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Ethical and cultural sensitivity in the palliative phase of heart failure: A scoping review
No full textBackground: Increasing migration is creating more multicultural and ethnically diverse societies, requiring healthcare professionals (HCPs) to address culturally determined values, preferences, and worldviews of patients and their families. Many patients with heart failure (HF) who require palliative care do not have their needs met within an equitable care pathway. This makes cultural sensitivity not only a practical necessity but also an ethical one.Aim/Research question or hypothesis: The aim is to explore the experiences of HF patients and their family caregivers regarding ethical and cultural sensitivity, as well as the factors that underlie or influence these experiences.Methods: A scoping review was conducted in accordance with the Joanna Briggs Institute (JBI) guidelines. The PALETTE framework for performing a literature search in palliative care was used. Six databases, including PubMed, CINAHL and PsycINFO were searched for empirical studies published from 2020-2024. Eligible studies focused on (1) HF patients and their family caregivers, (2) experiences regarding ethics, cultural sensitivity and inclusiveness in HF care and (3) conducted in Europe. The findings were discussed within an international group of researchers, synthesised using a qualitative approach and reported according to the PRISMA-ScR framework.Results: Findings on the ethical and cultural aspects of HF care include 1) ethical challenges in end-of-life decision-making processes, (2) communication about cultural and spiritual values, (3) inequalities in access to HF and palliative care, (4) ethnic, racial and gender related disparities, and (5) how socioeconomic factors shape HF patients’ approach to their illness.Discussion: HCPs need to consider the unique cultural contexts of HF patients and their families to make ethical decisions that align with the patient’s values. Subgroups may encounter potential disadvantages based on ethnicity, race, gender or socioeconomic circumstances, such as unequal access to appropriate treatment options or palliative care. Communication about ethical and cultural values is crucial in reducing disparities and providing culturally sensitive care
Where to aim with multispecies climate justice?:A critical realist account
No full textClimate justice has become a key concept in addressing normative challenges in climate change and related policies. However, most applications of the term have remained anthropocentric. The multispecies justice perspective seeks to remedy this anthropocentrism, through focusing on relationality between and among human and non-human actors in climate justice. We engage with three points where this perspective remains to be developed further: the scope of ‘subjects of justice’, the meaning of ‘justice’ and institutional applications of multispecies justice. We argue that the reliance in multispecies justice literature upon hybridist ontologies of nature and society hampers advancement in these three aspects. We, therefore, propose an alternative ontological foundation, based on critical realism, that can resolve these limitations in current approaches to multispecies justice, contributing to further development of the concept
What does it mean to live in posthuman times?
No full textText accompanying exhibition by media artist Herwig Scherabon
Relational rehabilitation.:Competencies and qualities needed in psychosocial rehabilitation when responding to hope and hopelessness.
No full textThis study explores how rehabilitation professionals engage with the dynamic nature of hope in acquired brain injury rehabilitation, identifying the qualities and competencies needed to respond with care. Using a qualitative design, data were collected through focus groups and individual interviews with cross-disciplinary professionals at a Danish rehabilitation centre. Reflexive thematic analysis revealed four distinct episodes of hope, each demanding a different response. Drawing on the concepts of ‘relational caring’ and ‘practicing presence’, and engaging with empirical data, essential qualities and competencies were revealed: being present, attuned, giving and sharing time, moving along, faithfully staying with, and embracing powerlessness and uncertainty. We conclude that current rehabilitation competency frameworks, such as Wade (Clin Rehabil 34(8):995–1003, 2020) and the Rehabilitation Competency Framework as reported by World Health Organization (Rehabilitation Competency Framework, World Health Organization, Geneva, 2020), fail to capture the more nuanced competencies required to address hopelessness in rehabilitation practice. This indicates that acknowledging and validating the full dynamics of hope and hopelessness within the frameworks shaping rehabilitation practice is essential to recognising the comprehensive range of qualities and competencies needed by rehabilitation professionals. This encompasses the capacity to navigate the shifting nature of hope as well as endure and ‘stay with’ the person in need during hardship. Specifically, education of rehabilitation professionals could gain from integrating the theoretical framework from relational caring and presence theory as a supplement to the International Classification of Functioning, disability and Health (ICF), enabling professionals to effectively navigate the psychosocial and existential dimensions of hope in their practice.This study explores how rehabilitation professionals engage with the dynamic nature of hope in acquired brain injury rehabilitation, identifying the qualities and competencies needed to respond with care. Using a qualitative design, data were collected through focus groups and individual interviews with cross-disciplinary professionals at a Danish rehabilitation centre. Reflexive thematic analysis revealed four distinct episodes of hope, each demanding a different response. Drawing on the concepts of ‘relational caring’ and ‘practicing presence’, and engaging with empirical data, essential qualities and competencies were revealed: being present, attuned, giving and sharing time, moving along, faithfully staying with, and embracing powerlessness and uncertainty. We conclude that current rehabilitation competency frameworks, such as Wade (Clin Rehabil 34(8):995–1003, 2020) and the Rehabilitation Competency Framework as reported by World Health Organization (Rehabilitation Competency Framework, World Health Organization, Geneva, 2020), fail to capture the more nuanced competencies required to address hopelessness in rehabilitation practice. This indicates that acknowledging and validating the full dynamics of hope and hopelessness within the frameworks shaping rehabilitation practice is essential to recognising the comprehensive range of qualities and competencies needed by rehabilitation professionals. This encompasses the capacity to navigate the shifting nature of hope as well as endure and ‘stay with’ the person in need during hardship. Specifically, education of rehabilitation professionals could gain from integrating the theoretical framework from relational caring and presence theory as a supplement to the International Classification of Functioning, disability and Health (ICF), enabling professionals to effectively navigate the psychosocial and existential dimensions of hope in their practice
Moral distress among healthcare professionals in long-term care settings:a scoping review
No full textAIM: To explore the body of knowledge available regarding the moral distress of healthcare professionals in long-term care settings, focusing on influencing factors and strategies to cope with moral distress.DESIGN: Scoping review.METHODS: This scoping review follows the guidelines of the PRISMA-ScR protocol (Tricco et al. 2018) Searches were done using a strategy that included MeSH terms and free text terms.DATA SOURCES: Data sources were PubMed, CINAHL, Psychinfo and Embase. Searches were done in October 2023 without any date restrictions.RESULTS: Eight articles were included in this review. Moral distress can impact the wellbeing of healthcare professionals. Influencing factors of moral distress of health care professionals appeared to be lack of resources, lack of communication and incongruence with colleagues. Strategies to cope with moral distress were talking about ethical issues with others, receiving support from colleagues and managers, and seeking support from outside the team or organization. Individual healthcare professionals relied on their personal characteristics or their professional identity and used rationalization, distancing themselves or acceptance of the situation to cope with their moral distress.CONCLUSION: Moral distress of healthcare professionals in long-term care settings appears not differently experienced than moral distress among healthcare professionals in other healthcare settings. This can be beneficial in learning from each other, but also raises the question whether moral distress is too broadly defined.IMPACT: This review addressed the scope and experiences of moral distress in long-term care settings. Future research can contribute to further insight into if and how specific features of long-term care are of influence on moral distress and formulate tailored strategies to lessen moral distress.REPORTING METHOD: PRISMA-ScR.</p
Revisiting the Formosan Encounter:how the Dutch-Formosan religious imagination informs contemporary Taiwanese citizenship
No full textThe Dutch East India Company encountered in 17th Century "Formosa" (Taiwan) an indigenous population whose religious practices were not yet influenced by either Christianity or Buddhism. In this paper, I will explore how the encounter between Dutch protestant missionaries and local indigenous religious practices shaped the foundation for a hybrid Dutch-indigenous Taiwanese culture and its influence on contemporary citizenship. I will do this by reviewing the literature of the "Formosan Encounter", reports of Dutch missionaries and East India Company personnel on indigenous Formosan religious practices. Secondly, I provide some case studies from fieldwork in Taiwan on the legacy of Dutch colonialism in indigenous Taiwanese folklore
The Educational Value of Gratitude
No full textThis article offers a theoretical investigation of the educational value of gratitude. We make the case that it is possible to learn from and through gratitude experiences. More specifically, gratitude experiences include understandings regarding and a reflective awareness of the value, contingency and vulnerability of certain goods as well as one's dependency in relation to these goods. We argue that such experiences can transform one's outlook on life in a sense that is educationally relevant and valuable in relation to one's flourishing. Building on this, we claim that gratitude can contribute to the development of wisdom. However, since the interpretations of the world inherent in gratitude can be epistemically inaccurate and/or morally inappropriate, gratitude experiences must also be guided by wisdom. Instead of blindly accepting the perceptions implicit in gratitude experiences, people must reflect on these with genuine care for the truth and for justice. We suggest that educators can bring their wisdom and concern for justice to bear in stimulating and guiding others' gratitude experiences in a desirable manner, especially in the case of young people, whose reflective capacities are still developing. We conclude that gratitude experiences should be recognized as a potential source of educationally valuable forms of awareness and insights
Rhizomatic religious belonging in times of the fourth industrial revolution
No full textDigital innovations are increasingly impacting our lives. While ‘offline’ religious practices and material religious culture had already been culminating in hybrid forms of religious belonging, such as rhizomatic religious belonging, technological innovations, and the digitalization of the immanent frame in which we engage in religious cultures complicates this picture even more. In this article, I will argue in favor of the conceptual frame of rhizomatic belonging to understand the negotiation of religious diversity in the context of the Fourth Industrial Revolution. I argue that a post-human religion is emerging, which, instead of being fragmented, individualized, or generally ‘lost’, is a transformation towards a new form of belonging, in which care, community, and play are elements. These post-human assemblages of rhizomatic religious belonging emerge at the intersection of digital culture and ‘offline’ material life. TikTok and Instagram become powerful tools for ‘Generation Z’ to explore new networks of religious connections. Digital dimensions of religion, such as the live streaming of the death wake of Buddhist teacher Thich Nhat Hanh, and the development of artificial intelligence as vicarious religious actors are expressions of new forms of religious constellations that are strongly impacting the affective and phenomenological experiences of religious belonging. I will conclude that ‘belonging’ in the digital age is fundamental in understanding the challenges of our times and our communities because it elicits sentiments of ‘feeling at home’ in a dynamic world in crisis
