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Ann Acad Med Singap ; 49(11): 897-901, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33381783


The COVID-19 pandemic has had a major impact in healthcare systems across the world, with many hospitals having to come up with protocols and measures to contain the spread of the virus. This affects various specialties' clinical practices in many ways. Since early 2020 in Singapore, the Department of Otorhinolaryngology at Tan Tock Seng Hospital had to rapidly adapt to this pandemic as we provided services to the main healthcare facility combating the virus in our country. We had to design new workflows and also remain flexible in view of the ever-changing situation. There are 6 important domains for an otolaryngology department or any clinical department in general to consider when making adjustments to their practices in an outbreak: (1) clinical work, (2) education, (3) research, (4) safety of patients and staff, (5) morale of medical staff and (6) pandemic frontline work. We hope that the sharing of our experiences and the lessons learnt will be useful for both our local and international colleagues.

/epidemiologia , Assistência à Saúde/métodos , Otolaringologia/métodos , Assistência Ambulatorial , Pesquisa Biomédica , Educação Médica , Procedimentos Cirúrgicos Eletivos , Mão de Obra em Saúde , Humanos , Moral , Otolaringologia/educação , Procedimentos Cirúrgicos Otorrinolaringológicos , Equipamento de Proteção Individual , Admissão e Escalonamento de Pessoal , Singapura/epidemiologia , Fluxo de Trabalho
Adv Chronic Kidney Dis ; 27(5): 412-417, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-33308507


As paradigms of clinical care delivery have been significantly impacted by the novel coronavirus disease-2019 pandemic, so has the structure, delivery, and future of medical education. Both undergraduate and graduate medical education have seen disruptions ranging from fully virtual delivery of educational content and limited clinical care for medical students to increased clinical demands with redeployment for residents and fellows. Adherence to social distancing has led to the adoption and implementation of already available technologies in medical education, including video conferencing softwares and social media platforms. Efficient and effective use of these technologies requires an understanding not only of these platforms and their features but also of their inherent limitations. During a time of uncertainty and increased clinical demands, the approach to medical education must be thoughtful with attention to wellness of both the educator and learner. In this review, we discuss the influence of the pandemic on the existing medical education landscape, outline existing and proposed adaptations to social distancing, and describe challenges that lie ahead.

Educação a Distância/métodos , Educação de Pós-Graduação em Medicina/métodos , Educação de Graduação em Medicina/métodos , Comunicação por Videoconferência , Humanos , Moral , Telemedicina
Texto & contexto enferm ; 29: e20190002, Jan.-Dec. 2020. graf
Artigo em Inglês | LILACS, BDENF - Enfermagem | ID: biblio-1101978


ABSTRACT Objective: to identify the elements of moral sensitivity held by nurses working in a medical clinic unit. Method: this exploratory-descriptive study with a qualitative approach addressed 18 nurses from a medical clinic of a university hospital located in southern Brazil using semi-structured interviews, which were analyzed using discursive textual analysis. Results: data were structured into six categories: relational orientation; experiencing moral dilemmas; following rules; benevolent motivation; structuring moral meaning; and autonomy. These categories enabled the identification of important elements of moral sensitivity, such as acknowledging the ethical dimension of one's attitudes, acknowledging the uniqueness of each patient, dealing with conflict between workers and patients and/or their companions, adapting to the workplace, empathy, dialogue, clinical decision-making, meeting the needs of patients, understanding patients' health condition, respect, welcoming patients' desires and providing guidance that concerns patients' requests and refusals. Conclusion: the elements of moral sensitivity identified in this study contribute to support nurses when making clinical decisions, especially when facing ethical issues arising in a medical clinic setting.

RESUMEN Objetivo: identificar los elementos de sensibilidad moral presentes en las enfermeras que trabajan en una Unidad de Clínica Médica. Método: investigación cualitativa, descriptiva exploratoria, desarrollada a través de entrevistas semiestructuradas analizadas mediante análisis discursivo textual, con 18 enfermeras trabajando en la unidad de clínica médica de un hospital universitario en el sur de Brasil. Resultados: se estructuran en seis categorías: orientación relacional; experimentando conflicto moral; seguir las reglas; motivación benevolente; Estructuración del significado moral y la autonomía que permitieron identificar elementos importantes de la sensibilidad moral, como el reconocimiento de la dimensión ética de las actitudes, el reconocimiento de la singularidad de los pacientes, la forma de hacer frente a los conflictos entre el profesional y el paciente y / o compañero, la adaptación en el entorno de trabajo. , empatía, diálogo, toma de decisiones clínicas, satisfacción de las necesidades de los pacientes, comprensión de su estado de salud, respeto, bienvenida a sus deseos y orientación con respecto a sus solicitudes y rechazos. Conclusión: los elementos de sensibilidad moral identificados en este estudio contribuyen a que las enfermeras puedan tomar decisiones clínicas, especialmente frente a problemas éticos experimentados en el entorno de la clínica médica.

RESUMO Objetivo: identificar os elementos da sensibilidade moral presentes em enfermeiros atuantes em uma Unidade de Clínica Médica. Método: pesquisa qualitativa, do tipo exploratório-descritiva, desenvolvida por meio de entrevistas semiestruturadas analisadas mediante análise textual discursiva, com 18 enfermeiros atuantes na unidade de clínica médica de um hospital universitário do sul do Brasil. Resultados: se estruturam em seis categorias: orientação relacional; experimentando o conflito moral; seguir regras; motivação benevolente; estruturação do significado moral e autonomia a qual foi possível identificar importantes elementos da sensibilidade moral como reconhecimento a dimensão ética das atitudes, reconhecer a singularidade dos pacientes, a forma de enfrentamento dos conflitos entre profissional e paciente e/ou acompanhante, adaptação no ambiente de trabalho, empatia, diálogo, tomada de decisão clínica, atendimento as necessidades dos pacientes, compreensão da sua condição de saúde, respeito, acolhimento aos seus desejos e orientação quanto as suas solicitações e recusas. Conclusão: os elementos da sensibilidade moral identificados nesse estudo contribuem para habilitar os enfermeiros para a tomada de decisão clínica, principalmente diante de problemas éticos vivenciados no ambiente de clínica médica.

Humanos , Adulto , Adulto Jovem , Saúde do Adulto , Enfermagem , Ética , Moral , Pesquisa Qualitativa , Ética em Enfermagem , Motivação
Texto & contexto enferm ; 29: e20190104, Jan.-Dec. 2020.
Artigo em Inglês | LILACS, BDENF - Enfermagem | ID: biblio-1101972


ABSTRACT Objective: to compare the moral values that nursing teachers and students consider important for vocational training with those they believe are promoted throughout undergraduate study. Method: a qualitative research; an ethnographic study conducted at a public nursing school in the state of Rio de Janeiro, in 2018, involving 40 interviews with teachers and students and a participant observation phase. Results: the moral values that teachers and students consider important for vocational training, as well as those that are promoted, converge on prudence, respect, responsibility, and empathy. It is noteworthy that the knowledge was much cited by the respondents and this article interpreted it as prudence. However, in relation to the values promoted during undergraduation, students warn that these are stimulated when referring to the binomial student-user of health, because they do not feel to the same intensity the presence of these moral values in the teacher-student relationship. Conclusion: a powerful strategy for teaching about moral values is to promote the care of their own students, teachers and staff. In this way, mismatches are avoided between what is said and what is done by experiencing values such as prudence, respect, responsibility and empathy within interpersonal relationships and in the daily life of the school.

RESUMEN Objetivo: comparar los valores morales que los profesores y estudiantes de enfermería consideran importantes para la formación profesional con los que creen que se promueven a lo largo de la carrera de grado. Método: investigación cualitativa; un estudio etnográfico realizado en el año 2018 en una facultad pública de enfermería del estado de Río de Janeiro, por medio de 40 entrevistas con profesores y estudiantes y una fase de observación de los participantes. Resultados: los valores morales que los profesores y estudiantes evalúan como importantes para la formación profesional, al igual como los que se promueven, convergen en la prudencia, el respeto, la responsabilidad y la empatía. Cabe destacar que el conocimiento fue muy citado por los entrevistados y, en este artículo, se lo interpretó como prudencia. Pese a ello, en relación con los valores promovidos a lo largo de la carrera de grado, los estudiantes manifiestan que se los fomenta cuando se refieren al binomio estudiante-usuario de servicios de salud, puesto que no sienten con la misma intensidad la presencia de estos valores en la relación profesor-estudiante. Conclusión: estamos frente a una poderosa estrategia para enseñar sobre los valores morales y promover el cuidado de sus propios estudiantes, profesores y personal administrativo. De esta manera, se evitan desencuentros entre lo que se dice y lo que se hace al respetar valores como la prudencia, el respeto, la responsabilidad y la empatía dentro de las relaciones interpersonales y en la vida cotidiana de la facultad.

RESUMO Objetivo: comparar os valores morais que professores e estudantes de enfermagem consideram importantes para a formação profissional com aqueles que eles acreditam que são promovidos ao longo da graduação. Método: pesquisa qualitativa; um estudo etnográfico realizado em uma faculdade pública de enfermagem do estado do Rio de Janeiro, em 2018, envolvendo 40 entrevistas com professores e estudantes e uma fase de observação participante. Resultados: os valores morais que os professores e estudantes avaliam ser importantes para a formação profissional, bem como aqueles que são promovidos, convergem para a prudência, o respeito, a responsabilidade e a empatia. Vale destacar que o conhecimento foi muito citado pelos entrevistados e, este artigo, interpretou-o como prudência. Todavia, em relação aos valores promovidos ao longo da graduação, os estudantes alertam que estes são estimulados quando referem-se ao binômio estudante-usuário de saúde, pois não sentem na mesma intensidade a presença desses valores morais na relação professor-estudante. Conclusão: uma potente estratégia para ensinar sobre os valores morais é promover o cuidado dos seus próprios estudantes, professores e funcionários. Dessa maneira, evitam-se desencontros entre o que se diz e o que se faz ao vivenciar os valores como a prudência, o respeito, a responsabilidade e a empatia dentro das relações interpessoais e no cotidiano da faculdade.

Humanos , Adulto , Teoria Ética , Ética , Moral , Estudantes de Enfermagem , Ensino , Enfermagem , Pesquisa Qualitativa , Educação em Enfermagem , Ética em Enfermagem , Docentes , Relações Interpessoais
Ann Cardiol Angeiol (Paris) ; 69(5): 227-232, 2020 Nov.
Artigo em Francês | MEDLINE | ID: mdl-33059875


The COVID-19 pandemic has swept through our hospitals which have had to adapt as a matter of urgency. We are aware that a health crisis of this magnitude is likely to generate mental disorders particularly affecting exposed healthcare workers. Being so brutal and global, this one-of the kind pandemic has been impacting the staff in their professional sphere but also within their private circle. The COV IMPACT study is an early assessment survey conducted for 2 weeks in May 2020, of the perception by all hospital workers of the changes induced in their professional activity by the pandemic. The study was carried out by a survey sent to the hospital staff of Béziers and Montfermeil. The readjusted working conditions were source of increased physical fatigue for 62 % of the respondents. Moral exhaustion was reported by 36 %. It was related to the stress of contracting the infection (72 %) but above all of transmitting it to relatives (89 %) with a broad perception of a vital risk (41 %). This stress affected all socio-professional categories (CSP) and was independent of exposure to COVID. Change in organisation, lack of information and protective gear and equipment were major factors of insecurity at the start of the epidemic. Work on supportive measures is necessary. It should focus on the spread of information, particularly towards the youngest, as well as bringing more psychological support and a larger amount of medical equipment, beyond healthcare workers and the COVID sectors.

Betacoronavirus , Infecções por Coronavirus/epidemiologia , Recursos Humanos em Hospital/psicologia , Pneumonia Viral/epidemiologia , Estresse Psicológico/etiologia , Adulto , Infecções por Coronavirus/psicologia , Infecções por Coronavirus/transmissão , Família , Fadiga/etiologia , Fadiga/psicologia , França/epidemiologia , Inquéritos Epidemiológicos , Humanos , Disseminação de Informação , Pessoa de Meia-Idade , Moral , Doenças Profissionais/etiologia , Doenças Profissionais/psicologia , Inovação Organizacional , Pandemias , Equipamento de Proteção Individual/provisão & distribução , Pneumonia Viral/psicologia , Pneumonia Viral/transmissão , Estresse Psicológico/psicologia , Adulto Jovem
An. psicol ; 36(2): 330-339, mayo 2020. graf
Artigo em Espanhol | IBECS | ID: ibc-192070


En la actualidad, la corrupción constituye uno de los principales problemas psicológicos, sociales, económicos y políticos a nivel mundial. El objetivo del presente estudio es analizar las variables psicológicas asociadas a la corrupción a través de una revisión sistemática de las publicaciones entre 2008 y 2018. Tras realizar una búsqueda en las bases de datos Psycinfo, Web of Science, Scopus, Scielo y Dialnet, se encontraron 44 artículos que cumplían con los criterios de selección propuestos. Los grandes núcleos encontrados fueron la ética organizacional, creencias y valores culturales, moral y normas percibidas, y personalidad y variables relacionadas. En general, los resultados apuntan a que variables organizacionales como la percepción de la conducta de sus dirigentes o las estrategias de justificación están relacionadas con la corrupción. Valores culturales meritocráticos y materialistas también han sido ligados a la conducta corrupta, como ocurre en el caso de la percepción de un entorno corrupto y de las normas sociales. En cuanto a la personalidad, rasgos como el narcisismo y la psicopatía se encuentran íntimamente ligados a este fenómeno. Por otra parte, variables como la percepción del poder o el sexo de los participantes han recibido un sustento empírico ambiguo

Nowadays, corruption is one of the most important psychological, social, economic and political issues worldwide. The present paper aims to analyse psychological variables related to corruption through a systematic review of publications from 2008 to 2018. After carrying out a bibliographic search in scientific databases such as Psycinfo, Web of Science and Dialnet, 41 papers were found to match selection criteria. Core topics haven been organizational ethics, cultural beliefs and values, perceived norms and moral, and personality and related variables. Overall, results have shown that organizational variables such as leaders' behaviour and justification strategies are linked to corruption. Meritocratic and materialist values have also been linked to corrupt behaviour, just like perceiving a corrupt environment and social norms. In regard to personality, features such as narcissism and psychopathy are deeply connected with this phenomenon. On the other side, perception of power and gender have a mixed empirical support

Humanos , Corrupção/psicologia , Valores Sociais , Normas Sociais , Ética Institucional , Religião , Bases de Dados como Assunto/estatística & dados numéricos , Moral
Rev. bioét. derecho ; (49): 7-23, jul. 2020.
Artigo em Espanhol | IBECS | ID: ibc-192091


El objetivo de este artículo es definir y clarificar el criterio del mejor interés (CMI) como un principio ético para la toma de decisiones por representación. En primer lugar, se exponen algunas propuestas conceptuales como la de Kopelman y Buchanan y Brock. En segundo lugar, analizamos algunas críticas que se han hecho al CMI. Por último, este trabajo responde algunas críticas y hace una propuesta integradora

The aim of this paper defines and clarifies the best interest criterion (BIC) as an ethical principle to substitute decision-making. First, this work exposes some conceptual proposals such as Kopelman and Buchanan and Brock. Second, the authors analyze some criticisms that have been made to BIC. Third, we want to respond such critics and we do a conciliatory proposal

L'objectiu d'aquest article és definir I clarificar el criteri del millor interès (CMI) com un principi ètic per a la presa de decisions per representació. En primer lloc, s'exposen algunes propostes conceptuals com la de Kopelman I Buchanan I Brock. En segon lloc, analitzem algunes crítiques que s'han fet al CMI. Finalment, aquest treball dóna resposta a algunes crítiques I fa una proposta integradora

Humanos , Criança , Tomada de Decisões/ética , Pediatria/ética , Bioética , Relações Médico-Paciente/ética , Competência Mental/legislação & jurisprudência , Suspensão de Tratamento/legislação & jurisprudência , Moral
BMC Public Health ; 20(1): 1166, 2020 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-32711485


BACKGROUND: The job morale of healthcare staff is widely seen as an important factor for the quality of care. Yet, there are different understandings of what constitutes job morale, which hinders systematic research and comparisons. We therefore conducted a scoping review of how the concept of job morale has developed over time and how it is used in healthcare research. METHODS: A scoping review was conducted to identify relevant literature. Data were gathered on study design and context, objectives, definitions of morale, outcome measures and key findings. Data was synthesised using a descriptive analytical framework. RESULTS: Ninety-three unique studies met eligibility criteria for the present review. The literature outlines four main periods of the evolution of the concept of job morale: The First World War and the interwar years; Second World War; Aftermath of the Second World War; and Contemporary period. The concept of job morale originated in a military context and was later applied to and specified in the healthcare literature. The concept has been applied to individuals and groups. The understandings used in healthcare vary, but overlap. Methods for assessing job morale in healthcare include quantitative scales, indirect measurements of consequences and predictors of morale, and qualitative approaches. Existing studies have mainly focused on the job morale of general practitioners, nurses and mental health professionals in high-income countries. CONCLUSIONS: Although the understandings of job morale in healthcare are heterogeneous and inconsistent, the concept appears to have been useful over longer periods of time and in different contexts. Which precise understanding of job morale is useful, depends on the given research purpose, and studies should make explicit which exact understanding they apply. Systematic research on job morale is required to facilitate measures to improve and maintain high levels of morale across different professional groups, including professionals in low- and middle-income countries.

Pessoal de Saúde/psicologia , Satisfação no Emprego , Formação de Conceito , Assistência à Saúde , Feminino , Pesquisa sobre Serviços de Saúde , Humanos , Masculino , Moral
Acta bioeth ; 26(1): 81-90, mayo 2020. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1114601


Doctor moral hazard has a significant effect on the doctor-patient relationship, increases the cost of healthcare, and introduces medical risks. It is a global concern. Doctor moral hazard behaviour is evolving in response to China's healthcare reform program which was inaugurated in 2009.A scientific understanding of doctor behaviour would facilitate the prevention and control of doctor moral hazard behaviour. This study used the principles and methodology of Glaser and Strauss's grounded theory. Theoretical and snowball samplings were used to identify 60 subjects. Semi-structured in-depth interviews were conducted with each subject. Themes were identified through substantial (open) coding and theoretical coding. Six types of doctor moral hazard behaviour were extracted from the data. A behavioural model was described and diagrammed to provide a conceptual framework of current doctor moral hazard behaviour. The conceptual model of doctor moral hazard behaviour can be used in several ways to correct or prevent undesirable actions. Rules governing hospital procedures can be strengthened and enforced by supervision and punishment; the asymmetry of information between doctor and patient can be reduced; patient participation in treatment decisions can be increased; the effectiveness of medical ethics education can be improved.

Para un médico, el riesgo moral tiene un efecto significativo en la relación médico-paciente, incrementa el costo de la atención de salud e introduce riesgos en la salud. Se trata de una preocupación global. El riesgo moral del comportamiento médico ha evolucionado en respuesta al programa de reforma de atención de salud del gobierno de China, inaugurado en 2009. Un entendimiento científico del comportamiento de los médicos facilitaría la prevención y el control del riesgo moral. El presente estudio usa los principios y metodología de la teoría fundamentada de Glaser y Strauss. Se usaron muestras teóricas y multiplicativas para identificar 60 sujetos y realizar entrevistas semiestructuradas en profundidad. Los temas se identificaron mediante codificación sustancial abierta y teórica. De los datos se extrajeron seis tipos de riesgo moral del comportamiento médico. Se describió y diagramó un modelo de comportamiento para proporcionar una estructura conceptual del riesgo moral del comportamiento médico actual. El modelo conceptual de riesgo moral del comportamiento médico puede usarse de varias maneras para corregir o prevenir acciones no deseadas. Las normas procedimentales de los hospitales pueden fortalecerse y exigirse mediante supervisión y castigo; se puede reducir la asimetría de la información que se da entre el médico y el paciente, incrementar la participación del paciente en decisiones de tratamiento y mejorar la efectividad en la educación en ética médica.

Risco moral médico tem um efeito significativo na relação médico-paciente, aumenta o custo dos cuidados à saúde e introduz riscos médicos. É uma preocupação global. Comportamento de risco moral médico vem se desenvolvendo em resposta ao programa de reforma de cuidados à saúde da China, que se iniciou em 2009. Uma compreensão científica do comportamento médico facilitaria a prevenção e controle do comportamento de risco moral médico. Este estudo utilizou os princípios da metodologia da Teoria Fundamentada de Glaser e Strauss. Amostragem teóricas e por bola de neve foram utilizadas para identificar 60 participantes. Entrevistas detalhadas semi-estruturadas foram realizadas com cada participante. Temas foram identificados através de codificação (aberta) substancial e codificação teórica. Seis tipos de comportamento de risco moral médico foram obtidos dos dados. Um modelo comportamental foi descrito e diagramado de forma a fornecer um enquadre conceitual do comportamento de risco moral médico. O modelo conceitual de comportamento de risco moral médico pode ser utilizado de diversas formas para corrigir ou prevenir ações indesejáveis. Regras que governam procedimentos em hospitais podem ser fortalecidas e reforçadas por supervisão e punição; a assimetria de informações entre médicos e pacientes pode ser reduzida; a participação dos pacientes nas decisões sobre tratamento pode ser aumentada; e a efetividade da educação ética médica pode ser melhorada.

Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Médicos/psicologia , Reforma dos Serviços de Saúde , Moral , Relações Médico-Paciente , Médicos/ética , Padrões de Prática Médica , Comportamentos Relacionados com a Saúde , China , Comportamento de Escolha , Risco , Entrevistas como Assunto , Teoria Fundamentada , Sobremedicalização
JAMA Netw Open ; 3(1): e1913202, 2020 01 03.
Artigo em Inglês | MEDLINE | ID: mdl-31922555


Importance: Improving health care in low- and middle-income countries (LMICs) requires a workforce with positive job morale. However, the level of job morale in this population remains unclear. Objective: To analyze studies measuring the job morale of physicians and dentists working in LMICs, using levels of job burnout, job satisfaction, and job motivation as indicators of job morale. Data Sources: A comprehensive search of Scopus, PubMed, PsycINFO, EMBASE, Web of Science, and the Cochrane Library, from database inception to October 30, 2018, and gray literature was performed. Study Selection: Studies were eligible if at least 50% of the sample were qualified physicians and/or dentists working in public health care settings in LMICs. Three indicators of job morale in this population were used: job burnout, job satisfaction, and job motivation. Of 12 324 records reviewed, 79 studies were included in the systematic review and 59 were eligible for the meta-analysis. Data Extraction And Synthesis: Data were extracted independently by several investigators in accordance with the Meta-analyses of Observational Studies in Epidemiology (MOOSE) reporting guidelines. Random-effects meta-analyses, planned subgroup analyses, and metaregression were performed. The Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was used to assess bias. Main Outcomes and Measures: Levels of job burnout, job satisfaction, and job motivation as indicators of job morale. Results: Overall, 12 324 records were identified. Of them, 80 records, representing 79 studies and involving 45 714 participants across 37 LMICs, met the inclusion criteria for the review; however, only 3 were from low-income countries. In 21 studies with 9092 participants working mainly in middle-income countries, 32% (95% CI, 27%-38%; I2 = 95.32%; P < .001) reported job burnout, and in 20 studies with 14 113 participants, 60% (95% CI, 53%-67%; I2 = 98.21%; P < .001) were satisfied with their job overall. Sufficient data were not available for a meta-analysis of job motivation. Conclusions and Relevance: The findings suggest that, among physicians and dentists working mainly in middle-income countries, more than half reported having positive job morale. Positive job morale among physicians and dentists may help with recruitment and retention and thus support programs for improving health care in LMICs.

Esgotamento Profissional/epidemiologia , Odontólogos/psicologia , Moral , Médicos/psicologia , Local de Trabalho/estatística & dados numéricos , Adulto , Estudos de Coortes , Estudos Transversais , Países em Desenvolvimento , Feminino , Humanos , Satisfação no Emprego , Masculino , Pessoa de Meia-Idade , Motivação , Estudos Observacionais como Assunto , Local de Trabalho/psicologia
J Sch Nurs ; 36(2): 94-103, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30157699


Physical education (PE) is a frequent site of public health intervention to promote physical activity (PA); however, intervention research frequently overlooks the perspective of PE teachers. The purpose of this qualitative study was to explore teachers' experiences with and perceptions of a PA curriculum intervention. Six findings within three categories were identified and described in detail. In-depth one-on-one semistructured interviews were conducted with nine PE teachers from eight middle schools in Los Angeles. Feeling underappreciated and having a "muddled mission" within PE were driving factors in teacher morale and practice. Teachers had positive experiences with the curriculum, but significant barriers remained and limited the potential for PA during PE classes. PE teachers are pulled in multiple directions and perceive a lack of necessary support systems to achieve student health goals. Interventions aimed at leveraging PE as a site of PA promotion must incorporate the perspectives of PE teachers.

Currículo/normas , Exercício Físico , Educação Física e Treinamento/normas , Professores Escolares/psicologia , Feminino , Humanos , Entrevistas como Assunto , Los Angeles , Masculino , Moral , Pesquisa Qualitativa
Med Leg J ; 88(1): 22-24, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31750767


The introduction of new rotas, rota gaps, poor handover arrangements, the junior hospital doctors' strike, the imposition of a new contract after a four-year period of contract negotiation, the Bawa-Garba case, the abolition of the "Firm", poor rest facilities and bullying have all contributed to eroding the morale of junior doctors. The retention of newly registered doctors is falling. Recent evidence shows that in 2010 83% of Foundation Year 2's went straight into training compared to 38% in 2018. This study was undertaken to assess the extent to which the plans and intentions of current Foundation Year Doctors have been influenced by recent history. With the large volume of complaints and their associated costs on the NHS, the study included questions to identify whether junior doctors feel prepared to deal with the medico-legal issues.

Atitude do Pessoal de Saúde , Corpo Clínico Hospitalar/psicologia , Bullying , Humanos , Imperícia/legislação & jurisprudência , Moral , Inquéritos e Questionários , Reino Unido
Dev Psychol ; 56(1): 91-102, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31670557


This study explored age-related changes in Chinese and Korean children's fairness judgments and reasoning regarding the gendered division of household labor. The majority of previous research on this issue has focused on adults' experiences and has been conducted in Western countries. Interviews were conducted with 133 children, 65 Chinese and 68 South Korean, ages 9-11 (N = 48), 12-14 (N = 43), and 16-18 (N = 42). Despite country differences in women's involvement in the workforce, in both countries women do most of the housework. Most participants across ages evaluated a hypothetical scenario in which the mother did most of the work as unfair and endorsed a hypothetical scenario in which housework was divided evenly as fair. Developmental effects were found with younger children in both countries employing more equality justifications and adolescents providing more social convention justifications. In both countries, children described their mother as doing most of the housework and, in contrast with their judgments about hypothetical situations, were evenly divided overall in their evaluations of whether this unequal distribution in their actual families was fair. Korean children were more likely to view their family's division as unfair than Chinese children and were more likely to employ equality justifications in support of those judgments. Unexpectedly, across countries moral reasoning in the form of expectations of equity rather than gender stereotyping was employed to justify an unequal division of labor. This study's findings suggest the value of investigating children's fairness judgments and moral reasoning regarding both hypothetical and actual situations. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Serviço de Limpeza , Julgamento , Moral , Sexismo , Estereotipagem , Adolescente , Fatores Etários , Criança , China , Comparação Transcultural , Características da Família , Feminino , Humanos , Masculino , República da Coreia