Empathy and values as predictors of care development.

This study investigates values and affective empathy as predictors for care-based moral development. Fifty-three students from a university of applied sciences were interviewed with Skoe's Ethic of Care Interview at the beginning of their studies and two years later. Value priorities were measured by Schwartz et al.'s Portrait Value Questionnaire, empathy variables by Davis' Interpersonal Reactivity Index, and feelings of sympathy were rated using a real-life moral conflict. The results showed that students in care-oriented fields progressed in care reasoning. Real-life sympathy and the value of self-direction positively predicted development in care reasoning, whereas personal distress was a negative predictor. The results indicate that care-based moral development is more closely connected with affective empathy than personal values. Individuals who feel empathy for others, and who prefer independent thinking and action, achieve the greatest gains in care development. In conclusion, educators should encourage students' empathy and moral reasoning in authentic moral conflicts.

Self-Efficacy, Internet Self-Efficacy, and Proxy Efficacy as Predictors of the Use of Digital Social and Health Care Services Among Mental Health Service Users in Finland: A Cross-Sectional Study.

BACKGROUND: The COVID-19 pandemic has accelerated the digitalization of services, but at the same time, some user groups are excluded due to a lack of digital skills. One of the vulnerable groups is people with mental health problems. It has previously been found that self-efficacy beliefs explain the use of digital technology, but the role of social support is largely unexamined. Bandura's concept of proxy agency provides a useful concept to investigate the role of social support in using digital services. OBJECTIVE: The study investigates sources of social support and the effect of proxy agency, Internet efficacy, and self-efficacy beliefs on the intention to use digital health and social care services. METHODS: Participants (N = 121) were users in community-based mental health services who were recruited through four organizations in southern Finland for a cross-sectional study. The scales for proxy agency and intention to use services were developed for purpose of the study. The questionnaire also comprised self-efficacy and Internet efficacy scales. Quantitative data were analyzed using descriptive statistics and linear regression analysis. RESULTS: Both Internet self-efficacy and proxy efficacy (p < 0.001) predicted the intention to use digital health and social care services. Self-efficacy had an indirect positive effect on intention through Internet self-efficacy. Family members and friends were the main source of social support in using digital services. CONCLUSION: Internet self-efficacy and proxy efficacy are important contributors to the intention to use digital health and social care services. Proxy agents may serve as facilitators to reduce the digital divide and promote the use of digital services by complementing individuals' self-efficacy and Internet self-efficacy beliefs. It is important to develop different forms of social support, such as peer support, to enhance the quality of proxy agency. The limitations of proxy agency are discussed.

Care-based ethical reasoning among first-year nursing and social services students.

AIM: This paper is a report of a study conducted to describe nursing and social services students' ethical reasoning at the start of their studies. BACKGROUND: Gilligan argued that there are two modes of moral reasoning - the ethic of justice, focusing on individuals' rights, and the ethic of care, focusing on responsibilities in relationships. Recent research has established the ethic of care as a developmental phenomenon. It has been widely argued that the ethic of care is crucial for nursing, but there has been little international research in this area. METHOD: Participants were first-year nursing and social services students in Finland (N =112). Their care-based moral reasoning was measured using the Ethic of Care Interview, and their ethical reasoning on an abortion-related dilemma was analysed by content analysis. Expressed ethical codes and principles were calculated according to levels. The data were collected over a 5-month period in 2007-2008. FINDINGS: Students' level of care reasoning was varied. Their current level of care reasoning was reflected in their responses to the ethical dilemma. Ethical reasoning at each level and its specific premises constituted a distinct entity. Use of the principle of self-determination was positively related to levels of care development. Care-based moral reasoning constitutes the bedrock for ethical reasoning among these novice students. CONCLUSION: Educators should be sensitive to the variation in students' current developmental levels in care reasoning. Reflective discussion on real-life ethical conflicts should be an explicit part of education and clinical practice in caring professions.

The ethic of care development: a longitudinal study of moral reasoning among practical-nursing, social-work and law-enforcement students.

The study investigated changes in care-based moral reasoning, in the context of justice development over the 2-year period among practical-nursing, bachelor-degree social-work and law-enforcement students (N = 59). Main measures were Skoe's Ethic of Care Interview and Colby et al.'s Moral Judgment Interview. Of the participants 34% progressed in care reasoning, and 48% in justice reasoning. Social-work and nursing students progressed in care reasoning, and all groups progressed in justice reasoning. One participant (1.7%) regressed in care reasoning. Care and justice reasoning were parallel in terms of internal consistency, and they were positively related to each other. Findings suggest that care reasoning follows a developmental sequence, involving three main and two transitional levels, as suggested by Gilligan (1982). Main levels include self-concern (Level 1), caring for others (Level 2), and balanced caring for self and others (Level 3).