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2.
J Clin Ethics ; 30(4): 376-383, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31851628

RESUMO

An Asian Indian Hindu family chose no intervention and hospice care for their newborn with hypoplastic right heart syndrome as an ethical option, and the newborn expired after five days. Professional nursing integrates values-based practice and evidence-based care with cultural humility when providing culturally responsive family-centered culture care. Each person's worldview is unique as influenced by culture, language, and religion, among other factors. The Nursing Team sought to understand this family's collective Indian Hindu worldview and end-of-life beliefs, values, and practices, in view of the unique aspects of the situation while the team integrated evidence-based strategies to provide family-centered culture care. Parental care choices conflicted with those of the Nursing Team, and some nurses experienced moral distress and cultural dissonance when negotiating their deeply held cultural and religious views to advocate for the family. The inability to reconcile and integrate a stressful or traumatic experience impacts nurses' well-being and contributes to compassion fatigue. Nurses need to be intentional in accessing interventions that promote coping and healing and moral resilience. Reflection and cultural humility, assessment, and knowledge in context, increase evidence-based culture care and positive outcomes. U.S. society's views on ethical behavior continue to evolve, and some may argue that the law should place more limits on parents' right to choose or to refuse treatment for their infants and children. Moral distress can lead to moral resilience and satisfaction of compassion when nurses provide family-centered culture care with cultural responsiveness and integrate values-based practice with evidence-based care, and aim to first do no harm.


Assuntos
Enfermagem Familiar/ética , Princípios Morais , Recursos Humanos de Enfermagem no Hospital/psicologia , Relações Profissional-Família/ética , Religião , Estresse Psicológico , Recusa do Paciente ao Tratamento/ética , Atitude Frente a Morte/etnologia , Criança , Cultura , Empatia , Hinduísmo , Humanos , Lactente , Recém-Nascido
4.
Medicine (Baltimore) ; 98(45): e17683, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31702621

RESUMO

A majority of nurses struggled with a negative emotion of anger, doubt, fear, or anxious, uncomfortable in the face of death and dying. However, little was known about community health care providers' in China. Therefore, we conducted a study to investigate their knowledge and attitudes toward end-of-life care and analyze its influencing factors. To provide reference for developing effective strategies to promote end-of-life care in China.A total of 132 community health care providers of 10 community health care centers in Changzhi city were investigated by a Questionnaire of Knowledge and Attitudes toward Caring for the Dying from May, 2017 to December, 2017, and data was analyzed by SPSS 22.0 software.Of the 132 community health care providers who were under investigation, 70 knew about hospice care, but they rated their overall content on end-of-life care as inadequacy, especially in communication skills and knowledge of pain management. The average score of attitudes was 3.47 (SD = 0.44), the lowest score was in the subscale of nurse-patient communication, which was 2.91 (SD = 0.65). Health care providers who had worked for more than 11 years, who had experiences of the death of relatives or friends, and who had previous experiences of caring for terminal patients had more positive attitudes toward caring for the dying (P < .05 for all). There was a significant relationship between community health care providers' attitudes toward death and their attitudes toward end-of-life care (r = -0.282, P < .01). The significant predictors of attitudes toward end-of-life care were attitudes toward death (ß = -0.342), experiences of the death of relatives (ß=-0.207), experiences of caring for the dying (ß = 0.185), and working experience (ß = 0.171).Community health care providers had positive attitudes toward end-of-life care, but they lacked systematic and professional knowledge and skills of caring for the terminal patients. Education is the top priority. It is imperative to set up palliative care courses and life-death education courses, establish an indigenous end-of-life care model, and improve policies, systems, and laws to promote end-of-life care.


Assuntos
Pessoal de Saúde/psicologia , Cuidados Paliativos/psicologia , Assistência Terminal/psicologia , Adulto , Atitude do Pessoal de Saúde , Atitude Frente a Morte , China , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
5.
Rev Esp Salud Publica ; 932019 10 03.
Artigo em Espanhol | MEDLINE | ID: mdl-31576814

RESUMO

OBJECTIVE: Ischemic cardiomyopathy is a major public health concern in Spain. Death from ischemic disease accounts for approximately a third of all deaths due to cardiovascular disease, and imposes a serious burden on already overstretched public health system owing to the tendency to chronicity. This study aimed to evaluate the psychometric properties of Templer's Death Anxiety Scale (DAS) in a sample of patients with ischemic cardiomyopathy (acute myocardial infarction and angina pectoris). METHODS: This study applied the Spanish version of Templer's Death Anxiety Scale (DAS). The sample consisted of 141 patients (61% men) with ischemic cardiomyopathy, mean agede 71.57 years (SD=5.76). A descriptive statistical analysis was performed, and factorial analysis of the principal components. RESULTS: The corrected element-total correlation was positive in all items, with values ranging from 0.32 and 0.54. Four factors jointly explained 51.85% of the data variance. The reliability coefficients were high in all of the variables analysed, with a total Cronbach Alpha of 0.77. CONCLUSIONS: The results obtained in this study revealed ischemic cardiomyopathy was susceptible to the process of death anxiety. This underscores the need for educating patients with this pathology to help them adapt to the process of chronicity, and to develop an understanding of the naturalization process of dying bearing in mind each person's multidimensionality.


Assuntos
Ansiedade/diagnóstico , Atitude Frente a Morte , Cardiomiopatias/psicologia , Infarto do Miocárdio/psicologia , Psicometria , Adulto , Idoso , Cardiomiopatias/diagnóstico , Coleta de Dados , Análise Fatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/diagnóstico , Análise de Componente Principal , Saúde Pública , Reprodutibilidade dos Testes , Espanha
6.
BMC Psychol ; 7(1): 61, 2019 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-31511068

RESUMO

BACKGROUND: In Germany, only limited data are available on attitudes towards death. Existing measurements are complex and time consuming, and data on psychometric properties are limited. The Death Attitude Profile- Revised (DAP-R) captures attitudes towards dying and death. The measure consists of 32 items, which are assigned to 5 dimensions (Fear of Death, Death Avoidance, Neutral Acceptance, Approach Acceptance, Escape Acceptance). It has been translated and tested in several countries, but no German version exists to date. This study reports the translation of the Death Attitudes Profile-Revised (DAP-R) into German (DAP-GR) using a cross-cultural adaption process methodology and its psychometric assessment. METHODS: The DAP-R was translated following guidelines for cultural adaption. A total of 216 medical students of the Heinrich Heine University Duesseldorf participated in this study. Interrater reliability was investigated by means of Kendall's W concordance coefficient. The internal consistency of the DAP-GR Scales was assessed with Cronbach's alpha coefficients. Split-half reliability was estimated using Spearman-Brown coefficients. Convergent validity was measured by Spearman's correlation coefficient. Content validity was assessed by means of confirmatory factor analysis (CFA). All statistical analyses were performed using SPSS 24 and AMOS 22. RESULTS: The items showed fair to good interrater reliability, with W-values ranging from .30 to .79. Internal consistency of the five subscales ranged from .61 (Neutral Acceptance) to .94 (Approach Acceptance). Split-half reliability was good, with a Spearman-Brown-coefficient of .83. The results of CFA slightly diverged from the original scale. CONCLUSION: Our results suggest overall good reliability of the German version of the DAP-R. The DAP-GR promises to be a robust instrument to establish normative data on death attitudes for use in German-speaking countries.


Assuntos
Atitude Frente a Morte , Testes Psicológicos , Adulto , Análise Fatorial , Feminino , Alemanha , Humanos , Masculino , Psicometria , Reprodutibilidade dos Testes , Traduções , Adulto Jovem
7.
Artigo em Inglês | MEDLINE | ID: mdl-31547290

RESUMO

Introduction: Old age is usually the natural time for people to prepare for death, which may evoke various emotions ranging from acceptance to hostility. Aim of the work: The study aimed at specifying various degrees to which elderly people accept death. Material and method: The study employed the diagnostic poll method and an Inventory of the Attitude towards Death (IAD) poll questionnaire. The investigation was administered in a cohort of 150 people over 65 years of age living in Poland. Results: The highest results were noted both for males and females on the "Value" scale (M = 4.94 and M = 4.96) and on the "Necessity" scale (M = 4.79 and M = 4.95). These two scales also had the highest values in the cohorts of city dwellers and country dwellers. A statistically significant difference (Z = 2.339, p = 0.019) was found in the "Necessity" dimension between investigated people with higher education and others. Furthermore, statistically significant differences were found in the following dimensions: "Mysteriousness", "Value", "Dread", "Tragedy", and "Absurdity". Comparing death dimensions in people with chronic illnesses and in those without such illnesses, meaningful statistical differences were noted in the "Necessity" dimension (t = 1.983, p = 0.049). However, analysing death dimensions in people who suffered because of a severe illness in a family member and respondents whose families were healthy, statistically significant differences were noted in the "Absurdity" dimension (t = 2.057, p = 0.041). Conclusions: Sex, the place of residence, and death of a close person did not affect elderly people's acceptance of death. On the other hand, those suffering from chronic diseases were more aware of the inevitability of death. People without higher education were also more aware of the inevitability of death. Suffering of a serious disease of a close one considerably affected acceptance of death in the elderly.


Assuntos
Atitude Frente a Morte , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Humanos , Masculino , Polônia
8.
Artigo em Inglês | MEDLINE | ID: mdl-31500266

RESUMO

Recent research has highlighted that the number of people impacted by a death by suicide is far greater than previously estimated and includes wider networks beyond close family members. It is important to understand the ways in which suicide impacts different groups within these wider networks so that safe and appropriate postvention support can be developed and delivered. A systematic review in the form of a qualitative research synthesis was undertaken with the aim of addressing the question 'what are the features of the experiences of workers in health, education or social care roles following the death by suicide of a client, patient, student or service user?' The analysis developed three categories of themes, 'Horror, shock and trauma', 'Scrutiny, judgement and blame', and 'Support, learning and living with'. The mechanisms of absolution and incrimination were perceived to impact upon practitioners' experiences within social and cultural contexts. Practitioners need to feel prepared for the potential impacts of a suicide and should be offered targeted postvention support to help them in processing their responses and in developing narratives that enable continued safe practice. Postvention responses need to be contextualised socially, culturally and organisationally so that they are sensitive to individual need.


Assuntos
Atitude Frente a Morte , Luto , Família/psicologia , Pessoal de Saúde/psicologia , Papel Profissional/psicologia , Suicídio/psicologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa
10.
Rev. Asoc. Méd. Argent ; 132(3): 19-26, sept. 2019.
Artigo em Espanhol | LILACS | ID: biblio-1045890

RESUMO

El presente trabajo desarrolla la problemática de un sujeto desde que conoce su enfermedad. ¿Cómo vivencia el diagnóstico el pronóstico y la terapia sugerida? ¿Cómo afecta esta situación al resto de los integrantes de la familia? ¿Cuál es el abordaje con pacientes crónicos y terminales? Además se hace incapié en la importancia de un tratamiento interdisciplinario. El rol del psicólogo frente a este tipo de pacientes consiste en sostener una postura ética que no haga foco solo en el diagnóstico orgánico, sino que tome en cuenta el sufrimiento de quien nos convoca, escuchando cuál es su deseo y su proyecto de vida más allá de la enfermedad. Se abordan los siguientes temas: la clínica con niños, el acompañamiento de docentes, clowns o payamédicos en la internación hospitalaria o domiciliaria: el lugar de la familia en este proceso, sus angustias y temores; los avances en la legislación sobre muerte digna; los cuidados paliativos. Algunas viñetas clínicas acompañan los aportes teóricos.


The present work develops the problem of a subject from the knowledge of his illness. How do you experience the diagnosis, prognosis and suggested therapy? How does this situation affect the rest of the family members? What is the approach with chronic and terminal patients? and the importance of an interdisciplinary treatment. The psychologist's role in dealing with this type of patients is to maintain an ethical stance that does not only remain with the organic diagnosis but also takes into account the suffering of the person who summons us, listening to what is his desire and his life project beyond the illness. The following topics are addressed: the clinic with children. The accompaniment of the teachers, clowns or payamédicos in the hospitalization or domiciliary hospitalization. The place of the family in this process, their anxieties and fears. Advances in legislation on dignified death. Palliative care. Some clinical vignettes accompany the theoretical contributions.


Assuntos
Humanos , Criança , Equipe de Assistência ao Paciente , Relações Profissional-Família , Doente Terminal/psicologia , Cuidados Paliativos , Pediatria , Direito a Morrer , Terapias Complementares , Atitude Frente a Morte , Doença Crônica
11.
Environ Sci Pollut Res Int ; 26(29): 29799-29809, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31407261

RESUMO

The economics of death and dying highlighted that environmental factors negatively influence healthcare sustainability. Therefore, this study conducted a system-based literature review to identify the negative externality of environmental damages on global healthcare reforms. Based on 42 peer-reviewed papers in the field of healthcare reforms and 12 papers in the field of environmental hazards, we identified 25 factors associated with death and dying and 15 factors associated with health-related damages across the world respectively. We noted that environmental factors are largely responsible to affect healthcare sustainability reforms by associating with the number of healthcare diseases pertaining to air pollutants. The study suggests healthcare practitioners and environmentalists to devise long-term sustainable healthcare policies by limiting highly toxic air pollutants through technology-embodied green healthcare infrastructure to attained efficient global healthcare recovery.


Assuntos
Poluição do Ar/economia , Assistência à Saúde/economia , Reforma dos Serviços de Saúde/economia , Modelos Econômicos , Poluição do Ar/efeitos adversos , Poluição do Ar/prevenção & controle , Atitude Frente a Morte , Política de Saúde/economia , Humanos , Desenvolvimento Sustentável/economia
12.
N Engl J Med ; 381(8): 701-703, 2019 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-31433917
13.
Eur J Oncol Nurs ; 42: 69-75, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31446266

RESUMO

PURPOSE: Burnout in nursing is a global phenomenon. Caring for dying patients could increase nurses' death anxiety. However, minimal information about oncology nurses' burnout and attitudes towards death in Chinese culture has been reported. This study aims to assess Chinese oncology nurses' burnout, and its relationship with attitudes towards death. METHOD: A cross-sectional design was used. A total of 279 oncology nurses from a cancer hospital in northern China were recruited using convenience sampling, and completed a survey containing a demographic form, the Death Attitudes Profile Scale and the Maslach Burnout Inventory. Descriptive statistics, independent t-test and one-way ANOVA, Pearson correlation analysis and multiple regression analysis were conducted to analyze data. RESULTS: An average of 73.1%-86.9% of oncology nurses reported moderate to high levels of burnout. Specifically, 48.7%, 45.4% and 65.1% of oncology nurses reported high levels of emotional exhaustion, depersonalization and personal accomplishment, respectively. Multiple regression analysis showed that fear of death, escape acceptance, younger age and participation of death education/training were significantly associated with emotional exhaustion (p < 0.01), accounting for 22.0% of the variance; fear of death, escape acceptance, and neutral acceptance in total explained 17.8% of depersonalization; fear of death, escape acceptance and neutral acceptance accounted for 8.5% of personal accomplishment. CONCLUSIONS: Oncology nurses with more positive attitudes towards death experience less burnout. Death education and death related training including discussion of personal attitudes towards death should be part of nursing education programs, which would in turn prevent oncology nurses from burnout.


Assuntos
Atitude do Pessoal de Saúde , Atitude Frente a Morte , Esgotamento Profissional/epidemiologia , Recursos Humanos de Enfermagem/psicologia , Enfermagem Oncológica , Adulto , Análise de Variância , Esgotamento Profissional/psicologia , China , Estudos Transversais , Despersonalização , Emoções , Empatia , Medo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Prevalência , Análise de Regressão , Inquéritos e Questionários
14.
Environ Health Prev Med ; 24(1): 51, 2019 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-31366323

RESUMO

BACKGROUND: Achieving a desirable death is an urgent aging-related problem in Japan. However, measures of the quality of death and dying in Japan are lacking. This study aimed to identify components of a desirable death in the residents of Kagawa prefecture, Japan, through focus group interviews. METHODS: A group interview was conducted with 30 residents aged 20-80 (Mage = 50.9, SD = 22.1 years; 43.3% ≥ 65 years; 40.0% unemployed) who had experienced the death of a closely associated person. Participants were grouped into four generations with diverse characteristics (e.g., age, sex, occupation). The interview lasted 1-2 h and involved one interviewer, one observer, and one recorder. The interview theme was "What is a desirable death?" Participants were asked "What do you want to achieve before you die?" or "What would a close friend want to experience when death is near?" We then extracted important items related to "desirable death" using serialization and observation records, while also consulting three analysts. The analysis results of the four generations were ultimately integrated into final categories. RESULTS: The most common experience of a familiar death was that of parents, followed by grandparents. Half of participants had witnessed the death. Through category analysis, eight important categories related to desirable death were ultimately extracted. Nine items were identified as common to all generations. While the elderly generation had wide-ranging opinions, the younger generations' opinions tended to concentrate on satisfaction with life and family relations. CONCLUSION: Eight concepts were extracted as important factors of a desirable death from the residents of Kagawa prefecture, Japan.


Assuntos
Atitude Frente a Morte , Morte , Adulto , Idoso , Idoso de 80 Anos ou mais , Relações Familiares , Feminino , Grupos Focais , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Adulto Jovem
16.
Cien Saude Colet ; 24(8): 3001-3012, 2019 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-31389547

RESUMO

We examined people's preferences for place of death and identified factors associated with a home death preference. We asked a representative sample (N = 400) of older people (≥ 60 years) residents in the city of Belo Horizonte, about their preferences for place of death in a situation of serious illness with less than a year to live. Data were analyzed using binomial regression to identify associated factors. 52.2% indicate home as the preferred place of death. Five variables were associated with preference for death at home: those living with 1 child (odds ratio (OR)0.41; 95% confidence interval (CI):0.18-0.92; ref: without children); being in education for up to 4 years (OR0.42; 95% CI:0.20-0.89; ref: higher education); finding it difficult to live with the present income (OR3.18; 95% CI:1.53-6.62; ref: living comfortably); self-assessed fair overall health (OR2.07; 95% CI:1.06-4.03; ref: very good health) and selecting "choosing who makes decisions about your care" as the care priority that would matter to them the most (OR2.43; 95%CI:1.34-4.40; ref: dying in the place you want). Most respondents chose home as preferred place of death. However, most residents of Belo Horizonte die in hospitals, suggesting that preferences are not being considered.


Assuntos
Atitude Frente a Morte , Morte , Preferência do Paciente/psicologia , Doente Terminal/psicologia , Idoso , Idoso de 80 Anos ou mais , Brasil , Estudos Transversais , Tomada de Decisões , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
17.
Artigo em Inglês | MEDLINE | ID: mdl-31349576

RESUMO

This study assessed the knowledge and attitude toward palliative care for the elderly among health professionals in a tertiary geriatric hospital in Vietnam and explored their determinants. Cross-sectional data were obtained on 161 geriatric health professionals at the National Geriatric Hospital. Modified-Palliative Care Knowledge Test and Frommelt Attitudes Toward Care of the Dying instruments were used to measure knowledge and attitude toward geriatric palliative care. As a result, 40.5% physicians and 74.2% nurses showed insufficient knowledge about geriatric palliative care (p < 0.05). The lowest score was for dyspnea, following by gastrointestinal and pain problems. No significant difference was found regarding the attitude between physicians and nurses (p > 0.05). Health professional category, age, and years of experience were found to be associated with knowledge about palliative care. Meanwhile, only knowledge score had correlations with total attitude score (Coef. = 0.2; 95%CI = 0.1-0.3), attitude toward patients (Coef. = 0.1; 95%CI = 0.0-0.1) and toward patients' family (Coef. = 0.1; 95%CI = 0.0-0.1). This study highlights a significant knowledge gap and preferable attitude toward palliative care for the elderly among physicians and nurses in the geriatric hospital. Intensive training about geriatric palliative care, focusing on pain, dyspnea and gastrointestinal issue management, should be performed to ensure the quality of palliative care services, especially in nurses.


Assuntos
Atitude do Pessoal de Saúde , Atitude Frente a Morte , Enfermagem Geriátrica , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/psicologia , Cuidados Paliativos/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Vietnã
19.
Emerg Med J ; 36(7): 444-445, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31320337

RESUMO

A short cut review was carried out to establish whether a staff debriefing session after involvement in a traumatic resuscitation reduces stress and anxiety, reduces sickness, improves team working and morale and improves staff retention. Four papers presented the best evidence to answer the question. The author, date and country of publication, group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. It is concluded that there is no evidence about the efficacy of team debriefing in the ED. However, there is some desire among staff for it to occur. Further research is needed and in the meantime local advice should be followed.


Assuntos
Ressuscitação/psicologia , Adolescente , Atitude Frente a Morte , Intervenção na Crise/métodos , Humanos , Masculino , Ressuscitação/métodos , Estresse Psicológico/etiologia , Estresse Psicológico/psicologia
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