BackgroundIn the last 2 weeks of January 2021, Portugal was the worst country in the world in incidence of infections and deaths due to COVID-19. As a result, the pressure on the healthcare system increased exponentially, exceeding its capacities and leaving hospitals in near collapse. This scenario caused multiple constraints, particularly for hospital medical staff. Previous studies conducted at different moments during the pandemic reported that COVID-19 has had significant negative impacts on healthcare workers’ psychological health, including stress, anxiety, depression, (...) burnout, post-traumatic stress symptoms, and sleep disturbances. However, there are many uncertainties regarding the professional quality of life of hospital nurses and physicians. To address gaps in previous research on secondary traumatic stress, we focused on healthcare workers working in hospitals affected by a major traumatic event: the third wave of COVID-19.ObjectivesThe aim of the present study was to identify the contribution of personal and work-related contextual variables on professional quality of life of healthcare workers.MethodsCross-sectional study with a web-based questionnaire given to physicians and nurses working in a hospital setting. A total of 853 healthcare professionals participated in the survey assessing professional quality of life compassion satisfaction, secondary traumatic stress, and burnout. Factors of professional quality of life were assessed using regression analysis.ResultsMost of the participants showed moderate or high levels of compassion satisfaction, whereas the majority of them experienced moderate levels of burnout and secondary traumatic stress. The analyzed variables demonstrated no differences between professionals who were directly or not involved in the care of COVID-19 patients. Parental status was found to be a significant factor in compassion satisfaction. Female gender was significantly associated with more susceptibility to secondary traumatization. Factors that may potentially contribute to burnout include years of professional experience and the number of work hours per week.ConclusionThe COVID-19 pandemic has created a new challenge for the healthcare system. Burnout and secondary traumatic stress can lead to medical errors and impact standards of patient care, particularly compromising compassionate care. It is therefore recommended that hospitals develop psychoeducational initiatives to support professionals in dealing with barriers to compassion. (shrink)

Background Workplace Incivility is a common issue in the nursing profession. Nurses who are affected by such behaviors may experience distress. Objectives This study aimed to assess the relationship between workplace incivility and nurses’ professional quality of life. Research design This cross-sectional correlational study was conducted in 2021 in “Tehran”. Data were collected using a demographic questionnaire, the Nursing Incivility Scale (NIS), and the Professional Quality Of Life scale (ProQOL). Data analysis was performed through the Pearson (...) correlation and multiple linear regression, using the SPSS v.16. Participants and research context Participants were 200 nurses randomly recruited from selected hospitals of “TUMS”. Ethical considerations The study obtained research ethics approval and all participants were informed of the voluntary and anonymous nature of their participation. Findings The mean age of participants was 32.30 ± 7.22, and 76.5% were female. There was a significant correlation between the professional quality of life and workplace incivility ( r = −0.23, p =.001). Multiple regression analysis between the subscales of workplace incivility and professional quality of life demonstrated that the incivility from the supervisor ( β = −0.29, p =.001) and incivility from patients ( β = −0.27, p <.001) can predict the compassion satisfaction dimension. The incivility from the supervisor ( β = 0.24, p =.001) and incivility from patients ( β = 0.26, p <.001) can explain burnout. The incivility of the patients can explain secondary traumatic stress ( β = 0.14, p =.02). Conclusion This study showed that workplace incivility is significantly related to professional quality of life. Therefore, the reduction of behaviors of incivility can lead to the improvement of the professional quality of life. (shrink)

"I confess — I took virtually every picture in this book with my compact camera!" Pros like Rick Sammon make their living with top-of-the-line dSLR cameras.

Background Professional values are important in promoting healthy work environments, patient satisfaction, and quality of care. Magnet® hospitals are recognized for excellence in nursing care and as such, understanding the relationship between nurses' values and Magnet status is essential as healthcare organizations seek to improve patient outcomes. Research question/aim/objectives The research question is: are there differences in individual values, professional values, and nursing care quality for nurses and nurse managers practicing in Magnet, Magnet journey, and non-Magnet (...) direct patient care settings? Research Design This descriptive cross-sectional study is guided and informed by the conceptual framework of the Professional Values Model including individual values, professional values, and nursing care quality. Participants and research context Convenience sampling of registered nurses and nurse managers, responsible for direct patient care, was utilized in a non-profit healthcare system in the Midwest region of the United States. Ethical Considerations Institutional review board approval was obtained. Participants were informed about the right to self-determine participation and assurance of anonymity. Findings 827 (n = 827) nurses and nurse managers responded to the survey. Significant differences were identified in individual values sub-scale: self-enhancement ( p = 0.38), professional values ( p = 0.037), practice environment: participation in hospital affairs ( p = 0.00), foundations for quality care ( p = 0.016), and resources adequacy ( p = 0.012) and in nurse sensitive HCAHPS questions: nurses explained things understandably ( p = 0.00), got help as soon as wanted ( p = 0.00), and treated with courtesy and respect ( p = 0.00). Discussion/Conclusions Findings indicate that fostering individual and professional values may impact nursing practice, regardless of Magnet designation. Promoting professional values may contribute to improved work environments, enhancing patient satisfaction. Study results offer valuable insights for organizations striving to enhance nursing values, impacting quality of care provided to patients. MeSH Terms Cross-Sectional Studies, Respect, Ethics Committees, Patient Satisfaction, Nurse Administrators, and Personal Satisfaction. (shrink)

The purpose of the research is to identify professionally important qualities of the specialists in design, technology, and service, in particular cutters in the postmodern society. At the first stage, a preliminary list of 39 professionally important qualities of the skilled workers in the fashion industry has been formulated by means of theoretical analysis. The list considers the specifics of the cutter`s work at the intersection of three industries – design, technology, and service. At the second stage, a priori ranking (...) of factors has been conducted by interviewing 5 experts. The list, reduced after a priori ranking, has become a basis for surveying 246 respondents from different groups of stakeholders at the third stage. As a result, the lists of input parameters of the model of specialist, which are professionally important qualities of the skilled cutters, are obtained. The lists contain 28 professionally important personal qualities, which are grouped into the following groups: executive and motor manifestations, cognitive processes, memory and thinking, emotions, business qualities, creative features, specific requirements. The obtained results make it possible to develop optimal prognostic models of training the skilled workers in the fashion industry, as well as to conduct a scientifically grounded selection of personnel and career counseling. (shrink)

The article analyzes the professional and ethical qualities of a natural science specialist, which must be formed in institutions of secondary vocational education during the training period for successful further professional activity. In the analysis of scientific and methodical literature identified the main groups of professional and ethical qualities that should be possessed by a future specialist science profile, graduate with a degree in pastry chef. The structure of professional and ethical attitudes of a pastry chef (...) is studied, and a detailed classification of professional and ethical qualities of a specialist is developed and presented. (shrink)

Quality of nursing cannot be assessed in terms of performance referenced criteria, but only in terms of the personal qualities displayed in the performance. The key to improvement in practice may be the improvement of emotional and motivational tendencies. In essence, professional development implies personal development. Harré makes a distinction between ‘powers to do’ and ‘powers to be’ (a state of being). The former are the capacities that individuals acquire to perform their tasks and roles. Professional development (...) therefore involves, first, the acquisition of the capacities necessary for the successful completion of a set of professional tasks (the powers to do). Secondly, it involves the acquisition of the appropriate emotions and motivations, and the theories about human nature and the conduct that underpins them (the powers to be). Therefore, these capacities cannot be derived from an analysis of tasks, since what are defined as tasks in the first place are determined by the exercise of such powers. The acquisition of attitudes constitutes a source of competent practice. Harré’s model of ‘personal identity’ provides a conceptual framework for thinking about the process of the acquisition of nursing competence and its relationship to differing views of nursing. Considerations relating to different priorities within Harré’s model make it possible to raise questions about the objectives of competence at different stages. (shrink)

The acquisition of professional knowledge is a core issue in the formation of auditor industry expertise; however, previous literature has neglected the time required for auditors to acquire professional knowledge. We examine the audit quality and fees of audit firms in different stages of an auditor acquiring professional knowledge and find that, in the initial stage of the process of knowledge acquisition, audit quality and audit fees decrease. However, in the long run, knowledge learning has (...) a more obvious effect on the improvement of audit quality and audit fees. Specifically, knowledge learning has a positive effect on the development of audit firms. (shrink)

The terms used to describe and negotiate environmental quality are both ambiguous and value-laden. Stakeholders intimately and actively involved in the management of forested lands were interviewed and found to use ambiguous, tautological, and value-laden definitions of terms such as health, biodiversity, sustainability, and naturalness. This confusing language hinders public participation efforts and produces calls to regulate and remove discretion from environmental professionals. Our data come from in-depth interviews with environmental management professionals and other stakeholders heavily vested In negotiating (...) the fate of forested lands. We contend that environmental science and management will be more effective if its practitioners embrace and make explicit these ambiguous and evaluative qualities rather than ignore and disguise them. (shrink)

BackgroundMany authors choose to work with professional medical writers when reporting the results of clinical trials. We conducted a systematic review to examine the relationship between professional medical writing support (PMWS) and the quality, ethics and timeliness of publications reporting clinical trials.MethodsUsing terms related to ‘medical writer’ and ‘observational study’, we searched MEDLINE and Embase (no date limits), as well as abstracts and posters from meetings of the International Society for Medical Publication Professionals (ISMPP; 2014–2018). We also (...) hand-searched the journals Medical Writing and The Write Stuff (2014–2018) and the bibliographies of studies identified in the electronic searches. We screened the results to identify studies that compared the quality, ethics and timeliness of clinical trial publications written with and without declared PMWS.ResultsOur searches identified 97 potentially relevant studies, of which 89 were excluded during screening and full paper review. The remaining eight studies compared 849 publications with PMWS with 2073 articles developed without such support. In these eight studies, PMWS was shown to be associated with increased adherence to Consolidated Standards of Reporting Trials (CONSORT) guidelines (in 3/3 studies in which this was assessed), publication in journals with an impact factor (one study), a higher quality of written English (one study), and a lower likelihood of reporting non-pre-specified outcomes (one study). PMWS was not associated with increased adherence to CONSORT for Abstracts guidelines (one study) or with the impact of published articles (mean number of citations per year, mean number of article views per year and Altmetric score; one study). In studies that assessed timeliness of publication, PMWS was associated with a reduced time from last patient visit in clinical trials to primary publication (one study), whereas time from submission to acceptance showed inconsistent results (two studies).ConclusionsThis systematic review of eight observational studies suggests that PMWS is positively associated with measures of overall quality of reporting of clinical trials and may improve the timeliness of publication.Video abstract. (MP4 161000 kb). (shrink)

ObjectiveThis study aimed to analyse how stereotypes towards older people moderate the relationship between burnout and quality of life of professionals working in nursing homes.MethodA total of 312 professionals were asked to complete questionnaires of burnout Maslach Burnout Inventory quality of Life and aging stereotypes. The moderation effects were tested using linear regression models.ResultsA negative association was observed between burnout and QoL. It was also found a statistically significant moderator effect of the total score of stereotypes and the (...) health stereotypes, besides a marginally statistically significant moderator effect for motivational stereotypes. The moderator effects were different for people with low and high negative stereotypes. QoL was more affected under conditions of high burnout, in which people with more negative stereotypes tended to present higher QoL than people with lower negative stereotypes.ConclusionHighly burned-out professionals in nursing homes may avoid their negative feelings projecting them to residents through stereotypes, as a way of coping with burnout and increasing their QoL. However, this mechanism is an “aggressive reaction” and may have negative effects for both the older adult and the professional. The comprehension of these variables is essential for developing adequate intervention programs. (shrink)

Professional Responsibility: New Horizons of Praxis addresses the manifold and complex challenges inherent in professional responsibility. Since the beginning of the 20th Century, professions have been accorded a conjoined mandate - political and moral responsibility - to serve the interests of individual's and society. The quality of professional work, how professionals understand and live out their responsibilities in practice, is a matter of pervasive concern since increasingly they have such a prominent presence in most people's lives. (...) Until the late 1960's, professionals' roles and responsibilities were rarely questioned, but such trust has since given way to collective scepticism concerning their commitment and willingness to live up to their moral and societal obligations. Abuse of power and privilege by some professionals has contributed to decline in trust by publics, the concept of 'good work' is increasingly challenged, and politicians and policy-makers have sought to regulate and hold professions to account. It is timely, therefore, to investigate critically conflicting discourses and practices on what counts as professional responsibility, to question how professionals understand and are prepared for a life of professional responsibility, and what acting with integrity and authority looks like in practice. One of the distinctive features of this book is the combination of normative and empirical dimensions that are used to dissect this question. The authors indicate from a diversity of disciplinary perspectives how professional responsibility includes particular thoughts and warranted actions yet remains multifaceted and inarticulate"-- Provided by publisher. (shrink)

BackgroundThe healthcare system is among the institutions operating under the most challenging conditions during the period of outbreaks like pandemic which affects the whole world and leads to deaths. During pandemics that affect the society in terms of socioeconomic and mental aspects, the mental health of healthcare teams, who undertake a heavy social and work load, is affected by this situation.AimThis research was conducted with the aim of determining the effect of stress, anxiety, and burnout levels of healthcare professionals caring (...) for COVID-19 patients on their quality of life.MethodThe sample of the study consisted of a total of 240 healthcare professionals, determined by random sampling method among the healthcare professionals working in pandemic hospitals in Tokat city center, Turkey. Perceived Stress Scale, Spielberger State-Trait Anxiety Inventory, Maslach Burnout Inventory and Quality of Life Scale were used in the study conducted in the relational screening model.FindingsWhile the stress, trait anxiety, and quality of life mean scores of healthcare professionals who were female, married and had children were higher than the other groups, high, moderate, negative, and positive correlations were found among all variables.ConclusionThe research concluded that the stress, anxiety, and burnout of healthcare workers caring for COVID-19 patients affected their quality of life. (shrink)

The level of medical care to patients and the success of the implementation of the national project "Health" depend on the health status and doctor's professionalism. Modern healthcare reform is being implemented by optimizing costs, merging medical organizations, closing ineffective hospitals, expanding the use of high-tech care and informatization of the doctor's activities. All this makes it necessary to assess the health of doctors. Scientists have studied the quality of life and identified the professional burnout of doctors in (...) children's clinics in different age groups. Primary care pediatricians have a higher quality of life score when compared to the standard [1]. However, all groups have a high level of professional burnout. The pre-retirement group of doctors has more unfavorable profile. They are highly professional specialists but may experience emotional discomfort because the pension system has been reformed. This situation requires the introduction of preventive work with doctors of this age as a group with great potential and capable of professional longevity. (shrink)

Professional, Ethical, Legal, and Educational Lessons in Medicine: A Problem Based Approach provides a comprehensive review of the complex and challenging field of professional medical practice. Its problem-based format incorporates a vast pool of practical, board-exam-style multiple-choice questions for self-assessment, and is an ideal resource for exam preparation as well as ongoing clinical education among trainees and clinicians The practice of medicine is not only about clinical care of patients. Physicians must navigate ethical conundrums, legal pitfalls, and (...) class='Hi'>quality improvement issues while maintaining scrupulous professionalism and being exemplary educators. This volume addresses common issues in the realm of professional medical practice not typically covered in other texts. Each of the 73 chapters presents a problem-based case that branches out into an oral board examination type stem questions. A discussion section with brief review articles summarizes the most recent literature. Multiple-choice questions with answers allows for comprehensive self-assessment or interactive group quizzes. This book will appeal to medical and allied health professionals in all specialties of medicine. It is an excellent and hands-on reference for the related but diverse domains associated with professional healthcare practice by students, physicians, and other healthcare providers compacted into one volume. (shrink)

Professional autonomy is often described as a claim of professionalsthat has to serve primarily their own interests. However, it can also beseen as an element of a professional ideal that can function as astandard for professional, i.e. medical practice. This normativeunderstanding of the medical profession and professional autonomy facesthree threats today. 1) Internal erosion of professional autonomy due toa lack of internal quality control by the medical profession; 2)the increasing upward pressure on health care (...) expenses that calls for ahealth care policy that could imply limitations for the professionalautonomy of physicians; 3) a distorted understanding of theprofession as being based on a formal type of knowledge and relatedtechnology, in which other normative dimensions of medical practice areneglected and which frustrates meaningful communication betweenphysicians and patients. To answer these threats a normative structureanalysis of medical practice is presented, that indicates whichprinciples and norms are constitutive for medical practice. It isconcluded that professional autonomy, normatively understood, should bemaintained to avoid the lure of the technological imperative and toprotect patients against third parties' pressure to undertreatment.However, this professional autonomy can only be maintained if members ofthe profession subject their activities and decisions to a criticalevaluation by other members of the profession and by patients and ifthey continue to critically reflect on the values that regulate today'smedicine. (shrink)

Building on a functionalist framework for decision-making in legal translation, a holistic approach to quality is presented in order to respond to the specificities of this field and overcome the shortcomings of general models of translation quality evaluation. The proposed approach connects legal, contextual, macrotextual and microtextual variables for the definition of the translation adequacy strategy, which guides problem-solving and the rest of the translation process. The same parameters remain traceable between the translation brief and the translation product (...) both in pre-delivery revision and in post-delivery assessment. They are the yardstick for identifying predictable evaluative criteria and competence requirements for translators and quality controllers. The implications of the approach on quality assessment and quality management practices are also discussed. Overall, the model illustrates the potential benefits of enhancing predictability and reducing subjectivity on the basis of specific legal translation methodologies. It supports the need for legal translation expertise in quality evaluation and the relevance of Legal Translation Studies to raising standards in professional practice. (shrink)

Scholars and professional organizations in bioethics describe various approaches to “quality assessment” in clinical ethics. Although much of this work represents significant contributions to the literature, it is not clear that there is a robust and shared understanding of what constitutes “quality” in clinical ethics, what activities should be measured when tracking clinical ethics work, and what metrics should be used when measuring those activities. Further, even the most robust quality assessment efforts to date are idiosyncratic, (...) in that they represent evaluation of single activities or domains of clinical ethics activities, or a range of activities at a single hospital or healthcare system. Countering this trend, in this article we propose a framework for moving beyond our current ways of understanding clinical ethics quality, toward comprehensive quality assessment. We first describe a way to conceptualize quality assessment as a process of measuring disparate, isolated work activities; then, we describe quality assessment in terms of tracking interconnected work activities holistically, across different levels of assessment. We conclude by inviting future efforts in quality improvement to adopt a comprehensive approach to quality assessment into their improvement practices, and offer recommendations for how the field might move in this direction. (shrink)

The main measure of quality of life is well-being. The aim of this article is to compare insights about well-being from contemporary philosophy with the practice-related opinions of palliative care professionals. In the first part of the paper two philosophical theories on well-being are introduced: Sumner’s theory of authentic happiness and Griffin’s theory of prudential perfectionism. The second part presents opinions derived from interviews with 19 professional palliative caregivers. Both the well-being of patients and the well-being of the (...) carers themselves are considered in this empirical exploration. In the third part the attention shifts from the description of “well-being” to prescriptions for the promotion of well-being. Our interview data are analysed in light of the theories of Sumner and Griffin for clues to the promotion of “well-being.” The analysis (1) underscores the subject-relativity of well-being, (2) points out that values that are considered important in every life still seem to be relevant (at least in palliative care practice), and (3) shows the importance of living a certain sort of life when aiming to enhance dying patients’ well-being. (shrink)

While there is a prolific debate surrounding the issue of conscientious objection of individuals towards performing certain clinical acts, this debate ignores the fact that there are other reasons why clinicians might wish to object providing specific services. This paper briefly discusses the idea that healthcare workers might object to providing specific services because they are against their professional judgement, they want to maintain a specific reputation, or they have pragmatic reasons. Reputation here is not simply understood as being (...) in good standing with a professional body. Rather, reputation is treated in the sense that a craftsman might wish to be known for providing a specific type, quality, and style of service. Professionalism is understood as acting according to the philosophical and scientific principles that are the basis of healthcare (such as acting for the benefit of the patient’s health and following well- evidenced treatment pathways). (shrink)

Background:Professional values improve the quality of nurses’ professional lives, reduce emotional exhaustion and depersonalization, increase personal success, and help to make collaborations with...

This study explored the relationship between professional quality of life and emotion work and the major stress factors related to abortion care in Japanese obstetric and gynecological nurses and midwives. Between October 2011 and January 2012, questionnaires that included questions concerning eight stress factors, the Professional Quality of Life Scale, and the Japanese version of the Frankfurt Emotional Work Scale, were answered by 255 nurses and midwives working in abortion and childbirth services. Professional Quality (...) of Life scores (compassion fatigue, compassion satisfaction, burnout) were significantly associated with stress factors and emotion work. Multiple regression analysis revealed that of all the evaluated variables, the Japanese version of the Frankfurt Emotional Work Scale score for negative emotions display was the most significant positive predictor of compassion fatigue and burnout. The stress factors “thinking that the aborted fetus deserved to live” and “difficulty in controlling emotions during abortion care” were associated with compassion fatigue. These findings indicate that providing abortion services is a highly distressing experience for nurses and midwives. (shrink)

Neonatal professionals encounter many ethical challenges especially when it comes to interventions at the limit of viability (weeks 22–25 of gestation). At times, these challenges make the moral dilemmas in neonatology tragic and they require a particular set of intellectual and moral virtues. Intellectual virtues of episteme and phronesis, together with moral virtues of courage, compassion, keeping fidelity to trust, and integrity were highlighted as key virtues of the neonatal professional. Recognition of the role of ethics requires a recognition (...) that answering the obvious question (what shall we do?) does not always suffice. Acknowledging the tragic question (is any of the alternatives open to us free from serious moral wrongdoing) and recognizing the ethical dilemmas, where the lines between right and wrong are blurred, leads to actions taken towards establishing ethics frameworks to support decision-making. In neonatology units, such organizational support can help in allowing the team members to recognize the ethical dilemmas, avoid moral distress, and improve team cohesion and the quality of care provided. Only when the organizational structure allows ethical dilemmas to be recognized, adequate decisions can be made. (shrink)

Before we can resolve or avoid an ethical dilemma, we need to understand what makes something ethical. Practical and Professional Ethics : Key Concepts introduces us to a series of real cases where the stakes can be high, the situations complex, and the ethical issues often difficult to see. Drawing on examples from medicine, law and science, it offers a practical approach to thinking critically about the ethical problems that occur in our professions, teaching us how to: focus on (...) the ethical aspects of any situation distinguish between different kinds of ethical problems tailor our response to the kind of problem we face construct arguments we can plausibly attribute to those involved identify the role of power, discretion and moral blindness By guiding us through the concepts, issues and skills at play when we face an ethical problem, we learn how to find a solution. Ideal for students or professionals, this book provides the grounding required to become a more complex moral thinker, a quality that can be applied in a number of fields and jobs. (shrink)

Clinicians and administrators have a professional obligation to contribute to improvement of healthcare quality. At the same time, participation in embedded research poses risks to healthcare institutions. Disclosure of an institution’s sensitive information could endanger relationships with patients and undermine its reputation. The existing ethical framework for learning healthcare systems does not address the conflict between the OTC and institutional interests. Ethical guidance and policy regulation are needed to create a safe environment for embedded research. In this article (...) we analyse the EF for LHSs and the concept of professionalism. We suggest that the EF should be supplemented with an obligation to protect provider’s legitimate interests. We define legitimate interests as those that enable providers to discharge their primary duties. We argue that both the OTC and the obligation to protect legitimate interests are grounded in the concept of medical professionalism and can be understood as a matter of contract between a democratic society and medical professionals. The proposed supplemented EF can be implemented into a regulatory system in three different ways: the self-regulating: where providers decide themselves how to balance the ethical claims, the centralised: where a governmental institution decides the right balance between providers’ interests and interests of a health system; and the mediating: where medical professionals, the state and patients negotiate their interests. Our article contributes to the discussion on ethical relevance of providers’ interests and the regulatory model for weighing opposite interests in LHSs. (shrink)

Regularly, the question on the quality of philosophical practice is raised. Practicing philosophers, policy makers, scientists and last but not least clients wonder how to assess the quality of philosophical practice. Professionals want to value the format of different practices and clients want to know what to expect from visiting a philosophical practice. Understanding the quality of philosophical practice is important for determining its value and its role in society. Quality indicators can provide such information. A (...) quality indicator is not a norm or criterion. A quality indicator is a sign or signal evoking reflection on the structure and process of the philosophical practice and the outcomes of the philosophizing that takes place there. As quality is an abstract phenomenon related to the way or how a philosophical practice is, the quality indicator should inform us on “the how”of a philosophical practice. With respect to the philosophizing in philosophical practice, reflexivity seems to be essential for recognizing it as philosophy. Just like the color of a litmus paper points at the presence or absence of an acid in a solution, the presence or absence of reflexivity informs us about the quality of the dialogue in philosophical practice. Reflexivity deepens such a dialogue every time it is applied. When applied consciously by the philosophical practitioner it can be called intentional depth. This intentional depth determines the quality of a philosophical practice. (shrink)

Since the 1990s, the essential function of teacher trainers in academic courses has gradually attained more attention from scholars. Also, the teacher trainers’ professional development has acquired worldwide attraction following the concept that teacher trainers are deeply liable for educator education quality. The present mini-review of literature indicates that while teacher trainers have several complicated functions, they obtain the least preparation or opportunities for professional development to perform such functions. Consequently, they require getting the related knowledge and (...) skills after accepting the role of teacher trainers. Besides numerous aspects affecting teacher trainers’ professional development, teaching skills, and knowledge have important functions that are at the center of attention in this mini-review of literature. In brief, several implications are presented for the instructional addressees. (shrink)

The degree of success in creating quality care for people suffering from dementia is limited despite extensive research. This article describes Healthcare providers’ experience with the ethical challenges and possibilities in the relationship with patients suffering from dementia and its impact on quality care. The material is based on qualitative, in-depth individual narrative interviews with 12 professional Healthcare providers from two different nursing homes. The transcribed interview texts were subjected to a phenomenological–hermeneutical interpretation. To provide quality (...) care to patients with dementia, the Healthcare providers emphasized the importance of sensing and understanding the patients’ emotional and bodily expressions through sentient attentiveness and recognition of the patient as a person. They also described reciprocity of expressions in the relationship where the patient recognized them both as persons and Healthcare providers. The analyses of the findings are, inter alia, discussed in light of Løgstrup’s relational philosophy of ethics. (shrink)

The Belgian health care system has a few features that may havecontributed to the rising costs of health care: patients' freechoice of physicians, large clinical freedom of physicians, essentiallya fee-for-service remuneration for medical specialists in which the feesare agreed between insurance funds and physicians. The increased medicalconsumption and costs have prompted the state and insurance companies totake measures that limit the professional autonomy of the physicians.Access to medical education, free until 1997, is now restricted. Themedical profession is organized in (...) the Order of Physicians that hasestablished a code of professional ethics that has moral but not legalforce. So far, there is no special legislation for thepatient–physician relationship, though laws on specific issueslike organ transplantation contain duties for physicians. In recentyears a debate is taking place on patients' rights, of which informedconsent is central and gaining importance in medico-legal publications.An analysis of (ethical and legal) regulations concerning thewithholding or withdrawal of treatment by physicians demonstrate thatthe profession still enjoys a large clinical autonomy, though duediscussion with the patient has become more explicitly required. Therespect for professional autonomy is not primarily due to any formalpower that the Order of Physicians would have, but is rather grounded inthe generally high quality of the patient–physician relationshipthat in ethical terms is considered essentially as a confidencerelationship rather than a contractual relationship. (shrink)

The Covid-19 pandemic is a tragedy for those who have been hard hit worldwide. At the same time, it is also a test of concepts and practices of what good care is and requires, and how quality of care can be accounted for. In this paper, we present our Care-Ethical Model of Quality Enquiry and apply it to the case of residential care for older people in the Netherlands during the Covid-19 pandemic. Instead of thinking about care in (...) healthcare and social welfare as a set of separate care acts, we think about care as a complex practice of relational caring, crossed by other practices. Instead of thinking about professional caregivers as functionaries obeying external rules, we think about them as practically wise professionals. Instead of thinking about developing external quality criteria and systems, we think about cultivating reflective quality awareness. Instead of abstracting from societal forces that make care possible but also limit it, we acknowledge them and find ways to deal with them. Based on these critical insights, the CEMQUE model can be helpful to describe, interrogate, evaluate, and improve existing care practices. It has four entries: the care receiver considered from their humanness, the caregiver considered from their solicitude, the care facility considered from its habitability and the societal, institutional and scholarly context considered from the perspective of the good life, justice and decency. The crux is enabling all these different entries with all their different aspects to be taken into account. In Corona times this turns out to be more crucial than ever. (shrink)

The discretionary powers of welfare state professionals are in tension with the requirements of the democratic Rechtsstaat. Extensive use of discretion can threaten the principles of the rule of law and relinquish democratic control over the implementation of laws and policies. These two tensions are in principle ineradicable. But does this also mean that they are impossible to come to grips with? Are there measures that may ease these tensions? We introduce an understanding of discretion that adds an epistemic dimension (...) (discretion as a mode of reasoning) to the common structural understanding of discretion (an area of judgment and decision). Accordingly we distinguish between structural and epistemic measures of accountability. The aim of the former is to constrain discretionary spaces or the behaviour within them while the aim of the latter is to improve the quality of discretionary reasoning. The focus in this article is on epistemic measures that are internally related to the main characteristic of accountability, namely justified use of discretionary power. (shrink)

The American Society for Bioethics and Humanities poses a chal­lenge in Core Competencies for Healthcare Ethics Consultation: health care ethics consultation services “should be able to demonstrate their value to those who pay for the service, as well as to those whom the service is intended to serve.” To respond to this challenge, this article provides a brief review of the literature on evaluating ethics consultation in its traditional frameworks of quality outcomes. The author follows this discussion with a (...) new methodology to evaluate ethics consultation on the basis of the intrinsic good of the service. He ends with a novel risk-based assessment to complement the evaluation of clinical ethics services grounded in the Ethical and Religious Directives for Catholic Health Care Services. (shrink)

The paper questions the effectiveness of the United Kingdom Central Council's (UKCC's) Code of Professional Conduct upon the moral climate of nursing. It challenges the claim that the empowerment of nurses is significantly enhanced by the Code or that it necessarily makes them more accountable for their practice. The position is taken that the Code, in the absence of an effective support network for whistle-blowers, places an unreasonable burden upon nurses in its exhortations to report unprofessional conduct. The paper (...) acknowledges the need to retain the Code, but with more modest claims being made concerning its empowering qualities. It is argued that unless more attention is focused on ways to support potential whistle-blowers, the Code will come to be seen as an irrelevance. Cet article met en question l'effet du Code du UKCC sur le climat moral des soins infirmiers. Il conteste l'affirmation que les infirmiers/ères sont considérablement plus fort à cause du Code ou qu'il les rend plus responsables dans leur pratique. La position est prise que le Code, en l'absence d'un réseau efficace de soutien pour les 'Whistleblowers' (personnes qui dévoilent un système), met un fardeau excessif sur les infirmiers/ères dans ses exhortations de signaler une conduite contraire au Code professionnel. Cet article reconnâit la nécessité de retenir le Code, mais avec des demandes plus modestes concernant ses pouvoirs de rendre fort. Il est soutenu que si non plus d'attention est concentré sur les moyens de soutenir les 'Whistlebowers', le Code va devenir hors de propos. Dieser Artikel bezweifelt die Wirksamkeit des Kodex des UKCC über das moralische Klima der Krankenpflege. Er stellt die Behauptung in Frage, dass der Kodex das Pflegepersonal bedeutend ermächtigt, oder dass er es mehr verantwortlich macht für seine Praxis. Die Position ist hier, dass der Kodex, in der Abwesenheit von effektiver Unterstützung für 'Whistleblowers' (d.h. Leute, die ein System verpfeifen), zu viel vom Pflegepersonal verlangt, in seiner Ermahnung, berufswidrige Praxis zu melden. Dieser Artikel anerkennt die Notwendigkeit, den Kodex zu behalten, aber mit kleineren Ansprüchen für seine ermächtigenden Qualitäten. Wenn nicht mehr Aufmerksamkeit gelegt wird, auf welche Weise die 'Whistleblowers' unterstützt werden können, dann wird der Kodex als eine Nebensächlichkeit verurteilt. (shrink)

This essay offers a proposal for the missing constructs and language with which we can more precisely think about and examine the Army's Professional Military Ethic, starting with its macro context which is the profession's culture. We examine three major long-term influences on that culture and its core ethos, thus describing how they evolve over time. We contend that in the present era of persistent conflict, we are witnessing dynamic changes within these three influences. In order to analyze these (...) changes, we introduce a more detailed framework which divides the Ethic into its legal and moral components, then divide each of these into their institutional and individual manifestations. Turning from description to analysis, we also examine to what extent, if any, recent doctrinal adaptations by the Army (FM 3-0, 3-24, and 6-22, etc.) indicate true evolution in the essential nature of the profession's Ethic. Then, we present what we believe to be the most significant ethical challenge facing the Army profession -- the moral development of Army leaders, moving them from 'values to virtues' in order that they, as Army professionals, can consistently achieve the high quality of moral character necessary to apply effectively and, in a trustworthy manner, their renowned military-technical competencies."--P. x. (shrink)

Background: The COVID-19 pandemic has produced high stress in nurses, affecting their professional quality of life. Different variables affect psychological stress response and professional quality of life. In this context, the role of professional values represents an interesting object of research. Objectives: To analyze the relationship between professional values, perceived stress, and professional quality of life among nurses during the COVID-19 crisis. Research design, participants, and research context: Descriptive cross-sectional study. Participants were (...) 439 registered nurses from the public health system. Perceived stress, professional quality of life, and professional values were evaluated by using measuring instruments adapted and validated in the geographic context of research. Data were collected online in December 2020 during the second wave of the COVID-19 pandemic in Spain. Ethical considerations: This study was approved by the Ethics Committee on Clinical Research of the Principality of Asturias. Findings: Within professional values, ethics obtained higher scores showing the primacy of ethical values among nurses. Moderate correlations between ethics, mastery, expertise, and compassion satisfaction were found. Frontline nurses informed high perceived stress. The correlations between professional values and compassion satisfaction were higher in non-frontline nurses. A moderate negative correlation between perceived stress and compassion satisfaction was found in both groups, which implies that the higher the stress, the lower the satisfaction in the helping relationship. Conclusion: Professional values positively influence compassion satisfaction during the COVID-19 pandemic. Compassion satisfaction presents a negative correlation with fatigue compassion and burnout in frontline and non-frontline nurses. Given the functionality of values both to guide clinical practice professionally and ethically, and prevent dissatisfaction with one’s professional quality of life by reinforcing compassion satisfaction, it is necessary to reinforce them with an intensive and cross-sectional learning during the university training. (shrink)

The role of the Sustainability Manager (SM) is expanding. Whether SMs are turning into a new profession is under debate. Pointing to the need for a distinct professional logic to qualify as a profession, we identify what is contained within a professional logic of SMs. Through analyzing ambiguities present in the role of the SMs, we show that there is no specific distinct professional logic of SMs, but rather a meta-construct building on market, bureaucratic, and sustainability logics. (...) In addition, we point to the complex configurations of and relationships between these underlying logics. The complexities also explain why the SMs differ from traditional professions and why it is problematic to talk about a ‘SM profession’. Rather, SMs are ‘organizational professionals’. The article builds on 21 interviews with SMs working for Swedish companies. (shrink)

Aim The aim is to understand current research into the impact of undergraduate nursing education on the development of professional values. Background Values are evident in the professional standards for nurses and the guidelines and healthcare policies of many countries. These professional values guide decisions and behaviour and are recognised as an essential component in the professions ability to provide safe and professional care. This literature review presents the current research on the impact of education on (...) professional values in undergraduate nurse education. Design An integrative review of the findings was conducted to provide insight into the current research on the professional value development in undergraduate nurses. Data sources CINAHL, PubMed and Scopus. Review methods A literature search was undertaken within defined date parameters 2010–2021 using a systematic approach. The Preferred Reporting Items for Systematic Reviews and Meta-analysis guide PRISMA was used to guide and illustrate the process. Papers were assessed for quality using the Mixed Methods Appraisal Tool. Results Two distinct areas of inquiry were identified. (a) Changes in professional values as an outcome of undergraduate nursing education or (b) changes in professional values as an outcome of specifically designed educational content. These areas were further explored to better understand the influences of undergraduate education on students’ professional values. Conclusion There is a lack of evidence in the literature to support the premise that professional values develop in line with academic year progression; however, there is strong evidence to support the inclusion of explicit learning in undergraduate education that engages students in education specifically designed to explore and develop professional values. (shrink)

Introduction The starting point is that ethical competence is the basis for ethical healthcare practices and quality of care. Simultaneously, there is a need for research and development from a holistic multi-professional perspective. Aim The aim is to create a proposed model for multi-professional ethical competence grounded in clarified meanings and dimensions of ethical competence studied from a multi-professional healthcare perspective. The research questions are, what is ethical competence from a multi-professional healthcare perspective and what (...) strengthens a multi-professional ethical healthcare practice? Research design The research has a qualitative approach and hermeneutic application research design. Two groups with six participants from clinical practice and two scientific researchers in each group met four times for dialogue. Thematic analysis was used as an analysis method. Ethical considerations The research is approved by the Declaration of Helsinki, the General Data Protection Regulations, and ethical permission was asked from the Norwegian Centre for Research Data (NSD). Results The proposed model for multi-professional ethical competence encompasses a three-dimensional ethical value base that is underpinned by: Ethical attitude – a personal desire to do good; Ethical basis – the best for the patient as a common goal and Ethical culture – common goals and values in the organization. Multi-professional ethical competence is strengthened by: Reflection – to see with new wondering eyes; Time for talk – interdisciplinary teamwork and Leadership – an ethical role model and support. Discussion Ethical competence has a strong link to the core of caring ethics and a deeper personal value base and attitude. Ethical competence involves the whole culture and is seen as a shared value base and a responsibility to do the best for the patient as a multi-professional team and organization. Ethical competence becomes active in healthcare practice by opening up for meaningful multi-professional talks and reflections. (shrink)

Because of their responsibilities for providing high-quality care, at times when they are continuously confronted with inherent professional and ethical challenges, nurses should meet high ethical standards of practice and conduct. Contrary to other countries, where codes of ethics for nurses are formulated to support those standards and to guide nurses’ professional practice, Belgian nurses do not have a formal code of ethics. Nevertheless, professional ethics is recognized as an important aspect in legal and other (...) class='Hi'>professional documents. The aim of this article is to illustrate that codes of ethics are not the only professional documents reflecting nurses’ values, norms and responsibilities. Other documents can also set out professional nursing ethics, and as such replace codes of ethics. (shrink)

There is no technical language with which to speak of patients' quality of life, there are no standard measures and no authority to validate criteria of measurement. It is well known that 'professionals' tend, often for institutional reasons, to play down or undervalue factors which are not defined by their particular expertise. It is fortunate that, despite this tendency, there is a growing interest in broadening the evaluation of medical care, but there is still a need to clarify what (...) is at issue in considerations of quality of life. This article examines the strengths and weaknesses of one approach to assessing quality of life, and sketches out the implications for anyone concerned to establish a framework within which both medical and non-medical objectives of care can be taken into account. (shrink)

Publicity for (and laterly increased economic stringency which makes more likely), failures of care in the NHS engender concern for care quality while its assurance remains the subject of a fragmented and unhelpful literature. A selective attempt is made to examine some underlying principles by posing and answering three questions. What is the quality of care? What basic principles must be followed in defining `standards'? How then may quality be assured? Any definition of care must be multi-faceted (...) and in common use pervaded with the patients' pre-occupation with a search for cures. Nevertheless, it is argued that there are gains in restricting the technical use of the term `care' to those systematic processes of health services and their culture which impinge on the personal experience of patients and which fashion their response. In contemporary society care ought to be designed to restore and enhance the independence, dignity and choice of the patient. Although there is a contrary tendency to abandon problems of care to the professionals, standards for care should be judged ultimately not from the specialised professional but from the viewpoint of lay people whose behaviour in the outside world fashions those norms by which independence, dignity and choice are judged. A number of difficulties in identifying and securing improvements in care are discussed. In particular, it is argued that such is the interdependence of the style of management of an institution and the style of care it provides that enforcement of high quality care is likley to be a contradiction in terms. Only trained and sensitive staff can act intuitively and pre-emptively to prevent even incipient deterioration in care. They cannot carefully foster at all times the independence and dignity of their patients unless they are treated in a similar way as professional employees. As an initial step in improving the quality of care a simple start is urged upon implementing an inventory of checks. These are designed to establish the identification and operation of health care policies and practices which give appropriate recognition to the characteristics of care that patients and public expect, coming as they do from a lay rather than professional world. The article concludes with an appropriate inventory of questions to be put to professionals by those laymen who are increasingly imported into health care management through community representation (in CHCs) and staff participation (in joint consultation) and whose interest and concern should be harnessed appropriately. (shrink)