect mediated the relation between generativity and life satisfaction. Perceived respect from a grandchild mediated the relation between generative concern expressed by caregiving grandparents and life satisfaction after controlling for demographic variables that have been shown to influence heterogeneity and overall well-being in caregiving grandparent samples. These findings suggest that the relation between life satisfaction and generativity in grandparents may depend, in part, on perceived respect from grandchildren, intimating that the implications of generativity may be influenced by the perceived appreciation of its recipients.


Assuntos
Avós , Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Avós/psicologia , Respeito , Família/psicologia , Personalidade , Satisfação Pessoal , Relação entre Gerações
18.
J Trauma Dissociation ; 24(4): 520-537, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37233983

RESUMO

Black individuals are at particularly high risk for birth-related posttraumatic stress disorder (PTSD) symptoms, in part due to a lack of opportunity to lead maternity care decisions. Maternal care providers need evidence-based ways to reduce pregnant persons' risk for birth-related PTSD symptoms despite reduced autonomy in decision making resulting from heightened restrictions on reproductive rights. We investigated whether a potential relation between autonomy in decision making and birth-related PTSD symptoms would be moderated by being mistreated or feeling respected by maternity care providers in a community sample of Black women (N = 52; Mage = 28.2 years, SDage = 5.7 years) seeking maternity care at a public hospital in the southeastern United States. At six weeks postpartum, participants completed measures assessing autonomy in decision making, current birth-related PTSD symptoms, number of mistreatment events, and feelings of respect from providers during pregnancy, childbirth, and the postpartum period. Autonomy in decision making was negatively correlated with birth-related PTSD symptoms, r=-.43, p < .01. An interaction between autonomy in decision making and mistreatment by providers was trending toward significance, B=-.23, SE=.14, p = .10. Autonomy in decision making and feeling respected by maternity care provider interacted to predict birth-related PTSD symptoms, B = .05, SE=.01, p < .01. Feeling respected by providers may buffer against the negative effects of lack of autonomy in decision making on birth-related PTSD symptoms, highlighting the importance of providers' ability to convey respect to pregnant patients when they cannot lead care decisions.


Assuntos
Serviços de Saúde Materna , Transtornos de Estresse Pós-Traumáticos , Gravidez , Feminino , Humanos , Adulto , Pré-Escolar , Parto , Período Pós-Parto , Emoções , Tomada de Decisões
19.
Nurs Ethics ; : 9697330231222598, 2023 Dec 26.
Artigo em Inglês | MEDLINE | ID: mdl-38147009

RESUMO

AIM: To synthesize qualitative research on perspectives and understandings of Intensive Care Unit (ICU) patients, family members, and staff regarding respect and dignity in ICU, in order to explore the connotations and meanings of respect and dignity in ICU. DESIGN: A qualitative meta-synthesis. METHODS: The Chinese and English databases were systematically searched, including PubMed, Web of Science, CINAHL, Embase, Cochrane Library, CNKI, Wangfang Data, VIP, and CBM from each database's inception to July 22, 2023. Studies were critically appraised using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Qualitative Research. Qualitative data were extracted, summarized, and meta-synthesized. (PROSPERO: CRD42023447218). RESULTS: A total of 9 studies from 6 countries were included in the meta-synthesis. Thirty-six main themes and 67 sub-themes were extracted, which were eventually integrated into 9 categories and 4 themes: (1) integrity of humanity; (2) autonomy; (3) equality; (4) environmental support. CONCLUSION: To maintain patient dignity, it is necessary to create an environment of respect within the ICU where healthcare professionals uphold the concept of preserving human integrity and respect patients' autonomy and equality. Healthcare professionals need to value the dignity of ICU patients and treat them as unique individuals during treatment and care. Hospital managers should also strive to create a respectful environment to provide environmental support for dignity care implementation.

20.
Camb Q Healthc Ethics ; : 1-8, 2023 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-37941123

RESUMO

The Dobbs decision has precipitated renewed medical, political, and professional interest in the issue of abortion. Because this decision handed responsibility for regulation of abortion back to the states, and because the states are enacting or have enacted policies that tend to be very permissive or very restrictive, the result has been legal and professional confusion for physicians and their patients. Medical education cannot resolve either the legal or ethical issues regarding abortion. However, medical education must prepare future physicians for caring for patients seeking abortion-related services. Physicians must be prepared to interact appropriately (sensitively and with integrity) with patients or colleagues whose views on abortion differ significantly from their own. This essay describes our educational effort to achieve that objective. The motto that governed this exercise was "No Easy Answers."

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