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  • 1.
    Bremer, Anders
    et al.
    University of Borås, Sweden.
    Jimenéz-Herrera, Maria
    Rovira i Virgili University, Spain.
    Axelsson, Christer
    University of Borås, Sweden.
    Burjalés Martí, D
    Rovira i Virgili University, Spain.
    Sandman, Lars
    University of Borås, Sweden.
    Casali, Luca
    Queensland University of Technology, Australia.
    Ethical values in emergency medical services: A pilot study2015In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 22, no 8, p. 928-942Article in journal (Refereed)
    Abstract [en]

    Background: Ambulance professionals often address conflicts between ethical values. As individuals’values represent basic convictions of what is right or good and motivate behaviour, research is neededto understand their value profiles.

    Objectives: To translate and adapt the Managerial Values Profile to Spanish and Swedish, and measure thepresence of utilitarianism, moral rights and/or social justice in ambulance professionals’ value profiles inSpain and Sweden.

    Methods: The instrument was translated and culturally adapted. A content validity index was calculated.Pilot tests were carried out with 46 participants.

    Ethical considerations: This study conforms to the ethical principles for research involving humansubjects and adheres to national laws and regulations concerning informed consent and confidentiality.

    Findings: Spanish professionals favoured justice and Swedish professionals’ rights in their ambulanceorganizations. Both countries favoured utilitarianism least. Gender differences across countries showedthat males favoured rights. Spanish female professionals favoured justice most strongly of all.

    Discussion: Swedes favour rights while Spaniards favour justice. Both contexts scored low onutilitarianism focusing on total population effect, preferring the opposite, individualized approach of therights and justice perspectives. Organizational investment in a utilitarian perspective might jeopardizeambulance professionals’ moral right to make individual assessments based on the needs of the patientat hand. Utilitarianism and a caring ethos appear as stark opposites. However, a caring ethos in its turn might well involve unreasonable demands on the individual carer’s professional role. Since both the justiceand rights perspectives portrayed in the survey mainly concern relationship to the organization and peerswithin the organization, this relationship might at worst be given priority over the equal treatment andmoral rights of the patient.

    Conclusion: A balanced view on ethical perspectives is needed to make professionals observant and readyto act optimally – especially if these perspectives are used in patient care. Research is needed to clarify howjustice and rights are prioritized by ambulance services and whether or not these organization-related valuesare also implemented in patient care.

  • 2.
    Bremer, Anders
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences. University of Borås, Sweden.
    Sandman, Lars
    University of Borås, Sweden.
    Futile cardiopulmonary resuscitation for the benefit of others: An ethical analysis2011In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 18, no 4, p. 495-504Article in journal (Refereed)
    Abstract [en]

    It has been reported as an ethical problem within prehospital emergency care that ambulance professionals administer physiologically futile cardiopulmonary resuscitation (CPR) to patients having suffered cardiac arrest to benefit significant others. At the same time it is argued that, under certain circumstances, this is an acceptable moral practice by signalling that everything possible has been done, and enabling the grief of significant others to be properly addressed. Even more general moral reasons have been used to morally legitimize the use of futile CPR: That significant others are a type of patient with medical or care needs that should be addressed, that the interest of significant others should be weighed into what to do and given an equal standing together with patient interests, and that significant others could be benefited by care professionals unless it goes against the explicit wants of the patient. In this article we explore these arguments and argue that the support for providing physiologically futile CPR in the prehospital context fails. Instead, the strategy of ambulance professionals in the case of a sudden death should be to focus on the relevant care needs of the significant others and provide support, arrange for a peaceful environment and administer acute grief counselling at the scene, which might call for a developed competency within this field.

  • 3.
    Brüggemann, Jelmer
    et al.
    Linköpings universitet.
    Wijma, Barbro
    Linköpings universitet.
    Swahnberg, Katarina
    Linköpings universitet.
    Patients’ silence following healthcare staff’s ethical transgressions2012In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 19, no 6, p. 750-763Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to examine to what extent patients remained silent to the health care system after they experienced abusive or wrongful incidents in health care. Female patients visiting a women’s clinic in Sweden (n = 530) answered the Transgressions of Ethical Principles in Health Care Questionnaire (TEP), which was constructed to measure patients’ abusive experiences in the form of staff’s transgressions of ethical principles in health care. Of all the patients, 63.6% had, at some point, experienced staff’s transgressions of ethical principles, and many perceived these events as abusive and wrongful. Of these patients, 70.3% had remained silent to the health care system about at least one transgression. This silence is a loss of essential feedback for the health care system and should not automatically be interpreted as though patients are satisfied.

  • 4.
    Furingsten, Lovisa
    et al.
    Dalarna University.
    Sjögren, Reet
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Mälardalen University.
    Forsner, Maria
    Dalarna University.
    Ethical challenges when caring for dying children2015In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 22, no 2, p. 176-187Article in journal (Refereed)
    Abstract [en]

    Background: Caring for dying children presents special challenges, according to the children themselves, their relatives and healthcare professionals. Objective: The aim of this study was to describe caring as represented in healthcare workers' experiences of caring for dying children. Method: A phenomenological approach was chosen, in-depth interviews were carried out and data were analysed in four steps focusing on (a) open reading, (b) meaning units, (c) constituents and (d) essence. Ethical considerations: Four nurses in a general acute paediatric care setting in Sweden participated after providing written informed consent. Voluntary participation and confidentiality were ensured, and the study was ethically approved. Findings: The essence of caring for dying children was likened to a musically attuned composition, comprising five constituents: presence, self-knowledge, injustice in dying, own suffering and in need of others. Presence was found to be a prerequisite for caring when a child is dying. Self-knowledge and support from others can be of help when struggling with emotional pain and injustice. Discussion: Caring for dying children has been found to be a delicate task for healthcare workers all over the world, and the ethical dimension is emphasized in international research. In this study, emotional pain and suffering accompanied caring, but an atmosphere in which it is possible to give and get support from colleagues and to have time to grieve and time to focus on the patient's needs may ease the burden, as can having time to process thoughts about life and death, and a possibility to grow in self-knowledge. Conclusion: Caring in ethically demanding situations may be facilitated through presence, atmosphere, self-knowledge and time. The challenge does not demand highly technological solutions; these assets are readily available, no matter where on earth. However, there is a need to further investigate these prerequisites for caring, particularly when a child is dying.

  • 5.
    Tang, Ping Fen
    et al.
    Kina.
    Johansson, Camilla
    Örebro universitet.
    Wadensten, Barbro
    Uppsala universitet.
    Wenneberg, Stig
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Ahlström, Gerd
    Hälsohögskolan i Jönköping.
    Chinese nurses´ethical concerns in a neurological ward2007In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 14, no 6, p. 810-824Article in journal (Refereed)
    Abstract [en]

    Our aim was to describe Chinese nurses' experiences of workplace distress and ethical dilemmas on a neurological ward. Qualitative interviews were performed with 20 nurses. On using latent content analysis, themes emerged in four content areas: ethical dilemmas, workplace distress, quality of nursing and managing distress. The ethical dilemmas were: (1) conflicting views on optimal treatment and nursing; (2) treatment choice meeting with financial constraints; and (3) misalignment of nursing responsibilities, competence and available resources. The patients' relatives lacked respect for the nurses' skills. Other dilemmas could be traced to the transition from a planned to a market economy, resulting in an excessive workload and treatment withdrawal for financial reasons. Lack of resources was perceived as an obstacle to proper patient care in addition to hospital organization, decreasing the quality of nursing, and increasing moral and workplace distress. The nurses managed mainly by striving for competence, which gave them hope for the future.

  • 6.
    Tuvesson, Hanna
    et al.
    Malmö University.
    Eklund, Mona
    Lund University.
    Wann-Hansson, Christine
    Malmö University.
    Stress of Conscience among psychiatric nursing staff in relation to environmental and individual factors2012In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 19, no 2, p. 208-19Article in journal (Refereed)
    Abstract [en]

    The present study aimed at investigating the relationship between environmental and individual factors and Stress of Conscience among nursing staff in psychiatric in-patient care. A questionnaire involving six different instruments measuring Stress of Conscience, the ward atmosphere, the psychosocial work environment, Perceived Stress, Moral Sensitivity, and Mastery was answered by 93 nursing staff at 12 psychiatric in-patient wards in Sweden. The findings showed that Sense of Moral Burden, Mastery, Control at Work and Angry and Aggressive Behavior were related to Stress of Conscience. We conclude that Mastery and Control at Work seemed to work as protective factors, while Sense of Moral Burden and perceptions of Angry and Aggressive Behavior made the nursing staff more vulnerable to Stress of Conscience. Future research should investigate whether measures to increase the level of perceived control and being part of decision making will decrease the level of Stress of Conscience among the staff.

  • 7.
    Tuvesson, Hanna
    et al.
    Blekinge Institute of Technology.
    Lützén, Kim
    Karolinska institutet.
    Demographic factors associated with moral sensitivity among nursing students2017In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 24, no 7, p. 847-855Article in journal (Refereed)
    Abstract [en]

    Background:Today’s healthcare environment is often characterized by an ethically demanding worksituation, and nursing students need to prepare to meet ethical challenges in their future role. Moralsensitivity is an important aspect of the ethical decision-making process, but little is known regardingnursing students’ moral sensitivity and its possible development during nursing education.Objectives:The aims of this study were to investigate moral sensitivity among nursing students,differences in moral sensitivity according to sample sub-group, and the relation between demographiccharacteristics of nursing students and moral sensitivity.Research design:A convenience sample of 299 nursing students from one university completed aquestionnaire comprising questions about demographic information and the revised Moral SensitivityQuestionnaire. With the use of SPSS, non-parametric statistics, including logistic regression models,were used to investigate the relationship between demographic characteristics and moral sensitivity.Ethical considerations:The study followed the regulations according to the Swedish Ethical Review Actand was reviewed by the Ethics Committee of South-East Sweden.Findings:The findings showed that mean scores of nursing students’ moral sensitivity were found in themiddle to upper segment of the rating scale. Multivariate analysis showed that gender (odds ratio¼3.32),age (odds ratio¼2.09; 1.73), and parental status (odds ratio¼0.31) were of relevance to nursing students’moral sensitivity. Academic year was found to be unrelated to moral sensitivity.Discussion and conclusion:These demographic aspects should be considered when designing ethicseducation for nursing students. Future studies should continue to investigate moral sensitivity in nursingstudents, such as if and how various pedagogical strategies in ethics may contribute to moral sensitivity innursing students

  • 8.
    Wadensten, Barbro
    et al.
    Uppsala Universitet.
    Wenneberg, stig
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Silén, Marit
    Hälsohögskolan i Jönköping.
    Tang, Ping Fen
    Kina.
    Ahlström, Gerd
    Hälsohögskolan i Jönköping.
    A cross-cultural comparison of nurses' ethical concerns2008In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 15, no 6, p. 745-760Article in journal (Refereed)
1 - 8 of 8
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  • ieee
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  • en-US
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