1,720,976 research outputs found
Moral distress among critical care clinicians: Protective factors and consequences on clinicians’ well-being and quality of care
Get PDFIntroduction. Psychological well-being of people working in the helping professions has received increased attention in the last decade. Working in critical care settings, such as Intensive Care Units (ICUs), is especially stressful as it exposes clinicians to high patient morbidity and mortality, challenging work routines, and regular encounters with traumatic and ethical issues. Growing literature highlights that the experience of moral distress, that means not acting accordingly to what one perceives to be ethically right, is relevant among clinicians working in critical care. However, there is a lack of quantitative studies aimed to identify the protective factors and the consequences of moral distress on clinicians and patients. This thesis aimed to fill this gap by exploring: 1) the dimensionality of the construct of moral distress, through the validation of a scale to measure moral distress in Italy; 2) the protective factors of moral distress and its effect on clinicians’ psychological well-being; and 3) the relationship between clinicians’ moral distress and the perception of care quality by family members of ICU patients. Methods. A cross-sectional study was conducted involving physicians, nurses, and residents working in ICU, and the family members of their patients. Clinicians working in 8 ICUs (n=184) were administered the Moral Distress Scale-Revised (MDS-R; Hamric et al., 2012) and the Beck Depression Inventory-II (BDI-II; Beck, Steer & Brown, 2006) for validation. In addition, a subsample of clinicians of 7 ICUs (n=170) were administered two further subscales (Value and Control) of the Areas of Worklife Scale (AWS; Leiter & Maslach, 2005) in order to assess the relationships between moral distress, value congruence, control and depression. Family members (n=59) of the patients hospitalized in a subsample of 5 ICUSs were administered the Family Satisfaction with care in the ICU survey (FS-ICU; Wall et al., 2007) in order to assess the relationship between clinicians’ moral distress and family satisfaction with care. Results. The Italian MDS-R showed a 4-factor structure composed of: Futile care, Poor teamwork, Deceptive communication, and Ethical Misconduct. This model accounted for 59% of the total variance and presented a good fit with the data (RMSEA=.06; CFI=.95; TLI=.94; WRMR=.65). For what concerns the protective factors of moral distress and its effect on clinicians’ well-being, a mediation path from value congruence and control to depression through moral distress was tested, yielding a significant total indirect effect of value congruence on depression through moral distress (β= -.12; p= .02). Regarding the effect of moral distress on the quality of care, moral distress of clinicians correlated with the family satisfaction as to the inclusion in the decision making process (ρ=-.900; p=.037). Moral distress of physicians and nurses correlated with different aspects of family members’ satisfaction. Conclusions. Findings of this thesis contributed to the refinement of the construct of moral distress and provided evidence of its multidimensionality. Congruence between individual and organizational value was found to influence moral distress. As moral distress was related to depression and family perception of care quality, interventions should be implemented to reduce it. The findings of this thesis offer a preliminary base for the development of tailored interventions for clinicians
When healthcare professionals cannot do the right thing : a systematic review of moral distress and its correlates
No full textMoral distress occurs when professionals cannot carry out what they believe to be ethically appropriate actions. This review describes the publication trend on moral distress and explores its relationships with other constructs. A bibliometric analysis revealed that since 1984, 239 articles were published, with an increase after 2011. Most of them (71%) focused on nursing. Of the 239 articles, 17 empirical studies were systematically analyzed. Moral distress correlated with organizational environment (poor ethical climate and collaboration), professional attitudes (low work satisfaction and engagement), and psychological characteristics (low psychological empowerment and autonomy). Findings revealed that moral distress negatively affects clinicians' wellbeing and job retention. Further studies should investigate protective psychological factors to develop preventive interventions
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
Hospital Employees' Well-Being Six Months after the COVID-19 Outbreak: Results from a Psychological Screening Program in Italy
Get PDFThe COVID-19 outbreak has taken a heavy toll on the mental well-being of healthcare workers. This study aims to describe a psychological screening program developed at a large University Hospital in Milan, Italy, and assess the psychological outcomes of employees and associated factors. A survey was electronically conducted among hospital employees between July and October 2020. Sociodemographic data, information about COVID-19 experience and three scales assessing anxiety (STAI-Y1), depression (HAM-D) and post-traumatic stress disorder (PCL-5) were collected. A total of 308 employees (80% women; mean age 45.1 years) responded: 16% physicians, 68% other healthcare professionals, and 16% administrative staff. Employees reported moderate/severe symptoms of anxiety (23%), depression (53%), and post-traumatic stress disorder (40%). At multivariate logistic regression analysis, having suffered a loss for COVID-19 in the personal context was independently associated with higher risk of moderate/severe anxiety (OR = 2.40; 95% CI 1.16–4.98), being female was associated with higher risk of moderate/severe depression (OR = 2.82; 95% CI 1.43–5.59), and having had a family member affected by COVID-19 was associated with higher risk of moderate/severe post-traumatic stress disorder (OR = 2.75; 95% CI 1.01–7.48). COVID-19 personal experience may have a profound impact on hospital workers’ mental health and should be considered in supportive interventions
- …
