Ethics, Medicine and Public Health最新文献

Background

The coronavirus disease of 2019 (Covid-19) pandemic led to strict visitation restrictions in Intensive Care Units (ICUs), negatively impacting patients, families, and healthcare workers (HCWs). The ICU-open project is a phased approach to engage with ICU patients’ families and reintroduce family visits during the Covid-19 pandemic. The ICU-open project embodies the unwavering commitment to a family-centred approach of the Cà Foncello-Treviso Hospital's ICU staff. The present work reports the perception of the project amongst HCWs and provides a snapshot of the psychological well-being of the ICU staff after the project.

Methodology

The 120 ICU HCWs who participated in the project from May 2020 to June 2021 were invited to answer an online survey. It assessed demographic information, project-related variables, attitudes towards family- and patient-centred care, and psycho-social variables, using ad-hoc items and validated measures including the Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, Moral Injury Events Scale, and Post-Traumatic Growth Inventory.

Results/discussion

Ninety-two HCWs (72% nurses; 65.5% female) completed the survey. HCWs highly valued the ICU-open project for both themselves and patients’ families. Positive perception of the project phases was associated with reduced levels of perceived moral transgressions. One-third of the participants reported moderate to severe levels of anxiety and depression, with notable post-traumatic growth observed in various dimensions.

Conclusion/perspectives

The ICU-open project was perceived very positively by the ICU staff and demonstrates the potential benefits of collaborative initiatives in alleviating the adverse impacts of family visitation restrictions in ICUs. The project may have prompted a positive reappraisal of events and coping mechanisms among HCWs, highlighting the significance placed on family involvement by ICU staff. It underscores the need for maintaining communication between ICU staff and patients’ families during emergencies.

This study explores the controversy over priests practicing medicine in 18th-century Milan. The analysis of existing norms, exceptions, and contemporary reflections highlights the tensions between ecclesiastical directives, civil laws, and the practical and social needs of the period. Among the issues addressed are the role of the state in regulating the professions, the relationship between religion and medicine, and the challenges associated with reconciling spiritual ideals with human and social needs.

Background

Literature has consistently reported that stringent COVID-19 lockdown measures have had profound adverse effects on mental health and have also led to changes in the dietary behavior of young adults. Therefore, this study investigates the relationship between psychological distress and the eating behavior of Malaysian young adults in the aftermath of the COVID-19 pandemic.

Methodology

Young adults aged 18–30 were recruited into this study using a combination of convenience and snowball sampling approaches. Socio-demographics, including gender, age, marital status, ethnicity, educational attainment, and employment status were self-reported by the young adults. The Depression, Anxiety, and Stress Scale-21 (DASS-21) was used to assess the psychological distress in young adults, whereas the eating behavior of young adults was evaluated using the Three-Factor Eating Questionnaire-R18 (TFEQ-R18).

Results

The findings revealed that young adults who experienced moderate to extremely severe psychological distress were 45.6% (anxiety), 38.3% (depression), and 16.2% (stress). The standardized mean scores of eating behavior were in the ascending order of emotional eating (36.41 ± 28.89) < uncontrolled eating (39.75 ± 22.60) < cognitive restraint (43.24 ± 20.04). Interestingly, young adults who experienced moderate to extremely severe depression attained significantly higher mean scores in emotional eating (F = 9.595, P = 0.002) and cognitive restraint (F = 5.380, P = 0.021) than their respective counterparts. Likewise, young adults who experienced moderate to extremely severe anxiety had a significantly higher mean score in emotional eating (F = 4.967, P = 0.027) compared to those in the normal to mild anxiety category.

Conclusion

Providing timely mental health support to individuals experiencing moderate to extremely severe psychological distress is crucial to prevent disordered eating behavior. Longitudinal studies may be carried out in the future to provide better insights into the relationship between psychological distress and eating behavior among young adults.

Background

In Eastern cultures, healthcare providers often engage the family in decision-making, frequently without the patient's explicit consent. Owing to a lack of information, we aimed to explore Kurdish families’ perceptions of cancer diagnosis disclosure.

Methods

Five hundred families of patients who attended the sole adult tertiary health facility in the Kurdistan Region were personally invited to this cross-sectional study.

Results

The mean age of the family members was 46.24 (19–87 years). Most of the participants reported that they prefer a patient be told he/she has cancer (63.60%). Their reasons were to help course of treatment (16.67%), to improve the relationship with the family (9.43%), to avoid living an illusion (5.66%), to better organize their life (20.13%), and a combination of these reasons (48.11%). The remaining 36.4% of participants did not agree to disclose the truth to their patients. The reasons of these participants were knowing the truth changes everyday life (3.30%), it helps in the course of treatment of patients (1.65%), because there is no treatment for cancer (5.50%), knowing the truth has negative psychological effects (21.98%), knowing the truth has negative social effects (1.65%), the patients will not be cooperative with treatment (3.85%), information disclosure may not be necessary be desired or helpful for some patients at a specific time (1.10%), and a combination of these reasons (60.99%). They reported that religion and family have roles in accepting the disease (67.2 and 94.2%, respectively).

Concussions

A considerable percentage of Kurdistan family members had a negative attitude towards diagnosis disclosure.

This article delves into the intricate journey of mental health and discrimination faced by a young non-White woman, an Asian-origin French language representative, as she navigates the complex terrain of identity construction: first within the realm of language teaching, then through the spheres of diplomacy and the corporate world. Through a qualitative analysis of narratives and experiences, drawing upon unique challenges and barriers that shape her identity, this study uncovers the ways in which language teaching and learning environments contribute to the perpetuation of harmful stereotypes and discriminatory practices. The article seeks to promote awareness, inclusivity and support the mental well-being of marginalized individuals. Through personal narratives and critical analysis, the article explores the structural inequities, resilience strategies and provides recommendations for fostering inclusivity in society.

Background

Ensuring an appropriate sample size is crucial for ethical reasons when conducting a clinical study.

Discussion

Insufficient participants may lead to underpowered studies, jeopardizing the detection of true effects and exposing individuals to suboptimal treatment. On the other hand, an excessive number of participants raise ethical concerns, subjecting individuals to unnecessary risks and burdens, and contributing to research waste, such as the misuse of resources.

Conclusion

Overall, there is a significant emphasis on striking a balance in participant inclusion to attain accurate, generalizable, and ethical outcomes in clinical trials.